Greater variability in judgements of the value of novel ideas.

Understanding the factors that hinder support for creative ideas is important because creative ideas fuel innovation-a goal prioritized across the arts, sciences and business. Here we document one obstacle faced by creative ideas: as ideas become more novel-that is, they depart more from existing norms and standards-disagreement grows about their potential value. Specifically, across multiple contexts, using both experimental methods (four studies, total n = 1,801) and analyses of archival data, we find that there is more variability in judgements of the value of more novel (versus less novel) ideas. We also find that people interpret greater variability in others' judgements about an idea's value as a signal of risk, reducing their willingness to invest in the idea. Our findings show that consensus about an idea's worth diminishes the newer it is, highlighting one reason creative ideas may fail to gain traction in the social world.

Inequities Along the Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis Services Continuum for Black Women in the United States, 2015-2020.

OBJECTIVE: To estimate the number of women who received human immunodeficiency virus (HIV) and sexually transmitted infection (STI) testing and HIV pre-exposure prophylaxis (PrEP) services by race and ethnicity in seven THRIVE (Targeted Highly Effective Interventions to Reverse the HIV Epidemic)-funded jurisdictions and to estimate associations of age and syphilis and gonorrhea diagnoses with receipt of HIV PrEP services. METHODS: We analyzed data collected from 2015 to 2020 in Birmingham, Alabama; Baltimore City, Maryland; Washington, DC, New Orleans, Louisiana; Brooklyn, New York; Philadelphia, Pennsylvania; and Hampton Roads, Virginia. We compared Black women and women of additional racial and ethnic groups by age, HIV status at enrollment, receipt of STI testing and test positivity, and steps in the PrEP continuum (screened, eligible, referred, linked, and prescribed). We also examined the association of age, syphilis, or gonorrhea with the following steps in the PrEP continuum: screened, referred, linked, and prescribed. RESULTS: Black women made up 69.2% (8,758/12,647) of women served in THRIVE. Compared with non-Black women, Black women were more likely to have a positive test result for syphilis (3.3% vs 2.1%), gonorrhea (4.9% vs 3.5%), chlamydia (5.1% vs 1.9%), or more than one STI (1.4% vs 0.3%). Among women with negative HIV test results or unknown HIV status, Black women were more likely to be screened for PrEP eligibility (88.4% vs 64.9%). Among Black women, the proportion screened for PrEP was higher among those diagnosed with syphilis (97.3%) or gonorrhea (100%) than among those without an STI (88.1% and 87.8%, respectively). Among 219 Black women who presented with syphilis, only 10 (4.6%) were prescribed PrEP; among 407 with gonorrhea, only 11 (2.7%) were prescribed PrEP. CONCLUSION: Although most Black women seeking services received STI testing, the proportion of Black women who were eligible for PrEP and prescribed PrEP was low. To achieve national HIV-prevention goals, it is imperative that Black women have access to PrEP information and services.

Dietary Supplementation with Milk Lipids Leads to Suppression of Developmental and Behavioral Phenotypes of Hyperexcitable Drosophila Mutants.

Dietary modifications often have a profound impact on the penetrance and expressivity of neurological phenotypes that are caused by genetic defects. Our previous studies in Drosophila melanogaster revealed that seizure-like phenotypes of gain-of-function voltage-gated sodium (Nav) channel mutants (paraShu, parabss1, and paraGEFS+), as well as other seizure-prone "bang-sensitive" mutants (eas and sda), were drastically suppressed by supplementation of a standard diet with milk whey. In the current study we sought to determine which components of milk whey are responsible for the diet-dependent suppression of their hyperexcitable phenotypes. Our systematic analysis reveals that supplementing the diet with a modest amount of milk lipids (0.26% w/v) mimics the effects of milk whey. We further found that a minor milk lipid component, α-linolenic acid, contributed to the diet-dependent suppression of adult paraShu phenotypes. Given that lipid supplementation during the larval stages effectively suppressed adult paraShu phenotypes, dietary lipids likely modify neural development to compensate for the defects caused by the mutations. Consistent with this notion, lipid feeding fully rescued abnormal dendrite development of class IV sensory neurons in paraShu larvae. Overall, our findings demonstrate that milk lipids are sufficient to ameliorate hyperexcitable phenotypes in Drosophila mutants, providing a foundation for future investigation of the molecular and cellular mechanisms by which dietary lipids modify genetically induced abnormalities in neural development, physiology, and behavior.

