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Presents a letter to the editor on a study about the origin of HIV and HTLV.

Background: In order to evaluate whether the expected increase in yield of detecting HBV infectious donations by pooled-sample HBV NAT is valid, we designed a study to estimate the increase in the number of HBV infectious units detected by newer HBsAg tests, pooled NAT, and single-sample NAT, compared to licensed HBsAg tests. Methods: Ten samples from each of 10 HBV seroconversion (SC) panels were selected from "pre-ramp-up" (early infection, low viral load) and "ramp-up" (viral load increase) phases. These were coded along with 28 analytical controls (FDA's HBsAg lot-release panel and WHO's HBV NAT standard). All 128 samples were tested in 7 HBsAg tests and in 4 HBV NAT assays, both undiluted and after dilution 1:16, 1:24, 1:512 and 1:1200 to resemble pooled NAT for Whole Blood (WB) and Source Plasma (SP). Results: Based on data from controls, the estimated concentration at cutoff (CO) for new HBsAg tests ranged from 0.09 to 0.18 ng HBsAg/mL, compared with 0.15 to 0.63 ng HBsAg/mL in licensed tests. Viral load at CO varied from 88 to 359 IU/mL for new HBsAg tests, and from 350 to 1114 IU/ mL in licensed tests. Of 10 pre-ramp-up samples in the SC panels, one new HBsAg assay detected 10%, pooled NAT detected 0 to 30%, and single-unit NAT detected 30 to 80%. Of 90 ramp-up samples HBsAg tests detected 31 to 61%, while pooled NAT detected 56 to 71% and single-sample NAT, 82 to 99%. WB format pooled NAT (pools of 16 or 24 samples) was not more sensitive than the SP format (pools of 512 or 1200 samples). Compared with currently approved HBsAg assays, pooled NAT would reduce the window period (wp) by 9 to 11 days; newer HBsAg assays, 11 to 15 days; and single-sample NAT, 25 to 36 days. Conclusions: There are significant differences in sensitivity between licensed and newer HBsAg assays, shown by estimated viral burden and HBsAg concentration at cutoff, and by wp closure estimates. Thus, newer HBsAg tests would be expected to detect ∼18 additional units/ 107 donations compared to licensed tests. Sensitivity, wp closure and incremental yield projections for newer HBsAg assays are comparable to those for pooled NAT. Single-sample NAT would increase yield by ∼25 units/ 107 donations over pooled NAT and newer HBsAg assays, and by ∼42 units/ 107 donations over current HBsAg assays. [ABSTRACT FROM AUTHOR]

Abstract: Physicochemical properties of metallosalen complexes entrapped within NaX zeolite and their catalytic activities in the oxidation of cyclooctane with dioxygen in the absence of a reducing agent were studied, and compared with free metallocomplexes. Broadening of the zeolite structure-sensitive vibrations observed after the encapsulation gives the evidence of the zeolite framework changes due to the presence of the “ship-in-the-bottle” species. EPR spectroscopy evidences the inclusion of metallosalen complexes since it distinguishes between encapsulated metallocomplexes and those adsorbed on the zeolite external surface. UV–vis spectra confirm the immobilization and stabilization of the metallocomplexes inside the zeolite structure. The most active catalysts are free metallosalen complexes. We have found that the activity of these complexes increases in the order Ni(salen), Fe(salen), Mn(salen), Cu(salen) and Co(salen) with triple difference in the catalytic activity between the most and the least active catalyst. Upon encapsulation their activity drops about two times. Only Ni(salen) after heterogenization does not change its catalytic activity. The reduction of catalytic activity of the encapsulated catalysts is probably governed by two factors: constraints in the formation of the intermediate complex and change of the redox potential of the metal in the salen complex. [Copyright &y& Elsevier]

Alterations in the redox status of proteins have been implicated in the pathology of several neurodegenerative diseases including Alzheimer’s and Parkinson’s. We report that peroxynitrite and H2O2-induced disulfides in the porcine brain microtubule-associated proteins tau and microtubule-associated protein-2 are substrates for the glutaredoxin reductase system composed of glutathione reductase, human or Escherichia coli glutaredoxin, reduced glutathione, and NADPH. Oxidation and reduction of cysteines in tau and microtubule-associated protein-2 were quantitated by monitoring the incorporation of 5-iodoacetamido-fluorescein, a thiol-specific labeling reagent. Reduction of disulfide bonds in the microtubule-associated proteins by the glutaredoxin reductase system restored their ability to promote the assembly of microtubules composed of purified porcine tubulin. Thiol-disulfide exchange between oxidized glutathione and the microtubule-associated proteins was detected by monitoring protein oxidation and was quantitated by measuring reduced glutathione by HPLC. [Copyright &y& Elsevier]

