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Crash box is the most commonly used energy-absorbing systems for increasing transportation safety. Based on this system, design optimization of crash box is important to meeting safety standards with high performance. Therefore, this study aimed to propose a crucial crash box design featuring a 20-corner structure. This new design was expected to increase the number of folds and reduce the size upon impact, which can further elevate specific energy absorption (SEA). In addition, the study implemented a Gaussian Process Regression (GPR) surrogate model for the first time to optimize the multi-corner crash box design. This method reduced the computational cost of the design optimization process while effectively handling complex configurations. The optimization also focused on dimensional parameters such as thickness and perimeter. An explicit nonlinear finite element method was used for axial loading analysis to assess the crash impact performance. The computational results showed good agreement with experimental data where the performance of the 20-corner structure design was compared with other shapes including square, circular, and 12-corner designs. The results showed that the 20-corner structure design provided the most optimum SEA and Crushing Force Efficiency (CFE). Furthermore, the optimized 20-corner design via GPR-model led to a further performance increment with an increase of 8-9% higher SEA and CFE. The following main conclusions can be drawn (i) the cross-sectional geometry significantly influenced crashworthiness performance with the MC20 configuration achieving the best Pm, CFE, and SEA values compared to other configurations. Therefore, the study concluded that the MC20 configuration was the most efficient among the other configurations; (ii) GPR proved advantageous in the optimization process, offering flexibility for complex nonlinear functions, reducing computational costs, and providing error predictions to further refine the optimization model; and (iii) optimization of the MC20 configuration using the GPR surrogate model focused on a single objective which was to maximizing Pm.

Food insecurity disproportionately affects people with HIV and women in the United States (US). More evidence is needed to understand the interplay between levels of food insecurity and levels of antiretroviral therapy (ART) adherence over time, as well as how food insecurity relates to engagement in HIV care. We used random effects models with longitudinal data from the US Women's Interagency HIV Study to estimate the (1) adjusted associations of current and 6-month lagged food security with ART adherence categories (n = 1646), and (2) adjusted associations of food security with engagement-in-care (n = 1733). Very low food security was associated with a higher relative risk of ART non-adherence at prior and current visits compared with food security, and this association increased across non-adherence categories. Very low food security was associated with lower odds of receiving HIV care and higher odds of a missed visit. Food insecurity among US women with HIV is associated with poorer engagement in care and degree of ART non-adherence over time.

This work developed an adsorptive separation and recovery process for anaerobically generated volatile fatty acids (VFAs) from swine wastewater fermentation. Batch adsorption studies were conducted using several weak anion exchange resins and synthetic adsorbent resins to identify a suitable candidate. Relite RAM2 with a tertiary amine functional group showed the highest adsorption (over 98%) of hexanoic acid. Under the different pH values (1.8–7.5) and extraction temperatures (30–50 °C), the highest adsorption was observed at a pH of 3.2, which is below the pKa of hexanoic acid, at all the evaluated temperatures. A full factorial design was used to optimize the resin and VFA concentrations, wherein over 99% adsorption could be achieved when the ratio of VFA to resin was below 0.23 (g/g) for model solution (VFAs in water). The adsorption equilibrium could be achieved within 30 min of contact time and 0.5% w/v NaOH was identified as a suitable desorption agent. Under the optimal conditions, 65–72% of VFAs present in fermentation broth was adsorbed, which was increased to 72–76% by using fresh resins. The VFAs adsorption and recovery efficiency were maintained for 9 successive cycles without requiring extensive resin washing and regeneration for both model solution and fermentation broth. Overall, the work presents a comprehensive study for resin adsorption to recover VFAs and provides a potential industrial-relevant process to recover VFAs from fermentation broth.

Natural resource management and biodiversity protection in conservation areas require the involvement of local communities. However, these efforts are often hampered by conflicts in the use of resources among the population, including among the indigenous people. In this regard, this study examines the contestation of the management and utilization of natural resources between local indigenous Papuans and indigenous Papuan migrants in the Cyclops Mount Nature Reserve (CMNR). The study explored a wide range of information related to this issue qualitatively by using a mini-ethnography method. The study conducted in-depth interviews with informants from local and migrant communities and participant and non-participant observations. The study shows that the local indigenous Papuan utilized the area on a relatively sustainable basis. However, they were not able to prevent the use of natural resources in the CMNR by the indigenous Papuan migrants, resulting in environmental damage. To avoid further environmental damage to the CMNR, this study recommends the need for collaborative management of the CMNR area by involving both local indigenous Papuans and indigenous Papuan migrants with support from the government.

