Interpersonal and Community-Level Influences Across the PrEP Cascade Among Young Adult Latinx Men who Have Sex with Men Living in a US-Mexico Border Region: A Qualitative Study.

Latinx men who have sex with men (MSM) are an at-risk population for new HIV diagnoses. Pre-exposure prophylaxis (PrEP) is a suite of biomedical approaches to prevent HIV infection. Latinx MSM are less likely to take PrEP compared to non-Latinx White MSM. This qualitative study identified interpersonal- and community-level barriers and facilitators of PrEP among young adult Latinx MSM. Using stratified purposeful sampling, 27 Latinx men, ages 19-29 years and living in a US-Mexico border region, completed self-report demographic surveys and participated in semi-structured in-depth interviews assessing barriers and facilitators to PrEP. Directed content analysis was used to identify both a priori and emerging themes. Most participants reported that other people, including peers, friends, partners, and health care providers were both supportive and discouraging of PrEP use. Participants' intersectional identities as members of both Latinx and LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer) communities both hindered and facilitated PrEP use.

Examining COVID-19 pandemic-related economic and household stress and its association with mental health, alcohol, and substance use in a national sample of Latinx sexual minority and heterosexual adults.

OBJECTIVE: Sexual minority adults of Latinx descent faced compounded intersectional stressors during the COVID-19 pandemic across socioeconomic and health domains. Latinx people have experienced some of the highest COVID-19 infection, hospitalization, and mortality rates in the United States in addition to significant economic challenges. Yet, current data have not observed the unique pandemic-related experiences of sexual minority Latinx (SML) adults. We examined sexual identity differences in economic and household stress, social support, mental health symptomatology (depression, anxiety), alcohol, and substance use among sexual minority and nonsexual minority Latinx adults in the United States. METHOD: Primary data were collected via the AmeriSpeak panel, a national probability sample of U.S.-based 2,286 Latinx adults [sexual minority = .34% (n = 465)]. Data were collected from November 2020 to January 2021, during the third wave of the COVID-19 pandemic. RESULTS: SML adults endorsed higher levels of economic and household stress, mental health symptomatology, and alcohol and substance use than nonsexual minority Latinx adults. Economic stress was associated with increased mental health symptomatology, alcohol, and substance use among SML adults. Social support moderated the association between economic stress and mental health symptomatology and substance use, but not alcohol use. CONCLUSION: Findings highlighted unique intersectional considerations among SML adults during the COVID-19 pandemic, including the importance of social support and the negative toll of economic stress on mental health and substance use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Medical Mistrust and the PrEP Cascade Among Latino Sexual Minority Men.

Latino sexual minority men (SMM) have high HIV incidence rates but report low pre-exposure prophylaxis (PrEP) use. Medical mistrust predicts lower medical care use and could contribute to decreased PrEP engagement. This study examines how medical mistrust relates to the PrEP cascade among 151 Latino SMM aged 18-29. Logistic regressions were employed with medical mistrust predicting PrEP awareness, willingness, current use, and adherence. Greater medical mistrust was associated with decreased odds of all outcomes and may represent a barrier to PrEP engagement for Latino SMM. Further research should explore whether reducing medical mistrust among Latino SMM could increase PrEP engagement.

High prevalence of chigger mite infection in a forest-specialist frog with evidence of parasite-related granulomatous myositis.

Amphibians are hosts for a wide variety of micro- and macro-parasites. Chigger mites from the Hannemania genus are known to infect a wide variety of amphibian species across the Americas. In Chile, three species (H. pattoni, H. gonzaleacunae and H. ortizi) have been described infecting native anurans; however, neither impacts nor the microscopic lesions associated with these parasites have been described. Here, we document 70% prevalence of chigger mite infection in Eupsophus roseus and absence of infection in Rhinoderma darwinii in the Nahuelbuta Range, Chile. Additionally, we describe the macroscopic and microscopic lesions produced by H. ortizi in one of these species, documenting previously undescribed lesions (granulomatous myositis) within the host's musculature. These findings highlight that further research to better understand the impacts of chigger mite infection on amphibians is urgently required in Chile and elsewhere.

