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1.
Sex Transm Dis ; 51(6): 420-424, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38372524

RESUMEN

BACKGROUND: Syphilis in Florida increased 49% from 2016 to 2020. Moreover, many serological tests for syphilis (STS) do not indicate current infection. Traditionally, syphilis surveillance systems used reactor grids, a method for prioritizing STS for investigation based on age, nontreponemal titer, and/or sex. In 2022, Florida's sexually transmitted disease surveillance system implemented an automated method for processing electronically reported STS (eSTS), expanding upon the reactor grid, using an individual's current STS (treponemal and nontreponemal), treatment history, and historical STS results aiming for more efficiently processing eSTS. We compared the new method of processing eSTS results against the reactor grid and determined potential value in time/cost savings of this change. METHODS: All eSTSs (n = 4144) from January 2, 2023 to January 8, 2023, were compared by how the logic-based method processed test results versus how the reactor grid processed test results. Each method was compared using measurements of accuracy (e.g., sensitivity/specificity). Time and cost savings in eSTS processing were estimated. RESULTS: Using the surveillance case definition as reference, the accuracy of the logic-based method for processing eSTS was nearly double (82.3% vs. 43.6%), had greater specificity (79.0% vs. 33.0%), and increased positive predictive value (47.5% vs. 22.0%) when compared with the reactor grid method. Sensitivity (99.5% vs. 98.6%) and negative predictive value (99.9% vs. 99.2%) remained similar. The logic-based method is estimated to save 7783 hours annually (~$185,000). CONCLUSIONS: Processing eSTS based on current and historical STS results is significantly more accurate than using a reactor grid. Moreover, these improvements save time and resources that can be better allocated to other program prevention activities.


Asunto(s)
Serodiagnóstico de la Sífilis , Sífilis , Humanos , Sífilis/diagnóstico , Sífilis/epidemiología , Florida/epidemiología , Serodiagnóstico de la Sífilis/métodos , Masculino , Femenino , Adulto , Sensibilidad y Especificidad , Persona de Mediana Edad , Treponema pallidum/inmunología , Treponema pallidum/aislamiento & purificación , Adulto Joven , Pruebas Serológicas , Adolescente
2.
Sex Transm Dis ; 50(5): 274-279, 2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-36630331

RESUMEN

BACKGROUND: The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) get tested annually for urethral and rectal chlamydia (CT) and gonorrhea (NG), and pharyngeal NG. There are no national recommendations to screen women and heterosexual men at extragenital sites. We assessed extragenital CT/NG screening among men and women at Louisiana's Parish Health Units (PHU). METHODS: The Louisiana STD/HIV/Hepatitis Program piloted extragenital screening at 4 PHUs in February 2016 and expanded to 11 PHUs in 2017. Sexual histories were used to identify gender of sex partners and exposed sites. Because of billing restrictions, up to 2 anatomical sites were tested for CT/NG. RESULTS: From February 2016 to June 2019, 70,895 urogenital and extragenital specimens (56,086 urogenital, 13,797 pharyngeal, and 1,012 rectal) were collected from 56,086 patients. Pharyngeal CT positivity was 160 of 7,868 (2.0%) among women, 54 of 4,838 (1.1%) among men who have sex with women (MSW) and 33 of 1,091 (3.0%) among MSM. Rectal CT positivity was 51 of 439 (11.6%) among women and 95 of 573 (16.6%) among MSM. Pharyngeal NG positivity was 299 of 7,868 (3.8%) among women, 222 of 4,838 (4.6%) among MSW, and 97 of 1,091 (8.9%) among MSM. Rectal NG positivity was 20 of 439 (4.6%) among women and 134 of 573 (23.4%) among MSM.Urogenital-only screening would have missed: among women, 173 of 3,923 (4.4%) CT and 227 of 1,480 (15.3%) NG infections; among MSW, 26 of 2,667 (1%) CT and 149 of 1,709 (8.7%) NG infections; and among MSM, 116 of 336 (34.5%) CT and 127 of 413 (42.1%) NG infections. CONCLUSIONS: Many CT/NG infections would have been missed with urogenital-only screening. Men who have sex with men had much higher extragenital infection rates than women and MSW.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Masculino , Humanos , Femenino , Homosexualidad Masculina , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Gonorrea/diagnóstico , Gonorrea/epidemiología , Chlamydia trachomatis , Louisiana/epidemiología , Prevalencia , Neisseria gonorrhoeae
3.
PLoS Pathog ; 16(8): e1008679, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32790802