Hepatitis C virus (HCV) is an important cause of liver disease throughout the world. However, the natural history and pathogenesis of this infection is still not completely understood. The aim of this study was to characterize the evolution of incident, asymptomatic HCV infection in a community-based population in Japan. The Miyazaki Cohort Study is a prospective study of adult residents in two villages, one of which has a very high prevalence of HCV. Nine hundred and seventy-three people from this village were enrolled in the cohort between 1984 and 1995, with antibodies to HCV (anti-HCV) found in 23%. During subsequent visits to annual health screens, new HCV seroconverters were identified among susceptible individuals, and their sequential samples were tested for anti-HCV, HCV-RNA, and HCV core antigen. Fourteen participants (six males, eight females) acquired anti-HCV during the first 11 years of study follow-up, at an incidence rate of 362 per 100 000 person-years. Detectable HCV-RNA and high anti-HCV titres (> 1:2048) were observed for more than 5 years following seroconversion in 80% (8/10) of seroconverters with sufficient information, indicating the development of persistent infection in these subjects. Three (37.5%) of the eight sero converters with persistent infection had fairly consistent, albeit mild, alanine aminotransferase elevations (30–130 IU/L) during the study. Anti-HCV seroconversions occurred at a very high rate in this community-based population in Japan, in which this infection is endemic. Persistence also developed at a high frequency among the cases of newly acquired infection, although the associated liver enzyme abnormalities were mild. [ABSTRACT FROM AUTHOR]

Background: PositiveLinks (PL) is a smartphone-based platform designed in partnership with people living with HIV (PLWH) to improve engagement in care. PL provides daily medication reminders, check-ins about mood and stress, educational resources, a community message board, and an ability to message providers. The objective of this study was to evaluate the impact of up to 24 months of PL use on HIV viral suppression and engagement in care and to examine whether greater PL use was associated with improved outcomes. Setting: This study occurred between September 2013 and March 2017 at a university-based Ryan White HIV clinic. Methods: We assessed engagement in care and viral suppression from study baseline to the 6-, 12-, 18- and 24-month follow-up time periods and compared trends among high vs. low PL users. We compared time to viral suppression, proportion of days virally suppressed, and time to engagement in care in patients with high vs. low PL use. Results: 127 patients enrolled in PL. Engagement in care and viral suppression improved significantly after 6 months of PL use and remained significantly improved after 24 months. Patients with high PL use were 2.09 (95% CI 0.64–6.88) times more likely to achieve viral suppression and 1.52 (95% CI 0.89–2.57) times more likely to become engaged in care compared to those with low PL use. Conclusion: Mobile technology, such as PL, can improve engagement in care and clinical outcomes for PLWH. This study demonstrates long-term acceptability of PL over two years and provides evidence for long-term improvement in engagement in care and viral suppression associated with PL use. [ABSTRACT FROM AUTHOR]

Although most cases of hepatocellular carcinoma (HCC) are associated with either the hepatitis B or C viruses (HBV, HCV), about 10–20% of HCCs occur in patients with chronic hepatitis that is aetiologically undefined. The aim of the present study was to determine the prevalence of the transfusion-transmitted SEN virus (SEN-V) in patients with HCC, including those patients who do not otherwise appear to be infected with HBV or HCV. Fragments of SEN-V subtypes D and H were amplified separately by PCR from the sera of 50 patients with HCC (31 from Canada and 19 from Japan) as well as from HCC and adjacent nontumourous liver tissues from eight of the Canadian patients. SEN-V DNA was found in the serum of 10 of 31 (32%) Canadian patients and eight of 19 (42%) Japanese patients [overall, 18 of 50 (36%) HCC patients]. SEN-V DNA was detected in the serum of 10 of 23 (43%) HCC patients with antibody to HCV (anti-HCV), six of 11 (55%) with hepatitis B surface antigen (HBsAg), and two of 16 (12%) without detectable anti-HCV or HBsAg. Twenty-three HCC patients in this study had ‘silent HBV,’ characterized by the detection of HBV DNA in the absence of HBsAg; eight of these (35%) also had SEN-V infections. SEN-V DNA was detected in HCC patients most typically in those with coexistent HBV or HCV infection. SEN-V was found in only one of seven HCC patients without HBV (without HBsAg or HBV DNA) or HCV and thus does not appear to be an important cause of ‘cryptogenic’ HCC. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate reports that hepatitis B virus (HBV) DNA sequences can be found in the serum and/or tumour tissue from some hepatocellular carcinoma (HCC) patients who have no detectable hepatitis B surface antigen (HBsAg) in their sera. Such HBV infections would be highly atypical, because prospective studies have shown a clear succession of specific serologic markers during and after most HBV infections. As most HBsAg-negative HCC patients in Japan have hepatitis C virus (HCV) infections, the present study was conducted to determine whether some of these patients actually have unrecognized HBV infections. Thirty newly diagnosed HCC patients from Kurume, Japan, with antibody to the hepatitis C virus (anti-HCV) were studied. None of the 30 had HBsAg detectable in their serum. Of 22 for whom test results for antibodies to the hepatitis B core antigen (anti-HBc) and antibodies to HBsAg (anti-HBs) were available, 14 (64%) had anti-HBc and anti-HBs, four (18%) had anti-HBc alone, and four (18%) had no HBV markers. Nested polymerase chain reaction was used to detect the HBV surface (S), core (C), polymerase (P) and core promoter gene sequences in the HCC tissues and in the adjacent nontumorous liver tissues. HBV DNA was detected in HCC and/or adjacent nontumorous liver in 22 of 30 (73%) patients [detected in both HCC and nontumorous liver in 19/30 patients (63%)]. Among the 22 patients with detectable HBV DNA, more than one HBV gene was detected in 10 (46%). Among the four patients whose sera were negative for all HBV markers, three had HBV DNA in either HCC and nontumorous liver (two cases) or only in the nontumorous liver (one case); HBV DNA could not be detected in tissues from the fourth patient. In 18 of 21 (86%) patients with detectable HBV core promoter sequences, mutations at both nucleotides 1762 (A–GT) and 1764 (G–A) in the core promoter region were found. No deletions were detected in the core promoter gene region of the type reported to be associated with some cases of HBsAg-negative HBV infection. Thus, HBV DNA was detectable in 22 (73%) HBsAg-negative, anti-HCV-positive HCCs, including three (10%) who were also negative for anti-HBc and anti-HBs. HBV mutations at both nucleotides 1762 (A–GT) and 1764 (G–A) in the core promoter region were found in the majority of cases, mutations that have previously been reported in HBV that is integrated in HCC DNA. In serologic surveys to determine etiologic associations of HCC, patients such as those in this study would have been incorrectly designated as having‘HCV-associated HCC,’ whereas the data in this study suggest that HBV could have played a role in the development of their HCCs. [ABSTRACT FROM AUTHOR]

