First nations people's perspectives on barriers and supports for enhancing HPV vaccination: Foundations for sustainable, community-driven strategies.

OBJECTIVE: In Canada, Indigenous people have higher human papillomavirus (HPV) infection rates, lower screening rates for cervical cancer, and higher rates of invasive cancer, leading to worse cervical cancer-related outcomes than observed in non-Indigenous Canadian women. Lingering harms from European colonization drive these health inequities and create public health challenges. Policy guidance is needed to optimize HPV vaccination rates and, thereby, decrease the burden of HPV-related illness, including high-morbidity surgical procedures and chemo-radiotherapy. The Enhancing HPV Vaccination In First Nations Populations in Alberta (EHVINA) project focuses on First Nations, a diverse subset of recognized Indigenous people in Canada, and seeks to increase HPV vaccination among girls and boys living in First Nation communities. METHODS: Developing an effective strategy requires partnership with affected communities to better understand knowledge and perceptions about cancer, healthcare, and the HPV vaccine. A 2017 community gathering was convened to engage First Nations community members, health directors, and health services researchers in dialogue around unique barriers and supports to HPV vaccination in Alberta. Voices of community Elders, parents, health directors, and cancer survivors (n=24) are presented as qualitative evidence to help inform intervention design. RESULTS: Key findings from discussions indicate barriers to HPV vaccination include resource constraints and service infrastructure gaps, historical mistrust in healthcare systems, impacts of changing modes of communication, and community sensitivities regarding sexual health promotion. Supports were identified as strengthened inter-generational relationships in communities. CONCLUSIONS AND FUTURE DIRECTION: Ongoing dialogue and co-development of community-based strategies to increase HPV vaccine uptake are required. The identification of possible barriers to HPV vaccination in a Canadian Indigenous population contributes to limited global literature on this subject and may inform researchers and policy makers who work with Indigenous populations in other regions.

Sensory integration deficits support a dimensional view of psychosis and are not limited to schizophrenia.

Visual dysfunction is commonplace in schizophrenia and occurs alongside cognitive, psychotic and affective symptoms of the disorder. Psychophysical evidence suggests that this dysfunction results from impairments in the integration of low-level neural signals into complex cortical representations, which may also be associated with symptom formation. Despite the symptoms of schizophrenia occurring in a range of disorders, the integration deficit has not been tested in broader patient populations. Moreover, it remains unclear whether such deficits generalize across other sensory modalities. The present study assessed patients with a range of psychotic and nonpsychotic disorders and healthy controls on visual contrast detection, visual motion integration, auditory tone detection and auditory tone integration. The sample comprised a total of 249 participants (schizophrenia spectrum disorder n=98; bipolar affective disorder n=35; major depression n=31; other psychiatric conditions n=31; and healthy controls n=54), of whom 178 completed one or more visual task and 71 completed auditory tasks. Compared with healthy controls and nonpsychotic patients, psychotic patients trans-diagnostically were impaired on both visual and auditory integration, but unimpaired in simple visual or auditory detection. Impairment in visual motion integration was correlated with the severity of positive symptoms, and could not be accounted for by a reduction in processing speed, inattention or medication effects. Our results demonstrate that impaired sensory integration is not specific to schizophrenia, as has previously been assumed. Instead, sensory deficits are closely related to the presence of positive symptoms independent of diagnosis. The finding that equivalent integrative sensory processing is impaired in audition is consistent with hypotheses that propose a generalized deficit of neural integration in psychotic disorders.

Revised diagnostic criteria for neurocysticercosis.

