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Early adolescent drinking onset is linked to myriad negative consequences. Using the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) baseline to year 8 data, this study (1) leveraged best subsets selection and Cox Proportional Hazards regressions to identify the most robust predictors of adolescent first and regular drinking onset, and (2) examined the clinical utility of drinking onset in forecasting later binge drinking and withdrawal effects. Baseline predictors included youth psychodevelopmental characteristics, cognition, brain structure, family, peer, and neighborhood domains. Participants (N=538) were alcohol-naïve at baseline. The strongest predictors of first and regular drinking onset were positive alcohol expectancies (Hazard Ratios [HRs]=1.67-1.87), easy home alcohol access (HRs=1.62-1.67), more parental solicitation (e.g., inquiring about activities; HRs=1.72-1.76), and less parental control and knowledge (HRs=.72-.73). Robust linear regressions showed earlier first and regular drinking onset predicted earlier transition into binge and regular binge drinking (βs=0.57-0.95). Zero-inflated Poisson regressions revealed that delayed first and regular drinking increased the likelihood (Incidence Rate Ratios [IRR]=1.62 and IRR=1.29, respectively) of never experiencing withdrawal. Findings identified behavioral and environmental factors predicting temporal paths to youthful drinking, dissociated first from regular drinking initiation, and revealed adverse sequelae of younger drinking initiation, supporting efforts to delay drinking onset.

Heavy alcohol drinking is a major, preventable problem that adversely impacts the physical and mental health of US young adults. Studies seeking drinking risk factors typically focus on young adults who enrolled in 4-year residential college programs (4YCP) even though most high school graduates join the workforce, military, or community colleges. We examined 106 of these understudied young adults (USYA) and 453 4YCPs from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) by longitudinally following their drinking patterns for 8 years from adolescence to young adulthood. All participants were no-to-low drinkers during high school. Whereas 4YCP individuals were more likely to initiate heavy drinking during college years, USYA participants did so later. Using mental health metrics recorded during high school, machine learning forecasted individual-level risk for initiating heavy drinking after leaving high school. The risk factors differed between demographically matched USYA and 4YCP individuals and between sexes. Predictors for USYA drinkers were sexual abuse, physical abuse for girls, and extraversion for boys, whereas 4YCP drinkers were predicted by the ability to recognize facial emotion and, for boys, greater openness. Thus, alcohol prevention programs need to give special consideration to those joining the workforce, military, or community colleges, who make up the majority of this age group.

The outbreak of COVID-19 in early 2020 has caused a crisis in various sectors, including the economic sector. In fact, its impact on the performance of Islamic banks in the ASEAN region is currently still unknown. Therefore, this study aims to obtain empirical evidence regarding the effect of COVID-19 on profitability performance and maqashid sharia performance in Islamic banks in the ASEAN region. Profitability performance is measured by return on equity (ROE) and return on assets (ROA). The number of observations from this study was 202 with a sample of 30 Islamic commercial banks in the ASEAN region in 2015–2021. The data analysis technique used is EViews 12. The results show that COVID-19 has no significant effect on profitability performance in Islamic banks, whether measured by ROE or ROA. On the other hand, COVID-19 has a significant effect on reducing the maqashid sharia performance. In addition, company size has been proven to positively affect profitability performance and maqashid sharia performance in Islamic banks before and after the COVID-19 pandemic. Operating expense ratio (OER) has been proven to affect ROE and ROA, whereas FDR and non-performing financing (NPF) have been proven to only affect ROA. OER influences promoting welfare, while FDR and NPF influence establishing justice. The study results confirm the ability of Islamic banks to generate profits amidst the COVID-19 pandemic. They also confirm the negative impact of the COVID-19 pandemic on three aspects of maqashid sharia performance.