Cryptic disease-induced mortality may cause host extinction in an apparently stable host-parasite system.

The decline of wildlife populations due to emerging infectious disease often shows a common pattern: the parasite invades a naive host population, producing epidemic disease and a population decline, sometimes with extirpation. Some susceptible host populations can survive the epidemic phase and persist with endemic parasitic infection. Understanding host-parasite dynamics leading to persistence of the system is imperative to adequately inform conservation practice. Here we combine field data, statistical and mathematical modelling to explore the dynamics of the apparently stable Rhinoderma darwinii-Batrachochytrium dendrobatidis (Bd) system. Our results indicate that Bd-induced population extirpation may occur even in the absence of epidemics and where parasite prevalence is relatively low. These empirical findings are consistent with previous theoretical predictions showing that highly pathogenic parasites are able to regulate host populations even at extremely low prevalence, highlighting that disease threats should be investigated as a cause of population declines even in the absence of an overt increase in mortality.

Dispersal and extrapolation on the accuracy of temporal predictions from distribution models for the Darwin's frog.

Climate change is a major threat to biodiversity; the development of models that reliably predict its effects on species distributions is a priority for conservation biogeography. Two of the main issues for accurate temporal predictions from Species Distribution Models (SDM) are model extrapolation and unrealistic dispersal scenarios. We assessed the consequences of these issues on the accuracy of climate-driven SDM predictions for the dispersal-limited Darwin's frog Rhinoderma darwinii in South America. We calibrated models using historical data (1950-1975) and projected them across 40 yr to predict distribution under current climatic conditions, assessing predictive accuracy through the area under the ROC curve (AUC) and True Skill Statistics (TSS), contrasting binary model predictions against temporal-independent validation data set (i.e., current presences/absences). To assess the effects of incorporating dispersal processes we compared the predictive accuracy of dispersal constrained models with no dispersal limited SDMs; and to assess the effects of model extrapolation on the predictive accuracy of SDMs, we compared this between extrapolated and no extrapolated areas. The incorporation of dispersal processes enhanced predictive accuracy, mainly due to a decrease in the false presence rate of model predictions, which is consistent with discrimination of suitable but inaccessible habitat. This also had consequences on range size changes over time, which is the most used proxy for extinction risk from climate change. The area of current climatic conditions that was absent in the baseline conditions (i.e., extrapolated areas) represents 39% of the study area, leading to a significant decrease in predictive accuracy of model predictions for those areas. Our results highlight (1) incorporating dispersal processes can improve predictive accuracy of temporal transference of SDMs and reduce uncertainties of extinction risk assessments from global change; (2) as geographical areas subjected to novel climates are expected to arise, they must be reported as they show less accurate predictions under future climate scenarios. Consequently, environmental extrapolation and dispersal processes should be explicitly incorporated to report and reduce uncertainties in temporal predictions of SDMs, respectively. Doing so, we expect to improve the reliability of the information we provide for conservation decision makers under future climate change scenarios.

Compact and flexible raster scanning multiphoton endoscope capable of imaging unstained tissue.

We present a compact and flexible endoscope (3-mm outer diameter, 4-cm rigid length) that utilizes a miniaturized resonant/nonresonant fiber raster scanner and a multielement gradient-index lens assembly for two-photon excited intrinsic fluorescence and second-harmonic generation imaging of biological tissues. The miniaturized raster scanner is fabricated by mounting a commercial double-clad optical fiber (DCF) onto two piezo bimorphs that are aligned such that their bending axes are perpendicular to each other. Fast lateral scanning of the laser illumination at 4.1 frames/s (512 lines per frame) is achieved by simultaneously driving the DCF cantilever at its resonant frequency in one dimension and nonresonantly in the orthogonal axis. The implementation of a DCF into the scanner enables simultaneous delivery of the femtosecond pulsed 800-nm excitation source and epi-collection of the signal. Our device is able to achieve a field-of-view (FOV(xy)) of 110 µm by 110 µm with a highly uniform pixel dwell time. The lateral and axial resolutions for two-photon imaging are 0.8 and 10 µm, respectively. The endoscope's imaging capabilities were demonstrated by imaging ex vivo mouse tissue through the collection of intrinsic fluorescence and second-harmonic signal without the need for staining. The results presented here indicate that our device can be applied in the future to perform minimally invasive in vivo optical biopsies for medical diagnostics.

