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In light of the ongoing COVID-19 pandemic, the health disparities plaguing our communities are highlighted more than ever. Community-based learning (CBL) and community-based participatory research (CBPR) provide a highly relevant framework in addressing health problems, especially those related to the Social Determinants of Health (AHRQ, 2020). Throughout the COVID-19 pandemic, the team at the Community Health Division (CHD) within the Family Medicine Department of Georgetown University School of Medicine (GUSOM) maintained and deepened relationships with community partners through engagement activities, which not only actively addressed community needs but also acted as an educational tool for a growing number of interdisciplinary students. This paper explores the effectiveness of CBL and CBPR as a framework, even when presented with challenges of the COVID-19 pandemic. It further underscores how students at Georgetown University have become more intimately involved in community health engagement during the pandemic. This serves as an encouraging model for establishing a student-based research learning community.

Yellow fever virus (YFV) is a reemerging global health threat, driven by several factors, including increased spread of the mosquito vector and rapid urbanization. Although a prophylactic vaccine exists, vaccine hesitancy, supply deficits, and distribution difficulties leave specific populations at risk of severe YFV disease, as evidenced by recent outbreaks in South America. To establish a treatment for patients with severe YFV infection, we tested 37 YFV-specific monoclonal antibodies isolated from vaccinated humans and identified two capable of potently neutralizing multiple pathogenic primary YFV isolates. Using both hamster and nonhuman primate models of lethal YFV infection, we demonstrate that a single administration of either of these two potently neutralizing antibodies during acute infection fully controlled viremia and prevented severe disease and death in treated animals. Given the potential severity of YFV-induced disease, our results show that these antibodies could be effective in saving lives and fill a much-needed void in managing YFV cases during outbreaks. A yellow fever virus treatment: Yellow fever virus (YFV) is once again becoming a threat to global health because of changes in the environment. A live attenuated vaccine (YFV-17D) has been used for decades, but immunization coverage diminished in recent years because of concerns about adverse reactions, which has left many unvaccinated people in endemic areas vulnerable to infection. Ricciardi et al. characterized monoclonal antibodies (mAbs) that can neutralize YFV and prevent severe disease in animal models. They screened 37 YFV-specific mAbs isolated from vaccinated humans, of which two showed potent neutralization activity against a range of YFV isolates. Administration of a single dose of either mAb to YFV-infected hamsters or nonhuman primates protected against severe disease and death. These findings suggest that YFV mAbs may be a potential therapeutic treatment that could improve outcomes during outbreaks. —CNF [ABSTRACT FROM AUTHOR]

Background: The surgical decision for limb-salvage with free tissue transfer (FTT), partial foot amputation (PFA), or below-knee amputation (BKA) for complex lower extremity (LE) wounds hinges on several factors, including patient choice and baseline function. However, patient-reported outcome measures (PROMs) on LE function, pain, and QoL for chronic LE wound interventions are limited. Thus, the study aim was to compare PROMs in patients who underwent FTT, PFA, or BKA for chronic LE wounds., Methods: PROMs were collected via QR code for all adult chronic LE wound patients who presented to a tertiary wound center between June 2022 and June 2023. A cross-sectional analysis of patients who underwent FTT, PFA, or BKA was conducted. The 12-Item Short Survey (SF-12), PROM Information System Pain Intensity (PROMIS-3a), and Lower Extremity Functional Scale (LEFS) were completed at 1, 3, and 6 months and 1, 3, and 5 years postoperatively. Patient demographics, comorbidities, preoperative characteristics, and amputation details were collected., Results: Of 200 survey sets, 71 (35.5%) underwent FTT, 51 (25.5%) underwent PFA, and 78 (39.0%) underwent BKA. Median postoperative time points of survey completion between FTT (6.2 months, IQR: 23.1), PFA (6.8 months, IQR: 15.5), and BKA (11.1 months, IQR: 21.3) patients were comparable (P = 0.8672). Most patients were male (n = 92, 76.0%) with an average age and body mass index (BMI) of 61.8 ± 12.6 years and 30.3 ± 7.0 kg/m2, respectively. Comorbidities for FTT, PFA, and BKA patients included diabetes mellitus (DM; 60.6% vs 84.2% vs 69.2%; P = 0.165), peripheral vascular disease (PVD; 48.5% vs 47.4% vs 42.3%; P = 0.790), and chronic kidney disease (CKD; 12.1% vs 42.1% vs 30.8%; P = 0.084). No significant differences were observed between FTT, PFA, and BKA patients in mean overall PROMIS-3a T-scores (49.6 ± 14.8 vs 54.2 ± 11.8 vs 49.6 ± 13.7; P = 0.098), LEFS scores (37.5 ± 18.0 vs 34.6 ± 18.3 vs 38.5 ± 19.4; P = 0.457), or SF-12 scores (29.6 ± 4.1 vs 29.5 ± 2.9 vs 29.0 ± 4.0; P = 0.298)., Conclusion: Patients receiving FTT, PFA, or BKA for chronic LE wounds achieve comparable levels of LE function, pain, and QoL postoperatively. Patient-centered functionally based surgical management for chronic LE wounds using interdisciplinary care, preoperative medical optimization, and proper patient selection optimizes postoperative PROMs., Competing Interests: Conflicts of interest disclosures: The authors have no conflicts of interest to declare., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Social integration is an essential element to the maintenance of health and well-being in elderly populations. In the Cumbaya Valley of Quito, Ecuador, community health clinics sponsor social clubs for specific populations to address this important aspect of health. Men, who tend to be less socially integrated than women, are largely absent from these programs., Objective: This paper investigates the quality and extent of men's social integration in the Cumbaya Valley of Quito to understand why men are less likely to attend the community health center clubs and to develop ideas for increasing male participation, which may differ from current methods., Methods: A composite survey was used to interview 100 men over the age of 40 to collect data on their social health and information regarding their interaction with community health center clubs and other local social groups., Findings: Social integration scores were varied, with some men having high social scores and others having low scores. Men generally had greater access to affectionate and tangible support but lower access to emotional support and positive social interaction. Men spend far more social time with their families and much less with friends and neighbors. Regression analysis revealed that social scores have a relationship with age and education. Qualitative results suggest gendered expectations of men in the community have negatively impacted their willingness to engage in community health groups. Participants also provided suggestions, including specific sports, gardening, and meal distribution, to promote male participation., Conclusion: There is a strong need to increase services, strategies, and programs that address the lack of social integration experienced by men. This paper presents the particular role community clinics can play in increasing the social well-being of its male patients., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)