The digital divide in Indonesia is rather big. This study aims to investigate the demographic and socioeconomic determinants affecting the quantity of uses of the Internet in Indonesia. The data used are based on the National Socioeconomic Survey in 2021. The object of the analysis is population aged 15 years and above possessing at least one digital gadget. The dependent variable is the purpose of the Internet use. The independent variables included gender, age, number of household members, marital status, education, employment status, place of dwelling, island of residence, and number of types of digital gadgets owned. A binary logistic regression model was employed in the analysis. The results of the study indicate that a higher quantity of uses of the Internet is associated with a female sex, younger age, smaller number of household members, unmarried status, higher education, dwelling in urban areas, living in Java Island, and owning more than one type of digital gadgets. These findings suggest the need to improve access to the Internet among men, older people, ever-married individuals, rural dwellers, and Outer Java inhabitants, to promote family planning, to improve education and accessibility of more types of digital gadgets in order to bridge the digital divide and to boost the global competitiveness index 4.0 in Indonesia.

This interview presents Professor István Szilágyi’s life and the major events in his career. It includes, among other things, the early school and university years, as well as all those by whom his career has been shaped. The semi-structured interview discusses his research activities, his travels and his advice for the younger generation of geographers. Professor István Szilágyi is a retired professor at the University of Pécs and the former Dean of the Faculty of Modern Philology and Social Sciences at Pannon University. He is a renowned researcher in the theory of international relations, geopolitics and political changes in Latin America and the Hispanic world. The Professor has not only published more than hundreds of papers and book chapters in Hungarian, English, German, Russian, Portuguese and Spanish, but also, he is the author of seventeen monographs. Throughout his career, he has developed significant foreign contacts in Latin America and Europe. As a guest professor, he has visited Valladolid, Paris, Cluj-Napoca, Cadiz, Valencia, La Laguna and Dijon, among others. He has also carried out research in Portugal, Brazil, Chile, Russia and Cuba.

Some studies have reported that the initial music training of primary teachers can be problematic due to gaps in disciplinary and didactic training and a relative neglect of the objectives that music education should address in the school curriculum. Such gaps may lead to low levels of self-confidence in teaching music in the general classroom. Furthermore, the fast transformations occurring in contemporary society in terms of access to and functions of music, demand novel pedagogical approaches that might be better equipped to address current social and educational needs such as creativity, collaborative work and interdisciplinarity. In order to investigate the relationship between the initial musical training of primary teachers and their self-confidence in teaching music, a study was carried out based on an intervention in the Primary Education Teaching degree program at a Spanish university. The intervention was innovative and based on a collaborative, creative, and interdisciplinary approach. The findings, referring both to the processes and products of this intervention, show both an increase in pedagogical reflection and in the transformation of values and beliefs, as well as an improvement of self-confidence in student teachers' musical skills.