RESUMEN

Antiretroviral drugs that target various stages of the Human Immunodeficiency Virus (HIV) life cycle have been effective in curbing the AIDS epidemic. However, drug resistance, off-target effects of antiretroviral therapy (ART), and varying efficacy in prevention underscore the need to develop novel and alternative therapeutics. In this study, we investigated whether targeting the signaling molecule Sphingosine-1-phosphate (S1P) would inhibit HIV-1 infection and generation of the latent reservoir in primary CD4 T cells. We show that FTY720 (Fingolimod), an FDA-approved functional antagonist of S1P receptors, blocks cell-free and cell-to-cell transmission of HIV and consequently reduces detectable latent virus. Mechanistically, FTY720 impacts the HIV-1 life cycle at two levels. Firstly, FTY720 reduces the surface density of CD4, thereby inhibiting viral binding and fusion. Secondly, FTY720 decreases the phosphorylation of the innate HIV restriction factor SAMHD1 which is associated with reduced levels of total and integrated HIV, while reducing the expression of Cyclin D3. In conclusion, targeting the S1P pathway with FTY720 could be a novel strategy to inhibit HIV replication and reduce the seeding of the latent reservoir.


Asunto(s)
Clorhidrato de Fingolimod/farmacología , Infecciones por VIH/tratamiento farmacológico , VIH-1/crecimiento & desarrollo , Proteína 1 que Contiene Dominios SAM y HD/antagonistas & inhibidores , Moduladores de los Receptores de fosfatos y esfingosina 1/farmacología , Linfocitos T/inmunología , Replicación Viral , Infecciones por VIH/inmunología , Infecciones por VIH/virología , VIH-1/efectos de los fármacos , VIH-1/inmunología , Humanos , Lisofosfolípidos/metabolismo , Fosforilación , Proteína 1 que Contiene Dominios SAM y HD/metabolismo , Transducción de Señal , Esfingosina/análogos & derivados , Esfingosina/metabolismo , Linfocitos T/efectos de los fármacos , Latencia del Virus
4.
Sex Transm Dis ; 49(8): 576-581, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35533017

RESUMEN

BACKGROUND: Shigella species, which cause acute diarrheal disease, are transmitted via fecal-oral and sexual contact. To better understand the overlapping populations affected by Shigella infections and sexually transmitted infections (STIs) in the United States, we examined the occurrence of reported STIs within 24 months among shigellosis case-patients. METHODS: Culture-confirmed Shigella cases diagnosed from 2007 to 2016 among residents of 6 US jurisdictions were matched to reports of STIs (chlamydia, gonorrhea, and all stages of syphilis) diagnosed 12 months before or after the shigellosis case. We examined epidemiologic characteristics and reported temporal trends of Shigella cases by sex and species. RESULTS: From 2007 to 2016, 10,430 shigellosis cases were reported. The annual number of reported shigellosis cases across jurisdictions increased 70%, from 821 cases in 2007 to 1398 cases in 2016; males saw a larger increase compared with females. Twenty percent of male shigellosis case-patients had an STI reported in the reference period versus 4% of female case-patients. The percentage of male shigellosis case-patients with an STI increased from 11% (2007) to 28% (2016); the overall percentage among females remained low. CONCLUSIONS: We highlight the substantial proportion of males with shigellosis who were diagnosed with STIs within 24 months and the benefit of matching data across programs. Sexually transmitted infection screening may be warranted for male shigellosis case-patients.


Asunto(s)
Infecciones por Chlamydia , Disentería Bacilar , Gonorrea , Infecciones por VIH , Enfermedades Bacterianas de Transmisión Sexual , Enfermedades de Transmisión Sexual , Sífilis , Infecciones por Chlamydia/epidemiología , Disentería Bacilar/epidemiología , Femenino , Gonorrea/epidemiología , Infecciones por VIH/epidemiología , Humanos , Masculino , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Sífilis/epidemiología , Estados Unidos/epidemiología
5.
Pediatr Blood Cancer ; 69(10): e29771, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35593589