Characterization and individual-level prediction of cognitive state in the first year after 'mild' stroke.

BACKGROUND: Mild stroke affects more than half the stroke population, yet there is limited evidence characterizing cognition over time in this population, especially with predictive approaches applicable at the individual-level. We aimed to identify patterns of recovery and the best combination of demographic, clinical, and lifestyle factors predicting individual-level cognitive state at 3- and 12-months after mild stroke. METHODS: In this prospective cohort study, the Montreal Cognitive Assessment (MoCA) was administered at 3-7 days, 3- and 12-months post-stroke. Raw changes in MoCA and impairment rates (defined as MoCA<24 points) were compared between assessment time-points. Trajectory clusters were identified using variations of ≥1 point in MoCA scores. To further compare clusters, additional assessments administered at 3- and 12-months were included. Gamma and Quantile mixed-effects regression were used to predict individual MoCA scores over time, using baseline clinical and demographic variables. Model predictions were fitted for each stroke survivor and evaluated using model cross-validation to identify the overall best predictors of cognitive recovery. RESULTS: Participants' (n = 119) MoCA scores improved from baseline to 3-months (p<0.001); and decreased from 3- to 12-months post-stroke (p = 0.010). Cognitive impairment rates decreased significantly from baseline to 3-months (p<0.001), but not between 3- and 12-months (p = 0.168). Nine distinct trajectory clusters were identified. Clinical characteristics between clusters at each time-point varied in cognitive outcomes but not in clinical and/or activity participation outcomes. Cognitive performance at 3- and 12-months was best predicted by younger age, higher physical activity levels, and left-hemisphere lesion side. CONCLUSION: More than half of mild-stroke survivors are at risk of cognitive decline one year after stroke, even when preceded by a significantly improving pattern in the first 3-months of recovery. Physical activity was the only modifiable factor independently associated with cognitive recovery. Individual-level prediction methods may inform the timing and personalized application of future interventions to maximize cognitive recovery post-stroke.

Miniature varifocal objective lens for endomicroscopy.

A miniature catadioptric lens for endoscopic imaging based on the principle of wavelength division multiplexing is presented. We demonstrate change of the magnification and the field of view (FOV) of the lens without any mechanical adjustment of the optical elements. The lens provides magnifications of ~-1.5× at 406-750 nm and ~-0.2× at 800 nm. The lens is used to demonstrate large-FOV (1.3 mm) reflectance imaging and high-resolution (0.57 µm) multiphoton fluorescence imaging of unstained mouse tissues.

Examining Mental Health, Academic, and Economic Stressors During the COVID-19 Pandemic Among Community College and 4-Year University Students.

Objective: The COVID-19 global pandemic has created severe, long-lasting challenges to college students in the United States (US). In the present study, we assessed mental health symptomatology (depression, anxiety, life stress), academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Method: A total sample of 361 college students (Mage = 22.26, SD = 5.56) was gathered from a community college (N = 134) and mid-size public university (N = 227) in Southwest US, both designated as Hispanic Serving Institutions. Results: Pearson and point biserial correlations indicated associations between mental health symptomatology, academic challenges, and economic stress, including expected delays in graduation. Multivariate analysis revealed that community college students had statistically significantly higher scores on anxiety F(1, 312) = 5.27, p = .02, ηp2 = .01 than 4-year university students, as well as key differences with respect to academic challenges. Chi Square analyses revealed that Latinx families experienced greater economic hardships, including job loss or reduced work hours (χ2 (1, N = 361) = 28.56, p = .00) than other ethnic/racial groups. Conclusions/Contributions: Findings revealed that community college students faced disparately negative mental health symptomatology, academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Further, Latinx students' families experienced significant economic hardship that may have impacted students' academic progress and future planning.

Geographic mobility and its impact on sexual health and ongoing HIV transmission among migrant latinx men who have sex with men.