Most studies of hepatitis C virus (HCV) quasispecies have reported the results of sequencing only three to five clones per sample. The possibility that sequencing so few clones might not provide a representative picture of the quasispecies present in a sample has never been evaluated. The present study was conducted to evaluate whether sequencing greater numbers of clones results in better information about the HCV quasispecies number and distribution, and to compare the HCV quasispecies in liver cancer cases and controls. RNA was extracted from serial serum samples from six subjects with HCV-associated liver cancer and 11 age- and sex-matched HCV-infected controls without liver cancer. The hypervariable region 1 (HVR1) of the HCV genome was amplified, cloned, and sequenced. For further studies of 12 serum samples from two liver cancer cases and two matched controls, successive groups of 10 additional clones were sequenced up to a total of 50 clones per serum sample. When only 10 clones were sequenced from each specimen, no consistent differences were seen between the number of HCV quasispecies in the six liver cancer cases and the 11 controls. However, sequencing 40 clones from each of 12 samples from two liver cancer cases and two controls revealed a greater number of quasispecies in liver cancer cases than in controls. Testing an additional 10 clones (50 clones per sample) did not significantly increase the number of quasispecies detected. [ABSTRACT FROM AUTHOR]

Background: Most people diagnosed with hepatitis C virus (HCV) have not linked to care, despite the availability of safe and effective treatment. We aimed to understand why people diagnosed with HCV have not pursued care in the non-urban Southern United States. Methods: We conducted a survey and semi-structured interview with participants referred to an HCV clinic who did not attend an appointment between 2014 and 2018. Our clinic is located in a non-urban region of Virginia at a university hospital. Qualitative data collection was guided by the Health Belief Model (HBM). Data was analyzed using qualitative content analysis to identify key factors influencing patient perceptions regarding HCV and pursuit of care. Results: Over half of previously referred patients (N = 200) could not be reached by phone. Eleven participants enrolled, including 7 men and 4 women. Based on survey responses, unreliable transportation, unstable housing, substance use, and lack of insurance were common. Participants demonstrated good knowledge of HCV disease, complications, and treatment. On qualitative analysis of semi-structured interviews, final themes emerged from within and between HBM constructs. Emerging themes influencing patient perceptions included (1) structural barriers, (2) stigma, (3) prior experiences of HCV disease and treatment, (4) discordance between the recognized severity of HCV and expected impacts on one's own health, and (5) patient-provider relationship. Substance use was not identified to be a barrier to care. Conclusions: Participants perceived individual and structural barriers to linking to care. A strong HCV knowledge base was not sufficient to motivate pursuit of care. Efforts to improve linkage to care must address barriers at multiple levels, and system-level changes are needed. As the majority of previously referred patients could not be contacted by phone, current approaches to patient engagement are not effective for reaching these populations. Expansion of HCV care to primary care settings with an established patient-provider relationship or co-located treatment within substance use treatment programs may serve to increase access to HCV treatment. [ABSTRACT FROM AUTHOR]

By consistently taking medication, people with HIV (PWH) can attain viral suppression, improving their health and reducing transmission risk. PositiveLinks (PL) is a clinic-deployed mobile platform designed to improve engagement in care for PWH by enabling them to track their medications, connect with peers, and communicate with providers. This project investigated the experience of PL users who had recent periods of viral non-suppression to understand how these high-risk episodes can be predicted and prevented. Fifteen participants completed mental health measures and in-depth interviews. Two members of the study team independently coded interview transcripts and resolved any discrepancies. The codebook was developed iteratively until thematic saturation and intercoder reliability were achieved. Participants revealed mental health and substance use concerns. Frequent stressors highlighted were relationship challenges, financial difficulties, and unstable living situations. Relationship challenges were a common barrier to care, along with competing priorities, transportation and finances. In contrast, positive relationships, motivation, positive interactions with clinic staff, and social programs facilitated regaining viral suppression. Participants highlighted the importance of strong patient-provider relationships and social support in overcoming barriers to care. We identified factors that impact medication adherence, which will inform efforts to mitigate and prevent viral non-suppression and thus improve health outcomes.