BACKGROUND: A unified set of criteria for neurocysticercosis (NCC) has helped to standardize its diagnosis in different settings. METHODS: Cysticercosis experts were convened to update current diagnostic criteria for NCC according to two principles: neuroimaging studies are essential for diagnosis, and all other information provides indirect evidence favoring the diagnosis. Recent diagnostic advances were incorporated to this revised set. RESULTS: This revised set is structured in absolute, neuroimaging and clinical/exposure criteria. Absolute criteria include: histological confirmation of parasites, evidence of subretinal cysts, and demonstration of the scolex within a cyst. Neuroimaging criteria are categorized as major (cystic lesions without scolex, enhancing lesions, multilobulated cysts, and calcifications), confirmative (resolution of cysts after cysticidal drug therapy, spontaneous resolution of single enhancing lesions, and migrating ventricular cysts on sequential neuroimaging studies) and minor (hydrocephalus and leptomeningeal enhancement). Clinical/exposure criteria include: detection of anticysticercal antibodies or cysticercal antigens by well-standardized tests, systemic cysticercosis, evidence of a household Taenia carrier, suggestive clinical manifestations, and residency in endemic areas. Besides patients having absolute criteria, definitive diagnosis can be made in those having two major neuroimaging criteria (or one major plus one confirmative criteria) plus exposure. For patients presenting with one major and one minor neuroimaging criteria plus exposure, definitive diagnosis of NCC requires the exclusion of confounding pathologies. Probable diagnosis is reserved for individuals presenting with one neuroimaging criteria plus strong evidence of exposure. CONCLUSIONS: This revised set of diagnostic criteria provides simpler definitions and may facilitate its more uniform and widespread applicability in different scenarios.

Transmission efficiency of 'Candidatus Liberibacter solanacearum' and potato zebra chip disease progress in relation to pathogen titer, vector numbers, and feeding sites.

ABSTRACT With diseases caused by vector-borne plant pathogens, acquisition and inoculation are two primary stages of the transmission, which can determine vector efficiency in spreading the pathogen. The present study was initiated to quantify acquisition and inoculation successes of 'Candidatus Liberibacter solanacearum', the etiological agent of zebra chip disease of potato, by its psyllid vector, Bactericera cockerelli (Hemiptera: Triozidae). Acquisition success was evaluated in relation to feeding site on the host plant as well as the acquisition access period. Inoculation success was evaluated in relation to vector number (1 and 4) on the plants. Acquisition success was influenced by the feeding site on the plant. The highest acquisition success occurred when insects had access to the whole plant. The results of the inoculation study indicated that the rate of successfully inoculated plants increased with the vector number. Plants inoculated with multiple psyllids had higher bacterial titer at the point of inoculation. Although disease incubation period was significantly shorter in plants inoculated with multiple psyllids, this effect was heterogeneous across experimental blocks, and was independent of pathogen quantity detected in the leaflets 3 days postinoculation. Disease progress was not affected by bacterial quantity injected or psyllid numbers.

Physiological responses of lichens to factorial fumigations with nitric acid and ozone.

This paper addresses the effects of gaseous nitric acid (HNO(3)) and ozone (O(3)), two important air pollutants, on six lichen species with different morphological, ecological, and biological characteristics. The treatment chambers were set up in a factorial design consisting of control chambers, chambers fumigated with HNO(3), with O(3), and with HNO(3) and O(3), together. Each species showed a different sensitivity to the fumigations, reflecting the physiological variation among species. Our results clearly indicate that HNO(3) is a strong phytotoxin to many lichens, and that O(3) alone has little effect on the measured parameters. The combined fumigation effects of HNO(3) and O(3) were not significantly different from HNO(3) alone.

High frequency of spinal involvement in patients with basal subarachnoid neurocysticercosis.

OBJECTIVE: To determine the frequency of spinal neurocysticercosis (NCC) in patients with basal subarachnoid NCC compared with that in individuals with viable limited intraparenchymal NCC (≤20 live cysts in the brain). METHODS: We performed a prospective observational case-control study of patients with NCC involving the basal cisterns or patients with only limited intraparenchymal NCC. All patients underwent MRI examinations of the brain and the entire spinal cord to assess spinal involvement. RESULTS: Twenty-seven patients with limited intraparenchymal NCC, and 28 patients with basal subarachnoid NCC were included in the study. Spinal involvement was found in 17 patients with basal subarachnoid NCC and in only one patient with limited intraparenchymal NCC (odds ratio 40.18, 95% confidence interval 4.74-340.31; p < 0.0001). All patients had extramedullary (intradural) spinal NCC, and the lumbosacral region was the most frequently involved (89%). Patients with extensive spinal NCC more frequently had ventriculoperitoneal shunt placement (7 of 7 vs 3 of 11; p = 0.004) and tended to have a longer duration of neurologic symptoms than those with regional involvement (72 months vs 24 months; p = 0.062). CONCLUSIONS: The spinal subarachnoid space is commonly involved in patients with basal subarachnoid NCC, compared with those with only intraparenchymal brain cysts. Spinal cord involvement probably explains serious late complications including chronic meningitis and gait disorders that were described before the introduction of antiparasitic therapy. MRI of the spine should be performed in basal subarachnoid disease to document spinal involvement, prevent complications, and monitor for recurrent disease.

