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Objective To compare racial differences in male fertility history and treatment. Design Retrospective review of prospectively collected data. Setting North American reproductive urology centers. Patient(s) Males undergoing urologist fertility evaluation. Intervention(s) None. Main Outcome Measure(s) Demographic and reproductive Andrology Research Consortium data. Result(s) The racial breakdown of 6,462 men was: 51% White, 20% Asian/Indo-Canadian/Indo-American, 6% Black, 1% Indian/Native, Conclusion(s) Racial differences exist for males undergoing fertility evaluation by a reproductive urologist. Better understanding of these differences in history in conjunction with societal and biologic factors can guide personalized care, as well as help to better understand and address disparities in access to fertility evaluation and treatment.

Thermogenesis in beige/brown adipose tissues can be leveraged to combat metabolic disorders such as type 2 diabetes and obesity. The complement system plays pleiotropic roles in metabolic homeostasis and organismal energy balance with canonical effects on immune cells and non-canonical effects on non-immune cells. The adipsin/C3a/C3aR1 pathway stimulates insulin secretion and sustains pancreatic beta cell mass. However, its role in adipose thermogenesis has not been defined. Here, we show thatAdipsinknockout mice exhibit increased energy expenditure and white adipose tissue (WAT) browning. C3a, a downstream product of adipsin, is generated from complement component 3 and decreasesUcp1expression in subcutaneous adipocytes. In addition, adipocyte-specificC3aR1knockout male mice show enhanced WAT thermogenesis and increased respiration. In stark contrast, adipocyte-specificC3aR1knockout female mice display decreased brown fat thermogenesis and are cold intolerant. Female mice express lower levels ofAdipsinin thermogenic adipocytes and adipose tissues than males.C3aR1is also lower in female subcutaneous adipose tissue than males. Collectively, these results reveal sexual dimorphism in the adipsin/C3a/C3aR1 axis in regulating adipose thermogenesis. Our findings establish a newly discovered role of the alternative complement pathway in adipose thermogenesis and highlight sex-specific considerations in potential therapeutic targets for metabolic diseases.

This study of ethnic Asian children in the United States asked whether their health exhibited relationship with any of six factors: social disorganization, social structural factors, social relationships, the health of their parents, their access to medical insurance, acculturation. The sample of 1350 ethnic Asian children was extracted from the 2018 National Survey of Children’s Health. Logistic regression results showed that these children’s excellent/very good/good health was associated positively with safe neighborhoods, family incomes, family cohesiveness, family support, and receipt of Temporary Assistance for Needy Families (TANF). In turn, health was associated negatively with single-mother households. Implications of the present results in terms of interventions promoting family support, TANF participation, safe neighborhoods, and professionals’ cultural competency are discussed.

Schistosomiasis is a helminthiasis infecting approximately 250 million people worldwide. In 2001, the World Health Assembly (WHA) 54.19 resolution defined a new global strategy for control of schistosomiasis through preventive chemotherapy programmes. This resolution culminated in the 2006 WHO guidelines that recommended empirical treatment by mass drug administration with praziquantel, predominately to school-aged children in endemic settings at regular intervals. Since then, school-based and community-based preventive chemotherapy programmes have been scaled-up, reducing schistosomiasis-associated morbidity. Over the past 15 years, new scientific evidence-combined with a more ambitious goal of eliminating schistosomiasis and an increase in the global donated supply of praziquantel-has highlighted the need to update public health guidance worldwide. In February, 2022, WHO published new guidelines with six recommendations to update the global public health strategy against schistosomiasis, including expansion of preventive chemotherapy eligibility from the predominant group of school-aged children to all age groups (2 years and older), lowering the prevalence threshold for annual preventive chemotherapy, and increasing the frequency of treatment. This Review, written by the 2018-2022 Schistosomiasis Guidelines Development Group and its international partners, presents a summary of the new WHO guideline recommendations for schistosomiasis along with their historical context, supporting evidence, implications for public health implementation, and future research needs.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infections in vaccinated individuals and reinfections in previously infected individuals have become increasingly common. Such infections highlight a broader need to understand the contribution of vaccination, including booster doses, and natural immunity to the infectiousness of individuals with SARS-CoV-2 infections, especially in high-risk populations with intense transmission, such as in prisons. Here we show that both vaccine-derived and naturally acquired immunity independently reduce the infectiousness of persons with Omicron variant SARS-CoV-2 infections in a prison setting. Analyzing SARS-CoV-2 surveillance data from December 2021 to May 2022 across 35 California state prisons with a predominately male population, we estimate that unvaccinated Omicron cases had a 36% (95% confidence interval (CI): 31-42%) risk of transmitting infection to close contacts, as compared to a 28% (25-31%) risk among vaccinated cases. In adjusted analyses, we estimated that any vaccination, prior infection alone and both vaccination and prior infection reduced an index case's risk of transmitting infection by 22% (6-36%), 23% (3-39%) and 40% (20-55%), respectively. Receipt of booster doses and more recent vaccination further reduced infectiousness among vaccinated cases. These findings suggest that, although vaccinated and/or previously infected individuals remain highly infectious upon SARS-CoV-2 infection in this prison setting, their infectiousness is reduced compared to individuals without any history of vaccination or infection. This study underscores benefit of vaccination to reduce, but not eliminate, transmission.