Background: Osteoporosis is a metabolic disease characterized by increased bone fragility. As it is characterized as a general skeletal disease, changes can also be seen in the stomatognathic system (edentulism, wrong fitting of dentures, etc.). The question is whether early changes in the salivary mineral content and acid-base balance may reflect skeletal status and risk of bone fracture., Objectives: The objective of the study was to evaluate whether minerals in the saliva were associated with skeletal fractures in a population of postmenopausal women., Material and Methods: In this observational study, dental examinations along with the collection of saliva were conducted in 117 randomly recruited women (mean age 64.6 ±5.9 years). The study group included 23 study participants with fractures, of which 10 had a history of osteoporotic fractures. Saliva samples for mineral content including copper (Cu), zinc (Zn), calcium (Ca), and phosphorus (P), as well as salivary pH were collected and analyzed to determine associations between salivary mineral content and fracture risk., Results: As a result, the median pH value was 6.8, and the median levels for Cu (0.35 μmol/L), Zn (0.61 μmol/L), Ca (0.7 mmol/L), and P (6.64 mmol/L) were observed. No differences were noted in salivary mineral content and acid-basic balance between the fractured and non-fractured participants., Conclusions: The results of our study suggest that salivary mineral content has limited usability in predicting skeletal fragility in postmenopausal women when used alone.

Background: The clinical significance of the genetic influence of vitamin D receptor polymorphisms has still not been well-analyzed., Objectives: To verify whether rs1544410, rs7975232 and rs731236 polymorphisms are associated with a higher 10-year fracture risk in postmenopausal women., Methods: The study group was a subset of a pre-defined population as part of the broader epidemiological research called the RAC-OST-POL Study and consisted of 358 postmenopausal women, chosen randomly from Racibórz (Poland) inhabitants (mean baseline age 65 ± 6.9 years, BMI 31.2 ± 5.5 kg/m 2 ). From all participants' medical history, data concerning co-morbidities, fracture history, the medication used, parental history of bone fractures, cigarettes and alcohol use were taken at baseline. Moreover, rs1544410, rs7975232 and rs731236 polymorphisms were analyzed. Next, over the following 10 years, participants were contacted once a year and questioned concerning new fractures events and their circumstances., Results: We did not find statistically significant main effects on the fracture incidence of single-polymorphism variants. However, there were some significant findings dependent on the co-existence of these polymorphisms and medical factors. Women with a positive history of parental fracture and configuration of CC rs7975232, AA rs731236 and CC rs1544410 had a higher fracture incidence. The risk of bone fracture was also significantly higher in the group of heterozygotes of AC rs7975232 if their BMI value was in the categories of normal weight or overweight, or if they were treated with calcium or vitamin D., Conclusions: Polymorphisms of rs1544410, rs7975232 and rs731236 are connected with the fracture incidence in postmenopausal women. Nevertheless, its influence should be considered with co-existing clinical factors, especially paternal fracture history, prior fracture, BMI value, any osteoporotic treatment or calcium/vit. D supplementation., Competing Interests: The authors declare no conflict of interest.

Background: Sexual orientation has been measured in a wide variety of ways which reflect both theoretical and practical considerations. However, choice of sexual orientation measure and recoding strategy can impact analytic sample, as well as demographic and health profiles, in analyses of sexual minority populations. We aimed to examine how choice of sexual orientation dimension and recoding decisions impact estimates in the sexual minority population in two population-based studies in the UK., Methods: We used data collected at age 17 (2018) in the UK Millennium Cohort Study and at sweep six (2012-13) and eight (2017-18) of the English Longitudinal Study of Ageing. Descriptive statistics were used to examine the impact of choice of sexual orientation dimension (i.e. identity, attraction and experience) and recoding decisions on achieved analytic sample and composition by selected demographic and health measures within and between datasets., Results: Dimension choice and recoding decisions resulted in variation in analytic sample. For example, more respondents reported some same-sex sexual attraction than reported a non-heterosexual identity (adolescents: 20.77% vs 8.97%, older adults: 4.77% vs 1.04%). Demographic distributions varied, but not substantially by dimension choice or recoding strategy. Overall, in both datasets sexual minority respondents were more likely to be White and in the highest quintiles for income and education than heterosexual respondents. Health status did not vary substantially by dimension choice or recoding strategy, however sexual minority respondents reported worse health than their heterosexual peers., Conclusions: This study explores a range of practical and theoretical considerations when analysing sexual minority respondents using survey data. We highlight the impact recoding decisions may have on the numbers of sexual minority respondents identified within a dataset and demographic and health distributions in this understudied population. We also demonstrate the benefits of including multiple dimensions for capturing mechanisms of interest in elucidating ambiguous responses and exploring sexual diversity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tabor et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In 2019, 80% of the 7.4 million global child deaths occurred in low- and middle-income countries (LMICs). Global and regional estimates of cause of hospital death and admission in LMIC children are needed to guide global and local priority setting and resource allocation but are currently lacking. The study objective was to estimate global and regional prevalence for common causes of pediatric hospital mortality and admission in LMICs. We performed a systematic review and meta-analysis to identify LMIC observational studies published January 1, 2005-February 26, 2021. Eligible studies included: a general pediatric admission population, a cause of admission or death, and total admissions. We excluded studies with data before 2,000 or without a full text. Two authors independently screened and extracted data. We performed methodological assessment using domains adapted from the Quality in Prognosis Studies tool. Data were pooled using random-effects models where possible. We reported prevalence as a proportion of cause of death or admission per 1,000 admissions with 95% confidence intervals (95% CI). Our search identified 29,637 texts. After duplicate removal and screening, we analyzed 253 studies representing 21.8 million pediatric hospitalizations in 59 LMICs. All-cause pediatric hospital mortality was 4.1% [95% CI 3.4%-4.7%]. The most common causes of mortality (deaths/1,000 admissions) were infectious [12 (95% CI 9-14)]; respiratory [9 (95% CI 5-13)]; and gastrointestinal [9 (95% CI 6-11)]. Common causes of admission (cases/1,000 admissions) were respiratory [255 (95% CI 231-280)]; infectious [214 (95% CI 193-234)]; and gastrointestinal [166 (95% CI 143-190)]. We observed regional variation in estimates. Pediatric hospital mortality remains high in LMICs. Global child health efforts must include measures to reduce hospital mortality including basic emergency and critical care services tailored to the local disease burden. Resources are urgently needed to promote equity in child health research, support researchers, and collect high-quality data in LMICs to further guide priority setting and resource allocation., Competing Interests: JC-C speaker for Novamed and Tecnoquimicas; received financial travel support from BAGO to attend the Colombian Congress of Pediatrics; participated in an Advisory Board for ZambonColombia; acted as an investigator in phase 2 and 3 clinical trials of Merck Sharp and Dhome drugs (antibiotics and monoclonal antibodies) that do not interfere in the course of this study. JL stock options in MERCK and MODERNA. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor “CFO” declared a past co-authorship with the authors “NK & MOW”. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Kortz, Mediratta, Smith, Nielsen, Agulnik, Gordon Rivera, Reeves, O’Brien, Lee, Abbas, Attebery, Bacha, Bhutta, Biewen, Camacho-Cruz, Coronado Muñoz, deAlmeida, Domeryo Owusu, Fonseca, Hooli, Wynkoop, Leimanis-Laurens, Nicholaus Mally, McCarthy, Mutekanga, Pineda, Remy, Sanders, Tabor, Teixeira Rodrigues, Yuee Wang, Kissoon, Takwoingi, Wiens and Bhutta.)

