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Based on three large randomized controlled trials (RCTs) conducted in Africa, it can clearly be stated that circumcision lowers the risk of infection with the human immunodeficiency virus (HIV) and some sexually transmitted infections (STIs) among males in settings of high HIV and STI endemicity. Similar effects on STI risk may exist for females, although this may result from an indirect effect of decreasing risk of infection among male partners. It is unknown whether circumcision prevents HIV acquisition in men who have sex with men (MSM), although there might be a protective effect for men who engage mainly in insertive anal intercourse. When the effects of adult circumcision on sexual function and satisfaction of men are examined, high-quality evidence strongly supports lack of harm. Whether circumcision alters sexual satisfaction of female partners is not known as fewer and smaller studies reported conflicting results. Circumcision rarely causes serious complications if practiced by trained practitioners, in a sterile setting, and with a proper follow-up. These conclusions are limited by the lack of high-quality data from areas outside of Africa. RCTs have not been conducted to assess the effects of circumcising infants or MSM. Circumcision has well-proven benefits for people residing in areas with high prevalence of STIs, including HIV, and is not unethical for those who choose to be circumcised or have their children circumcised on religious, social, or cultural grounds. For many others, a definite pro or con recommendation, based on a risk-benefit ratio, cannot be made. [ABSTRACT FROM AUTHOR]

To evaluate the feasibility of applying the AAGL 2021 Endometriosis Classification system to pre-operative MRI findings in order to predict surgical complexity. A retrospective chart review of patients who had a pelvic MRI performed for the indication of pelvic pain and underwent surgery for presumed endometriosis. N/A. 190 charts were reviewed of patients referred for an MRI for pelvic pain. Of those patients, 47 had both an MRI and subsequently underwent pelvic surgery. N/A. Of the 190 charts reviewed, 48 patients had both an MRI and underwent pelvic surgery. Using the AAGL Endometriosis Classification system, patients were assigned a score for their MRI and operative findings. When measurements were not specified in the MRI report, they were reviewed on the images or assigned based on terminology of "mild" and "severe." Scores for operative findings were based on explicit use of the scoring system (14.89%) or deduced from the operative and pathology reports. Scores differed significantly for overall AAGL score (t(46) = 3.964, p = 0.00026) with a mean difference between operative and MRI scores of 6.55 (mean operative score of 16.3, SD = 12.54; mean MRI score 9.74, SD = 8.42). Scores differed significantly for stage of endometriosis (t(46) = 4.15, p = 0.0001) with a mean difference between operative and MRI scores of 0.809 (mean operative score of 2.4, SD = 1.48; mean MRI score 1.57, SD = 1.28). Use of the AAGL Classification system has been implemented to better assess surgical complexity of endometriosis cases. Assigned scores for MRI results, however, differ significantly from operative findings suggesting that there are limitations to the adoptability of this system to imaging findings. Future consistent use of the scoring system in operative reports may improve consistency and more detailed imaging reports may improve accuracy of assigning scores to pre-operative imaging. [ABSTRACT FROM AUTHOR]