Redistribution layer (RDL) is one key enabling technology for advanced packaging. RDL is usually fabricated at wafer level by a photolithography process. An alternative approach for implementing RDL by additive manufacturing (AM) method is proposed in this study. This allows RDL to be fabricated on a singulated chip. Nanosilver (nano-Ag) ink is printed on the silicon chip to form routing traces and bond pads. However, the Ag pad may be consumed by the solder quickly if the reflow process is not properly controlled. The mechanical integrity of the solder joint was evaluated by both solder ball shear and die shear tests. A high temperature storage test and humidity test were carried out to evaluate the solder joint reliability. Experiment results showed that the Ag pad fabricated by AM is compatible with surface mount technology (SMT). Reliable solder joints on the Ag pad were achieved. There was no significant change in the Ag3Sn intermetallic compound (IMC) layer thickness and mechanical strength after aging at high temperature and high humidity conditions. There was no early solder joint failure observed. The finding of the present study will serve as a very useful reference for the future practice of forming solder joints on sintered nano-Ag pads.

BACKGROUND Backward walking (BW) interventions have improved gait and balance in persons with stroke, cerebral palsy, and Parkinson disease but have not been studied in persons with multiple sclerosis (MS). We examined the feasibility of a BW intervention and how it affected strength, balance, and gait vs forward walking (FW) in persons with MS. METHODS Sixteen persons with MS with a Patient-Determined Disease Steps (PDDS) scale score of 3 to 5 (gait impairment-late cane) were randomized to the FW (n = 8) or BW (n = 8) group. Participants did 30 minutes of FW or BW on a treadmill 3 times per week for 8 weeks (24 visits). Enrollment, adherence rate, and safety were tracked. The Timed Up and Go test, Six-Spot Step Test, single-leg stance, and abbreviated Activities-specific Balance Confidence scale were used to measure balance. Hip and knee flexion and extension strength (isometric peak torque), gait speed, and spatiotemporal gait parameters were measured. A 2×2 factorial multivariate analysis of covariance was used to examine changes in strength, balance, and gait, with the PDDS scale score as the covariate. RESULTS Treatment adherence rate was 99.7%, with no safety concerns. After controlling for baseline differences in disability (PDDS scale score; P = .041), the BW group improved dominant hip flexion strength preintervention to postintervention compared with the FW group (F1,13 = 9.03; P = .010). No other significant differences were seen between groups. CONCLUSIONS This was the first study to look at BW as an intervention in persons with MS. Based on its feasibility, safety, and significant finding, BW should be studied in a larger, definitive trial in the future.

Background In monitoring population health and the effectiveness of public health strategies, the body mass index (BMI) is often assessed within national surveys from self-reported height and weight rather than measured values. Using data collected within a recent health examination survey (HES), the discrepancies between self-reported and measured values were assessed, and correction models were estimated and implemented on national interview survey data. Methods Within the CUORE Project, the Italian National Institute of Health conducted the HES 2018-2019 measuring height and weight as well as collecting data on self-reported values in random samples of general population aged 35-74 years residing in ten (of 20) Italian regions distributed in the North, Centre and South: 1033 men and 1061 women. Results Self-reported and measured data comparison showed greater differences in mean values of height than weight and in women than in men (height +2 cm in men and +3.2 in women; weight -0.7 kg and -1.4 kg, respectively) and a corresponding underestimation of BMI (-0.7 kg/m2 and -1.4 kg/m2, respectively). Differences were stable across age groups and educational levels, except for height discrepancy, which was greatest in women aged 65-74 years. Self-reported vs measured prevalence were: normal weight 39.7%-33.3% in men and 54.8%-44.7% in women, overweight 45.8%-46.1% and 26.0%-29.2%, obesity 13.8%-20.1% and 15.7%-23.9%. Linear regression models adjusted by sex and age classes were assessed for height and weight (R2 > =0.92) and implemented to estimate adjusted BMI and normal weight/overweight/obesity prevalence on the national multi-purpose interview survey data collected by the Italian National Institute of Statistics. Conclusions To provide more accurate prevalence of normal weight, overweight and obesity, self-reported values could be adjusted using correction models developed on the basis of the relationship between self-reported and measured height and weight values. Key messages • Discrepancies between self-reported and measured values of height and weoght were found. • Self-reported values could be adjusted using correction models developed on the basis of the relationship between self-reported and measured height and weight values.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to be a global threat since its emergence. Although several COVID-19 vaccines have become available, the prospective timeframe for achieving effective levels of vaccination across global populations remains uncertain. Moreover, the emergence of SARS-CoV-2 variants presents continuing potential challenges for future vaccination planning. Therefore, development of effective antiviral therapies continues to be an urgent unmet need for COVID-19. Successful antiviral regimens for the treatment of human immunodeficiency virus and hepatitis C virus infections have established viral proteases as validated targets for antiviral drug development. In this context, we review protease targets in drug development, currently available antiviral protease inhibitors, and therapeutic development efforts on SARS-CoV-2 main protease and papain-like protease. SIGNIFICANCE STATEMENT: Coronavirus disease 2019 (COVID-19) continues to be a global threat since its emergence. The development of effective antiviral therapeutics for COVID-19 remains an urgent and long-term need. Because viral proteases are validated drug targets, specific severe acute respiratory syndrome coronavirus 2 protease inhibitors are critical therapeutics to be developed for treatment of COVID-19.