Expanding PrEP Services for Men Who Have Sex With Men and Transgender Persons Through Health Department Programs: Key Processes and Outcomes From Project PrIDE, 2015-2019.

OBJECTIVE: Pre-exposure prophylaxis (PrEP) Implementation, Data to Care, and Evaluation (PrIDE) was a demonstration project implemented by 12 state and local health departments during 2015-2019 to expand PrEP services for men who have sex with men (MSM) and transgender persons at risk for HIV infection. We describe findings from the cross-jurisdictional evaluation of the project. METHODS: We analyzed work plans, annual progress reports, and aggregate quantitative program data submitted by funded health departments (n = 12) to identify key activities implemented and summarize key project outcomes. RESULTS: PrIDE jurisdictions implemented multiple health equity-focused activities to expand PrEP services to priority populations, including building program capacity, conducting knowledge and awareness campaigns, providing PrEP support services, and addressing barriers to PrEP use. Overall, PrIDE jurisdictions identified 44 813 persons with PrEP indications. Of these, 74.8% (n = 33 500) were referred and 33.1% (n = 14 821) were linked to PrEP providers, and 25.3% (n = 11 356) were prescribed PrEP. Most persons prescribed PrEP were MSM or transgender persons (87.9%) and persons from racial and ethnic minority groups (65.6%). However, among persons with PrEP indications, non-Hispanic Black/African American persons (14.9% of 18 782) were less likely than non-Hispanic White persons (31.0% of 11 633) to be prescribed PrEP (z = -33.57; P < .001). CONCLUSIONS: PrIDE jurisdictions successfully expanded PrEP services for MSM, transgender persons, and racial and ethnic minority groups by implementing health equity-focused activities that addressed barriers to PrEP services. However, PrEP prescription was generally low, with significant disparities by demographic characteristics. Additional targeted interventions are needed to expand PrEP services, achieve equity in PrEP use, and contribute to ending the HIV epidemic in the United States.

Expanding Data to Care Programs to Improve HIV Care Continuum Among Men Who Have Sex With Men and Transgender Persons: Key Processes and Outcomes From Project PrIDE, 2015-2019.

OBJECTIVES: During 2015-2019, five local and state health department jurisdictions implemented Data to Care (D2C) programs supported by Project PrIDE (Pre-exposure prophylaxis, Implementation, Data to Care, and Evaluation) to improve linkage or reengagement in HIV medical care among persons with HIV (PWH) who had gaps in care, particularly among men who have sex with men (MSM) and transgender persons. We describe findings from the cross-jurisdiction evaluation of the project. METHODS: We conducted a qualitative analysis of the final progress reports submitted by PrIDE jurisdictions to the Centers for Disease Control and Prevention to identify key D2C activities implemented and challenges encountered. We also conducted descriptive analysis on aggregate quantitative data to summarize key D2C program outcomes. RESULTS: PrIDE jurisdictions implemented multiple activities to build their D2C capacity, identify PWH who were not in care or virally suppressed, provide linkage/reengagement services, and monitor outcomes. Overall, 11 463 PWH were selected for follow-up, 45% of whom were MSM or transgender persons. Investigations were completed for 8935 (77.9%) PWH. Only 2323 (26.0%) PWH were confirmed not in care or virally suppressed; 1194 (51.4%) were subsequently linked/reengaged in care; among those, 679 (56.9%) were virally suppressed at last test. PrIDE jurisdictions identified data-related (eg, incomplete or delayed laboratory results), program capacity (eg, insufficient staff), and social and structural (eg, unstable housing) challenges that affected their D2C implementation. CONCLUSIONS: PrIDE jurisdictions successfully enhanced their D2C capacity, reached priority populations who were not in care or virally suppressed, and improved their engagement in care and health outcomes. Data-related and non-data-related challenges limited the efficiency of D2C programs. Findings can help inform other D2C programs and contribute to national HIV prevention goals.

