The development and implementation of a proficiency testing program for SARS-CoV-2 using dried tube specimens in resource-limited countries.

INTRODUCTION: When COVID-19 hit the world in 2019, an enhanced focus on diagnostic testing for SARS-CoV-2 was essential for a successful pandemic response. Testing laboratories stretched their capabilities for the new coronavirus by adopting different test methods. The necessity of having external quality assurance (EQA) mechanisms was even more critical due to this rapid expansion. However, there was a lack of experience in providing the necessary SARS-CoV-2 EQA materials, especially in locations with constrained resources. OBJECTIVE: We aimed to create a PT (Proficiency testing) programme based on the Dried Tube Specimens (DTS) method that would be a practical option for molecular based SARS-CoV-2 EQA in Low- and Middle-Income Countries. METHODS: Based on previous ISO/IEC 17043:2010 accreditation experiences and with assistance from the US Centers for Disease Control and Prevention, The Supranational Reference Laboratory of Uganda (adapted the DTS sample preparation method and completed a pilot EQA program between 2020 and 2021. Stability and panel validation testing was conducted on the designed materials before shipping to pilot participants in six African countries. Participants received a panel containing five SARS-CoV-2 DTS samples, transported at ambient conditions. Results submitted by participants were compared to validation results. Participants were graded as satisfactory (≥ 80%) or unsatisfactory (< 80%) and performance reports disseminated. RESULTS: Our SARS-CoV-2 stability experiments showed that SARS-CoV-2 RNA was stable (-15 to -25 °C, 4 to 8 °C, (18 to 28 °C) room temperature and 35 to 38 °C) as well as DTS panels (4 to 8 °C, 18 to 28 °C, 35 to 38 °C and 45 °C) for a period of 4 weeks. The SARS-CoV-2 DTS panels were successfully piloted in 35 test sites from Zambia, Malawi, Mozambique, Nigeria, and Seychelles. The pilot results of the participants showed good accuracy, with an average of 86% (30/35) concordance with the original SARS CoV-2 expectations. CONCLUSION: The SARS-CoV-2 DTS PT panel is reliable, stable at ambient temperature, simple to prepare and requires minimal resources.

Pelvic Floor Disorders Among U.S. Military Active-Duty Females.

IMPORTANCE: Women are a growing cohort within the U.S. military. Pelvic floor health is a component of health maintenance for which support needs vary by sex. The American Journal of Obstetrics & Gynecology reports that 1 in 4 women is affected by moderate to severe pelvic floor dysfunction (PFD). Understanding the specific experience of female service members is warranted for health care optimization and preservation of force readiness. OBJECTIVE: We aimed to identify the prevalence, incidence, and risk factors associated with incident PFD in active-duty females during an 11-year window. STUDY DESIGN: We used the Medical Assessment and Readiness System at Womack Army Medical Center, which includes medical record and personnel data from 2011 to 2022. Pelvic floor dysfunction diagnoses were identified using diagnosis codes and analyzed with respect to demographic parameters. RESULTS: Between 2011 and 2022, 32,996 of 550,303 active-duty females were diagnosed with PFD (period prevalence: 6.00%). Using 2011-2012 as a washout period, 27,046 of 486,558 participants were diagnosed during 1,879,990.90 person-years of follow-up (incidence rate: 14.39 cases per 1,000 person-years). The incidence rate of PFD increased in both new and established active-duty females. Increasing time since service entry was the strongest, statistically significant independent predictor of PFD. Three or more deployments and specific physical fitness scoring were also predictors of PFD. CONCLUSIONS: The incidence rate of PFD among female service members is increasing, and multiple military-specific factors predict PFD. As the percentage of women in active-duty service continues to grow, additional investigation is needed to confirm PFD trends, illuminate other predictors, and prevent adverse outcomes.

Transplantation: platform to study recurrence of disease.

Beyond the direct benefit that a transplanted organ provides to an individual recipient, the study of the transplant process has the potential to create a better understanding of the pathogenesis, etiology, progression and possible therapy for recurrence of disease after transplantation while at the same time providing insight into the original disease. Specific examples of this include: 1) recurrence of focal segmental glomerulosclerosis (FSGS) after kidney transplantation, 2) recurrent autoimmunity after pancreas transplantation, and 3) recurrence of disease after orthotopic liver transplantation (OLT) for cirrhosis related to progressive steatosis secondary to jejuno-ileal bypass (JIB) surgery. Our team has been studying these phenomena and their immunologic underpinnings, and we suggest that expanding the concept to other pathologic processes and/or transplanted organs that harbor the risk for recurrent disease may provide novel insight into the pathogenesis of a host of other disease processes that lead to organ failure.