RESUMEN

RAS mutations are frequently observed in childhood B-cell acute lymphoblastic leukemia (B-ALL) and previous studies have yielded conflicting results as to whether they are associated with a poor outcome. We and others have demonstrated that the mitogen-activated protein kinase-extracellular signal-regulated kinase (MAPK) pathway can be activated through epigenetic mechanisms in the absence of RAS pathway mutations. Herein, we examined whether MAPK activation, as determined by measuring phosphorylated extracellular signal-regulated kinase (pERK) levels in 80 diagnostic patient samples using phosphoflow cytometry, could be used as a prognostic biomarker for pediatric B-ALL. The mean fluorescence intensity of pERK (MFI) was measured at baseline and after exogenous stimulation with or without pretreatment with the mitogen-activated protein kinase kinase (MEK) inhibitor trametinib. Activation levels (MFI stimulated/MFI baseline) ranged from 0.76 to 4.40 (median = 1.26), and inhibition indexes (MFI stimulated/MFI trametinib stimulated) ranged from 0.439 to 5.640 (median = 1.30), with no significant difference between patients with wildtype versus mutant RAS for either. Logistic regression demonstrated that neither MAPK activation levels nor RAS mutation status at diagnosis alone or in combination was prognostic of outcome. However, 35% of RAS wildtype samples showed MAPK inhibition indexes greater than the median, thus raising the possibility that therapeutic strategies to inhibit MAPK activation may not be restricted to patients whose blasts display Ras pathway defects.


Asunto(s)
Linfoma de Células B , Leucemia-Linfoma Linfoblástico de Células Precursoras , Niño , Activación Enzimática , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Humanos , Sistema de Señalización de MAP Quinasas , Quinasas de Proteína Quinasa Activadas por Mitógenos/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética
6.
Soc Networks ; 68: 84-96, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34149153

RESUMEN

Teammate invitation networks are foundational for team assembly, and recommender systems (similar to dating websites, but for selecting potential teammates) can aid the formation of such networks. This paper extends Hinds, Carley, Krackhardt, and Wholey's (2000) influential model of team member selection by incorporating online recommender systems. Exponential random graph modeling of two samples (overall N = 410; 63 teams; 1,048 invitations) shows the invitation network is predicted by online recommendations, beyond previously-established effects of prior collaboration/familiarity, skills/competence, and homophily. Importantly, online recommendations are less heeded when there is prior collaboration (effect replicates across samples). This study highlights technology-enabled team assembly from a network perspective.

7.
PLoS Med ; 18(9): e1003729, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34491999

RESUMEN

BACKGROUND: Previous product placement trials in supermarkets are limited in scope and outcome data collected. This study assessed the effects on store-level sales, household-level purchasing, and dietary behaviours of a healthier supermarket layout. METHODS AND FINDINGS: This is a prospective matched controlled cluster trial with 2 intervention components: (i) new fresh fruit and vegetable sections near store entrances (replacing smaller displays at the back) and frozen vegetables repositioned to the entrance aisle, plus (ii) the removal of confectionery from checkouts and aisle ends opposite. In this pilot study, the intervention was implemented for 6 months in 3 discount supermarkets in England. Three control stores were matched on store sales and customer profiles and neighbourhood deprivation. Women customers aged 18 to 45 years, with loyalty cards, were assigned to the intervention (n = 62) or control group (n = 88) of their primary store. The trial registration number is NCT03518151. Interrupted time series analysis showed that increases in store-level sales of fruits and vegetables were greater in intervention stores than predicted at 3 (1.71 standard deviations (SDs) (95% CI 0.45, 2.96), P = 0.01) and 6 months follow-up (2.42 SDs (0.22, 4.62), P = 0.03), equivalent to approximately 6,170 and approximately 9,820 extra portions per store, per week, respectively. The proportion of purchasing fruits and vegetables per week rose among intervention participants at 3 and 6 months compared to control participants (0.2% versus -3.0%, P = 0.22; 1.7% versus -3.5%, P = 0.05, respectively). Store sales of confectionery were lower in intervention stores than predicted at 3 (-1.05 SDs (-1.98, -0.12), P = 0.03) and 6 months (-1.37 SDs (-2.95, 0.22), P = 0.09), equivalent to approximately 1,359 and approximately 1,575 fewer portions per store, per week, respectively; no differences were observed for confectionery purchasing. Changes in dietary variables were predominantly in the expected direction for health benefit. Intervention implementation was not within control of the research team, and stores could not be randomised. It is a pilot study, and, therefore, not powered to detect an effect. CONCLUSIONS: Healthier supermarket layouts can improve the nutrition profile of store sales and likely improve household purchasing and dietary quality. Placing fruits and vegetables near store entrances should be considered alongside policies to limit prominent placement of unhealthy foods. TRIAL REGISTRATION: ClinicalTrials.gov NCT03518151 (pre-results).