Applying the multiple disadvantage model, a study of children in the United States examined experiences of being bullied in terms of 5 factors: social disorganization, social structural factors, social relationships, mental health and access to care, and acculturation. The study was a secondary data analysis of 19,882 immigrant and non-immigrant children, using data from the 2018 National Survey of Children's Health. Logistic regression results show children's likelihood of being bullied to be associated positively with racial discrimination; child mental health problem (either attention deficit/hyperactivity disorder, depression, anxiety, behavioral/conduct problem, or Tourette Syndrome); family substance use; being female; being age 6-10; being age 11-13; and parent education level. Likelihood of being bullied was associated negatively with safe neighborhood; being Black; being Asian; family cohesiveness; neighbor support; parent mental health; being a first- or second-generation immigrant; and parent age. The results imply the usefulness of interventions promoting racial harmony and family support.

Recently, the Geotechnical Engineering Office has initiated a pilot study on data-driven landslide susceptibility analysis (LSA) using a machine learning (ML) approach. A study area covering about one-fifth of the total natural hillside area of Hong Kong on and around the Lantau Island was considered. Three common tree-type ML classifiers: Decision Tree, Random Forest and XGBoost have been used. Conditioning factors (or features) including rainfall, geological and topography-related features were considered. In the study, the domain knowledge on natural terrain landslides in Hong Kong were critically incorporated into the susceptibility models through feature engineering to ensure that the resulted models are physically meaningful. In addition, an approach proposed to resolve the serious data imbalance problem, which is common in LSA, will be highlighted. Under this approach, the predicted probabilities of the positive class (i.e., landslide) can also be taken as a proxy to the landslide probability. This paper reports the methodology and key findings of this pilot study. The approach can be extended to cover other ML algorithms and features, and to a territory-wide scale with a view to enhancing the resolution and accuracy of the current susceptibility model of natural hillsides in Hong Kong.

The trial application of fibre optics and remote sensing techniques for monitoring a peanut-shaped tunnel boring machine (TBM) launching shaft in the Trunk Road T2 and Cha Kwo Ling Tunnel project has recently been completed. This is the first time in Hong Kong that these techniques are deployed to systematically monitor the entire excavation process of the peanut-shaped shaft. In particular, distributed fibre optic sensing (DFOS) technique based on optical frequency domain reflectometry (OFDR) was used to capture the continuous profiling of the strain measurement by fibre optics installed in the diaphragm wall panels, thus enabling the development of hoop strain to be revealed. To facilitate data interpretation, the excavation process was regularly recorded by the handheld light detection and ranging (LiDAR) scanning technique. This paper reports the background and key findings of the monitoring work as well as the results of the data analysis. The monitoring work provides valuable field data, which could not be easily obtained on site in the past. The data may be of use for numerical back-analysis to better understand the behaviour of shaft excavation. Insights gained in this study could also be useful to future design and construction of similar excavation works.