Impact of Acute Alcohol Consumption on Sexuality: A Look at Psychological Mechanisms.

Alcohol's link with sexuality is long-standing and prominent. While research continues to document robust associations between drinking and sexual behavior, attention now centers primarily on evaluating mechanisms and attendant theoretical frameworks to advance our understanding of how alcohol exerts a causal impact. We describe four domains with reliable evidence of alcohol effects: sexualized social perceptions, sexual arousal, sexual risk taking, and sexual assault. We consider three contextual frames: distal factors associated with encountering opportunities for alcohol-involved sex, proximal factors associated with alcohol's acute effects, and distal-proximal interactions. We then examine the empirical support for mechanisms embedded within four theoretical frameworks: alcohol disinhibition, alcohol expectancy, alcohol myopia, and emotion regulation. Support for disinhibition mechanisms is evident with sexual arousal only. Expectancy and myopia mechanisms enjoy support across domains and make up bases for integrative expectancy-myopia causal explanations. Emotion regulation mechanisms evidence preliminary support in risk taking and sexual assault. Implications and future directions are considered. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Autophagy and neuroprotection in astrocytes exposed to 6-hydroxydopamine is negatively regulated by NQO2: relevance to Parkinson's disease.

Dopaminergic degeneration is a central feature of Parkinson's disease (PD), but glial dysfunction may accelerate or trigger neuronal death. In fact, astrocytes play a key role in the maintenance of the blood-brain barrier and detoxification. 6-hydroxydopamine (6OHDA) is used to induce PD in rodent models due to its specific toxicity to dopaminergic neurons, but its effect on astrocytes has been poorly investigated. Here, we show that 6OHDA dose-dependently impairs autophagy in human U373 cells and primary murine astrocytes in the absence of cell death. LC3II downregulation was observed 6 to 48 h after treatment. Interestingly, 6OHDA enhanced NRH:quinone oxidoreductase 2 (NQO2) expression and activity in U373 cells, even if 6OHDA turned out not to be its substrate. Autophagic flux was restored by inhibition of NQO2 with S29434, which correlated with a partial reduction in oxidative stress in response to 6OHDA in human and murine astrocytes. NQO2 inhibition also increased the neuroprotective capability of U373 cells, since S29434 protected dopaminergic SHSY5Y cells from 6OHDA-induced cell death when cocultured with astrocytes. The toxic effects of 6OHDA on autophagy were attenuated by silencing NQO2 in human cells and primary astrocytes from NQO2-/- mice. Finally, the analysis of Gene Expression Omnibus datasets showed elevated NQO2 gene expression in the blood cells of early-stage PD patients. These data support a toxifying function of NQO2 in dopaminergic degeneration via negative regulation of autophagy and neuroprotection in astrocytes, suggesting a potential pharmacological target in PD.

GM-Ledger: Blockchain-Based Certificate Authentication for International Food Trade.

Maritime transportation plays a critical role for many Arab countries and their food security and has evolved into a complex system that involves a plethora of supply chain stakeholders spread around the globe. This inherent complexity brings huge security challenges, including cargo loss and high burdens in cargo document inspection. The emerging blockchain technology provides a promising tool to build a unified maritime cargo tracking system critical for cargo security. This is because blockchains are a tamper-proof distributed ledger technology that can store and track data in a secure and transparent manner. Using the State of Qatar as a case study, this research introduces the Global Maritime Ledger (GM-Ledger), which will aid authorities in verifying, signing and transacting food certificates in an efficient manner. The methodology of this research includes reviewing past publications, identifying the requirements of various players in the Qatari food import-export industry and then creating a smart contract framework that will efficiently manage the work with necessary human intervention as and when required. The result of this work is the formation of a solid framework that can be employed in future works. This work realized that employing web3 solutions for the food import sector is highly viable and that with the right social, economic and policy reforms, it is possible to transform the entire food system to bear healthy transparency and power balance in global supply chains. In conclusion, this study argues that BCT has the ability to assist the government and other players to minimize fraud and maximize food supply chain stakeholder participation.