Asunto(s)
Comercio , Comportamiento del Consumidor , Dieta Saludable , Alimentos , Valor Nutritivo , Supermercados , Adolescente , Adulto , Dulces , Conducta de Elección , Comercio/economía , Comportamiento del Consumidor/economía , Dieta Saludable/economía , Inglaterra , Femenino , Alimentos/efectos adversos , Alimentos/economía , Preferencias Alimentarias , Alimentos Congelados , Frutas , Humanos , Análisis de Series de Tiempo Interrumpido , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Factores de Tiempo , Verduras , Adulto Joven
8.
Cultur Divers Ethnic Minor Psychol ; 27(3): 447-459, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32757570

RESUMEN

OBJECTIVES: This research describes how family immigrant statuses are related to Latino/a adolescents' responses to recent immigration actions and news and, in turn, adolescent adjustment. METHOD: Study 1 included a school-based sample of 11- to 15-year-olds in suburban Atlanta, Georgia (N = 547); Study 2 included a convenience sample of 15- to 18-year-olds in the Washington, DC area (N = 340). Family immigrant status was defined by adolescents' immigrant generation status in Study 1 and by parent residency status in Study 2. In both studies, a 14-item measure assessed responses to recent immigration actions and news, including psychological worries and behavioral withdrawal. Dependent variables included internalizing and externalizing symptoms, suicidal ideation, e-cigarette use, and alcohol use (Study 1), and alcohol use and depressive symptoms (Study 2). RESULTS: Psychological worry and behavioral withdrawal responses to immigration actions and news were significantly greater among adolescents with foreign-born, compared to U.S.-born, parents (Study 1), and among adolescents with undocumented, Temporary Protected Status (TPS), or permanent resident parents, as compared to citizen parents (Study 2). Results from tests of indirect effects indicated that these worries and behavioral withdrawal responses were, in turn, associated with higher levels of adolescent internalizing and externalizing symptoms, a higher odds of substance use and suicidal ideation (Study 1), and higher levels of adolescent depressive symptoms (Study 2). CONCLUSIONS: As 1-quarter of the U.S. child population is Latino/a, there is a need to address immigration threats jeopardizing the adjustment of Latino/a teenagers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Emigrantes e Inmigrantes , Adolescente , Niño , Emigración e Inmigración , Hispánicos o Latinos , Humanos , Padres
9.
Clin Infect Dis ; 70(6): 1115-1120, 2020 03 03.
Artículo en Inglés | MEDLINE | ID: mdl-30976788

RESUMEN

BACKGROUND: Human immunodeficiency virus (HIV) prevention interventions for prevention interventions for women include screening, partner notification, promoting condoms, and preexposure prophylaxis (PrEP). Women's risk of acquiring HIV can help guide recommendations. METHODS: We used data from Louisiana's sexually transmitted infection (STI) and HIV registries to study 13- to 59-year-old women following first diagnosis of syphilis, gonorrhea, or chlamydia during 2000-2015. We measured HIV rates reported subsequent to STI (through 2016). Rates for women without STI were estimated by subtracting women with STI from reported cases and from Census estimates for the population. PrEP cost was estimated as $11 000 per year, and effectiveness estimated as 100%. RESULTS: STIs were syphilis (6574), gonorrhea (64 995), or chlamydia (140 034). These 211 603 women had 1 865 488 person-years of follow-up and 969 HIV diagnoses. Women with no STI had 5186 HIV diagnoses over 24 359 397 person-years. HIV rates diagnosis (per 100 000 person-years) were higher for women after syphilis (177.3), gonorrhea (73.2), or chlamydia (35.4) compared to women with no STI (22.4). Providing PrEP to all women diagnosed with syphilis or gonorrhea would cost $7 371 111 000 and could have prevented 546 HIV diagnoses. Limiting PrEP to 1 year after syphilis or gonorrhea diagnosis would cost $963 847 334, but only 143 HIV diagnoses were within 2 years after a syphilis or gonorrhea diagnosis. CONCLUSIONS: Rates of HIV diagnosis were high after women had STI, but not high enough to make PrEP cost-effective for them. Most women diagnosed with HIV did not have previously reported STI.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Infecciones por VIH , Profilaxis Pre-Exposición , Enfermedades de Transmisión Sexual , Sífilis , Adolescente , Adulto , Femenino , Gonorrea/diagnóstico , Gonorrea/epidemiología , Gonorrea/prevención & control , VIH , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Humanos , Louisiana , Persona de Mediana Edad , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Sífilis/diagnóstico , Sífilis/epidemiología , Adulto Joven
10.
Artículo en Inglés | MEDLINE | ID: mdl-32482680