Reaching racial/ethnic and sexual and gender minorities with HIV prevention information via social marketing.

The Pre-exposure Prophylaxis, Data to Care, Implementation, and Evaluation (PrIDE) multi-site demonstration project utilized a cluster evaluation approach and identified six funding recipients that evaluated similar media evaluation questions (Baltimore, Los Angeles County, Lousiana, Michigan, New York City, and Virginia). All of the evaluated social marketing campaigns were developed in collaboration with health department staff, external marketing firms, and community advisory boards (CAB) aiming to produce changes in PrEP outcomes by reaching racial/ethnic and sexual and gender minorities. Jurisdictions demonstrated changes in PrEP awareness, knowledge, willingness to take PrEP, and/or PrEP literacy following initiation of the campaigns. In data from four sites, PrEP awareness significantly increased from 72 % at baseline to 86 % at mid-project, and to 90 % post-campaigns. The campaigns illustrate the importance of partnerships and stakeholder engagement, audience segmentation, and intentional evaluation planning. As PrEP services mature, evaluating PrEP demand and PrEP use resulting from campaigns, will be necessary. Also, future campaigns for racial/ethnic and sexual and gender minorities should identify the best channels to reach each group based on their input, disaggregate data by priority group, and determine campaign effectiveness.

The Influence of Active Hamstring Stiffness on Markers of Isotonic Muscle Performance.

BACKGROUND: Previous research demonstrates hamstring muscle-tendon stiffness (HMTS) influences isometric strength, landing biomechanics and architectural tissue properties. However, the influence on kinetics & kinematics during other modes of strength testing (isotonic dynamometry) has yet to be established. PURPOSE: Investigate how HMTS influences kinetics and kinematics during a novel isotonic muscle performance test which has never been done for the hamstrings. Previous work using dynamometry has been limited to isometric or isokinetic contractions, so the novelty arises from our custom isotonic protocol which allows quantitative assessment of the stretch-shortening cycle. METHODS: Twenty-six recreationally active individuals (15 males, 11 females, 23.8 ± 2.5 years) completed baseline testing for anthropometry and maximum isometric hamstring strength (MVIC). At least 48 h later, subjects completed a measure of HMTS (damped oscillation technique) followed by an isotonic knee flexion test (eccentric velocity 180°/s; concentric torque 25% of MVIC). Separate linear regression models with examination of residuals were conducted between HMTS and each muscle performance variable. Standardized coefficients determined the magnitude of the relationships. RESULTS: Significance was found for all outcome variables tested. HMTS and rate of torque development demonstrated the strongest relationship followed by isotonic concentric peak torque. The weakest relationship observed was with isometric peak torque. CONCLUSIONS: These findings build off previous work quantifying HMTS by showing HMTS more strongly relates to dynamic versus static muscle testing and identifies the potential clinical utility of isotonic dynamometry.

Human Immunodeficiency Virus Prevention for People Who Use Drugs: Overview of Reviews and the ICOS of PICOS.

BACKGROUND: This article summarizes the results from systematic reviews of human immunodeficiency virus (HIV) prevention interventions for people who use drugs (PWUD). We performed an overview of reviews, meta-analysis, meta-epidemiology, and PROSPERO Registration CRD42017070117. METHODS: We conducted a comprehensive systematic literature search using the Centers for Disease Control and Prevention HIV/AIDS Prevention Research Synthesis Project database to identify quantitative systematic reviews of HIV public heath interventions with PWUD published during 2002-2017. We recombined results of US studies across reviews to quantify effects on HIV infections, continuum of HIV care, sexual risk, and 5 drug-related outcomes (sharing injection equipment, injection frequency, opioid use, general drug use, and participation in drug treatment). We conducted summary meta-analyses separately for reviews of randomized controlled trials (RCTs) and quasi-experiments. We stratified effects by 5 intervention types: behavioral-psychosocial (BPS), syringe service programs (SSP), opioid agonist therapy (OAT), financial and scheduling incentives (FSI), and case management (CM). RESULTS: We identified 16 eligible reviews including >140 US studies with >55 000 participants. Summary effects among US studies were significant and favorable for 4 of 5 outcomes measured under RCT (eg, reduced opioid use; odds ratio [OR] = 0.70, confidence interval [CI] = 0.56-0.89) and all 6 outcomes under quasi-experiments (eg, reduced HIV infection [OR = 0.42, CI = 0.27-0.63]; favorable continuum of HIV care [OR = 0.68, CI = 0.53-0.88]). Each intervention type showed effectiveness on 1-6 outcomes. Heterogeneity was moderate to none for RCT but moderate to high for quasi-experiments. CONCLUSIONS: Behavioral-psychosocial, SSP, OAT, FSI, and CM interventions are effective in reducing risk of HIV and sequelae of injection and other drug use, and they have a continuing role in addressing the opioid crisis and Ending the HIV Epidemic.