Sensitive in vitro system to assess morphological and biochemical effects of praziquantel and albendazole on Taenia solium cysts.

Neurocysticercosis resulting from Taenia solium infections is a major cause of adult-acquired seizures worldwide. Disease is caused by larval cysts, and treatment consists of the anthelmintic drugs albendazole or praziquantel. There are no standard methods to assess drug activity to T. solium cysts in vitro. Morphological, functional, and biochemical changes that might reflect damaging (inhibiting, cytotoxic) drug effects were analyzed after exposure of cysts to albendazole sulfoxide (ABZ-SO), the major active metabolite of the drug in vivo, praziquantel (PZQ), or combinations of both. PZQ exposure led to a decrease in cyst size and inhibition of evagination, whereas ABZ-SO exposure resulted in minimal changes. Alkaline phosphatase (AP) is normally secreted by cysts, and both drugs inhibited AP secretion at concentrations of 5 and 50 ng/ml for PZQ and ABZ-SO, respectively. Some combinations of both drugs resulted in additive and/or synergistic activities. Parasite-specific antigen, detected in the cerebrospinal fluid and blood of infected patients, is also normally secreted by T. solium cysts. Antigen secretion was similarly inhibited by ABZ-SO and PZQ and a combination of both drugs, suggesting that inhibition of secretion is a common downstream consequence of the activities of both drugs. These studies establish quantitative methods to measure in vitro anthelmintic activity and suggest combination therapy with ABZ-SO and PZQ may have clinical benefit.

Design of dynamic Hohlraum opacity samples to increase measured sample density on Z.

We are attempting to measure the transmission of iron on Z at plasma temperatures and densities relevant to the solar radiation and convection zone boundary. The opacity data published by us to date has been taken at an electron density about a factor of 10 below the 9×10(22)/cm(3) electron density of this boundary. We present results of two-dimensional (2D) simulations of the heating and expansion of an opacity sample driven by the dynamic Hohlraum radiation source on Z. The aim of the simulations is to design foil samples that provide opacity data at increased density. The inputs or source terms for the simulations are spatially and temporally varying radiation temperatures with a Lambertian angular distribution. These temperature profiles were inferred on Z with on-axis time-resolved pinhole cameras, x-ray diodes, and bolometers. A typical sample is 0.3 µm of magnesium and 0.078 µm of iron sandwiched between 10 µm layers of plastic. The 2D LASNEX simulations indicate that to increase the density of the sample one should increase the thickness of the plastic backing.

Nutrient digestion and performance by lambs and steers fed thermochemically treated crop residues.