An understudied social process that may determine variable HIV risk, testing, and linkage to care is geographic mobility, including immigration as well as short-term mobility, especially among sexual minority populations. We aimed to assess how geographic mobility over the lifecourse between Latin America and the U.S., and within the U.S., was linked to sexual risk and health behaviors among Latinx migrant men who have sex with men (MSM) in San Bernardino County, California. Qualitative analysis of 16 semi-structured interviews revealed four major domains of influence on participants' sexual risk behaviors. At the micro level, these included social environment/interpersonal factors (e.g., family and peer support) and geographic factors and pathways (e.g., migration journey to the U.S.). At the macro level data centered on cultural factors (e.g., gender norms in home country) and structural factors (e.g., HIV healthcare). Our results can illuminate and promote effective health policies and HIV reduction efforts for Latinx migrant MSM in metro areas.

Multifocal multiphoton endoscope.

We report a miniaturized resonant/non-resonant multi-fiber raster scanner that is paired with a gradient-index lens assembly to achieve a compact and flexible multifocal multiphoton endoscope capable of longitudinal parallel image acquisition. Multiphoton images are obtained simultaneously at three axial depths, separated by ≥4.8 µm, by incorporating three axially offset double clad optical fibers into the miniaturized scanner. The fabricated endoscope has an outer diameter of 3 mm, a rigid length of 4 cm, and acquires images at 4 frames/s per focal plane, with lateral and axial resolutions for two-photon imaging of 0.8 and 10 µm, respectively.

Use of a lensed fiber for a large-field-of-view, high-resolution, fiber-scanning microendoscope.

We report the application of a lensed fiber to a miniaturized fiber raster scanner in order to reduce the fiber's output beam size, thereby allowing for a compact and flexible endoscope capable of a large field of view (FOV) and high spatial resolution. For a proof of principle, the fabricated lensed fiber scanner is paired with a miniaturized gradient-index assembly to achieve a one-photon lateral resolution of 1.1 µm with a FOV that has a diameter of 440 µm.

Trauma and latinx sexual- and gender-minority immigrants in the U.S.

Due to their multiple minoritized identities, Latinx sexual- and gender-minority immigrants risk exposure to various forms of traumatic stressors at home and abroad that can result in post-traumatic stress disorder and other comorbid problems like depression. A much-needed review and synthesis of the latest research highlights important factors for practitioners and scholars to consider relevant to this vulnerable and under researched population. A data-driven conceptualization helps identify risk factors across different points in time such as violence and discrimination from communal and institutional sources as well as acculturative and minority stressors. Gender can heighten the risk for victimization. Response factors to consider include social support and coping, trauma-informed interventions, and access to culturally competent integrative care.

Semiactive Knee Orthotic Using a MR Damper and a Smart Insole to Control the Damping Force Sensing the Plantar Pressure.

This work presents the development of semiactive knee orthosis prototype that focus to absorb the forces and impacts in this joint during the human gait. This prototype consists of three subsystems: the first is a wireless and portable system capable of measuring the ground reaction forces in the stance phase of the gait cycle, by means of an instrumented insole with force sensing resistors strategically placed on the sole of the foot, an electronic device allows processing and transmit this information via Bluetooth to the control system. The second is a semiactive actuator, which has inside a magnetorheological fluid, highlighting its ability to modify its damping force depending on the intensity of the magnetic field that circulates through the MR fluid. It is regulated by a Proportional Derivative (PD) controller system according to the values of plantar pressure measured by the insole. The third component is a mechanical structure manufactured by 3D printing, which adapts to the morphology of the human leg. This exoskeleton is designed to support the forces on the knee controlling the action of the magnetorheological actuator by ground reaction forces. The purpose of this assistance system is to reduce the forces applied to the knee during the gait cycle, providing support and stability to this joint. The obtained experimental results indicate that the device fulfills the function by reducing 12 % of the impact forces on the user's knee.

Antianemic activity of quinoa (Chenopodium quinoa Willd) Collana Negra variety and kanihua (Chenopodium pallidicaule Aellen) Ramis variety seed flour in anemic rats.