RESUMEN

"Shock and kill" therapeutic strategies toward HIV eradication are based on the transcriptional activation of latent HIV with a latency-reversing agent (LRA) and the consequent killing of the reactivated cell by either the cytopathic effect of HIV or an arm of the immune system. We have recently found several benzotriazole and benzotriazine analogues that have the ability to reactivate latent HIV by inhibiting signal transducer and activator of transcription 5 (STAT5) SUMOylation and promoting STAT5 binding to the HIV long terminal repeat and increasing its transcriptional activity. To understand the essential structural groups required for biological activity of these molecules, we performed a systematic analysis of >40 analogues. First, we characterized the essential motifs within these molecules that are required for their biological activity. Second, we identified three benzotriazine analogues with similar activity. We demonstrated that these three compounds are able to increase STAT5 phosphorylation and transcriptional activity. All active analogues reactivate latent HIV in a primary cell model of latency and enhance the ability of interleukin-15 to reactivate latent HIV in cells isolated from aviremic participants. Third, this family of compounds also promote immune effector functions in vitro in the absence of toxicity or global immune activation. Finally, initial studies in mice suggest lack of acute toxicity in vivo A better understanding of the biological activity of these compounds will help in the design of improved LRAs that work via inhibition of STAT5 SUMOylation.


Asunto(s)
Infecciones por VIH , VIH-1 , Animales , Linfocitos T CD4-Positivos , Infecciones por VIH/tratamiento farmacológico , Ratones , Relación Estructura-Actividad , Triazinas , Activación Viral , Latencia del Virus
11.
Pediatr Blood Cancer ; 67(7): e28306, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32391957

RESUMEN

Relapse-enriched somatic variants drive drug resistance in childhood acute lymphoblastic leukemia. We used digital droplet-based polymerase chain reaction to establish whether relapse-enriched mutations in emerging subclones could be detected in peripheral blood samples before frank relapse. Although limitations in sensitivity for some probes hindered detection of certain variants, we successfully detected variants in NT5C2 and PRPS1 at a fractional abundance of 0.005% to 0.3%, 41 to 116 days before relapse. As mutations in both these genes confer resistance to thiopurines, early detection protocols using peripheral blood could be implemented to preemptively alter maintenance therapy to extinguish resistant clones before overt relapse.


Asunto(s)
Biomarcadores de Tumor/sangre , Células Clonales/patología , Mutación , Recurrencia Local de Neoplasia/patología , Leucemia-Linfoma Linfoblástico de Células Precursoras/patología , Biomarcadores de Tumor/genética , Estudios de Casos y Controles , Niño , Células Clonales/metabolismo , Terapia Combinada , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/genética , Recurrencia Local de Neoplasia/terapia , Reacción en Cadena de la Polimerasa , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangre , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Pronóstico
12.
J Neurosci ; 38(9): 2163-2176, 2018 02 28.
Artículo en Inglés | MEDLINE | ID: mdl-29371320

RESUMEN

Despite their small size, microsaccades can impede stimulus detections if executed at inopportune times. Although it has been shown that microsaccades evoke both inhibitory and excitatory responses across different visual regions, their impact on the higher-level neural decision processes that bridge sensory responses to action selection has yet to be examined. Here, we show that when human observers monitor stimuli for subtle feature changes, the occurrence of microsaccades long after (up to 800 ms) change onset predicts slower reaction times and this is accounted for by momentary suppression of neural signals at each key stage of decision formation: visual evidence encoding, evidence accumulation, and motor preparation. Our data further reveal that, independent of the timing of the change events, the onset of neural decision formation coincides with a systematic inhibition of microsaccade production, persisting until the perceptual report is executed. Our combined behavioral and neural measures highlight antagonistic interactions between microsaccade occurrence and evidence accumulation during visual decision-making tasks.SIGNIFICANCE STATEMENT When fixating on a location in space, we frequently make tiny eye movements called microsaccades. In the present study, we show that these microsaccades impede our ability to make perceptual decisions about visual stimuli and this impediment specifically occurs via the disruption of several processing levels of the sensorimotor network: the encoding of visual evidence itself, the accumulation of visual evidence toward a response, and effector-selective motor preparation. Furthermore, we show that the production of microsaccades is inhibited during the perceptual decision, possibly as a counteractive measure to mitigate their negative effect on behavior in this context. The combined behavioral and neural measures used in this study provide strong and novel evidence for the interaction of fixational eye movements and the perceptual decision-making process.