Growth in Proportion and Disparities of HIV PrEP Use Among Key Populations Identified in the United States National Goals: Systematic Review and Meta-analysis of Published Surveys.

BACKGROUND: Pre-exposure prophylaxis (PrEP) use among populations most vulnerable to HIV as identified in the national HIV prevention goals is not fully known. This systematic review assessed trends of lifetime self-reported PrEP use and disparities among key populations. METHODS: We used the CDC HIV/AIDS Prevention Research Synthesis cumulative database of electronic and manual searches in MEDLINE, CINAHL, EMBASE, and PsycINFO from 2000 to 2019 to identify English-language primary studies reporting PrEP use. Two reviewers independently screened citations, extracted data, and assessed the risk of bias with the modified Newcastle-Ottawa Scale. We estimated pooled proportions and crude/adjusted odds ratio. RESULTS: We identified 95 eligible studies including 95,854 US-based survey respondents. A few studies (6.3%) focused on persons who inject drugs. In 2015-2017, men who have sex with men (MSM) had highest proportion of individuals who used PrEP over their lifetime [13.9% (95% confidence interval: 8.8 to 21.1), k (number of surveys) = 49] followed by Hispanic/Latinos [11.5 (7.1 to 18.1), 12], transgender women [11.2 (5.8 to 20.6), 5], and blacks [9.9 (8.3 to 11.8), 18]. Odds of PrEP use increased by 34%/year [odds ratio = 1.34/year (95% confidence interval: 1.09 to 1.64)] and significantly increased over time among MSM [1.53/year (1.21-1.93)] and blacks [1.44 (1.13-1.83)]. People in the Southern United States [9.9 (4.7-19.7), 8] and youth [7.3 (4.7-11.2), 8] had lower rates and did not demonstrate growth [0.94 (0.29-3.18); 0.82 (0.43-1.55)]. Odds of reporting lifetime PrEP use was twice [2.07 (1.27-3.38)] as great among MSM than non-MSM. CONCLUSIONS: Proportions of PrEP use in published surveys have been growing, but remain low for people in the Southern United States and youth, and understudied in persons who inject drugs. Limitations include few studies in certain years, whereas strengths include a large number of respondents. Culturally tailored approaches targeting vulnerable populations are essential in increasing PrEP use to reduce disparities in HIV acquisition.

Orthopaedic Faculty and Resident Racial/Ethnic Diversity is Associated With the Orthopaedic Application Rate Among Underrepresented Minority Medical Students.