Iron-containing zeolite-based catalysts play a pivotal role in environmental processes aimed at mitigating the release of harmful greenhouse gases, such as nitrous oxide (N 2 O) and methane (CH 4 ). Despite the rich iron chemistry in zeolites, only a fraction of iron species that exhibit an open coordination sphere and possess the ability for electron transfer are responsible for activating reagents. In addition, the splitting of molecular oxygen is facilitated by bare iron cations embedded in zeolitic matrices. Mössbauer spectroscopy is the ideal tool for investigating the valency and geometry of iron species in zeolites because it leaves no iron forms silent and provides insights into in-situ processes. This review is dedicated to the utilization of Mössbauer spectroscopy to elucidate the nature of the extra-framework iron centers in ferrierite (FER), beta-structured (*BEA), and ZSM-5 zeolite (MFI) zeolites, which are active in N 2 O decomposition and CH 4 oxidation through using the active oxygen derived from N 2 O and O 2 . In this work, a structured summary of the Mössbauer parameters established over the last two decades is presented, characterizing the specific iron active centers and intermediates formed upon iron's interaction with N 2 O/O 2 and CH 4 . Additionally, the impact of preparation methods, iron loading, and the long-term stability on iron speciation and its redox behavior under reaction conditions is discussed., (© 2023 The Authors. ChemPlusChem published by Wiley-VCH GmbH.)

Background: Postmenopausal osteoporosis is not only related to hormonal factors but is also associated with environmental and genetic factors. One of the latter is the polymorphism of vitamin D receptor ( VDR ). The aim of the reported study was to comprehensively analyze the VDR gene polymorphic variants rs731236 (TaqI), rs1544410 (BsmI) and rs7975232 (ApaI) in the Polish population of postmenopausal women., Methods: The study group consisted of 611 women after menopause (their median age was 65.82 ± 6.29 years). Each of them underwent bone densitometry (DXA) of the non-dominant femoral neck and total hip with a biochemical analysis of vitamin D3 serum concentration and genotyping of the above-mentioned single nucleotide polymorphisms (SNPs); the obtained results were analyzed in the aspect of waist circumference (WC), body mass index (BMI) and past medical history., Results: The genotype prevalence rates of all SNPs were compatible with Hardy-Weinberg equilibrium ( p > 0.050). Out of the studied polymorphisms, only rs731236 genotype variants affected DXA, with AG heterozygotes showing the worst bone parameters. Neither patient age nor vitamin D3 concentration, BMI, WC or comorbidities was associated with rs731236 genotype., Conclusions: Out of the polymorphisms studied, only rs731236 genotypes differed among the DXA results, while the AG heterozygotes were characterized by the lowest median bone mineral density.

Objective: Latinx people comprise 30% of all new human immunodeficiency virus (HIV) infections in the United States and face many challenges to accessing and engaging with HIV care. To bridge these gaps in care, a Spanish-language mobile health (mHealth) intervention known as ConexionesPositivas (CP) was adapted from an established English-language platform called PositiveLinks (PL) to help improve engagement in care and reduce viral nonsuppression among its users. We aimed to determine how CP can address the challenges that Latinx people with HIV (PWH) in the United States face., Materials and Methods: We conducted a post-implementation study of the CP mHealth platform, guided by principles of user-centered design. We enrolled 20 Spanish-speaking CP users in the study, who completed the previously validated System Usability Scale (SUS) and semistructured interviews. Interviews were transcribed and translated for analysis. We performed thematic coding of interview transcripts in Dedoose., Results: The SUS composite score was 75, which is within the range of good usability. Four categories of themes were identified in the interviews: client context, strengths of CP, barriers to use and dislikes, and suggestions to improve CP. Positive impacts included encouraging self-monitoring of medication adherence, mood and stress, connection to professional care, and development of a support system for PWH., Discussion: While CP is an effective and easy-to-use application, participants expressed a desire for improved personalization and interactivity, which will guide further iteration., Conclusion: This study highlights the importance of tailoring mHealth interventions to improve equity of access, especially for populations with limited English proficiency., Competing Interests: R.D. provides consulting services to Warm Health Technologies, Inc, a mobile health company. None of the other authors have any financial or nonfinancial interests to disclose., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