Immune imprinting and next-generation coronavirus vaccines.

Vaccines based on historical virus isolates provide limited protection from continuously evolving RNA viruses, such as influenza viruses or coronaviruses, which occasionally spill over between animals and humans. Despite repeated booster immunizations, population-wide declines in the neutralization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have occurred. This has been compared to seasonal influenza vaccinations in humans, where the breadth of immune responses induced by repeat exposures to antigenically distinct influenza viruses is confounded by pre-existing immunity-a mechanism known as imprinting. Since its emergence, SARS-CoV-2 has evolved in a population with partial immunity, acquired by infection, vaccination or both. Here we critically examine the evidence for and against immune imprinting in host humoral responses to SARS-CoV-2 and its implications for coronavirus disease 2019 (COVID-19) booster vaccine programmes.

AirQo sensor kit: A particulate matter air quality sensing kit custom designed for low-resource settings.

Air pollution remains a major public health risk. People living in urban spaces are among those most affected by exposure to unhealthy levels of air pollution. However, many urban spaces especially in low- and middle-income countries lack high resolution and long-term data on the state of air quality. Without high resolution air quality data on the different spaces in a city, citizens and authorities are unable to quantify the challenge and act. This is in part attributed to the high cost of air quality monitoring equipment that are expensive to set up, maintain and not designed for local operating conditions that characterise environments in such contexts. In this paper, we describe AirQo sensor kit, a low-cost sensing hardware system designed for and custom made to work in low-resource settings and outdoor urban environments. We describe the design of the air quality sensing device, 3D-printed enclosure, installation-mount, fabrication and deployment configurations. We demonstrate that the low-cost sensing hardware provides a complete solution comparable to the traditional monitoring system and inspires action to tackle air pollution issues. The sensor kit presented in this paper has been widely deployed in cities in Eastern, Western and Central African countries.

A computationally designed antigen eliciting broad humoral responses against SARS-CoV-2 and related sarbecoviruses.

The threat of spillovers of coronaviruses associated with the severe acute respiratory syndrome (SARS) from animals to humans necessitates vaccines that offer broader protection from sarbecoviruses. By leveraging a viral-genome-informed computational method for selecting immune-optimized and structurally engineered antigens, here we show that a single antigen based on the receptor binding domain of the spike protein of sarbecoviruses elicits broad humoral responses against SARS-CoV-1, SARS-CoV-2, WIV16 and RaTG13 in mice, rabbits and guinea pigs. When administered as a DNA immunogen or by a vector based on a modified vaccinia virus Ankara, the optimized antigen induced vaccine protection from the Delta variant of SARS-CoV-2 in mice genetically engineered to express angiotensin-converting enzyme 2 and primed by a viral-vector vaccine (AZD1222) against SARS-CoV-2. A vaccine formulation incorporating mRNA coding for the optimized antigen further validated its broad immunogenicity. Vaccines that elicit broad immune responses across subgroups of coronaviruses may counteract the threat of zoonotic spillovers of betacoronaviruses.

Sexual Decision Making When Intoxicated: Women's Reasons for and Against Having Sex in a Laboratory-Based Scenario.

Young adult women report high condom use intentions, but inconsistent condom use. Cognitive appraisals during sexual encounters are important determinants of condom use decisions, but a nuanced understanding of what cognitions emerge during women's "hot states" (e.g., sexual arousal, alcohol intoxication) remains lacking. To address this gap, we examined women's heat of the moment cognitions in their own words using mixed methods. Young adult women (N = 503; Mage = 25.01, SDage = 2.66) were randomized to a beverage condition (alcohol or control), then read and responded to questions about an eroticized sexual scenario. The nature and strength of reasons for and against having sex were reported before and after learning no condom was available. Multilevel models revealed intoxicated participants were more likely to let the partner decide how far to go sexually than sober participants at both timepoints, but the strength of cognitive appraisals (reasons for, reasons against, and feeling conflicted) only differed between beverage conditions after knowledge of no condom. These results suggest alcohol myopia was evident in the presence of inhibition conflict. Content analysis of these reasons revealed multifaceted cognitions that changed upon learning there was no condom. Findings highlight cognitions to target through interventions and underscore the importance of both alcohol and situational context in decision making.