The Andean grains from the Peruvian Altiplano, quinoa (Chenopodium quinoa Willd) and kanihua (Chenopodium pallidicaule Aellen) have high protein content and an optimal balance of essential amino acids and minerals such as iron (19.8 mg/100 g y 17.6 mg/100 g, respectively). The objective of this research was to evaluate the antianemic activity of extruded flour from quinoa seeds variety Negra Collana and kanihua variety Ramis in anemic Holtzman strain rats. The results of the proximal analysis showed high protein content in quinoa at 22% and kanihua at 16.2%, and the acute toxicity test showed harmlessness up to the dose of 15000 mg/Kg in both flours confirmed with the anatomopathological observation of organs such as liver, stomach, lung, kidneys, and brain. In the evaluation of the antianemic activity, a basal average of 29.3 ± 0.2% of hematocrit was observed in the group of anemic rats treated with quinoa flour, and in twelve weeks, it increased to 53.8 ± 0.3% of hematocrit (p ≤ 0.05). A group of anemic rats treated with kanihua flour had a basal average of 29.5 ± 0.3%, and in twelve weeks, it increased to 51.7 ± 0.3% (p ≤ 0.05). A group of rats without anemia treated with quinoa and kanihua flour showed a basal average of 50.2 ± 0.2% and 49.3 ± 0.3%; in twelve weeks, it increased to 55.2 ± 0.2% and 54.8 ± 0.1%, respectively. It was concluded that oral administration of 360 mg/Kg every 24 h of quinoa flour and kanihua flour increased hematocrit levels by 24.5 ± 0.5% and 22.2 ± 0.3%; weight 65.8 ± 0.3 g and 59.2 ± 0.1 g; height 6.8 ± 0.1 cm and 5.7 ± 0.5 cm, respectively (p ≤ 0.05). In rats without anemia increased hematocrit levels by 5.3 ± 0.0% and 5.5 ± 0.0%; weight 37.7 ± 0.1 g and 21.7 ± 0.05 g; height 4 ± 0.0 cm and 3.9 ± 0.0 cm, respectively (p ≤ 0.05).

Medical decision support system using weakly-labeled lung CT scans.

Purpose: Determination and development of an effective set of models leveraging Artificial Intelligence techniques to generate a system able to support clinical practitioners working with COVID-19 patients. It involves a pipeline including classification, lung and lesion segmentation, as well as lesion quantification of axial lung CT studies. Approach: A deep neural network architecture based on DenseNet is introduced for the classification of weakly-labeled, variable-sized (and possibly sparse) axial lung CT scans. The models are trained and tested on aggregated, publicly available data sets with over 10 categories. To further assess the models, a data set was collected from multiple medical institutions in Colombia, which includes healthy, COVID-19 and patients with other diseases. It is composed of 1,322 CT studies from a diverse set of CT machines and institutions that make over 550,000 slices. Each CT study was labeled based on a clinical test, and no per-slice annotation took place. This enabled a classification into Normal vs. Abnormal patients, and for those that were considered abnormal, an extra classification step into Abnormal (other diseases) vs. COVID-19. Additionally, the pipeline features a methodology to segment and quantify lesions of COVID-19 patients on the complete CT study, enabling easier localization and progress tracking. Moreover, multiple ablation studies were performed to appropriately assess the elements composing the classification pipeline. Results: The best performing lung CT study classification models achieved 0.83 accuracy, 0.79 sensitivity, 0.87 specificity, 0.82 F1 score and 0.85 precision for the Normal vs. Abnormal task. For the Abnormal vs COVID-19 task, the model obtained 0.86 accuracy, 0.81 sensitivity, 0.91 specificity, 0.84 F1 score and 0.88 precision. The ablation studies showed that using the complete CT study in the pipeline resulted in greater classification performance, restating that relevant COVID-19 patterns cannot be ignored towards the top and bottom of the lung volume. Discussion: The lung CT classification architecture introduced has shown that it can handle weakly-labeled, variable-sized and possibly sparse axial lung studies, reducing the need for expert annotations at a per-slice level. Conclusions: This work presents a working methodology that can guide the development of decision support systems for clinical reasoning in future interventionist or prospective studies.

