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Characterizing HIV-related stigma and its impacts are important for interventions toward their elimination. A cross-sectional study was conducted in 2016 to evaluate enacted and internalized stigma among adult people living with HIV (PLWH) across four cities in Myanmar using the India Stigma Index questionnaire. Multivariable regression analyses were performed to determine differences in measured enacted and internalized stigma outcomes. Among 1,006 participants, 89% reported any stigma indicator, 47% enacted stigma, and 87% internalized stigma. In regression analysis, city and duration of illness were associated with higher enacted stigma, and younger age was associated with higher internalized stigma. Those with HIV duration > 7.4 years had mean enacted stigma nearly 2 units higher than the overall mean. Internalized stigma increased with duration of illness and leveled off at 5 years. PLWH from smaller cities experienced lower stigma. In Myanmar, nearly 90% of PLWH experience stigma, results that reflect a unique transition point.

Introduction: Femoral neck fractures (FNF) represent a significant challenge in orthopedic practice, demanding prompt intervention to restore function and mobility in affected individuals. Numerous surgical interventions have been developed to address these fractures, including internal fixation with devices such as the Femoral Neck System (FNS, DePuy Synthes, Inc., West Chester, PA, USA). However, the optimal fixation system remains unclear. Understanding the postoperative outcomes associated with these interventions is crucial for optimizing patient care and informing treatment decisions. Significance: This PRISMA-compliant systematic literature review evaluates the efficacy and safety of the Femoral Neck System relative to other operative treatment options. Clinical and safety outcomes included mortality, perioperative complications, postoperative complications at 1 year, and reoperation. Results: A total of 117 studies with 68,567 patients with FNF treated with internal fixation were identified. Of these, thirteen included FNS as a treatment arm (1078 patients). Due to heterogeneity in study designs and populations, only the eleven studies that directly compared FNS to other operative treatments, and 2 non-comparative studies that treated with FNS were included in the systematic review. Seven of the eleven included studies had high risk of bias, 2 had moderate risk of bias, and 2 had low risk of bias. FNS groups had similar or significantly lower incidences of postoperative complications, reoperations, and mortality compared to cannulated screw, cancellous screw, or dynamic or sliding hip screw groups in all studies. Conclusion: FNS can be a safe and effective operative treatment option for FNF. Safety outcomes and reoperation rates are comparable between patients treated with FNS and patients treated with cannulated screws, cancellous screws, and dynamic or sliding hips screws. Future prospective, controlled studies are needed to confirm the safety and efficacy of FNS relative to other operative treatment options. [ABSTRACT FROM AUTHOR]

Estradiol administration increases mammary parenchyma growth and can increase the mass of the mammary fat pad (MFP) in calves. Estradiol can affect fatty acid metabolism, but it is unknown how estradiol affects the fatty acid profile of the MFP and if these effects are consistent across adipose stores. The objective of this investigation was to determine if fatty acid profiles were affected by estradiol administration and if this response is adipose tissue type specific. Holstein heifer calves were reared on a common diet and administered 12 daily injections prior to euthanasia at 82 days of age. Injections were either daily injections of corn oil (n = 4; CON), 9 injections of corn oil followed by 3 injections of estradiol (n = 4; SHORT), or 12 injections of estradiol (n = 4; LONG). Fatty acids were extracted from MFP and subcutaneous adipose tissues samples and analyzed using gas chromatography. Data were analyzed using a mixed model considering the effect of treatment, adipose tissue depot, their interaction, and the random effect of animal. Only significant treatment effects and treatment-adipose type interactions are presented here (Table 1). Estradiol administration (SHORT and LONG) increased total C18:1 fatty acids (P = 0.05), and tended to increase non-C18:2 t10 c12 CLAs, C18:3, and total omega-3 fatty acids (P = 0.1) in the MFP and subcutaneous adipose tissues relative to CON. There was a treatment by tissue interaction for C18:1 trans-10 (P = 0.01), and a tendency for C18:1 trans-11 and C18:2 trans-10 cis-12 (P = 0.1) indicating that estradiol's effects on fatty acids are tissue specific. Together, these results indicate that the MFP responds differently to estradiol than subcutaneous adipose tissues and that these alterations are associated with different periods of induced mammary growth via estradiol. [ABSTRACT FROM AUTHOR]

Growth of the bovine mammary gland is influenced by estradiol during a heifer's life. The objective of this study was to determine the effect of estradiol administration on two different mammary parenchymal tissue regions and quantify the response in cellular proliferation between different estradiol treatments and regions. Treatments were administered daily during the 12 days prior to euthanasia at 82 days of age. Holstein heifer calves (n = 12) were divided amongst 3 treatments, control (n = 4, CON), short term (n = 4, SHORT), and long term (n = 4, LONG). CON calves were administered corn oil injections while SHORT calves received 9 injections of corn oil followed by 3 injections of estradiol; LONG calves received 12 injections of estradiol. BrdU was administered 2 hours prior to harvest to label proliferating mammary epithelial cells. Mammary parenchyma was dissected from the right rear gland and separated into two regions, center and edge parenchyma, for further examination. Tissues were examined using brightfield microscopy and fluorescent immunohistochemistry. LONG calves had a greater percentage (P < 0.05) of epithelial tissue area (34.0% ± 1.51) than CON (21.4% ± 1.5) and SHORT (23.0% ± 1.51) calves, and a lower stromal tissue area percentage (63.6% vs 73.9% and 74.0% ± 2.10, respectively; P < 0.05). There was a treatment by region interaction in the cellular proliferation. LONG calves had a greater percentage of proliferating epithelial cells than CON calves in the center (P < 0.05) and edge (P < 0.05) parenchymal regions, and a greater percentage of proliferating cells in the center parenchyma than SHORT calves (P < 0.05). These results indicate that duration of estradiol administration elicits different effects on mammary growth and that mammary epithelial cell proliferation is specific to mammary gland region. [ABSTRACT FROM AUTHOR]

Introduction: Understanding social and structural barriers that determine antiretroviral therapy (ART) adherence can improve care. Assessment of such factors is limited in Myanmar, a country with high HIV prevalence and increasing number of people living with HIV initiating ART., Methods: Questionnaires were administered to adults with HIV across 4 Myanmar cities to estimate adherence and its potential determinants, including HIV knowledge, social support, barriers to care, enacted and internalized stigma, and engagement in peer-to-peer HIV counseling (PC). Associations were determined using logistic mixed-effects modeling., Results: Among 956 participants, the mean age was 39 years, 52% were female, 36% had CD4 <350 cells/mm3, and 50% received pre-ART PC. Good adherence was reported by 74% of participants who had better HIV knowledge than those reporting nonadherence. Among nonadherent, 44% were forgetful and 81% were careless about taking ART. Among all participants, most (53%) were very satisfied with their social support and 79% reported lack of financial resources as barriers to care. Participants most frequently reported being viewed differently by others (30%) and feeling as if they were paying for past karma or sins because of their HIV diagnosis (66%). Enacted stigma (odds ratio 0.86; 95% confidence interval 0.79 to 0.92, P < 0.01) and internalized stigma (odds ratio 0.73; 95% confidence interval: 0.56 to 0.95, P = 0.023) were associated with worse adherence., Conclusions: Increased self-reported ART adherence in Myanmar is associated with less enacted and internalized stigma. These findings suggest the benefit of developing and promoting adherence interventions, which are focused on mitigating HIV-related stigma in the county., Competing Interests: The authors report no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)