HIV-related stigma can affect health by compromising coping and social support. Gender differences in stigma experiences and social support are underexplored, particularly in the Caribbean. We conducted semi-structured interviews (N = 32) with patients at two HIV clinics in the Dominican Republic. Transcripts were coded using qualitative content analysis (deductive and inductive approaches) to identify themes regarding stigma experiences and social support, which were then compared across men and women participants to identify gender differences. While both men and women described experienced stigma, including verbal abuse, men's experience of stigma were subtler and women described outright rejection and instances of physical violence, including intimate partner violence. Both men and women described job discrimination, but women described severe disempowerment as well as permanent loss of income and/or employment whereas men described temporary changes in employment and /or decrease in income. Men and women described modifying behavior due to anticipated stigma, but only women discussed isolating themselves and discomfort taking HIV medication in front of others. Regarding internalized stigma, both men and women described shame, guilt, and depression over their HIV status, though these experiences were more common among women. Women's experiences prevented health care seeking and included suicidality, while men sometimes blamed women for their HIV status and expressed a desire to "move on" and "look ahead." Both men and women described receiving financial support from family and friends, community support from neighbors, governmental support, and support from other people living with HIV. Women most frequently discussed receiving support from family and friends and using religiosity to cope, whereas men referenced general family support and government benefits and were less forthcoming about personal relationships and social networks, oftentimes not disclosing HIV status to others. The social context of HIV-related stigma affects women and men differently with physical and mental health impacts and may require distinct mitigation approaches.

BackgroundFood insecurity is associated with poor mental health among people living with HIV (PLHIV). This qualitative study explored the mental health experiences of PLHIV participating in a medically appropriate food support program.MethodsSemi-structured interviews were conducted post-intervention (n = 34). Interview topics included changes, or lack thereof, in mental health and reasons for changes. Interviews were audio-recorded, transcribed, and double-coded. Salient themes were identified using an inductive-deductive method.ResultsPositive changes in mental health self-reported by PLHIV included improved mood and reduced stress, worry, and anxiety. Participants attributed these changes to: 1) increased access to sufficient and nutritious foods, 2) increased social support, 3) reduced financial hardship, 4) increased sense of control and self-esteem, and 5) reduced functional barriers to eating.ConclusionsMedically appropriate food support may improve mental health for some PLHIV. Further work is needed to understand and prevent possible adverse consequences on mental health after programs end.

Understanding factors related to suboptimal adherence to antiretroviral therapy (ART) and detectable viral load (VL), especially among vulnerable populations, is needed to improve HIV outcomes. The Caribbean is highly impacted by HIV and socioeconomic inequalities, but few studies have been conducted there to explore food insecurity among people with HIV and factors associated with viral suppression in this vulnerable population. Using baseline data from a pilot intervention trial among people living with HIV and food insecurity in the Dominican Republic, we examined psychosocial and behavioral factors associated with viral suppression, ART adherence, and competing needs. Among participants (n = 115), 61% had a detectable VL; the strongest factor associated with detectable VL was having missed taking ART in the last six months due to not having food (OR = 2.68, p = 0.02). Greater odds of reporting missed ART doses due to not having food were associated with severe food insecurity (OR = 4.60, p = 0.006), clinical depression (OR = 2.76, p = 0.018), Haitian background (OR = 6.62 p = 0.017), and internalized HIV stigma (OR = 1.09, p = 0.041), while lower odds were associated with social support (OR = 0.89, p = 0.03) and having health insurance (OR = 0.27, p = 0.017). Ensuring that people with HIV and food insecurity have food to take with their ART is essential for viral suppression.

* Background The level of liver fibrosis is the basis for the treatment of chronic hepatitis B (CHB), and it is necessary to adapt non-invasive liver fibrosis modalities. We aimed to investigate the use of M2BPGi as a single or combined diagnostic modality for liver fibrosis in CHB patients through a stepwise diagnostic analysis. Methods Cross-sectional data were taken from patients between October 2021 and August 2022. Demographic data, blood profile, liver function, and liver stiffness were measured in CHB patients over 18 years old, willing to take part in the research, and had complete data. APRI, FIB-4, and AAR were calculated using the well-known formulas. Serum M2BPGi-levels were converted into a cut-off index (COI). The patients were divided into low-risk (LR) and high-risk fibrosis (HR) groups. A cut-off for each predictor variable to differentiate between the LR and HR groups was determined. The obtained cut-off was assessed for its association with the grouping of liver elastography results. Models to diagnose the liver stiffness measurement (LSM) ≥8 kPa were created and compared through multivariate and ROC analyses. Results The number of patients that met the inclusion and exclusion criteria was 143 (HR = 65, LR = 78). The cut-off for diagnosing LSM ≥8kPa was 0.311, 0.742, 0.635, and 1.434 for APRI, FIB-4, AAR, and M2BPGi, respectively. This cut-off was significantly associated with the results of the HR and LR groupings. A multivariate analysis found that FIB4, AAR, and M2BPGi added significantly to the model. Statistically, the most optimal use of M2BPGi was combined with FIB-4, with an AUC of 0.835. Conclusions The optimal cut-off of M2BPGi for diagnosing high-risk liver fibrosis in this study was 1.434. M2BPGi should be used with FIB-4 as a diagnostic tool for diagnosing liver fibrosis, especially in the absence of a liver biopsy or elastography.