Evaluation of Xpert MTB/XDR test for susceptibility testing of Mycobacterium tuberculosis to first and second-line drugs in Uganda.

BACKGROUND: Drug-Resistant Tuberculosis (DR-TB) is one of the major challenges to TB control. DESIGN AND METHODS: This was a blinded, laboratory-based cross-sectional study using sputum samples or culture isolates. Samples were from patients with rifampicin-resistant-TB and/or with high risk for isoniazid (INH) resistance and/or 2nd line fluoroquinolones (FQ) and injectable agents (IAs). The diagnostic accuracy of the Xpert® MTB/XDR test was compared to MGIT960 and the Hain Genotype® MTBDRplus and MDRsl assays (LPA) as reference DST methods. Factors for laboratory uptake of the Xpert® MTB/XDR test were also evaluated. RESULTS: Of the 100 stored sputum samples included in this study, 65/99 (65.6%) were resistant to INH, 5/100 (5.0%) were resistant to FQ and none were resistant to IAs using MGIT960. The sensitivity and specificity, n (%; 95% Confidence Interval, CI) of Xpert® MTB/XDR test for; INH was 58 (89.2; 79.1-95.5) and 30 (88.2; 72.5-96.6) and for FQ; 4 (80.0; 28.3-99.4) and 95 (100; 96.2-100), respectively. Using LPA as a reference standard, a total of 52/98 (53.1%) were resistant to INH, 3/100 (3.0%) to FQ, and none to IA. The sensitivity and specificity, n (%; 95%CI) of Xpert® MTB/XDR test compared to LPA for; INH was 50 (96.1; 86.7-99.5) and 34 (74.0; 58.8-85.7) for FQ 3 (100; 29.2-100) and 96 (99.0; 94.3-99.9) respectively. The factors for laboratory uptake and roll-out of the Xpert® MTB/XDR test included: no training needed for technicians with, and one day for those without, previous Xpert-ultra experience, recording and reporting needs were not different from those of Xpert-ultra, the error rate was 4/100 (4%), one (1%) indeterminate rate and test turn-around-time were 1hr/45 minutes. CONCLUSION: There is high sensitivity and specificity of Xpert® MTB/XDR test for isoniazid and fluoroquinolones. There are acceptable Xpert® MTB/XDR test attributes for the test uptake and roll-out.

Ticks and tick-borne microbes identified through passive and active surveillance in Alaska.

Rapid environmental change in Alaska and other regions of the Arctic and sub-Arctic has raised concerns about increasing human exposure to ticks and the pathogens they carry. We tested a sample of ticks collected through a combination of passive and active surveillance from humans, domestic animals, and wildlife hosts in Alaska for a panel of the most common tick-borne pathogens in the contiguous United States to characterize the diversity of microbes present in this region. We tested 189 pooled tick samples collected in 2019-2020 for Borrelia spp., Anaplasma spp., Ehrlichia spp., and Babesia spp. using a multiplex PCR amplicon sequencing assay. We found established populations of Ixodes angustus Neumann (Acari: Ixodidae), Ixodes uriae White (Acari: Ixodidae), and Haemaphysalis leporispalustris Packard (Acari: Ixodidae) in Alaska, with I. angustus found on a variety of hosts including domestic companion animals (dogs and cats), small wild mammals, and humans. Ixodes angustus were active from April through October with peaks in adult and nymphal activity observed in summer months (mainly July). Although no known human pathogens were detected, Babesia microti-like parasites and candidatus Ehrlichia khabarensis were identified in ticks and small mammals. The only human pathogen detected (B. burgdorferi s.s.) was found in a tick associated with a dog that had recently traveled to New York, where Lyme disease is endemic. This study highlights the value of a combined passive and active tick surveillance system to detect introduced tick species and pathogens and to assess which tick species and microbes are locally established.

A Pilot Single-Blinded, Randomized, Controlled Trial Comparing BNT162b2 vs. JNJ-78436735 Vaccine as the Third Dose After Two Doses of BNT162b2 Vaccine in Solid Organ Transplant Recipients.