THIS REPORT UPDATES PREVIOUS CDC GUIDELINES AND RECOMMENDATIONS ON PREFERRED PREVENTION AND TREATMENT REGIMENS REGARDING NATURALLY OCCURRING ANTHRAX. ALSO PROVIDED ARE A WIDE RANGE OF ALTERNATIVE REGIMENS TO FIRST-LINE ANTIMICROBIAL DRUGS FOR USE IF PATIENTS HAVE CONTRAINDICATIONS OR INTOLERANCES OR AFTER A WIDE-AREA AEROSOL RELEASE OF: Bacillus anthracis spores if resources become limited or a multidrug-resistant B. anthracis strain is used (Hendricks KA, Wright ME, Shadomy SV, et al.; Workgroup on Anthrax Clinical Guidelines. Centers for Disease Control and Prevention expert panel meetings on prevention and treatment of anthrax in adults. Emerg Infect Dis 2014;20:e130687; Meaney-Delman D, Rasmussen SA, Beigi RH, et al. Prophylaxis and treatment of anthrax in pregnant women. Obstet Gynecol 2013;122:885-900; Bradley JS, Peacock G, Krug SE, et al. Pediatric anthrax clinical management. Pediatrics 2014;133:e1411-36). Specifically, this report updates antimicrobial drug and antitoxin use for both postexposure prophylaxis (PEP) and treatment from these previous guidelines best practices and is based on systematic reviews of the literature regarding 1) in vitro antimicrobial drug activity against B. anthracis; 2) in vivo antimicrobial drug efficacy for PEP and treatment; 3) in vivo and human antitoxin efficacy for PEP, treatment, or both; and 4) human survival after antimicrobial drug PEP and treatment of localized anthrax, systemic anthrax, and anthrax meningitis. CHANGES FROM PREVIOUS CDC GUIDELINES AND RECOMMENDATIONS INCLUDE AN EXPANDED LIST OF ALTERNATIVE ANTIMICROBIAL DRUGS TO USE WHEN FIRST-LINE ANTIMICROBIAL DRUGS ARE CONTRAINDICATED OR NOT TOLERATED OR AFTER A BIOTERRORISM EVENT WHEN FIRST-LINE ANTIMICROBIAL DRUGS ARE DEPLETED OR INEFFECTIVE AGAINST A GENETICALLY ENGINEERED RESISTANT: B. anthracis strain. In addition, these updated guidelines include new recommendations regarding special considerations for the diagnosis and treatment of anthrax meningitis, including comorbid, social, and clinical predictors of anthrax meningitis. The previously published CDC guidelines and recommendations described potentially beneficial critical care measures and clinical assessment tools and procedures for persons with anthrax, which have not changed and are not addressed in this update. In addition, no changes were made to the Advisory Committee on Immunization Practices recommendations for use of anthrax vaccine (Bower WA, Schiffer J, Atmar RL, et al. Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices, 2019. MMWR Recomm Rep 2019;68[No. RR-4]:1-14). The updated guidelines in this report can be used by health care providers to prevent and treat anthrax and guide emergency preparedness officials and planners as they develop and update plans for a wide-area aerosol release of B. anthracis.

Microencapsulation could be employed to coat bacteria with protective compounds to enhance their viability. The freeze-drying method uses low temperatures, thereby reducing heat damage. Bifidobacterium breve was used as a probiotic along with Streptococcus thermophilus and Lactobacillus bulgaricus, two common yogurt cultures. Yogurt, a nutrient-rich milk product, has the potential to be an effective probiotic carrier. This research aimed to examine how the freeze-drying process with varying ratios of coating materials affects the viability of the bacteria combination B. breve, S. thermophilus, and L. bulgaricus under acidic and bile salt conditions, as well as the microencapsulation efficiency and particle size. The treatments tested different ratios of whey protein isolate to trehalose as a coating (1:1, 1.5:1, 2:1, 2.5:1, 3:1). The 1:1 ratio yielded the best results, with lactic acid bacteria counts of 6.60 log colony/mL at pH 2.0, 6.84 log colony/mL at pH 3.0, 7.39 log colony/mL at pH 4.0, 7.47 log colony/mL at pH 5.0, 7.70 log colony/mL at pH 6.0, and 7.05 log colony/mL in a bile salt environment. This ratio demonstrated 107.96% microencapsulation efficiency and a particle size of 9.66 μm.