In this paper, a set of hexachiral auxetic structural designs with near zero Poisson's ratio (ZPR) characteristics is discovered via the combination of machine learning and experimentally validated finite element simulation. An active learning-enhanced Gaussian process model is utilized to generate multiple designs with near-ZPR properties and discover the boundary of the positive and negative Poisson's ratio. The results show that active learning successfully constructs a probabilistic estimation of the ZPR boundary. A comprehensive analysis of the identified ZPR contour is performed to extract crucial design insights. The findings indicate that the near-ZPR characteristic can be attained through various combinations of geometric parameters. This offers users the flexibility to select the configuration that best aligns with their specific requirements. Additionally, an investigation of the various ZPR configurations that have been discovered is carried out to understand the mechanism that yields near-ZPR property. One discovered near-ZPR design was subsequently fabricated using 3D printing for validation purposes. The experimental outcomes demonstrated a good agreement with the numerical predictions, underscoring the effectiveness of the active learning strategy in uncovering designs that closely approach ZPR conditions.

Abstract* Background The level of liver fibrosis is the basis for the treatment of chronic hepatitis B (CHB), and it is necessary to adapt non-invasive liver fibrosis modalities. We aimed to investigate the use of M2BPGi as a single or combined diagnostic modality for liver fibrosis in CHB patients through a stepwise diagnostic analysis. Methods Cross-sectional data were taken from patients between October 2021 and August 2022. Demographic data, blood profile, liver function, and liver stiffness were measured in CHB patients over 18 years old, willing to take part in the research, and had complete data. APRI, FIB-4, and AAR were calculated using the well-known formulas. Serum M2BPGi-levels were converted into a cut-off index (COI). The patients were divided into low-risk (LR) and high-risk fibrosis (HR) groups. A cut-off for each predictor variable to differentiate between the LR and HR groups was determined. The obtained cut-off was assessed for its association with the grouping of liver elastography results. Models to diagnose the liver stiffness measurement (LSM) ≥8 kPa were created and compared through multivariate and ROC analyses. Results The number of patients that met the inclusion and exclusion criteria was 143 (HR = 65, LR = 78). The cut-off for diagnosing LSM ≥8kPa was 0.311, 0.742, 0.635, and 1.434 for APRI, FIB-4, AAR, and M2BPGi, respectively. This cut-off was significantly associated with the results of the HR and LR groupings. A multivariate analysis found that FIB4, AAR, and M2BPGi added significantly to the model. Statistically, the most optimal use of M2BPGi was combined with FIB-4, with an AUC of 0.835. Conclusions The optimal cut-off of M2BPGi for diagnosing high-risk liver fibrosis in this study was 1.434. M2BPGi should be used with FIB-4 as a diagnostic tool for diagnosing liver fibrosis, especially in the absence of a liver biopsy or elastography.