Asunto(s)
Toma de Decisiones/fisiología , Movimientos Sacádicos/fisiología , Percepción Visual/fisiología , Adulto , Femenino , Humanos , Masculino , Tiempo de Reacción/fisiología
13.
Sex Transm Dis ; 46(1): 52-57, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30148756

RESUMEN

BACKGROUND: Chlamydial infections are common among young women and can lead to serious reproductive health complications. We assessed the risk of reported repeat chlamydial infection among young women in Louisiana and time interval between infections by age and race/ethnicity. METHODS: We analyzed surveillance data on chlamydial infections reported among women in Louisiana from January 1, 2000, to December 31, 2015. Multiple reports for the same person were matched using unique codes. Chlamydial infections reported more than 30 days after a previous positive test were considered new infections. Women aged 15 to 34 years at first infection during 2000 to 2012 were censored after 3 years or after they had a repeat infection. Cumulative incidence and incidence rate of repeat chlamydial infection among women were determined by year of first infection. Race- and age-specific results were obtained using stratified analyses. RESULTS: One in 4 women diagnosed with a chlamydial infection at 15-34 years of age in Louisiana had a reported repeat infection in 3 years or less. Risk of repeat infection increased for younger women, racial/ethnic minorities, and women in more recent cohorts. Young black women aged 15 to 19 years in 2012 had the highest risk (44%). Black women also had shorter intervals between infections than white women. CONCLUSIONS: Repeat chlamydial infections were common, especially among young black women. The true number is likely higher because surveillance data only count infections that were detected and reported. Comprehensive prevention strategies are needed to address high rates of repeat chlamydial infections among women.


Asunto(s)
Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/patogenicidad , Adolescente , Adulto , Negro o Afroamericano , Femenino , Humanos , Incidencia , Louisiana/epidemiología , Recurrencia , Factores de Riesgo , Adulto Joven
14.
J Neurosci ; 37(12): 3378-3385, 2017 03 22.
Artículo en Inglés | MEDLINE | ID: mdl-28242798

RESUMEN

Healthy subjects tend to exhibit a bias of visual attention whereby left hemifield stimuli are processed more quickly and accurately than stimuli appearing in the right hemifield. It has long been held that this phenomenon arises from the dominant role of the right cerebral hemisphere in regulating attention. However, methods that would enable more precise understanding of the mechanisms underpinning visuospatial bias have remained elusive. We sought to finely trace the temporal evolution of spatial biases by leveraging a novel bilateral dot motion detection paradigm. In combination with electroencephalography, this paradigm enables researchers to isolate discrete neural signals reflecting the key neural processes needed for making these detection decisions. These include signals for spatial attention, early target selection, evidence accumulation, and motor preparation. Using this method, we established that three key neural markers accounted for unique between-subject variation in visuospatial bias: hemispheric asymmetry in posterior α power measured before target onset, which is related to the distribution of preparatory attention across the visual field; asymmetry in the peak latency of the early N2c target-selection signal; and, finally, asymmetry in the onset time of the subsequent neural evidence-accumulation process with earlier onsets for left hemifield targets. Our development of a single paradigm to dissociate distinct processing components that track the temporal evolution of spatial biases not only advances our understanding of the neural mechanisms underpinning normal visuospatial attention bias, but may also in the future aid differential diagnoses in disorders of spatial attention.SIGNIFICANCE STATEMENT The significance of this research is twofold. First, it shows that individual differences in how humans direct their attention between left and right space reflects physiological differences in how early the brain starts to accumulate evidence for the existence of a visual target. Second, the novel methods developed here may have particular relevance to disorders of attention, such as unilateral spatial neglect. In the case of spatial neglect, pathological inattention to left space could have multiple underlying causes, including biased attention, impaired decision formation, or a motor deficit related to one side of space. Our development of a single paradigm to dissociate each of these components may aid in supporting more precise differential diagnosis in such heterogeneous disorders.