INTRODUCTION: Orthopaedic surgery is among the least diverse fields in all of medicine. To promote the recruitment of minorities, a commonly proposed strategy is to increase the exposure of minority medical students to orthopaedic surgeons and residents who are minorities themselves. This study examines the degree to which the racial/ethnic diversity of the orthopaedic faculty and residency program influences underrepresented in medicine (URM) medical students at that institution to pursue a career in orthopaedics. METHODS: Using data provided by the Association of American Medical Colleges, we identified all US medical schools that were affiliated with an orthopaedic department and an orthopaedic residency program (n = 110). For each institution, data were collected on URM representation among the orthopaedic faculty and residents (2013 to 2017), as well as the proportion of URM medical students who applied to an orthopaedic residency program (2014 to 2018). The association between institutional factors and the URM medical student orthopaedic application rate was then assessed. RESULTS: Of 11,887 URM students who graduated from medical school during the 5-year study period, 647 applied to an orthopaedic residency program (5.4%). URM students who attended medical school at institutions with high URM representation on the orthopaedic faculty were more likely to apply in orthopaedics (odds ratio 1.27, 95% confidence interval 1.04 to 1.55, P = 0.020), as were URM students at institutions with high URM representation in the residency program (odds ratio 1.45, 95% confidence interval 1.17 to 1.79, P < 0.001). DISCUSSION: The benefits of a diverse orthopaedic workforce are widely acknowledged. In this study, we found that increased URM representation among the orthopaedic faculty and residents was associated with a greater likelihood that URM medical students at that institution would apply in orthopaedics. We also suggest a set of strategies to break the cycle and promote the recruitment of minorities into the field of orthopaedic surgery.

Effects of medicine ball mass on the intensity of 90°/90° plyometric throwing exercise.

OBJECTIVES: To quantify the effects of medicine ball mass (1 kg, 1.5 kg, 2 kg) on the intensity of 90°/90° plyometric throwing exercise. STUDY DESIGN: Controlled laboratory study. SETTING: Biomechanics laboratory. PARTICIPANTS: Fifteen physically active collegiate aged men. MAIN OUTCOME MEASURES: Kinematics of the upper extremity were collected during completion of eight to ten repetitions of 90°/90° plyometric throwing exercise with three different mass medicine balls. Four parameters, medicine ball release and contact momentum, time-to-rebound, and contact time, were computed for each selected repetition and used for statistical analysis. RESULTS: Ball mass did not significantly influence time-to-rebound (P = .718) and had a small (less than 0.05s) effect on ball contact time (P = .039). Ball release momentum was significantly greater (P < .001, 67-123% greater) than ball contact momentum. Medicine ball mass significantly increased both ball release (34-35%) and ball contact (45-67%) momentum however the effect was significantly greater for ball release momentum (P = .005). CONCLUSIONS: These results document the effects of increasing medicine ball mass during 90°/90° plyometric throwing exercise and provide evidence for designing upper extremity plyometric training programs. Based on ball contact momentum being less than ball release momentum, as well as ball mass having greater influence on ball release velocity, we suggest that 90°/90° plyometric throwing exercise is a safe exercise.

Effect of a Community-Level HIV Prevention Intervention on Psychosocial Determinants of HIV Risk Behaviors among Young Black Men Who Have Sex with Men (YBMSM).

In contrast to intervention studies that assess psychosocial factors only as mediators or moderators of HIV risk, the present study assessed the effects of an Mpowerment-based community-level intervention on psychosocial determinants (e.g., depressive symptoms, sexual stigma) of HIV risk behavior among young black MSM. Approximately 330 respondents were surveyed annually for 4 years in each of two sites. General linear models examined change across time between the intervention and comparison communities, and participation effects in the intervention site. Social diffusion (spreading information within networks) of safer sex messages (p < 0.01) and comfort with being gay (p < 0.05) increased with time in intervention versus control. Cross-sectionally, intervention participants responded more favorably (p < 0.05) on social diffusion and depressive symptoms, but less favorably (p < 0.01) on sex in difficult situations and attitudes toward condom use. Findings suggest a need to address broader health issues of MSM as well as sexual risk.

A Bilateral Comparison of the Underlying Mechanics Contributing to the Seated Single-Arm Shot-Put Functional Performance Test.