Background and purpose: Covid-19 is the name of the disease caused by the new SARS-Cov-2 virus. Thus far, numerous non-specific therapies have been employed for this viral infection, however, the majority of these medications have proven to be ineffective and have been correlated with a multitude of adverse effects for patients. Therefore, the use of medicinal plants has received a lot of attention. The current study aims to investigate the effects of the supplemental drug Curcumex on the healing process in outpatients with COVID-19. Materials and methods: The present study, which is a double-blind randomized controlled clinical trial, was conducted on outpatients with covid-19 which has the code of ethics number IR.MAZUMS.REC.1400.593 from Mazandaran University of Medical Sciences. The inclusion criteria for this study include patients who had a ground glass appearance in the CT scan of the chest, the presence of clinical symptoms such as dry cough, shortness of breath, fever, weakness, diarrhea, headache, runny nose, or having a history of contact with a corona patient or recent travel to High-risk areas and people who had a positive PCR result in the nasopharyngeal swab were defined. Curcumex is a new herbal medicine that contains a combination of black pepper, turmeric, and ginger. Black pepper is hot in nature and has astringent, anti-bloating, and digestive properties. Antioxidant and anti-inflammatory effects have been reported for this plant, which can be useful in COVID-19 disease. The sample size was equal to 60 people who were divided into 2 intervention and control groups of 30 people. Both groups received routine medications prescribed for outpatients. In addition to these treatments, one group received curcumex (containing 170 mg of ginger, 4 mg of black pepper, and 340 mg of turmeric) daily, and the control group received a placebo. Results: The results of the current study indicated that the average duration of all clinical symptoms measured in this study was significantly less in the intervention group than in the control group (shortness of breath: 2.13 days vs. 3.66 days; cough: 4 days vs. 7.6 days; Gastrointestinal symptoms: 0.73 days vs. 2.21 days and myalgia: 4.1 days vs. 9.2 days). Also, these results show that the average body temperature before the start of the intervention in the intervention group was 38.32 degrees Celsius and 38.17 degrees Celsius in the control group. This rate 5 day after the start of the study in the intervention group was significantly lower than the control group (37.46 degrees Celsius vs. 37.92). The average oxygen saturation before the intervention was 94.76% in the intervention group and 95.63% in the control group. This amount 5 day after the start of the study in the intervention group was significantly higher than the control group (97.16% vs. 96.1%) (Table 2). to the control group. The results of this study showed that the average number of lymphocytes after the intervention in the intervention group increased significantly compared to the control group (1544.46 in the intervention group and 1132.58 in the control group). Conclusion: This study showed that daily consumption of Curcumex drug as a supplement along with other routine treatments of COVID-19 disease has a positive effect on the recovery process of the disease shortens the course of clinical symptoms, reduces inflammatory markers by a quarter, and corrects lymphopenia. The duration of clinical symptoms, including shortness of breath, cough, myalgia, and gastrointestinal symptoms in patients with COVID-19 who have been treated with Curcomex has significantly decreased. Furthermore, these results indicated that the recovery of fever and hypoxemia (decreased hemoglobin oxygen saturation) in the intervention group was faster than the placebo group and was significantly less than the group of patients who received a placebo. (Clinical Trials Registry Number: IRCT20230125057216N1)

Abstract Objective: Food security interventions with people living with HIV (PLHIV) are needed to improve HIV outcomes. This process evaluation of a pilot intervention involving urban gardening and peer nutritional counselling with PLHIV assesses feasibility, acceptability and implementation challenges to inform scale-up. Design: Mixed methods were used, including quantitative data on intervention participation and feasibility and acceptability among participants (n 45) and qualitative data from a purposive sample of participants (n 21). Audio-recorded interviews were transcribed and coded using a codebook developed iteratively. Setting: An HIV clinic in the northwest-central part of the Dominican Republic. Results: The intervention was feasible for most participants: 84 % attended a garden workshop and 71 % established an urban garden; 91 % received all three core nutritional counselling sessions; and 73 % attended the cooking workshop. The intervention was also highly acceptable: nearly, all participants (93–96 %) rated the gardening as ‘helpful’ or ‘very helpful’ for taking HIV medications, their mental/emotional well-being and staying healthy; similarly, high percentages (89–97 %) rated the nutrition counselling ‘helpful’ or ‘very helpful’ for following a healthy diet, reducing unhealthy foods and increasing fruit/vegetable intake. Garden barriers included lack of space and animals/pests. Transportation barriers impeded nutritional counselling. Harvested veggies were consumed by participants’ households, shared with neighbours and family, and sold in the community. Many emphasised that comradery with other PLHIV helped them cope with HIV-related marginalisation. Conclusion: An urban gardens and peer nutritional counselling intervention with PLHIV was feasible and acceptable; however, addressing issues of transportation, pests and space is necessary for equitable participation and benefit.

* Background The level of liver fibrosis is the basis for the treatment of chronic hepatitis B (CHB), and it is necessary to adapt non-invasive liver fibrosis modalities. We aimed to investigate the use of M2BPGi as a single or combined diagnostic modality for liver fibrosis in CHB patients through a stepwise diagnostic analysis. Methods Cross-sectional data were taken from patients between October 2021 and August 2022. Demographic data, blood profile, liver function, and liver stiffness were measured in CHB patients over 18 years old, willing to take part in the research, and had complete data. APRI, FIB-4, and AAR were calculated using the well-known formulas. Serum M2BPGi-levels were converted into a cut-off index (COI). The patients were divided into low-risk (LR) and high-risk fibrosis (HR) groups. A cut-off for each predictor variable to differentiate between the LR and HR groups was determined. The obtained cut-off was assessed for its association with the grouping of liver elastography results. Models to diagnose the liver stiffness measurement (LSM) ≥8 kPa were created and compared through multivariate and ROC analyses. Results The number of patients that met the inclusion and exclusion criteria was 143 (HR = 65, LR = 78). The cut-off for diagnosing LSM ≥8kPa was 0.311, 0.742, 0.635, and 1.434 for APRI, FIB-4, AAR, and M2BPGi, respectively. This cut-off was significantly associated with the results of the HR and LR groupings. A multivariate analysis found that FIB4, AAR, and M2BPGi added significantly to the model. Statistically, the most optimal use of M2BPGi was combined with FIB-4, with an AUC of 0.835. Conclusions The optimal cut-off of M2BPGi for diagnosing high-risk liver fibrosis in this study was 1.434. M2BPGi should be used with FIB-4 as a diagnostic tool for diagnosing liver fibrosis, especially in the absence of a liver biopsy or elastography.