Despite different lifestyles, humankind has suffered from osteoporosis for thousands of years. A literature review concerning the history of osteoporosis in the following databases: Index Medicus, Medline, PubMed, and PMC Citations was done. In the final analysis, 18 review articles and 31 original papers were included. The works were published during the period 1705-2020. Although there is evidence of the existence of osteoporosis for many centuries, it was first described as a disease at the beginning of the 18th century. It was first perceived as an unavoidable course of aging with no possibility to cure. This approach changed only in the 20th century thanks to sudden diagnostic and therapeutic progress. This paper presents the milestones and most important researchers in osteoporosis history. Rapid progress in diagnostic and therapeutic possibilities sheds new light on osteoporosis’ nature. A comprehensive outlook on its history may help find answers for the still unsolved problems of this disease.

Introduction: Vitamin D (VD) has a pleiotropic effect on many health‑related aspects, yet the results of studies regarding vitamin D deficiency (VDD) and both glycemic control and cardiovascular disease (CVD) are conflicting., Objective: The aim of this work was to determine the prevalence of VDD and its associations with CVD and glycemic control among patients with type 2 diabetes mellitus (T2DM)., Patients and Methods: This was an observational study in T2DM patients recruited at the diabetology clinic in Zabrze, Poland (April-September 2019 and April-September 2020). The presence of CVD was determined based on medical records. Blood biochemical parameters, densitometry, and carotid artery ultrasound examination were performed. Control of diabetes was assessed based on glycated hemoglobin A1c (HbA1c) levels. A serum VD level below 20 ng/ml was considered as VDD., Results: The prevalence of VDD in 197 patients was 36%. CVD was evident in 27% of the patients with VDD and in 33% of the patients with VD within the normal range (vitamin D sufficiency [VDS]) (P = 0.34). The difference between the groups regarding diabetes control was insignificant (P = 0.05), as for the VDD patients the median value (interquartile range) of HbA1c was 7.5% (6.93%-7.9%), and for VDS patients it was 7.5% (6.56%-7.5%). The VDD patients were more often treated with sodium‑glucose cotransporter‑2 inhibitors (SGLT‑2is) (44% vs 25%; P = 0.01)., Conclusions: About one‑third of the patients showed VDD. The VDD and VDS groups did not differ in terms of CVD occurrence and the difference in glycemic control was insignificant. The patients with VDD were more often treated with SGLT‑2is, which requires further investigation.

Background: To provide just equity in academic exchange, as well as to reduce prohibitive travel cost and address environmental concerns, the past paradigm of international student exchange has fundamentally shifted from one directional travel to mutually beneficial bidirectional remote communication between students all over the globe. Current analysis aims to quantify cultural competency and evaluate academic outcomes., Methods: Sixty students half from the US and half from Rwanda grouped in teams of 4 engaged in a nine-month project-focused relationship. Cultural competency was evaluated prior to project initiation and six months after completion of the project. Student perspective of project development was analyzed weekly and final academic outcome was evaluated., Results: Change in cultural competency was not significant; however, students did identify satisfaction in team interaction and academic outcomes were achieved., Conclusion: A single remote exchange between students in two countries may not be transformative but it can provide cultural enrichment and successful academic project outcome and may serve to enhance cultural curiosity., (© 2023. The Author(s).)

We show that four cooperating Al atoms located at the two neighboring six-membered (6-MR) rings in the ferrierite framework can be readily discerned by luminescence studies. Thus, luminescent Zn(II) cations accommodated by one aluminum pair of the 6-MR ring can be effectively quenched by neighboring Co(II) ions stabilized by the second ring. Quenching occurs via the energy transfer mechanism and allows estimation of the critical radius of Zn(II)-Co(II) interactions. This points to the appropriate geometry and distance of the transition metal ions accommodated within zeolite, providing direct evidence of the four-aluminum atom arrangement in the ferrierite framework., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Purpose: This study employed an intersectional framework to examine impact of inequalities related to sexual minority (SM) and ethnic minority (EM) identities in risk for health, well-being, and health-related behaviors in a nationally representative sample. Methods: Participants included 9789 (51% female) adolescents aged 17 years from the U.K.-wide Millennium Cohort Study, with data on self-identified sexual and ethnic identities. Adolescents were grouped into White heterosexual, White-SM, EM-heterosexual, and EM-SM categories. Questionnaires assessed mental health (e.g., self-reported psychological distress, doctor-diagnosed depression, attempted suicide), general health (self-rated health, chronic illness, body mass index), and health-related behaviors (e.g., smoking, substance use). Associations were analyzed using multivariable logistic regression. Results: SM individuals (White: 18% and EM: 3%) had increased odds for mental health difficulties and attempted suicide, with higher odds for White-SM individuals than for EM-SM individuals. Compared with White heterosexual individuals, White-SM and EM-SM individuals had higher risk for psychological distress (adjusted odds ratios [OR] 3.47/2.24 for White-SM/EM-SM, respectively) and emotional symptoms (OR 3.17/1.65). They had higher odds for attempted suicide (OR 2.78/2.02), self-harm (OR 3.06/1.52), and poor sleep quality (OR 1.88/1.67). In contrast, the White heterosexual and White-SM groups had similarly high proportions reporting risky behaviors except for drug use (OR 1.45) and risky sex (OR 1.40), which were more common in White-SM individuals. EM-heterosexual and EM-SM individuals had decreased odds for health-related behaviors. Conclusion: SM (White and EM) individuals had substantially worse mental health compared with heterosexual peers. Adverse health-related behaviors were more common in White-SM individuals. Investigation into the mechanisms leading to these differences is needed.