Objectives: Few prospective studies have examined personality and depression in older adults. The authors investigated whether the Five-Factor Model of personality traits-Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness-and trait combinations (styles) are related to incident major or minor depression.Participants/setting: Prospective data were gathered on a community sample of 512 older adults with disability and a history of significant health care utilization who were enrolled in a Medicare Demonstration Project.Measurements: Depression and personality traits and styles were assessed at baseline; depression was assessed again at approximately 12 and 22 months.Design: Participants who developed incident major depression were compared with those free of depression at all three assessments. Similar analyses were done for minor depression.Results: High Neuroticism and low Conscientiousness were risk factors for both major and minor depression. Combinations of high Neuroticism with low or high Extraversion or high Openness conferred risk for major depression. Other novel findings for major depression revealed new trait combinations of low Conscientiousness with low or high Extraversion, high Openness, or low Agreeableness. Three trait combinations, all involving low Conscientiousness, predicted risk for minor depression: high Neuroticism, high Agreeableness, and low Openness.Conclusion: The present findings highlight the importance of examining combinations of personality traits or personality styles when identifying those who are most at-risk for geriatric depression. Since other personality domains may modify the risk related to high Neuroticism and low Conscientiousness, the prevention, diagnosis, and treatment of depression could be greatly improved by assessing older patients not only on all five domains of personality but in terms of their combinations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the symptomatology and treatment outcomes for patients with superficial endometriosis lesions found on MRI using novel detection methods. A retrospective chart review over a 10-year period of patients referred for MRI with keyword of "endometriosis" within the report. MRIs were performed by an expert team of radiologists trained for detection of superficial endometriosis lesions. N/A 161 charts were reviewed of patients referred for MRI over a 10-year period with 100 meeting criteria for MRI evidence of endometriosis and 50 with detectable superficial endometriosis implants. N/A Of the 100 patients with MRI evidence of endometriosis, 18 patients had superficial implants alone without endometriomas or deep infiltrating endometriosis. Patients who only had superficial implants were significantly more likely to report symptoms of sexual dysfunction (2(1, N=100)= 7.454, p <.05). They were also significantly less likely to have surgery within one year (2(1, N=100)=5.426, p<.05) compared to patients with other endometriosis lesions. There was no significant difference between those with superficial lesions and those with other lesions regarding NSAID use, prior surgery for endometriosis, medication use (overall or type), pain symptoms, infertility, or presence of GI/GU symptoms. Of the patients who only had superficial implants, 50% had had surgery for endometriosis, 17% would have surgery within a year of the MRI, 56% were on some medication, 72% reported pain, 39% reported sexual dysfunction, and 11% reported infertility. MRI capabilities have expanded to include detection of superficial endometriosis lesions but the clinical relevance of these findings is still being elucidated. This study suggests that these superficial implants are clinically significant for patients' quality of life but may potentially differ regarding symptom profile including increased sexual dysfunction complaints and overall management pursued, medical as opposed to surgical. [ABSTRACT FROM AUTHOR]

Assesses the nutrient intake of children who eat school breakfast. Benefits of the School Breakfast Program in the United States; Methods of the study; Results and discussion.

Presents information on a study which aims to determine if direct examination of menus used by Texas schools supported the results of the School Nutrition Dietary Assessment Study (SNDAS). Methods used in the study; Results and discussion; Applications.

More than 2.5 million U.S. emergency department (ED) visits each year are for low back pain (LBP). Nearly half of these patients report persistent pain and functional disability 3 months later. While baseline depression has been shown to predict these poor outcomes, little is known about whether persistent pain and disability correlate with worsening depression. This is a secondary analysis of 362 patients seen at an urban ED with LBP who completed the Roland-Morris Disability Questionnaire (RMDQ), a 0-10 pain numeric rating scale (NRS), and Patient Health Questionnaire depression subscale (PHQ-9) at their ED visit and 3 months later. Linear regression analysis was used to determine the association between changes in depression severity from index ED visit to 3-month follow-up, and changes in RMDQ and pain scores over the same period. Models were adjusted for age, gender, race, ethnicity, education, and depression severity at baseline. At the index ED visit, median PHQ score was 0 (IQR 0,4) and median RMDQ score was 22 (IQR 17,24). At one week, median pain score was 6 (IQR 2,8). At 3 months, median change in PHQ from baseline was 0 (IQR -24,23), change in RMDQ was -8 (IQR -20,0), and change in pain score was -1 (IQR -3,0). After adjusting for potential confounders, worsening depression score between the ED visit and 3 month follow-up was associated with worsening function (B=0.85, 95% CI=0.68-1.03) and pain scores (B=0.11, 95%CI=0.05-0.17). The 3-month disability and pain intensity outcomes were more strongly correlated with change in depression than with baseline depression scores. Future work among ED patients with LBP should consider progressive depressive symptoms as a potentially modifiable risk factor for persistent pain and disability. [ABSTRACT FROM AUTHOR]