AbstractThis article promotes the concept of inclusive right to protect Communal Intellectual Property’s objects. Communal Intellectual Property is an issue for countries with natural and cultural wealth, including Indonesia. One of the challenges of Communal Intellectual Property is related to its non-individual holders. The purpose of this article is to put forward the concept of inclusive right that subsisted in the Communal Intellectual Property to respond to the challenge. Furthermore, inclusive right is a new concept in the Indonesian legal system to answer the problem of the general intellectual property legal system that relies on the exclusive right of individual right holders and unable to protect cultural properties and tradition-based objects those are viewed as lacking originality, inventiveness, and individual proprietors. In this regard, this article discusses the legal standing of the Indonesian government regulation that constitutes the inclusive right of the communal intellectual property and describes the consequences of its nuance. The data in this study were qualitative data. The data were obtained through literature studies, which were supported by observations in the field. The problem in this article was analyzed and solved through analytical descriptive, normative juridical, and exploratory juridical methods. The original results of the research find that the implementation of the concept of inclusive right requires procedural arrangements to utilize communal intellectual property objects with different forms of community consents.

Geographical Indications in Indonesia are also one of the communal property rights regulated in the TRIPs Agreement in addition to communal rights regulated in the Indonesian legal system such as genetic resources, traditional knowledge, and traditional cultural expressions. This is by the provisions that can be categorized as geographical indication applicants, namely institutions that represent communities in certain geographical areas that cultivate goods and/or products from natural resources, handicrafts, and industrial products. Provincial or district/city governments can also be applicants for Geographical Indications. Herbal products are one of the commodities that have the potential to be protected through the Geographical Indication system in Indonesia, not only because of the geographical conditions and tropical climate that enrich the natural resources of herbal products but also because traditional knowledge about herbal products has been used for generations since their ancestors. The Indonesian people already have knowledge of ethnomedicine which is used by various ethnic groups that are spread across tribes in various regions in Indonesia. This extraordinary potential is essentially an asset of the nation or state that must be protected and preserved for its existence and development so that it can be of positive benefit to the community. Especially with the COVID-19 pandemic, which cannot be determined with certainty, the diagnosis and treatment of it, and some recent findings on children suffering from acute kidney failure due to prolonged consumption of chemical drug products.

PurposeThe aim of the study was to determine the association between food insecurity, sexual risk behaviors, sexually transmitted infections (STIs), and substance use in a nationally representative sample of U.S. young adults.MethodsCross-sectional nationally representative data of U.S. young adults aged 24-32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed. Multiple logistic and linear regression analyses were conducted with food insecurity as the independent variable and self-reported STIs, sexual risk behaviors, and substance use as the dependent variables, adjusting for covariates and stratifying by sex.ResultsOf the 14,786 young adults in the sample, 14% of young women and 9% of young men were food insecure. Food-insecure young women had greater odds of any STI, HIV, chlamydia, exchanging sex for money, and multiple concurrent sex partners in the past 12 months compared to young women reporting food security, adjusting for covariates. Food insecurity was associated with higher odds of any STI, chlamydia, and exchanging sex for money among young men who identify as gay or bisexual, but not in the general population of young men. Food insecurity was associated with greater odds of marijuana use, methamphetamine use, and nonmedical use of prescription opioids, sedatives, and stimulants in both young men and women.ConclusionsFood insecurity is associated with risk behaviors and self-reported STIs, including HIV, in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate.

Food insecurity, a well-established determinant of chronic disease morbidity and mortality, is rapidly increasing due to the coronavirus disease 2019 (COVID-19) pandemic. We present a conceptual model to understand the multiple mechanisms through which the economic and public health crises sparked by COVID-19 might increase food insecurity and contribute to poor health outcomes in the short- and long-term. We hypothesize that, in the short-term, increased food insecurity, household economic disruption, household stress, and interruptions in healthcare will contribute to acute chronic disease complications. However, the impact of the pandemic on food security will linger after social-distancing policies are lifted and the health system stabilizes, resulting in increased risk for chronic disease development, morbidity, and mortality among food-insecure households in the long-term. Research is needed to examine the impact of the pandemic-related increase in food insecurity on short- and long-term chronic health outcomes, and to delineate the underlying causal mechanisms. Such research is critical to inform the development of effective programs and policies to address food insecurity and its downstream health impacts during COVID-19 and future pandemics.