Background: People with HIV in the United States are aging, with risk for negative health outcomes from social isolation. PositiveLinks is a mobile health (mHealth) intervention that includes an anonymous Community Message Board (CMB) for peer-to-peer conversations. We investigated differences in CMB usage and social support between younger (<50 years) and older (≥50) members., Methods: We assessed the relationship between age groups and app use using chi-square tests. CMB posts were analyzed qualitatively to categorize forms of social support. To have a visual understanding of this relationship, we created a network diagram to display interactions among PL members., Results: Among 87 participants, 31 (42.5%) were in the older age group. Older members launched the app more often at 6 months (445.5 vs. 240.5 mean launches per participant, p  ≤ 0.001) and 12 months (712.3 vs. 292.6 launches, p  ≤ 0.001) compared with younger members. Older members also demonstrated more CMB posts at 6 months (47.4 vs. 7.6 mean posts per participant, p  = 0.02) and 12 months (77.5 vs. 10.6 posts, p  = 0.04). Of 1861 CMB posts, 7% sought support and 72% provided support. In addition, the network visualization showed that four participants, who were in the older age group, had more post generation than others and most of their posts provided support., Conclusions: Older PL members demonstrated significantly more app use than younger members, including CMB posts for social support. This durable app engagement indicates that mHealth can enable social connection among people living with chronic disease across the lifespan., Competing Interests: R.D. provides consulting services to WHT, Inc., an mHealth company. None of the other authors have any financial or nonfinancial interests to disclose., (© Tabor E. Flickinger et al., 2022; Published by Mary Ann Liebert, Inc.)

The purpose of the research was to assess the genetic and environmental influences on bone properties. One hundred thirty-two pairs of twins (99/33 monozygotic/dizygotic) underwent anthropometric measurements and phalangeal quantitative ultrasound (DBM Sonic 1200, Igea, Italy) measuring the amplitude speed of sound (AD-SoS, m/s). The mean age was 16.78 ± 12.35 years for monozygotic twins and 14.30 ± 8 years for dizygotic. Interpair and intrapair correlations between twins were calculated. In the groups of monozygotic and dizygotic twins, Ad-SoS correlated significantly with age (r = 0.56−0.73, p < 0.05), weight (r = 0.73−0.78, p < 0.05), and height (r = 0.80−0.81, p < 0.05). The strongest intrapair correlation (r = 0.99−0.998) was noted in monozygotic females for Ad-SoS, weight, and height. There was a statistically significant correlation between the intrapair difference of Ad-SoS and age but only in the groups of monozygotic and dizygotic females (r = 0.281, r2 = 0.079, and p = 0.028; r = 0.544, r2 = 0.296, and p = 0.01, respectively). After age adjustment, it was estimated that 28.62% of Ad-SoS in women and 13.2% of Ad-SoS in men was explained by genetic influence, leading to the conclusion that Ad-SoS changed with age, weight, and height. The strongest correlation between pairs of twins was observed in monozygotic twins. The differences in bone values between female twins arose with age, which indicated the role of environmental factors.

Background: During the COVID-19 pandemic, mobile sensing and data analytics techniques have demonstrated their capabilities in monitoring the trajectories of the pandemic, by collecting behavioral, physiological, and mobility data on individual, neighborhood, city, and national scales. Notably, mobile sensing has become a promising way to detect individuals' infectious status, track the change in long-term health, trace the epidemics in communities, and monitor the evolution of viruses and subspecies., Methods: We followed the PRISMA practice and reviewed 60 eligible papers on mobile sensing for monitoring COVID-19. We proposed a taxonomy system to summarize literature by the time duration and population scale under mobile sensing studies., Results: We found that existing literature can be naturally grouped in four clusters , including remote detection , long-term tracking , contact tracing , and epidemiological study . We summarized each group and analyzed representative works with regard to the system design, health outcomes, and limitations on techniques and societal factors. We further discussed the implications and future directions of mobile sensing in communicable diseases from the perspectives of technology and applications., Conclusion: Mobile sensing techniques are effective, efficient, and flexible to surveil COVID-19 in scales of time and populations. In the post-COVID era, technical and societal issues in mobile sensing are expected to be addressed to improve healthcare and social outcomes., Competing Interests: The authors declare no conflict of interest regarding this article., (Copyright © 2022 Zhiyuan Wang et al.)