Asunto(s)
Atención/fisiología , Dominancia Cerebral/fisiología , Tiempo de Reacción/fisiología , Percepción Espacial/fisiología , Campos Visuales/fisiología , Percepción Visual/fisiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Análisis y Desempeño de Tareas , Adulto Joven
15.
Sex Transm Dis ; 44(8): 498-502, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28703731

RESUMEN

BACKGROUND: From 2012 to 2014, rates of congenital syphilis increased in Louisiana and Florida. We evaluated the effectiveness of early (first or second) and third trimester syphilis screening for the prevention of congenital syphilis in these high-morbidity states. METHODS: Reported syphilis cases among pregnant women in Louisiana and Florida during January 1, 2013, to December 31, 2014, were reviewed for documented screening for syphilis in the first 2 trimesters and third trimester. Pregnant women with syphilis were linked to congenital syphilis records and stratified by whether the pregnancy led to a reported congenital syphilis case. RESULTS: Seven hundred ten pregnant women with syphilis in Louisiana and Florida were linked to 155 congenital syphilis cases. Three hundred seventy (52%) pregnant women with syphilis were staged as early syphilis (n = 270) or high-titer late or unknown duration-latent syphilis (n = 100), and 109 (70% of the total) were linked to congenital syphilis cases. Screening in the first 2 trimesters identified 513 pregnant women who tested positive for syphilis, and 470 (92%) potential congenital syphilis were averted. One hundred nine pregnant women tested positive for syphilis in the third trimester, and 85 (78%) had babies without congenital syphilis. During their pregnancy, 85 (12%) women tested negative at least once, and 55 (65%) had babies with congenital syphilis. Thirty-nine women had no reported syphilis screening 30 days or longer before delivery. CONCLUSIONS: Screening for syphilis both early and in the third trimester prevented many pregnant women with syphilis from having a baby with congenital syphilis. Preventing all congenital syphilis would likely require preventing all syphilis among women.


Asunto(s)
Diagnóstico Prenatal , Sífilis Congénita/prevención & control , Negro o Afroamericano , Femenino , Florida , Hispánicos o Latinos , Humanos , Louisiana , Embarazo , Primer Trimestre del Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Sífilis Congénita/diagnóstico , Sífilis Congénita/tratamiento farmacológico , Sífilis Congénita/etnología , Población Blanca
16.
Muscle Nerve ; 56(2): 197-201, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28063152

RESUMEN

Dysfunction in central control of breathing in some amyotrophic lateral sclerosis (ALS) patients is not adequately detected with standard evaluation for respiratory dysfunction. Nocturnal oximetry reveals periodic desaturations despite normal respiratory muscle movements. Continuous diaphragmatic electromyography has provided in vivo data consistent with impaired central control of diaphragm motor units. Current understanding of central control of breathing identifies the pre-Botzinger complex as the inspiratory rhythm generator. Animal models of pre-Botzinger complex neurodegeneration demonstrate rapid eye movement-related central sleep apneas progressing to loss of rapid eye movement sleep, also apparent in some ALS patients. Evidence supports the hypothesis that dysfunction in central control of breathing in some ALS patients may be related to pre-Botzinger complex degeneration. As the impact dysfunction of central control of breathing has on ALS becomes better defined the current standard of evaluating respiratory dysfunction in ALS patients may need updating. Muscle Nerve 56: 197-201, 2017.


Asunto(s)
Esclerosis Amiotrófica Lateral/complicaciones , Sistema Nervioso Central/patología , Trastornos Respiratorios/etiología , Animales , Humanos , Trastornos Respiratorios/patología
17.
Langmuir ; 33(43): 11911-11918, 2017 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-28927271

RESUMEN

Irreversible changes to the morphology of glassy carbon (GC) electrodes at potentials between 3.5 and 4.5 V vs Li/Li+ in propylene carbonate (PC) solvent containing lithium hexafluorophosphate (LiPF6) are reported. Analysis of cyclic voltammetry (CV) experiments in the range of 3.0 to 6.0 V shows that the capacitance of the electrochemical double-layer increased irreversibly beginning at potentials as low as 3.5 V. These changes resulted from nonfaradaic interactions, and were not due to oxidative electrochemical decomposition of the electrode and electrolyte, anion intercalation, nor caused by the presence of water, a common impurity in organic electrolyte solutions. Atomic force microscopy (AFM) images revealed that increasing the potential of a bare GC surface from 3.0 to 4.5 V resulted in a 6× increase in roughness, in good agreement with the changes in double-layer capacitance. Treating the GC surface via exposure to trichloromethylsilane vapors resulted in a stable double-layer capacitance between 3.0 and 4.5 V, and this treatment also correlated with less roughening. These results inform future efforts aimed at controlling surface composition and morphology of carbon electrodes.