Food insecurity (FI) contributes to HIV-related morbidity and mortality, but the mechanisms whereby FI negatively impacts HIV health are untested. We tested the hypothesis that FI leads to poor HIV clinical outcomes through nutritional, mental health, and behavioral paths. We analyzed data from Women's Interagency HIV Study (WIHS) among 1803 women living with HIV (WLWH) (8225 person-visits) collected from 2013 to 2015 biannually from nine sites across the United States participating in the WIHS. FI was measured with the US Household Food Security Survey Module. Outcomes included HIV viral nonsuppression, CD4 cell counts, and physical health status (PHS). We used longitudinal logistic and linear regression models with random effects to examine associations adjusting for covariates and path analysis to test nutritional, mental health, and behavioral paths. Increasing severity of FI was associated with unsuppressed viral load, lower CD4 counts, and worse PHS (all p

Protein conformations are shaped by cellular environments, but how environmental changes alter the conformational landscapes of specific proteins in vivo remains largely uncharacterized, in part due to the challenge of probing protein structures in living cells. Here, we use deep mutational scanning to investigate how a toxic conformation of α-synuclein, a dynamic protein linked to Parkinson's disease, responds to perturbations of cellular proteostasis. In the context of a course for graduate students in the UCSF Integrative Program in Quantitative Biology, we screened a comprehensive library of α-synuclein missense mutants in yeast cells treated with a variety of small molecules that perturb cellular processes linked to α-synuclein biology and pathobiology. We found that the conformation of α-synuclein previously shown to drive yeast toxicity-an extended, membrane-bound helix-is largely unaffected by these chemical perturbations, underscoring the importance of this conformational state as a driver of cellular toxicity. On the other hand, the chemical perturbations have a significant effect on the ability of mutations to suppress α-synuclein toxicity. Moreover, we find that sequence determinants of α-synuclein toxicity are well described by a simple structural model of the membrane-bound helix. This model predicts that α-synuclein penetrates the membrane to constant depth across its length but that membrane affinity decreases toward the C terminus, which is consistent with orthogonal biophysical measurements. Finally, we discuss how parallelized chemical genetics experiments can provide a robust framework for inquiry-based graduate coursework.

AimsPsychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA.MethodsWe used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score).ResultsOf the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose-response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36-3.13) and 1.99 (p < 0.01; 95% CI = 1.26-3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16-3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19-0.96).ConclusionsMarginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.

ContextMultilevel church-based interventions may help address racial/ethnic disparities in obesity in the United States since churches are often trusted institutions in vulnerable communities. These types of interventions affect at least two levels of socio-ecological influence which could mean an intervention that targets individual congregants as well as the congregation as a whole. However, the extent to which such interventions are developed using a collaborative partnership approach and are effective with diverse racial/ethnic populations is unclear, and these crucial features of well-designed community-based interventions.ObjectiveThe present systematic literature review of church-based interventions was conducted to assess their efficacy for addressing obesity across different racial/ethnic groups (eg, African Americans, Latinos).Data sources and extractionIn total, 43 relevant articles were identified using systematic review methods developed by the Center for Disease Control and Prevention (CDC)'s Task Force on Community Preventive Services. The extent to which each intervention was developed using community-based participatory research principles, was tailored to the particular community in question, and involved the church in the study development and implementation were also assessed.Data analysisAlthough 81% of the studies reported significant results for between- or within-group differences according to the study design, effect sizes were reported or could only be calculated in 56% of cases, and most were small. There was also a lack of diversity among samples (eg, few studies involved Latinos, men, young adults, or children), which limits knowledge about the ability of church-based interventions to reduce the burden of obesity more broadly among vulnerable communities of color. Further, few interventions were multilevel in nature, or incorporated strategies at the church or community level.ConclusionsChurch-based interventions to address obesity will have greater impact if they consider the diversity among populations burdened by this condition and develop programs that are tailored to these different populations (eg, men of color, Latinos). Programs could also benefit from employing multilevel approaches to move the field away from behavioral modifications at the individual level and into a more systems-based framework. However, effect sizes will likely remain small, especially since individuals only spend a limited amount of time in this particular setting.

Every civil servant has the same opportunity to get a position to improve their career, including employees in the North Sulawesi Provincial Government Office. The structural position is a very strategic position for anyone who can reach the position. However, it is not uncommon to find gender inequality in a community group that can affect every employee in reaching the position. As for this study, it can be understood that there are several factors that cause an imbalance in occupying echelon positions. The existing factors are divided into internal factors that come from within the employee, and external factors that come from outside the employee and influence them to develop themselves, especially for female employees. All of these factors are expected to create gender equality in the Regional Government of North Sulawesi. Keywords: Women's struggle, Minahasa culture, local government