BACKGROUND The Multiple Sclerosis Resiliency Scale (MSRS) was designed to assess factors connected to resilience when facing MS-related challenges. Although the MSRS has demonstrated good internal consistency and construct validity, its test-retest reliability has yet to be established. Identifying the minimal detectable change (MDC) of the scale will also improve its utility as an outcome measure for resilience-based interventions. This study aimed to determine the test-retest reliability and MDC of the MSRS. METHODS Participants were 62 persons with MS who completed the MSRS twice, with a mean ± SD of 16.60 ± 3.97 days (range, 14–30 days) between assessments. Test-retest reliability was evaluated using a 2-way, random-effects, single-measurement intraclass correlation coefficient (ICC), with agreement between time 1 and time 2 visualized with a Bland-Altman plot. The MDC was calculated using the standard error of measurement with a 95% CI. RESULTS At time 1, the mean ± SD MSRS score was 77.19 ± 11.97 (range, 45.83–97.00); at time 2, the mean ± SD score was 76.38 ± 12.75 (range, 46–98). The MSRS total score had good test-retest reliability (ICC = 0.88), with the subscale ICCs ranging from 0.77 (MS Peer Support) to 0.93 (Spirituality). The MDC for the total score was 11.95. CONCLUSIONS These findings suggest that the MSRS has good test-retest reliability and that persons with MS with a difference of 12 points or more between assessments have experienced a reliable change. The results support the utility of the MSRS as a potential outcome measure for MS-related resilience.

The United States CDC defines a county metric of COVID-19 Community Levels to inform public health measures. We find that the COVID-19 Community Levels vary frequently over time, which may not be optimal for decision making. Alternative metric formulations that do not compromise predictive ability are shown to reduce variability.

Background Despite evidence of adverse health consequences of inadequate restorative sleep for older adults, assessment of sleep quantity, quality, and use of sleep aids is not routinely done. We aimed to characterize sleep problems, sleep risks, and advice received about sleep in a community-dwelling older adult population, overall and in subgroups with health conditions and functional difficulties. Methods This cross-sectional study used weighted self-report data for 5074 Kaiser Permanente Northern California members aged 65-79y who responded to a 2017 or 2020 Member Health Survey. We estimated usual amount of sleep ( Results Approximately 30% of older adults usually got less than the recommended ≥7 hours sleep per day, and 9% experienced frequent daytime fatigue, 13% frequent insomnia, 18% frequent insomnia/poor quality sleep, and 8% potential OSA symptoms. Prevalence of frequent insomnia was higher among women than men (16% vs. 11%). Higher percentages of those in fair/poor health and those with frequent balance/walking and memory problems reported sleeping 20% reported discussing diet and exercise. Conclusions Large percentages of older adults experience sleep problems or get less sleep than recommended for optimal sleep health. Older patients should routinely be assessed on multiple components of sleep health (sleep hygiene, quantity, quality, problems, and sleep aid use) and educated about sleep hygiene and the importance of getting adequate restorative sleep for their overall health and wellbeing.

Evidence has shown that podocyte-directed autoantibodies can cause membranous nephropathy (MN). In the present work we investigated sera of MN patients using a high-density peptide array covering the whole coding sequences of the human genome encompassing 7,499,126 tiled peptides. A panel of 21 proteins reactive to MN sera were identified. We focused our attention on Formin-like 1 (FMNL1), a protein expressed by macrophages in MN patients tissues. High levels of anti-FMNL1 IgG4 were demonstrated in sera of MN patients with an orthogonal methodology (ELISA) contemporary demonstrating FMNL1 positive cells in kidney co-staining with CD68 in glomeruli. High levels of circulating anti-FMNL1 IgG4 were associated with lack of remission of proteinuria, potentially indicating that autoantibodies directed against cells other than podocytes, involved in tissue repair, might play a role in MN disease progression. High serum levels of anti-FMNL1 IgGs were also observed in other non-autoimmune glomerolonephrites, i.e. idiopathic and genetic FSGS, IgAGN. These findings are suggestive of a broader role of those autoantibodies in other glomerular disease conditions.

Preservation and expansion of β-cell mass is a therapeutic goal for diabetes. Here we show that the hyperactive isoform of carbohydrate response-element binding protein (ChREBPβ) is a nuclear effector of hyperglycemic stress occurring in β-cells in response to prolonged glucose exposure, high-fat diet, and diabetes. We show that transient positive feedback induction of ChREBPβ is necessary for adaptive β-cell expansion in response to metabolic challenges. Conversely, chronic excessive β-cell-specific overexpression of ChREBPβ results in loss of β-cell identity, apoptosis, loss of β-cell mass, and diabetes. Furthermore, β-cell “glucolipotoxicity” can be prevented by deletion of ChREBPβ. Moreover, ChREBPβ-mediated cell death is mitigated by overexpression of the alternate CHREBP gene product, ChREBPα, or by activation of the antioxidant Nrf2 pathway in rodent and human β-cells. We conclude that ChREBPβ, whether adaptive or maladaptive, is an important determinant of β-cell fate and a potential target for the preservation of β-cell mass in diabetes.