Abstract Introduction Long-acting injectable antiretroviral treatment (LAI-ART) has emerged as a novel alternative to the burden of daily oral pills. The bi-monthly intramuscular injectable containing cabotegravir and rilpivirine holds the promise of improving adherence to ART. The perspectives of potential users of LAI-ART, the majority of whom reside in Eastern and Southern Africa, are still largely unexplored. We set out to understand the experiences of people with HIV (PWH) who received LAI-ART at Fort Portal Regional Referral Hospital in mid-Western Uganda for at least 12 months. Methods This qualitative study, conducted between July and August 2023, was nested within a larger study. We conducted four focus groups with 32 (out of 69) PWH who received intramuscular injections of cabotegravir and rilpivirine. In-depth interviews were held with six health workers who delivered LAI-ART to PWH. Data were analyzed by thematic approach broadly modeled on the five domains of the Consolidated Framework for Implementation Research (CFIR). Results There was high acceptability of LAI-ART (30 /32 or 94%) participants requested to remain on LAI-ART even after the end of the 12-month trial. Adherence to ART was reportedly improved when compared to daily oral treatment. Participants credited LAI-ART with; superior viral load suppression, redemption from the daily psychological reminder of living with HIV, enhanced privacy in HIV care and treatment, reduced HIV-related stigma associated with taking oral pills and that it absolved them from carrying bulky medication packages. Conversely, nine participants reported pain around the injection site and a transient fever soon after administering the injection as side effects of LAI-ART. Missed appointments for receiving the bi-monthly injection were common. Providers identified health system barriers to the prospective scale-up of LAI-ART which include the perceived high cost of LAI-ART, stringent cold chain requirements, physical space limitations, and workforce skills gaps in LAI-ART delivery as potential drawbacks. Conclusion Overall, PWH strongly preferred LAI-ART and expressed a comparatively higher satisfaction with this treatment alternative. Health system barriers to potential scale-up are essential to consider if a broader population of PWH will benefit from this novel HIV treatment option in Uganda and other resource-limited settings. Trial registration Trial Registry Number PACTR ID PACTR202104874490818 (registered on 16/04/2021).

Abstract Objectives We aimed to evaluate the ability of the parasternal intercostal (PIC) thickening fraction during spontaneous breathing trial (SBT) to predict the need for reintubation within 48 h after extubation in surgical patients with sepsis. Methods This prospective observational study included adult patients with sepsis who were mechanically ventilated and indicated for SBT. Ultrasound measurements of the PIC thickening fraction and diaphragmatic excursion (DE) were recorded 15 min after the start of the SBT. After extubation, the patients were followed up for 48 h for the need for reintubation. The study outcomes were the ability of the PIC thickening fraction (primary outcome) and DE to predict reintubation within 48 h of extubation using area under receiver characteristic curve (AUC) analysis. The accuracy of the model including the findings of right PIC thickening fraction and right DE was also assessed using the current study cut-off values. Multivariate analysis was performed to identify independent risk factors for reintubation. Results We analyzed data from 49 patients who underwent successful SBT, and 10/49 (20%) required reintubation. The AUCs (95% confidence interval [CI]) for the ability of right and left side PIC thickening fraction to predict reintubation were 0.97 (0.88–1.00) and 0.96 (0.86–1.00), respectively; at a cutoff value of 6.5–8.3%, the PIC thickening fraction had a negative predictive value of 100%. The AUCs for the PIC thickening fraction and DE were comparable; and both measures were independent risk factors for reintubation. The AUC (95% CI) of the model including the right PIC thickening fraction > 6.5% and right DE ≤ 18 mm to predict reintubation was 0.99 (0.92–1.00), with a positive predictive value of 100% when both sonographic findings are positive and negative predictive value of 100% when both sonographic findings are negative. Conclusions Among surgical patients with sepsis, PIC thickening fraction evaluated during the SBT is an independent risk factor for reintubation. The PIC thickening fraction has an excellent predictive value for reintubation. A PIC thickening fraction of ≤ 6.5–8.3% can exclude reintubation, with a negative predictive value of 100%. Furthermore, a combination of high PIC and low DE can also indicate a high risk of reintubation. However, larger studies that include different populations are required to replicate our findings and validate the cutoff values.

This narrative review addresses the integration of health education into school curricula in South Tyrol, an Italian province with significant cultural and linguistic diversity. This review’s objective is to analyze current health education initiatives and propose a strategic framework to enhance school-based health education, aiming to improve student well-being post-pandemic. The review synthesizes global examples and recent local studies, highlighting the importance of comprehensive teacher training, mindfulness-based interventions, culturally sensitive health education, and community engagement. The key findings indicate that current health education programs in South Tyrol are insufficient to meet immediate public health needs, such as low vaccine uptake and mental health challenges exacerbated by the COVID-19 pandemic. The proposed strategic framework seeks to align educational strategies with the diverse needs of South Tyrol’s student population, thereby improving health literacy and behavior and strengthening the region’s public health infrastructure.