The study aims to examine the distribution of questions in the Higher Order Thinking Skills (HOTS) category on the comprehensive examination of the Biblical Major at the IAKN Manado Theology Study Program, with the indicator for the Higher Order Thinking Skills (HOTS) questions based on the revised Bloom's Taxonomy. A descriptive method with a qualitative approach was applied. Data which was sourced from the comprehensive examination of Biblical Major at Theology Study Program of IAKN Manado, then analyzed using an interactive analysis model by Miles and Huberman, including data condensation, data display, verification, and conclusion. Analysis of questions was according to the revised Bloom's Taxonomy by Anderson & Krathwohl (2001). The results indicated that the comprehensive examination questions of Biblical majors at the Theology Study Program were taken from 15 courses with a total of 100 questions. Of the 100 questions, it was found that 9 courses contained HOTS questions and 6 courses contained questions classified in the MOTS and LOTS categories. Specifically, the percentages in each cognitive level were as follows, C6 at 1%, C5 at 16%, C4 at 23%, C3 at 38%, C2 at 8% and C1 at 14%. Thus, the HOTs level achieved 40%, the MOTS level reached 38%, while the LOTS level got 22%. It was concluded that the comprehensive examination questions of the Biblical Major at the Theology Study Program of IAKN Manado were dominated by the HOTS questions, although they were not evenly distributed in all questions of the subjects tested. The results of this study can be used as a reference in the preparation of exam questions for all subjects, so that the test administrator team or educators can determine the quality of each question made. Furthermore, the test administrators will also be able to map the categories of questions based on HOTS, MOTS, and LOTS, therefore the exam questions quality can be improved which affects the increase of students' higher-order thinking skills (HOTS).

PurposeThe aim of the study was to determine the association between food insecurity, mental health, and sleep outcomes among young adults. Young adulthood represents an important developmental period when educational and economic transitions may increase the risk for food insecurity; however, little is known about associations between food insecurity and health outcomes in this period.MethodsCross-sectional nationally representative data of U.S. young adults aged 24-32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2018. Multiple logistic regression analysis was conducted with food insecurity as the independent variable and self-reported mental health (depression, anxiety, and suicidality) and sleep (trouble falling and staying asleep) outcomes as the dependent variables.ResultsOf the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of mental health problems including a depression diagnosis (1.67, 95% confidence interval [CI] 1.39-2.01), anxiety or panic disorder diagnosis (1.47, 95% CI 1.16-1.87), and suicidal ideation in the past 12 months (2.76, 95% CI 2.14-3.55). Food insecurity was also associated with poorer sleep outcomes including trouble falling (adjusted odds ratio 1.78, 95% CI 1.52-2.08) and staying (adjusted odds ratio 1.67, 95% CI 1.42-1.97) asleep.ConclusionsFood insecurity is associated with poorer mental and sleep health in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should test interventions to simultaneously combat food insecurity and mental health problems in young adulthood.

BackgroundFood insecurity, or the limited or uncertain access to food resulting from inadequate financial resources, is associated with a higher prevalence of chronic disease in adulthood. Little is known about these relationships specifically in young adulthood, an important time for the development of chronic disease.ObjectiveTo determine the association between food insecurity and chronic disease including diabetes, hypertension, obesity, and obstructive airway disease in a nationally representative sample of US young adults.DesignCross-sectional nationally representative data collected from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health was analyzed using multiple logistic regression models.ParticipantsUS young adults ages 24-32 years old MAIN MEASURES: Food insecurity and general health; self-reported diabetes, hypertension, hyperlipidemia, "very overweight," and obstructive airway disease; measured obesity derived from body mass index; and inadequate disease control (hemoglobin A1c ≥ 7.0%, blood pressure ≥ 140/90 mmHg) among those with reported diabetes and hypertension.Key resultsOf the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of self-reported poor health (2.63, 95% confidence interval (CI) 1.63-4.24), diabetes (1.67, 95% CI 1.18-2.37), hypertension (1.40, 95% CI 1.14-1.72), being "very overweight" (1.30, 95% CI 1.08-1.57), and obstructive airway disease (1.48, 95% CI 1.22-1.80) in adjusted models compared with young adults who were food secure. Food insecurity was not associated with inadequate disease control among those with diabetes or hypertension.ConclusionsFood insecurity is associated with several self-reported chronic diseases and obesity in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should evaluate the impact of early interventions to combat food insecurity on the prevention of downstream health effects in later adulthood.