Five studies were conducted to determine nutrient digestibility and performance of lambs and steers fed thermochemically treated crop residues and distillers dried grains with solubles (DDGS) as a corn replacement pellet (CRP; 75% residue:25% DDGS, DM basis). Fifteen Hampshire, Suffolk, or Dorset wethers (BW 33.3 +/- 5.0 kg) were utilized to evaluate nutrient digestibility of the unprocessed native (NAT) and CRP [Exp. 1: wheat straw (WS); Exp. 2: corn stover (CS); Exp. 3: switchgrass (SWG) and corn fiber:wheat chaff (CFWC)] when limit fed (Exp. 1 and 2: 1.8% of BW daily; Exp. 3: 2.5% of BW daily) compared with a 60% corn diet. In Exp. 4, 56 individually fed Dorset-cross wether lambs (BW 32.0 +/- 1.4 kg) were utilized to compare performance and digestibility of WS, wheat chaff (WC), corn fiber (CF), a 3:1 blend of corn fiber:wheat straw (CFWS), a 3:1 blend of CFWC, and SWG-CRP fed for ad libitum intake compared with a 45% corn diet. In Exp. 5, 32 individually fed Holstein steers (BW 185.2 +/- 0.9 kg) were used to evaluate performance and digestibility of diets containing corn, WS-CRP, CFWC-CRP, or NAT-WS fed for ad libitum intake. Crop residues were processed with 5% calcium oxide (DM basis) and 35% water in a double-shaft enclosed mixer (Readco Kurimoto Continuous Processor, York, PA) and subsequently pelleted with DDGS to form CRP. Feeding lambs WS-CRP (Exp. 1) or CS-CRP (Exp. 2) increased digestion of DM, NDF, and ADF compared with NAT (P < 0.05). In Exp. 3, feeding CFWC-CRP increased total tract NDF digestibility and ADF digestibility (P < 0.05). Experiment 4 final BW were greatest for control lambs and least for lambs fed CFWS-CRP or SWG-CRP. Body weight gains for lambs fed CRP averaged 15.9% less than control (P < 0.05). Lambs fed CRP diets had greater (P < 0.05) NDF and ADF intake and output. In Exp. 5, steers fed the corn or 2 CRP diets gained similarly and faster (P < 0.05) than those fed the NAT-WS diet. Steers fed the control corn diet were more efficient (P < 0.05) than steers fed other treatments. Steers fed the corn diet, CFWC-CRP, and WS-CRP had greater (P < 0.01) DM digestibility than NAT. The results confirm benefits for nutrient digestion and subsequent animal performance when crop residues are thermochemically processed. Processed crop residues may be fed in combination with DDGS to partially replace corn in ruminant diets.

Diagnosis of x-ray heated Mg/Fe opacity research plasmas.

Understanding stellar interiors, inertial confinement fusion, and Z pinches depends on opacity models for mid-Z plasmas in the 100-300 eV temperature range. These models are complex and experimental validation is crucial. In this paper we describe the diagnosis of the first experiments to measure iron plasma opacity at a temperature high enough to produce the charge states and electron configurations that exist in the solar interior. The dynamic Hohlraum x-ray source at Sandia National Laboratories' Z facility was used to both heat and backlight Mg/Fe CH tamped foils. The backlighter equivalent brightness temperature was estimated to be T(r) approximately 314 eV+/-8% using time-resolved x-ray power and imaging diagnostics. This high brightness is significant because it overwhelms the sample self-emission. The sample transmission in the 7-15.5 A range was measured using two convex potassium acid phthalate crystal spectrometers that view the backlighter through the sample. The average spectral resolution over this range was estimated to be lambda/deltalambda approximately 700 by comparing theoretical crystal resolution calculations with measurements at 7.126, 8.340, and 12.254 A. The electron density was determined to be n(e)=6.9+/-1.7 x 10(21) cm(-3) using the Stark-broadened Mg Hebeta, Hegamma, and Hedelta lines. The temperature inferred from the H-like to He-like Mg line ratios was T(e)=156+/-6 eV. Comparisons with three different spectral synthesis models all have normalized chi(2) that is close to unity, indicating quantitative consistency in the inferred plasma conditions. This supports the reliability of the results and implies the experiments are suitable for testing iron opacity models.

Wire initiation critical for radiation symmetry in z-pinch-driven dynamic hohlraums.

Axial symmetry in x-ray radiation of wire-array z pinches is important for the creation of dynamic hohlraums used to compress inertial-confinement-fusion capsules. We present the first evidence that this symmetry is directly correlated with the magnitude of the negative radial electric field along the wire surface. This field (in turn) is inferred to control the initial energy deposition into the wire cores, as well as any current shorting to the return conductor.

Treatment of neurocysticercosis: current status and future research needs.

Here we put forward a roadmap that summarizes important questions that need to be answered to determine more effective and safer treatments. A key concept in management of neurocysticercosis is the understanding that infection and disease due to neurocysticercosis are variable and thus different clinical approaches and treatments are required. Despite recent advances, treatments remain either suboptimal or based on poorly controlled or anecdotal experience. A better understanding of basic pathophysiologic mechanisms including parasite survival and evolution, nature of the inflammatory response, and the genesis of seizures, epilepsy, and mechanisms of anthelmintic action should lead to improved therapies.