Racial dialogues: challenges faculty of color face in the classroom.

Research on the experiences of faculty of color in predominantly White institutions (PWIs) suggests that they often experience the campus climate as invalidating, alienating, and hostile. Few studies, however, have actually focused on the classroom experiences of faculty of color when difficult racial dialogues occur. Using Consensually Qualitative Research, eight faculty of color were interviewed about their experiences in the classroom when racially tinged topics arose. Three major findings emerged. First, difficult racial dialogues were frequently instigated by the presence of racial microaggressions delivered toward students of color or the professor. Dialogues on race were made more difficult when the classrooms were diverse, when heated emotions arose, when there was a strong fear of self-disclosure, and when racial perspectives differed. Second, all faculty experienced an internal struggle between balancing their own values and beliefs with an attempt to remain objective. This conflict was often described as exhausting and energy-depleting. Third, faculty of color described both successful and unsuccessful strategies in facilitating difficult dialogues on race that arose in the course of their teaching. These findings have major implications for how PWIs can develop new programs, policies, and practices that will aid and support colleagues of color.

Traditional Machismo, Caballerismo, and the Pre-Exposure Prophylaxis (PrEP) Cascade Among a Sample of Latino Sexual Minority Men.

Between 2010 and 2017, HIV diagnoses increased 17% among Latino sexual minority men (SMM) while decreasing 19% among White SMM and stabilizing among African American SMM. Traditional machismo is characterized by aggressiveness/power; caballerismo consists of family values/chivalry. Latino SMM high in traditional machismo may avoid seeking Pre-Exposure Prophylaxis (PrEP) to prevent being stigmatized as effeminate. Latino SMM high in caballerismo may be more likely to use PrEP to remain healthy for their family and/or partners. The current study explored the association between traditional machismo and caballerismo with four steps of the PrEP cascade. Participants were 151 HIV-negative/unknown Latino SMM living in San Diego, California (M = 24.18 years old) who completed an online study. Traditional machismo was associated with low odds of PrEP awareness, willingness, and adherence and high odds of PrEP use. Caballerismo was associated with greater odds of PrEP awareness, willingness, use, and adherence. High levels of traditional machismo among Latino SMM may be a barrier to PrEP. Caballerismo may be a facilitator of PrEP awareness, willingness, use, and adherence. Programs which serve to move Latino SMM through the PrEP cascade may benefit from discussing culturally-relevant masculinity given the potential for their differential associations with PrEP variables.

Cardiovascular vulnerability in COVID-19 elderly patients: getting into the biological mechanisms / Vulnerabilidad cardiovascular en adultos mayores con COVID-19: conociendo los mecanismos biológicos

The COVID-19 pandemic has had an important impact on older adults, conferring a worse prognosis. Older adults may have atypical presentations, which can delay the diagnosis of the disease, making its evolution more unfavorable. In addition to the cardiovascular damage mechanisms conferred by SARS-CoV-2 infection, the changes inherent in the aging cardiovascular and immune system favor the appearance of cardiovascular complications in a more relevant way in this population. The objective of this article will be to summarize the knowledge about cardiovascular involvement in older adults and explain its pathophysiological mechanisms, to alert about the early recognition and timely treatment of these complications.

La pandemia por COVID-19 ha impactado de forma importante en los adultos mayores, confiriéndoles un peor pronóstico. Los adultos mayores pueden tener presentaciones atípicas, las cuales pueden retrasar el diagnóstico de la enfermedad, haciendo su evolución más desfavorable. Además de los mecanismos de daño cardiovascular conferidos por la infección por SARS-CoV-2, los cambios inherentes al sistema cardiovascular e inmune ya envejecido, favorecen la aparición de complicaciones cardiovasculares de forma más relevante en esta población. El objetivo de este artículo será resumir los conocimientos sobre el involucro cardiovascular en adultos mayores y explicar los mecanismos fisiopatológicos de este, para alertar sobre el reconocimiento temprano y tratamiento oportuno de estas complicaciones.