CONTEXT: Functional performance tests (FPTs) are tools used to assess dynamic muscle strength and power. In contrast to the lower extremity, fewer FPTs are available for the upper extremity. The seated single-arm shot put test has the potential to fill the void in upper extremity FPTs; however, the underlying mechanics have not been examined and, therefore, the validity of bilateral comparisons is unknown. OBJECTIVE: To examine the effects of upper extremity dominance and medicine-ball mass on the underlying mechanics of the seated single-arm shot put. DESIGN: Crossover study. SETTING: Biomechanics laboratory. PATIENTS OR OTHER PARTICIPANTS: Fifteen women (age = 23.6 ± 2.1 years, height = 1.65 ± .07 m, mass = 68.1 ± 11.7 kg) and 15 men (age = 24.3 ± 4.0 years, height = 1.80 ± 0.06 m, mass = 88.1 ± 16.4 kg), all healthy and physically active. INTERVENTION(S): Seated single-arm shot-put trials using the dominant and nondominant limbs were completed using three 0.114-m-diameter medicine-ball loads (1 kg, 2 kg, 3 kg). MAIN OUTCOME MEASURE(S): Customized touch-sensitive gloves, synchronized with kinematic data of the hands, signaled ball release, so that release height, release angle, and peak anterior and vertical velocity could be quantified for each trial. In addition, the horizontal range from release to first floor impact was recorded. RESULTS: The dominant-limb horizontal ranges were 7% to 11% greater ( P < .001) than for the nondominant limb for each of the 3 ball masses. No bilateral release-height or -angle differences were revealed ( P ≥ .063). Release velocities were 7.6% greater for the dominant limb than the nondominant limb ( P = .001). CONCLUSIONS: Our results support the use of the seated single-arm shot put test as a way to compare bilateral upper extremity functional performance. The near-identical release heights and angles between the dominant and nondominant limbs support the interpretation of measured bilateral horizontal-range differences as reflecting underlying strength and power differences.

Increasing prevalence of self-reported HIV preexposure prophylaxis use in published surveys: a systematic review and meta-analysis.

: When combining results from all published surveys, about one in nine global study participants (10.7%) reported ever using preexposure prophylaxis (PrEP) by 2017, a significant increase since US FDA approval in 2012 [odds ratio (OR) = 1.6/year, P < 0.00001]. Moreover, nearly one in six US-based study participants (17.3%) and nearly one in four MSM who met the Centers for Disease Control and Prevention's PrEP indications (24.5%) reported ever using PrEP by 2016. The odds of reporting PrEP use are approximately doubling each year (OR = 1.8/year, P < 0.00001; OR = 2.0/year, P < 0.00001).

Per-partner condom effectiveness against HIV for men who have sex with men.

OBJECTIVE: Few studies have examined condom effectiveness for HIV prevention among MSM. We estimated condom effectiveness per partner in four cohorts of MSM during 1993-2003 (JumpStart, Vaccine Preparedness Study, VAX004 and Project Explore). METHODS: We used logistic regression to estimate the increase in odds of new HIV infection per HIV-positive partner for condom-protected receptive anal intercourse (PRAI; partners with whom condoms were always used) and condomless (unprotected) receptive anal intercourse (URAI; partners with whom condoms were sometimes or never used). To estimate condom effectiveness for preventing HIV transmission, we applied the concept of excess odds, the odds ratio minus 1. The condom failure rate was estimated as the excess odds per PRAI partner divided by the excess odds per URAI partner. Condom effectiveness was then 1 minus the failure rate. RESULTS: The excess odds of HIV infection per HIV-positive partner were 83% for URAI and 7% for PRAI. The resulting failure rate (9%) indicated per-partner condom effectiveness of 91% (95% confidence interval 69-101). CONCLUSION: The increase in odds of new HIV infection per HIV-positive partner for receptive anal intercourse was reduced by 91% for each partner with whom condoms were always used.

Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis.

HIV testing is the gateway into both prevention and treatment services. It is important to understand how men who have sex with men (MSM) perceive HIV self-tests. We conducted focus groups and individual interviews to collect feedback on two HIV self-tests, and on a dried blood spot (DBS) specimen collection kit. Perceptions and attitudes around HIV self-testing (HIVST), and willingness to distribute HIV self-tests to others were assessed. MSM reported HIVST to be complementary to facility-based testing, and liked this approach because it offers privacy and convenience, does not require counseling, and could lead to linkage to care. However, they also had concerns around the accuracy of HIV self-tests, their cost, and receiving a positive test result without immediate access to follow-up services. Despite these issues, they perceived HIVST as a positive addition to their HIV prevention toolbox.

The Role of the Primary Romantic Relationship in HIV Care Engagement Outcomes Among Young HIV-Positive Black Men Who Have Sex with Men.