Solid Organ Transplant (SOT) recipients are at significant higher risk for COVID-19 and due to immunosuppressive medication, the immunogenicity after vaccination is suboptimal. In the previous studies, booster method showed significant benefit in this population. In the current study, we compared using a mix-and-match method vs. same vaccine as a third dose in SOT recipients. This was a patient-blinded, single center, randomized controlled trial comparing BNT162b2 vs. JNJ-78436735 vaccine as the third dose after two doses of BNT162b2 vaccine. We included adult SOT recipients with functional graft who had received two doses of BNT162b2 vaccine. Participants were randomly assigned to receive either BNT162b2 or JNJ-78436735 in one-to-one ratio. Primary outcome was SARS-CoV-2 IgG positivity at 1 month after the third dose. Sixty SOT recipients, including 36 kidney, 12 liver, 2 lung, 3 heart, and 5 combined transplants, were enrolled, and 57 recipients were analyzed per protocol. There were no statistically significant differences between the two vaccine protocols for IgG positivity (83.3% vs. 85.2% for BNT162b2 and JNJ-78436735, respectively, p = 0.85, Odds Ratio 0.95, 95% Confidence Interval 0.23-4.00). Comparison of the geometric mean titer demonstrated a higher trend with BNT162b2 (p = 0.09). In this pilot randomized controlled trial comparing mix and match method vs. uniform vaccination in SOT recipients, both vaccines were safely used. Since this was a small sample sized study, there was no statistically significant difference in immunogenicity; though, the mix and match method showed relatively lower geometric mean titer, as compared to uniform vaccine. Further studies need to be conducted to determine duration of this immunogenicity. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05047640?term=20210641&draw=2&rank=1, identifier 20210641.

Influence of land-sea breeze on PM[Formula: see text] prediction in central and southern Taiwan using composite neural network.

PM[Formula: see text] prediction plays an important role for governments in establishing policies to control the emission of excessive atmospheric pollutants to protect the health of citizens. However, traditional machine learning methods that use data collected from ground-level monitoring stations have reached their limit with poor model generalization and insufficient data. We propose a composite neural network trained with aerosol optical depth (AOD) and weather data collected from satellites, as well as interpolated ocean wind features. We investigate the model outputs of different components of the composite neural network, concluding that the proposed composite neural network architecture yields significant improvements in overall performance compared to each component and the ensemble model benchmarks. The monthly analysis also demonstrates the superiority of the proposed architecture for stations where land-sea breezes frequently occur in the southern and central Taiwan in the months when land-sea breeze dominates the accumulation of PM[Formula: see text].

Advancing proficiency testing for ultra in resource-limited settings using dried tube specimen: A study by SRL-Uganda.

BACKGROUND: Proficiency testing (PT) has been hard to set up due to cost limitations and technical capacity. Conventional Xpert MTB/RIF PT programs use liquid and culture spots which require stringent storage and transportation conditions with cross-contamination chances prevalent. These setbacks prompted the use of dried tube specimens (DTS) for Ultra assay PT. For continuity of PT provision, stability of DTS and compatibility with testing protocols when kept for a long period needs to be established. METHODS: DTS were prepared from known isolates inactivated using a hot air oven at 85°C. 100µl of bacterial suspensions were aliquoted and dried inside a Biosafety cabinet. Panel validation was done to establish the baseline Deoxyribonucleic acid (DNA) concentration in terms of cycle threshold (Ct) value. DTS aliquots were shipped to participants to test and report within six weeks. The remaining DTS were kept at 2-8°C and room temperature for one year with testing at six months. Twenty (20) DTS samples per set remaining at one year were heated at 55°C for two weeks before testing. The means of the different samples were compared to validation data using paired t-tests. Boxplots were designed to visualize the differences in the medians of the DTS. RESULTS: Overall mean Ct value increased by 4.4 from the validation to testing after one year at the different storage conditions. Samples heated at 55°C showed a 6.4 Ct difference from validation data. Testing done at six months on 2-8°C stored items showed no statistical difference. At all the remaining testing times and conditions, P-values were less than 0.008 although the absolute mean Ct when compared showed slight increments and accommodated differences for the detection of MTB and rifampicin resistance. Median values for samples stored at 2-8°C were lower compared to those at room temperature. CONCLUSION: DTS stored at 2-8°C remain more stable for one year compared to higher temperatures and can be consistently used as PT materials in more than one PT round for biannual PT providers.

