Detectable Viral Load May Be Associated with Increased Pain Sensitivity in Persons Living with HIV: Preliminary Findings.

OBJECTIVE: Animal models have previously shown that HIV is associated with hyperalgesia, or heightened sensitivity to painful stimuli. Efforts to determine whether this finding translates to humans are presently lacking. Among persons living with HIV (PLWH), those with detectable viral loads may be at greatest risk for heightened pain sensitivity. It was hypothesized that PLWH with detectable viral loads would be more sensitive to painful stimuli compared with PLWH without detectable viral loads and healthy controls without HIV. DESIGN: A total of 47 PLWH and 50 community-dwelling, healthy adults without HIV (controls) were recruited. Participants completed a quantitative sensory testing protocol to assess threshold, tolerance, and temporal summation in response to painful mechanical and heat stimuli. Most recent viral load was collected from medical records, and viral load was considered detectable if the count was greater than 50 copies/mL of blood. Of the 47 PLWH, 11 (23.4%) had detectable viral loads, the median viral load count was 10,200 copies/mL. RESULTS: PLWH with detectable viral loads demonstrated significantly lower pain thresholds for mechanical stimuli (F2,89 = 3.15, P = 0.049), significantly lower heat pain tolerances (F2,89 = 3.38, P = 0.039), and significantly greater temporal summation of heat pain at 48 °C (F2,89 = 10.66, P < 0.001) and 50 °C (F2,89 = 3.82, P = 0.026), compared with PLWH without detectable viral loads and healthy controls. CONCLUSIONS: These preliminary results tentatively suggest that the detectable presence of the virus may sensitize PLWH to painful mechanical and heat stimuli.

Anatomical variations and neurosurgical significance of Liliequist's membrane.

INTRODUCTION: Liliequist's membrane is an arachnoid membrane that forms a barrier within the basilar cisternal complex. This structure is an important landmark in approaches to the sellar and parasellar regions. The importance of this membrane was largely recognized after the advance of neuroendoscopic techniques. Many studies were, thereafter, published reporting different anatomic findings. METHOD: A detailed search for studies reporting anatomic and surgical findings of Liliequist's membrane was performed using "PubMed," and included all the available literature. Manual search for manuscripts was also conducted on references of papers reporting reviews. RESULTS: Liliequist's membrane has received more attention recently. The studies have reported widely variable results, which were systematically organized in this paper to address the controversy. CONCLUSION: Regardless of its clinical and surgical significance, the anatomy of Liliequist's membrane is still a matter of debate.

Treatment of spinal cord injury: a review of engineering using neural and mesenchymal stem cells.

Over time, various treatment modalities for spinal cord injury have been trialed, including pharmacological and nonpharmacological methods. Among these, replacement of the injured neural and paraneural tissues via cellular transplantation of neural and mesenchymal stem cells has been the most attractive. Extensive experimental studies have been done to identify the safety and effectiveness of this transplantation in animal and human models. Herein, we review the literature for studies conducted, with a focus on the human-related studies, recruitment, isolation, and transplantation, of these multipotent stem cells, and associated outcomes.

The microanatomy of spinal cord injury: a review.

Spinal cord injury is a highly prevalent condition associated with significant morbidity and mortality. The pathophysiology underlying it is extraordinarily complex and still not completely understood. We performed a comprehensive literature review of the pathophysiologic processes underlying spinal cord injury. The mechanisms underlying primary and secondary spinal cord injury are distinguished based on a number of factors and include the initial mechanical injury force, the vascular supply of the spinal cord which is associated with spinal cord perfusion, spinal cord autoregulation, and post-traumatic ischemia, and a complex inflammatory cascade involving local and infiltrating immunomodulating cells. This review illustrates the current literature regarding the pathophysiology behind spinal cord injury and outlines potential therapeutic options for reversing these mechanisms.

Impact of In-Home Handwashing Stations on Hand Hygiene During the COVID-19 Pandemic in Unpiped Rural Alaska Native Homes.

OBJECTIVES: More than 3300 rural Alaska Native homes lack piped water, impeding hand hygiene. During the COVID-19 pandemic, the Alaska Native Tribal Health Consortium and the Centers for Disease Control and Prevention partnered with 10 Tribal communities and regional Tribal health organizations to install a low-cost, intermediate-technology water and sanitation system, the Miniature Portable Alternative Sanitation System (Mini-PASS). We assessed the impact of the Mini-PASS handwashing station on handwashing, other water-related uses, and problems encountered over time. METHODS: In this pre-postintervention study, we conducted semi-structured interviews by telephone seasonally with representatives of 71 households with the Mini-PASS from February 2021 through November 2022 to assess the impact of the units on water use and health. RESULTS: Before Mini-PASS installation, all participating households primarily used washbasins for handwashing. Postintervention, more than 70% of households reported using the Mini-PASS as their primary handwashing method in all 3 follow-up intervals (3, 6-9, and 12 months postintervention). The proportion of households using the handwashing station for other household tasks increased during 12 months, from 51.4% (19 of 37) at 3 months postintervention to 77.8% (21 of 27) at 12 months postintervention. Although approximately 20% to 40% of households reported problems with their handwashing station during the 12 months postintervention, a large proportion of interviewees (47% to 60%) said they were able to conduct repairs themselves. CONCLUSIONS: Households in rural Alaska quickly adopted the Mini-PASS for hand hygiene and other needs and were largely able to troubleshoot problems themselves. Further research evaluating the impact of improved handwashing behaviors facilitated by the Mini-PASS should be conducted.

A continuous, in-situ, near-time fluorescence sensor coupled with a machine learning model for detection of fecal contamination risk in drinking water: Design, characterization and field validation.

We designed and validated a sensitive, continuous, in-situ, remotely reporting tryptophan-like fluorescence sensor and coupled it with a machine learning model to predict high-risk fecal contamination in water (>10 colony forming units (CFU)/100mL E. coli). We characterized the sensor's response to multiple fluorescence interferents with benchtop analysis. The sensor's minimum detection limit (MDL) of tryptophan dissolved in deionized water was 0.05 ppb (p <0.01) and its MDL of the correlation to E. coli present in wastewater effluent was 10 CFU/100 mL (p <0.01). Fluorescence response declined exponentially with increased water temperature and a correction factor was calculated. Inner filter effects, which cause signal attenuation at high concentrations, were shown to have negligible impact in an operational context. Biofouling was demonstrated to increase the fluorescence signal by approximately 82% in a certain context, while mineral scaling reduced the sensitivity of the sensor by approximately 5% after 24 hours with a scaling solution containing 8 times the mineral concentration of the Colorado River. A machine learning model was developed, with TLF measurements as the primary feature, to output fecal contamination risk levels established by the World Health Organization. A training and validation data set for the model was built by installing four sensors on Boulder Creek, Colorado for 88 days and enumerating 298 grab samples for E. coli with membrane filtration. The machine learning model incorporated a proxy feature for fouling (time since last cleaning) which improved model performance. A binary classification model was able to predict high risk fecal contamination with 83% accuracy (95% CI: 78% - 87%), sensitivity of 80%, and specificity of 86%. A model distinguishing between all World Health Organization established risk categories performed with an overall accuracy of 64%. Integrating TLF measurements into an ML model allows for anomaly detection and noise reduction, permitting contamination prediction despite biofilm or mineral scaling formation on the sensor's lenses. Real-time detection of high risk fecal contamination could contribute to a major step forward in terms of microbial water quality monitoring for human health.