Abstract Background Cervical cancer continues to disproportionately burden women in low/middle-income countries like Ghana. We examined treatment patterns and histopathological outcomes among women screened using visual inspection with acetic acid (VIA) and/or mobile colposcopy who subsequently underwent thermal ablation, large loop excision of the transformation zone (LLETZ), or cold knife conization at the Cervical Cancer Prevention and Training Centre, Battor. We also assessed the prevalence of cervical intraepithelial neoplasia 2+ (CIN2+) or micro-invasive disease and their associated factors for women who underwent excisional treatments. The treatment choices for cervical precancerous lesions suitable for resource-limited settings have also been described from the perspective of a center that manages a heterogenous population. Methods We conducted an analysis of secondary data collected between June 2016 and June 2023 among women with positive findings on VIA or mobile colposcopy who subsequently underwent thermal ablation or large loop excision of the transformation zone (LLETZ). The prevalence of histopathology outcomes, including no dysplasia, CIN1 − 3, and micro-invasive disease, were estimated with 95% confidence intervals (CIs). Factors associated with histopathological findings were modeled using multinomial logistic regression. Results For the study period, 14 (10.6%) of the total 132 participants underwent cervical lesion treatment at outreach locations, all via thermal ablation. The remaining 118 (89.4%) were treated at the Catholic Hospital, Battor using LLETZ (n = 66, 55.9%), thermal ablation (n = 51, 43.2%), and cold knife conization (n = 1, 0.9%). Among 65 women with histopathology reports, the most frequent histopathological finding was no dysplasia (47.7%; 95% CI, 35.1 − 60.5), followed by CIN2 and CIN3 (20.0%; 95% CI, 11.1 − 31.8 each), CIN1 (7.7%; 95% CI, 2.5 − 17.0) and micro-invasion (4.6%; 95% CI, 1.0 − 12.9). Those with micro-invasive disease were significantly older than those with CIN1, CIN2, and CIN3 (p = 0.036, 0.022, 0.009, respectively), but not significantly older than those who showed no dysplasia (p = 0.088). For each unit increase in age, the likelihood of CIN3 was relatively significantly reduced compared to no dysplasia (crude relative risk ratio [RRR] = 0.93; 95% CI, 0.86 − 0.99). This association was neither observed with the remaining histopathological groups nor for parity and persisted after controlling for parity (adjusted RRR = 0.92; 95% CI, 0.85 − 0.99; p = 0.025). Conclusion This paper largely demonstrates treatment options available to women and practitioners in LMICs. The high combined prevalence of high-grade precancerous lesions and micro-invasive disease underscores the need to increase cervical cancer awareness that would enhance screening attendance and hasten efforts at moving from opportunistic to organized screening in Ghana. This will enhance early cervical lesion detection and treatment, while simultaneously re-evaluating and cutting down on unnecessary treatment.

Abstract Scincidae is one of the most species-rich and cosmopolitan clades of squamate reptiles. Abundant disarticulated fossil material has also been attributed to this group, however, no complete pre-Cenozoic crown-scincid specimens have been found. A specimen in Burmite (99 MYA) is the first fossil that can be unambiguously referred to this clade. Our analyses place it as nested within extant skinks, supported by the presence of compound osteoderms formed by articulated small ostedermites. The specimen has a combination of dorsal and ventral compound osteoderms and overlapping cycloid scales that is limited to skinks. We propose that this type of osteoderm evolved as a response to an increased overlap of scales, and to reduced stiffness of the dermal armour. Compound osteoderms could be a key innovation that facilitated diversification in this megadiverse family.