Using satellite data on remote transportation of air pollutants for PM2.5 prediction in northern Taiwan.

Accurate PM2.5 prediction is part of the fight against air pollution that helps governments to manage environmental policy. Satellite Remote sensing aerosol optical depth (AOD) processed by The Multi-Angle Implementation of Atmospheric Correlation (MAIAC) algorithm allows us to observe the transportation of remote pollutants between regions. The paper proposes a composite neural network model, the Remote Transported Pollutants (RTP) model, for such long-range pollutant transportation that predicts more accurate local PM2.5 concentrations given such satellite data. The proposed RTP model integrates several deep learning components and learns from the heterogeneous features of various domains. We also detected remote transportation pollution events (RTPEs) at two reference sites from the AOD data. Extensive experiments using real-world data show that the proposed RTP model outperforms the base model that does not account for RTPEs by 17%-30%, 23%-26% and 18%-22% and state-of-the-art models that account for RTPEs by 12%-22%, 12%-14%, and 10%-11% at +4h to +24h, +28h to +48 hours, and +52h to +72h hours respectively.

Factors associated with severity and anatomical distribution of diabetic foot ulcer in Uganda: a multicenter cross-sectional study.

BACKGROUND: Diabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) that is associated with increased mortality, morbidity, amputation rate and economic burden. This study aimed at identifying the anatomical distribution and factors associated with severity of DFU in Uganda. METHODOLOGY: This was a multicenter cross-sectional study conducted in seven selected referral hospitals in Uganda. A total of 117 patients with DFU were enrolled in this study between November 2021 and January 2022. Descriptive analysis and modified Poisson regression analysis were performed at 95% confidence interval; factors with p-value < 0.2 at bivariate analysis were considered for multivariate analysis. RESULTS: The right foot was affected in 47.9% (n = 56) of patients, 44.4% (n = 52) had the DFU on the plantar region of the foot and 47.9% (n = 56) had an ulcer of > 5 cm in diameter. The majority (50.4%, n = 59) of patients had one ulcer. 59.8% (n = 69) had severe DFU, 61.5% (n = 72) were female and 76.9% had uncontrolled blood sugar. The mean age in years was 57.5 (standard deviation 15.2 years). Primary (p = 0.011) and secondary (p < 0.001) school educational levels, moderate (p = 0.003) and severe visual loss (p = 0.011), 2 ulcers on one foot (p = 0.011), and eating vegetables regularly were protective against developing severe DFU (p = 0.03). Severity of DFU was 3.4 and 2.7 times more prevalent in patients with mild and moderate neuropathies (p < 0.01), respectively. Also, severity was 1.5 and 2.5 higher in patients with DFU of 5-10 cm (p = 0.047) and in those with > 10 cm diameter (p = 0.002), respectively. CONCLUSION: Most DFU were located on the right foot and on the plantar region of the foot. The anatomical location was not associated with DFU severity. Neuropathies and ulcers of > 5 cm diameter were associated with severe DFU but primary and secondary school education level and eating vegetables were protective. Early management of the precipitating factors is important to reduce the burden of DFU.

Assessment of the Impact of Early Diagnosis and Early Treatment in the Integrated Control of East Coast Fever (ECF) Involving Acquired Immunity Induced by Natural Infection in Ankole Cattle.

The integrated control of East Coast fever (ECF) by early diagnosis and treatment involving acquired immunity induced by natural infection in Ankole cattle was assessed. A longitudinal study was carried out in Kiruhura district, southwestern Uganda for six months on 244 Ankole breed of cattle from 18 herds under natural tick challenge and relaxed tick control measures. Calves aged three to six months old were recruited and monitored daily by farmers for detection of ECF clinical symptoms. The reported sick animals were treated using Buparvaquone and treatment outcome determined. Monthly follow-ups and blood collections were done to monitor ECF status. Blood was analyzed for Theileria parva parasites by microscopy, DNA by polymerase chain reaction (PCR) and antibodies by enzyme-linked immunosorbent assay (ELISA). The overall prevalence of ECF clinical disease within six months period was 30.3% (74). The major symptoms of early clinical ECF disease were fever and enlarged parotid or prescapular lymph nodes. Clinical cases were categorized as mild, 24% (18) or moderate, 76% (56). There was an overall recovery rate of 100% (74) of the ECF cases whereby 94.6% (70) recovered promptly and 5.4% (4) recovered slowly. Based on blood analysis, prevalence of ECF at baseline was 3.7% (9) by microscopy, 31.1% (76) by PCR and 38.1% (93) by ELISA. A significant increase (p < 0.05) was shown by the increased number of calves with T. parva specific antibodies in the sera from 38.1% at baseline to 68.8% after six months. High antibody levels (positive percentage ≥ 50%) were detected in all ECF-treated and recovered calves at the end of six months. The acquired immunity to ECF was high in treated and recovered cattle, indicating that natural exposure to infection, accurate early diagnosis and effective treatment enhance development of immune-protection in indigenous cattle in an endemic area. The prominent early clinical symptoms for ECF could be exploited in the development of decision support tools for chemotherapy and other integrated control measures.