ObjectiveTo elucidate the perceived health benefits of an urban home gardening and nutritional education program in a population at high cardiometabolic risk.DesignQualitative data collected via in-depth, semistructured interviews in Spanish or English.SettingCommunity-based program offering supported urban home gardening together with nutrition education in Santa Clara County, CA.ParticipantsA total of 32 purposively sampled low-income participants in an urban home gardening program. Participants were primarily female (n = 24) and Latino/a (n = 22).Phenomenon of interestPerceptions of the nutrition and health benefits of education-enhanced urban home gardening.AnalysisBilingual researchers coded transcripts using a hybrid inductive and deductive approach. Two coders double coded at intervals, independently reviewed coding reports, organized content into key themes, and selected exemplary quotations.ResultsThe most salient perceived impacts were greater food access, increased consumption of fresh produce, a shift toward home cooking, and decreased fast food consumption. Participants attributed these changes to greater affordability, freshness, flavor, and convenience of their garden produce; increased health motivation owing to pride in their gardens; and improved nutritional knowledge. Participants also reported improved physical activity, mental health, and stress management; some reported improved weight and adherence to diabetes-healthy diets.Conclusions and implicationsEducation-enhanced urban home gardening may facilitate multidimensional nutrition and health improvements in marginalized populations at high cardiometabolic risk.

PurposeLittle is known about food insecurity and unmet subsistence needs and their association with antiretroviral therapy adherence among youth and young adults living with HIV (YLWH).MethodsWe conducted a cross-sectional survey to examine this association in 101 YLWH (aged 18-29 years). Poisson regression models with robust standard errors were used to estimate adjusted risk ratios (RRs) and 95% confidence intervals (CIs).ResultsApproximately 51.7% of participants experienced at least one unmet subsistence need (difficulty finding enough to eat [36.6%], clothing [22.8%], place to sleep [21.8%], place to wash [17.8%], and bathroom [15.8%]), and 64.2% reported being food insecure. For every additional unmet need, the risk of very good/excellent adherence was reduced by 15% (RR = .85; 95% CI = .72-.99; p value = .04). The risk of very good/excellent adherence was lowered by 39% (RR = .61; 95% CI = .43-.87; p value = .005) among food insecure youth, compared with those who were food secure.ConclusionsThese data highlight the need for more research and structural interventions targeting food assistance strategies among YLWH.

BackgroundFood insecurity, which disproportionately affects marginalized women in the United States, is associated with depressive symptoms. Few studies have examined relations of food insecurity with other mental health outcomes.ObjectiveThe aim of this study was to investigate the associations of food insecurity with symptoms of generalized anxiety disorder (GAD), stress, and posttraumatic stress disorder (PTSD) in the Women's Interagency HIV Study (WIHS), a prospective cohort study of women with or at risk of HIV in the United States.MethodsParticipants were 2553 women with or at risk of HIV, predominantly African American/black (71.6%). Structured questionnaires were conducted during April 2013-March 2016 every 6 mo. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. We measured longitudinal outcomes for GAD (GAD-7 score and a binary GAD-7 screener for moderate-to-severe GAD). Only cross-sectional data were available for outcomes measuring perceived stress (PSS-10 score) and PTSD (PCL-C score and a binary PCL-C screener for PTSD). We examined associations of FS with the outcomes through use of multivariable linear and logistic regression, including lagged associations with GAD outcomes.ResultsAfter adjusting for sociodemographic and health-related factors including HIV serostatus, current marginal, low, and very low FS were associated with increasingly higher GAD-7 scores, and with 1.41 (95% CI: 1.10, 1.80; P

Crash box is the most commonly used energy-absorbing systems for increasing transportation safety. Based on this system, design optimization of crash box is important to meeting safety standards with high performance. Therefore, this study aimed to propose a crucial crash box design featuring a 20-corner structure. This new design was expected to increase the number of folds and reduce the size upon impact, which can further elevate specific energy absorption (SEA). In addition, the study implemented a Gaussian Process Regression (GPR) surrogate model for the first time to optimize the multi-corner crash box design. This method reduced the computational cost of the design optimization process while effectively handling complex configurations. The optimization also focused on dimensional parameters such as thickness and perimeter. An explicit nonlinear finite element method was used for axial loading analysis to assess the crash impact performance. The computational results showed good agreement with experimental data where the performance of the 20-corner structure design was compared with other shapes including square, circular, and 12-corner designs. The results showed that the 20-corner structure design provided the most optimum SEA and Crushing Force Efficiency (CFE). Furthermore, the optimized 20-corner design via GPR-model led to a further performance increment with an increase of 8-9% higher SEA and CFE. The following main conclusions can be drawn (i) the cross-sectional geometry significantly influenced crashworthiness performance with the MC20 configuration achieving the best Pm, CFE, and SEA values compared to other configurations. Therefore, the study concluded that the MC20 configuration was the most efficient among the other configurations; (ii) GPR proved advantageous in the optimization process, offering flexibility for complex nonlinear functions, reducing computational costs, and providing error predictions to further refine the optimization model; and (iii) optimization of the MC20 configuration using the GPR surrogate model focused on a single objective which was to maximizing Pm. [ABSTRACT FROM AUTHOR]