Durian (Durio zibethinus) is highly consumed seasonal fruit that generates abundant waste in the form of peel. Durian peel can serve as an effective adsorbent because it is rich in cellulose–lignin. This waste has potential applications in the chemical industry, such as using durian peel to purify crude glycerol. This research studied durian peel as an adsorbent in the form of activated carbon in the purification of acidified crude glycerol. The purification process begins with the acidification process of crude glycerol using concentrated acid with a mole ratio of phosphoric acid:glycerol (n/n) of 0.5:1, 1:1, 1.5:1, 2:1, and 2.5:1. The adsorption process by carbonization and activated of durian peel using 0.1 N KOH as adsorbent with a mass percentage ratio of adsorbent:crude glycerol (%wt) of 5 %, 10 %, 15 %, 20 %, and 25 %, and stirred using a magnetic stirrer at a speed of 250 rpm for 2 h. The adsorbent utilized has a carbon-rich content of as much as 80.6 % based on Energy Dispersive X-ray analysis. The highest glycerol purity obtained at 96.26 % is achieved at phosphoric acid:glycerol mole ratio of 1:1 and adsorbent:glycerol mass ratio of 25 %. This result also matches the analysis by gas chromatography. Thus, the others test of the purified glycerol, such as density of 1.267 g/cm3, water content of 1.6 %, ash content of 0.2 %, and matter organic non-glycerol of 1.94 %, are in accordance with the glycerol standard BS 2621:1979.

Background: Most of the murder victims in Nigeria are concealed in shallow graves or clandestine paths or bushes. Knowledge of post-mortem interval (PMI) of buried carcasses is useful in estimating time since death for buried homicide scenarios. The PMI of buried remains is different from that of remains on the soil surface. Aims and Objectives: The study aimed at investigating the PMI of buried remains in a tropical rainforest vegetation of Nigeria using matured domestic pigs as human analogs. Materials and Methods: Four animals were used for this study. Animals were sacrificed and buried in one-foot-depth graves. A flat wood was placed on top of the animals before it was covered with sand so that the visible changes can be monitored during the study period. The study was carried out during the rainy and dry seasons. Soil analysis was carried out to ensure that there was no chemical substance inhibiting decomposition. Results: Animals did not completely skeletonize within the study period (168 days). However, four stages of decomposition were identified within the study period – Fresh, bloat, active decay, and advanced decay stages. Conclusions: The PMI was influenced by fungi activities and rain infusion. On the last day of the study, the decomposition was at the advanced decay stage and only few bones of the head, neck, trunk, and limbs were visible with greyish discoloration of the skin and other visceral structures. The visible post-mortem changes of the buried carrions noted in this study may be used to estimate the time of death of buried humans in a tropical rainforest vegetation of Nigeria.

The aim of the study is to analyze the aptitudes required for youth and activity leaders, which reflect the identity construction of people living in a prison environment. When caring for people in precarious situations, the needs of the situation and the needs of the individual must be taken into account (Kaës, 2022). Identifying the tutor's conceptualization in his management of interactions means taking into account the link between the objectives pursued and the rules of action, information gathering and control that he uses. The operational dimension of knowledge and the subjective involvement of the incarcerated person are necessary for this interpretation of the tutor's position. This raises the question of the skills required for support in order to successfully carry out the support system. An analysis of the results shows that, while support is a set of tools to facilitate self development and self-maintenance, this process requires the person handling it to have certain skills, such as neutrality, active listening, authenticity/congruence and awareness of their limits.