18.
Nurse Res ; 25(1): 37-42, 2017 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-28639528

RESUMEN

Background Interviews are widely used in qualitative research to collect data. However, little has been written about interviewing people with severe mental illness (SMI). Aim To report and analyse an experience of addressing the ethical and practical challenges of interviewing people with SMI. Discussion Semi-structured interviews were conducted as part of a doctoral study to explore how service users and healthcare professionals built relationships with each other. Conclusion Although interviewing participants with SMI was challenging, rich data illustrating their experiences were gathered. Careful planning around ethical considerations, such as obtaining informed consent, was required to maximise the opportunities to gather in-depth information during the interviews. The relationship established between researcher and the participants assisted with sensitive disclosures and allowed participants to tell their stories. Implications for research This paper provides strategies to help guide researchers planning interviews with vulnerable populations, including those with SMI. These strategies include how to discuss sensitive issues and promote engagement. Listening to participants' life stories is an intense experience, requiring support for the interviewer to stay neutral during interviews. It is also important to be aware of the differences between the roles of nurse and nurse researcher before undertaking in-depth qualitative interviews, particularly with vulnerable participants.


Asunto(s)
Ética en Investigación , Entrevistas como Asunto/métodos , Trastornos Mentales , Investigación en Enfermería/métodos , Selección de Paciente/ética , Relaciones Investigador-Sujeto/ética , Humanos , Investigación Cualitativa
19.
J Neurosci ; 34(47): 15743-50, 2014 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-25411502

RESUMEN

Although lateral asymmetries in orienting behavior are evident across species and have been linked to interhemispheric asymmetries in dopamine signaling, the relative contribution of attentional versus motoric processes remains unclear. Here we took a cognitive genetic approach to adjudicate between roles for dopamine in attentional versus response selection. A sample of nonclinical adult humans (N = 518) performed three cognitive tasks (spatial attentional competition, spatial cueing, and flanker tasks) that varied in the degree to which they required participants to resolve attentional or response competition. All participants were genotyped for two putatively functional tandem repeat polymorphisms of the dopamine transporter gene (DAT1; SLC6A3), which are argued to influence the level of available synaptic dopamine and confer risk to disorders of inattention. DAT1 genotype modulated the task-specific effects of the various task-irrelevant stimuli across both the spatial competition and spatial cueing but not flanker tasks. Specifically, compared with individuals carrying one or two copies of the 10-repeat DAT1 allele, individuals without this allele demonstrated an immunity to distraction, such that response times were unaffected by increases in the number of distractor stimuli, particularly when these were presented predominantly in the left hemifield. All three genotype groups exhibited uniform costs of resolving leftward response selection in a standard flanker task. None of these significant effects could be explained by speed-accuracy trade-offs, suggesting that participants without the 10-repeat allele of the DAT1 tandem repeat polymorphism possess an enhanced attentional ability to suppress task-irrelevant stimuli in the left hemifield.


Asunto(s)
Atención/fisiología , Proteínas de Transporte de Dopamina a través de la Membrana Plasmática/genética , Cognición/fisiología , Señales (Psicología) , Femenino , Lateralidad Funcional/genética , Lateralidad Funcional/fisiología , Genotipo , Humanos , Masculino , Orientación/fisiología , Desempeño Psicomotor/fisiología , Percepción Espacial/fisiología , Adulto Joven
20.
Dev Psychopathol ; 27(3): 725-46, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25221946

RESUMEN

Here we tested whether there was genetic moderation of effects of early maternal sensitivity on social-emotional and cognitive-linguistic development from early childhood onward and whether any detected Gene × Environment interaction effects proved consistent with differential-susceptibility or diathesis-stress models of Person × Environment interaction (N = 695). Two new approaches for evaluating models were employed with 12 candidate genes. Whereas maternal sensitivity proved to be a consistent predictor of child functioning across the primary-school years, candidate genes did not show many main effects, nor did they tend to interact with maternal sensitivity/insensitivity. These findings suggest that the developmental benefits of early sensitive mothering and the costs of insensitive mothering look more similar than different across genetically different children in the current sample. Although acknowledgement of this result is important, it is equally important that the generally null Gene × Environment results reported here not be overgeneralized to other samples, other predictors, other outcomes, and other candidate genes.


Asunto(s)
Desarrollo Infantil/fisiología , Interacción Gen-Ambiente , Predisposición Genética a la Enfermedad , Conducta Materna/psicología , Relaciones Madre-Hijo/psicología , Adolescente , Preescolar , Femenino , Humanos , Lactante , Masculino , Modelos Psicológicos
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