Estimation of the cost of Taenia solium cysticercosis in Eastern Cape Province, South Africa.

OBJECTIVES: To provide a comprehensive estimate of the societal costs of Taenia solium cysticercosis for the Eastern Cape Province (ECP), South Africa, as an objective measure of its impact in this endemic area. METHODS: Epidemiological data on the prevalence of epilepsy, proportion of epilepsy cases due to neurocysticercosis (NCC) and consequences of cysticercosis were gathered from published and unpublished sources. Economical data were mostly obtained from governmental sources. Three methods were used for estimating productivity losses. Monte Carlo sampling was used to represent the uncertainty of the estimates with 95% Credible Intervals (95% CI). The estimation is for 1 year using a societal approach. All costs are reported in 2004 US Dollars. RESULTS: Overall, there were an estimated 34 662 (95% CI: 17 167-54 068) NCC-associated cases of epilepsy in ECP in 2004. The overall monetary burden (in million of US Dollars) was estimated to vary from US Dollars 18.6 (95% CI: US Dollars 9.0-32.9) to US Dollars 34.2 (95% CI: US Dollars 12.8-70.0) depending on the method used to estimate productivity losses. The agricultural sector contributed an average of Dollars 5.0 million. The prevalence of epilepsy, proportion of productivity reduction and the proportion of epilepsy cases attributable to NCC had the largest impact on the overall estimates. CONCLUSION: This preliminary estimate suggests that T. solium cysticercosis results in considerable monetary costs to a region that is already economically constrained. Because this infection is preventable, these results could guide stakeholders in deciding where to invest scarce health and agricultural resources in their countries.

Characteristics and scaling of tungsten-wire-array z -pinch implosion dynamics at 20 MA.

We present observations for 20-MA wire-array z pinches of an extended wire ablation period of 57%+/-3% of the stagnation time of the array and non-thin-shell implosion trajectories. These experiments were performed with 20-mm-diam wire arrays used for the double- z -pinch inertial confinement fusion experiments [M. E. Cuneo, Phys. Rev. Lett. 88, 215004 (2002)] on the Z accelerator [R. B. Spielman, Phys. Plasmas 5, 2105 (1998)]. This array has the smallest wire-wire gaps typically used at 20 MA (209 microm ). The extended ablation period for this array indicates that two-dimensional (r-z) thin-shell implosion models that implicitly assume wire ablation and wire-to-wire merger into a shell on a rapid time scale compared to wire acceleration are fundamentally incorrect or incomplete for high-wire-number, massive (>2 mg/cm) , single, tungsten wire arrays. In contrast to earlier work where the wire array accelerated from its initial position at approximately 80% of the stagnation time, our results show that very late acceleration is not a universal aspect of wire array implosions. We also varied the ablation period between 46%+/-2% and 71%+/-3% of the stagnation time, for the first time, by scaling the array diameter between 40 mm (at a wire-wire gap of 524 mum ) and 12 mm (at a wire-wire gap of 209 microm ), at a constant stagnation time of 100+/-6 ns . The deviation of the wire-array trajectory from that of a thin shell scales inversely with the ablation rate per unit mass: f(m) proportional[dm(ablate)/dt]/m(array). The convergence ratio of the effective position of the current at peak x-ray power is approximately 3.6+/-0.6:1 , much less than the > or = 10:1 typically inferred from x-ray pinhole camera measurements of the brightest emitting regions on axis, at peak x-ray power. The trailing mass at the array edge early in the implosion appears to produce wings on the pinch mass profile at stagnation that reduces the rate of compression of the pinch. The observation of precursor pinch formation, trailing mass, and trailing current indicates that all the mass and current do not assemble simultaneously on axis. Precursor and trailing implosions appear to impact the efficiency of the conversion of current (driver energy) to x rays. An instability with the character of an m = 0 sausage grows rapidly on axis at stagnation, during the rise time of pinch power. Just after peak power, a mild m = 1 kink instability of the pinch occurs which is correlated with the higher compression ratio of the pinch after peak power and the decrease of the power pulse. Understanding these three-dimensional, discrete-wire implosion characteristics is critical in order to efficiently scale wire arrays to higher currents and powers for fusion applications.