The Relationship Between Alcohol and Drug Use, Compulsive Sexual Behavior, and Condomless Anal Sex in Men Who have Sex with Men: Analysis of Retrospectively-Reported Sexual Behavior.

Men who have sex with men (MSM) are disproportionately impacted by HIV in the United States, and substance use and compulsive sexual behavior (CSB) are contributors to HIV risk behavior. This study sought to examine the direct and interactive effects of concurrent substance use and CSB on condomless anal sex (CAS) in a community sample of MSM (N = 200) utilizing a 90-day timeline follow-back assessment. Results indicated CSB did not directly increase risk for CAS when controlling for substance use and age. There was limited evidence for a direct effect of concurrent alcohol use on CAS, and no evidence for an interaction effect with CSB. The relationship between concurrent drug use and CAS was moderated by CSB, such that concurrent drug use was positively associated with CAS for those who screened positive for CSB, while the association was non-significant for those who screened negative. Implications and limitations of these findings are discussed.

RESUMEN: En los Estados Unidos, los hombres que tienen sexo con hombres (HSH) se ven afectados de manera desproporcionada, por el VIH, el uso de sustancias y el comportamiento sexual compulsivo (CSB), lo que contribuye al comportamiento de riesgo del VIH. Este estudio buscó examinar los efectos directos e interactivos del uso simultáneo de sustancias y el CSB sobre el sexo anal sin condón (CAS) en una muestra comunitaria de HSH (N = 200) utilizando una evaluación de retrospectiva de 90 días. Los resultados indicaron que CSB no aumentó directamente el riesgo de CAS al controlar el uso de sustancias y la edad. Se encontró evidencia limitada de un efecto directo del consumo concurrente de alcohol sobre CAS y no se encontró evidencia de efecto de interacción con la CSB. La relación entre el uso concurrente de drogas y CAS fue moderada por CSB, de modo que el uso concurrente de drogas se asoció positivamente con CAS para aquellos que dieron positivo para CSB, mientras que la asociación no fue significativa para aquellos que dieron negativo. Se discuten las implicaciones y limitaciones de estos hallazgos.

Power-Related Emotions, Alcohol Intoxication, and Nonconsensual Sex Intentions: The Role of Fear of Intimacy.

The problem of alcohol-involved sexual assault against women highlights the need to identify how the presence of alcohol interacts with risk factors associated with sexual assault perpetration. One risk factor for sexual assault perpetration is fear of intimacy, the inhibited capacity to exchange vulnerable thoughts and emotions with a valued individual. Men who have perpetrated sexual violence report higher fear of intimacy and alcohol use than those who have not. However, little research has investigated how fear of intimacy may contribute to sexual assault perpetration in the context of alcohol intoxication. This study examined alcohol intoxication, fear of intimacy, proximal power-related emotions, and nonconsensual sex intentions. Non-monogamous, male social drinkers (N = 94) completed measures and were randomly assigned to an alcohol condition (alcohol [BrAC = .10%] versus control). Participants then read a sexual assault analogue scenario depicting sexual assault against a hypothetical woman and reported power-related emotions and nonconsensual sex intentions. Self-reported fear of intimacy differed across types of past perpetration. Results found that for intoxicated men only, fear of intimacy was positively associated with power-related emotions, and power-related emotions were positively associated with nonconsensual sex intentions. These associations were not observed for men in the control condition who did not consume alcohol. Future research should examine intimacy-related interventions for sexual assault prevention programming.