Vibrio vulnificus ( Vv ) and V. parahaemolyticus ( Vp ) illnesses are typically acquired through the consumption of raw molluscan shellfish, particularly oysters. As Vibrio spp. are naturally-occurring bacteria, one means of mitigation of illness is achieved by limiting post-harvest growth. In this study, effects of ambient air storage, refrigeration, and icing of oysters on Vibrio spp. abundances were examined at two sites in Alabama (AL) [Dog River (DR) and Cedar Point (CP)] and one site in Delaware Bay, New Jersey (NJ). As the United States shellfish program recommendations include testing for total these organisms and gene targets, Vv and total ( tlh ) and pathogenic ( tdh + and trh + ) Vp were enumerated from samples using MPN-real-time-PCR approaches. Mean Vv and Vp abundances in oysters from AL-DR were lowest in immediately iced samples (2.3 and − 0.1 log MPN/g, respectively) and highest in the 5 h ambient then refrigerated samples (3.4 and 0.5 log MPN/g, respectively). Similarly, in AL-CP Vv and Vp mean levels in oysters were lowest in immediately iced samples (3.6 and 1.2 log MPN/g, respectively) and highest in 5 h ambient then refrigerated samples (5.1 and 3.2 log MPN/g, respectively). Mean levels of pathogenic Vp from AL sites were frequently below the limit of detection (< 0.3 MPN/g). In NJ, Vv and Vp mean abundances in oysters were highest in samples which were held for 7 h in the shade (5.3 and 4.8 log MPN/g, respectively). Mean pathogenic Vp levels in oysters at initial harvest were also highest in oysters 7 h in the shade (2.1 and 2.2 log MPN/g for tdh + and trh + Vp ). Regardless of sampling location, Vibrio spp. levels were generally significantly (p < 0.05) greater in oysters exposed to 5 h of air storage compared to the initially harvested samples. In addition, the data demonstrated that the use of layered ice resulted in lower Vibrio spp. levels in oysters, compared to those that were refrigerated post-harvest. These results suggest vibriosis risk can be mitigated by shorter storage times and more rapid cooling of oysters, providing data regulatory authorities can use to evaluate Vibrio spp. control plans. [ABSTRACT FROM AUTHOR]

In this study, we sought to determine the rate of progression of atherosclerosis using coronary calcium scores derived from electron beam tomography (EBT). We studied a variety of disease states (hypertension, high cholesterol, tobacco use, diabetes mellitus) followed for 1 to 6.5 years. We evaluated 299 asymptomatic persons (227 men and 72 women) who underwent 2 consecutive EBT scans at least 12 months apart. The average change in the calcium score (Agatston method) for the entire group was 33.2 +/- 9.2%/year. The treated group (receiving statins) demonstrated an average increase in calcium scores of 15 +/- 8%/year compared with 39 +/- 12%/year for untreated patients (p <0.001). Among the 60 patients on statin monotherapy, 37% had a decrease in the calcium score from baseline to follow-up scan. The relative increase in calcium scores did not vary significantly by gender or risk factors, with the exception of statin-treated hypercholesterolemic subjects. Scores of zero on the initial scan portend a low likelihood of significant calcific deposits on repeat scanning. Only 2 of 81 participants (2%) with scores of zero at baseline had scores >10 on repeat study. In this study, statin therapy induced a 61% reduction in the rate of coronary calcium progression. This study demonstrates that EBT may be a useful tool in assessing efficacy of different interventions to retard progression of atherosclerosis, noninvasively, over relatively short time periods. [ABSTRACT FROM AUTHOR]

An abstract of the article "Home Food Environment Observations Using a Photo Voice Texting Method With Parents" by Lesli Biediger-Friedman et al. is presented.

An abstract of the article "Intent to Use WIC Smartphone Application to Promote Breastfeeding, Physical Activity, and Healthy Eating in WIC Participants" by Lesli Biediger-Friedman et al. is presented.