The primary romantic relationship plays a fundamental role in health maintenance, but little is known about its role in HIV care engagement among young Black men who have sex with men (MSM) living with HIV. We examined how HIV care engagement outcomes (i.e., having a primary healthcare provider, receiving HIV treatment, taking antiretroviral medication, and medication adherence) vary by partnership status (single vs. concordant-positive vs. discordant) in a sample of young Black MSM living with HIV. Results showed mixed findings. Partnership status was significantly associated with HIV care engagement, even after adjusting for individual, social, and structural factors. While partnered men were consistently more likely than their single counterparts to have a regular healthcare provider, to receive recent treatment, and to have ever taken antiretroviral medication, they were less likely to report currently receiving antiretroviral therapy. Moreover, men with a discordant partner reported better adherence compared to men with a concordant or no partner. The association between partnership status and HIV care engagement outcomes was not consistent across the stages of the HIV Care Continuum, highlighting the complexity in how and why young Black men living with HIV engage in HIV healthcare. Given the social context of HIV disease management, more research is needed to explicate underlying mechanisms involved in HIV care and treatment that differ by relational factors for young Black MSM living with HIV.

Structural Interventions in HIV Prevention: A Taxonomy and Descriptive Systematic Review.

One of the four national HIV prevention goals is to incorporate combinations of effective, evidence-based approaches to prevent HIV infection. In fields of public health, techniques that alter environment and affect choice options are effective. Structural approaches may be effective in preventing HIV infection. Existing frameworks for structural interventions were lacking in breadth and/or depth. We conducted a systematic review and searched CDC's HIV/AIDS Prevention Research Synthesis Project's database for relevant interventions during 1988-2013. We used an iterative process to develop the taxonomy. We identified 213 structural interventions: Access (65%), Policy/Procedure (32%), Mass Media (29%), Physical Structure (27%), Capacity Building (24%), Community Mobilization (9%), and Social Determinants of Health (8%). Forty percent targeted high-risk populations (e.g., people who inject drugs [12%]). This paper describes a comprehensive, well-defined taxonomy of structural interventions with 7 categories and 20 subcategories. The taxonomy accommodated all interventions identified.

Generation and characterization of new alleles of quiver (qvr) that encodes an extracellular modulator of the Shaker potassium channel.

Our earlier genetic screen uncovered a paraquat-sensitive leg-shaking mutant quiver1 (qvr1), whose gene product interacts with the Shaker (Sh) K+ channel. We also mapped the qvr locus to EY04063 and noticed altered day-night activity patterns in these mutants. Such circadian behavioral defects were independently reported by another group, who employed the qvr1 allele we supplied them, and attributed the extreme restless phenotype of EY04063 to the qvr gene. However, their report adopted a new noncanonical gene name sleepless (sss) for qvr. In addition to qvr1 and qvrEY, our continuous effort since the early 2000s generated a number of novel recessive qvr alleles, including ethyl methanesulfonate (EMS)-induced mutations qvr2 and qvr3, and P-element excision lines qvrip6 (imprecise jumpout), qvrrv7, and qvrrv9 (revertants) derived from qvrEY. Distinct from the original intron-located qvr1 allele that generates abnormal-sized mRNAs, qvr2, and qvr3 had their lesion sites in exons 6 and 7, respectively, producing nearly normal-sized mRNA products. A set of RNA-editing sites are nearby the lesion sites of qvr3 and qvrEY on exon 7. Except for the revertants, all qvr alleles display a clear ether-induced leg-shaking phenotype just like Sh, and weakened climbing abilities to varying degrees. Unlike Sh, all shaking qvr alleles (except for qvrf01257) displayed a unique activity-dependent enhancement in excitatory junction potentials (EJPs) at larval neuromuscular junctions (NMJs) at very low stimulus frequencies, with qvrEY displaying the largest EJP and more significant NMJ overgrowth than other alleles. Our detailed characterization of a collection of qvr alleles helps to establish links between novel molecular lesions and different behavioral and physiological consequences, revealing how modifications of the qvr gene lead to a wide spectrum of phenotypes, including neuromuscular hyperexcitability, defective motor ability and activity-rest cycles.