Given the large numbers of people with HIV (PWH) with Medicaid coverage, it is important to understand the patient experience with Medicaid. Understanding experiences with and attitudes around the program have important policy and clinical implications. The objective was to understand the patient perspective of PWH in Virginia, who transitioned to Medicaid in 2019 due to Medicaid expansion. English-speaking PWH who gained Medicaid due to Medicaid expansion in 2019 were recruited at one Virginia Ryan White HIV/AIDS Program clinic. The goal was to enroll >33% of those who newly were on Medicaid for 2019. Participants were surveyed about demographic characteristics, and semistructured interviews were performed. Descriptive analyses were performed for cohort characteristics. Using qualitative description and an open coding strategy, codebooks were generated for the interviews and themes were identified. The cohort ( n  = 28) met our recruitment goal. Most participants had positive feelings about Medicaid before enrollment (general: 68%; good for general health: 75%, and good for HIV care: 67%) and after enrollment (general: 93% and good for HIV care: 93%). All participants expressed incomplete understanding about Medicaid before enrollment. Seventy-nine percent needed outside help to complete enrollment. Approximately 40% described overlaps of Medicaid with other insurance/payers or gaps in insurance coverage when transitioning from one insurance/payer (such as AIDS Drug Assistance Program [ADAP] medication provision and ADAP-subsidized insurance) to Medicaid. Participants suggested more access or easier access to information about Medicaid and more explanation of Medicaid benefits would be helpful. Our findings indicate participants had mostly positive perceptions of Medicaid before and after enrollment. Even with enrollment help, participants voiced that dealing with insurance is hard. Medicaid and other programs should prioritize more access to information, smoother processes, and less burdensome enrollment/re-enrollment.

Introduction: Our team developed the HOPE app as a clinic-based platform to support patients receiving medication assisted treatment (MAT) for opioid use disorder. We investigated the app's two communication features: an anonymous community message board (CMB) and secure messaging between patients and their clinic team., Methods: The HOPE (Heal Overcome Persist Endure) app was piloted with patients and MAT providers. Text from the CMB and messaging were downloaded and de-identified. Content analysis was performed using iteratively developed codebooks with team consensus., Results: The pilot study enrolled 28 participants; 25 were "members" (patients) and 3 were providers (physician, nurse, social worker). Of member-generated CMB posts, 45% described the poster's state of mind, including positive and negative emotions, 47% conveyed support and 8% asked for support. Members' secure messages to the team included 52% medical, 45% app-related, and 8% social topics. Provider's messages contained information exchange (90%) and relationship-building (36%)., Discussion: Through the CMB, members shared emotions and social support with their peers. Through secure messaging, members addressed medical and social needs with their care team, used primarily for information exchange but also relationship-building., Practice Implications: The HOPE app addresses communication needs for patients in MAT and can support them in recovery., (Copyright © 2022. Published by Elsevier B.V.)

Framework Al FR Lewis sites represent a substantial portion of active sites in H-BEA zeolite catalysts activated at low temperatures. We studied their nature by 27 Al WURST-QCPMG nuclear magnetic resonance (NMR) and proposed a plausible mechanism of their formation based on periodic density functional theory calculations constrained by 1 H MAS, 27 Al WURST-QCPMG, and 29 Si MAS NMR experiments and FTIR measurements. Our results show that the electron-pair acceptor of Al FR Lewis sites corresponds to an Al TRI atom tricoordinated to the zeolite framework, which adsorbs a water molecule. This Al TRI -OH 2 complex is reflected in 27 Al NMR resonance with δ iso = 70 ± 5 ppm and C Q = 13 ± 2 MHz. In addition, the Al TRI atom with adsorbed acetonitrile-d 3 (the probe of Al FR Lewis sites in FTIR spectroscopy) exhibits a similar 27 Al NMR resonance. We suggest that these Al FR Lewis sites are formed from Al-OH-Si-O-Si-O-Si-OH-Al sequences located in 12-rings (i.e., close unpaired Al atoms).

The stresses of medical training can lead to burnout and other adverse outcomes. The Flourish curriculum was designed to mitigate negative effects of stress among clerkship students through debriefing and skills-building activities that foster practical wisdom: mindfulness, appreciative practice, story-telling/listening, and reflection. Students rated the curriculum highly, felt it addressed common concerns about clerkships, and were able to apply techniques from the curriculum to their clinical work. This framework can help students process their experiences and benefit from peer support, mentorship, and reflection. Fostering medical students' wisdom capacities for reflection and compassion may be protective against burnout during their training., Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01522-z., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) under exclusive licence to International Association of Medical Science Educators 2022.)

Introduction: The aim of the study was to establish the influence of knowledge of osteoporosis and educational level on bone health., Material and Methods: The study group consisted of 351 women, aged 50-88 years (mean 66.3 ± 8.6). None of them had had any previous personal experience with osteoporosis diagnosis and treatment. They filled in a questionnaire consisting of 10 questions assessing their knowledge about osteoporosis. All of them underwent femoral neck densitometry (GE Lunar, USA)., Results: The mean score in the knowledge questionnaire was 7.4 ± 1.6 points (range 2-10). The lowest percentage of correct answers was observed in the sentences regarding the possibility of successful cure of osteoporosis and the role of physical activity in osteoporosis treatment. The mean score in the osteoporosis questionnaire correlated negatively with the age of the participants (r = -0.2, p < 0.05) and was better among patients with higher educational degree (8.2 vs. 6.4 points, p < 0.001). Both the educational degree and the level of knowledge of osteoporosis correlated with bone mineral density (BMD) and T-score., Conclusions: Elderly and less educated women showed lower levels of knowledge about osteoporosis and its consequences. The study suggests that bone health in postmenopausal women may be indirectly improved by education concerning osteoporosis and its prevention.