Abstract Functional inhibition is known to improve treatment outcomes in substance use disorder (SUD), potentially through craving management enabled by underlying cerebral integrity. Whereas treatment is challenged by a multitude of substances that patients often use, no study has yet unraveled if inhibition and related cerebral integrity could prevent relapse from multiples substances, that is, one’s primary drug of choice and secondary ones. Individuals with primary alcohol, cannabis, or tobacco use disorders completed intensive Ecological Momentary Assessment (EMA) coupled with resting-state functional MRI (rs-fMRI) to characterize the extent to which inhibition and cerebral substrates interact with craving and use of primary and any substances. Participants were 64 patients with SUD and 35 healthy controls who completed one week EMA using Smartphones to report 5 times daily their craving intensity and substance use and to complete Stroop inhibition testing twice daily. Subsamples of 40 patients with SUD and 34 control individuals underwent rs-fMRI. Mixed Model Analysis revealed that reported use of any substance by SUD individuals predicted later use of any and primary substance, whereas use of the primary substance only predicted higher use of that same substances. Craving and inhibition level independently predicted later use but did not significantly interact. Preserved inhibition performance additionally influenced use indirectly by mediating the link between subsequent uses and by being linked to rs-fMRI connectivity strength in fronto-frontal and cerebello-occipital connections. As hypothesized, preserved inhibition performance, reinforced by the integrity of inhibitory neurofunctional substrates, may partake in breaking an unhealthy substance use pattern for a primary substance but may not generalize to non-target substances or to craving management.

Smoking is one of the factors that can affect serum glucose in patients with type 1 diabetes (T1DM). Control of T1DM is associated with achieving glycated hemoglobin [HbA1c] levels of approximately 7%, which leads to reduced long-term cardiovascular risk. Thyroid hormones can also affect blood sugar levels. Therefore, appropriate control of diabetes can reduce the risk of developing thyroid disorders and vice versa. The aim of the study is to determine whether smoking affects glycemic control and thyroid function in established type 1 diabetes mellitus (T1DM). Materials and methods: A heterogeneous group of 73 patients aged 39±13 years were examined: men 49 (65.3%), women 24 (32%) with T1DM upon admission to the endocrinology department “St. Georgi” (Plovdiv); smokers 25; non-smokers 48. The following were investigated: blood glucose profile (BGP): serum glucose (mmol/L) at 6, 12, 17, 21, 24 hours; HBA1c (%); FT4 pmol/L; TSH mIU/L; TC: total cholesterol mmol/L; HDL-C mmol/L; LDL-C mmol/L; TAG mmol/L; BMI kg/m2 on admission to the ward. Results: In smokers compared to non-smokers, we found statistically significant, p

Abstract People living with HIV and those diagnosed with alcohol use disorders (AUD) relative to healthy individuals commonly have low levels of serum albumin, substantiated as an independent predictor of cardiovascular events. White matter hyperintensities (WMH)—a neuroimaging feature of cerebral small vessel disease—are also related to cardiovascular disease. Despite consensus regarding associations between high levels of urine albumin and WMH prevalence, and low serum albumin levels and impaired cognitive functioning, relations between serum albumin and WMH burdens have rarely been evaluated. Here, a sample including 160 individuals with AUD, 142 living with HIV, and 102 healthy controls was used to test the hypothesis that serum albumin would be inversely related to WMH volumes and directly related to cognitive performance in the two diagnostic groups. Although serum albumin and periventricular WMH volumes showed an inverse relationship in both AUD and HIV groups, this relationship persisted only in the HIV group after consideration of traditional cardiovascular (i.e., age, sex, body mass index (BMI), nicotine use, hypertension, diabetes), study-relevant (i.e., race, socioeconomic status, hepatitis C virus status), and disease-specific (i.e., CD4 nadir, HIV viral load, HIV duration) factors. Further, serum albumin contributed more significantly than periventricular WMH volume to variance in performance on a verbal learning and memory composite score in the HIV group only. Relations in both HIV and AUD groups between albumin and hematological red blood cell markers (e.g., hemoglobin, hematocrit) suggest that in this sample, serum albumin reflects hematological abnormalities. Albumin, a simple serum biomarker available in most clinical settings, may therefore help identify periventricular WMH burden and performance levels in specific cognitive domains in people living with HIV. Whether serum albumin contributes mechanistically to periventricular WMH in HIV will require additional investigation.