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Despite declines in HIV prevalence among all U.S. women, HIV remains a serious concern for Black women. PrEP is an effective biomedical intervention and has high acceptability among Black women. Therefore, offering PrEP, in addition to screening and testing for STI/HIV consistently, can reduce HIV risk among this population. We examine the associations of preventive sexual health service utilization (PSHSU) and PrEP interest among young Black women (YBW) (N = 209) in the United States in 2018. YBW, ages 18–25, completed a self-administered questionnaire, assessing sexual risk and prevention behaviors, HIV/STI testing, and PrEP interest. More than half of YBW were aware of PrEP and its benefits. YBW, who received an HIV test within the past three to six months, had higher odds of PrEP interest. The proportion of YBW who reported being interested in PrEP did not differ by PSHSU. Active contraceptive use was associated with PrEP interest. The results suggest YBW engage in preventive sexual health services, including HIV/STI testing, reproductive health, and sexual health behavioral counseling. Additional efforts should be made to normalize PrEP education for heterosexual, cisgender women at student health centers on college and university campuses, and other venues outside of traditional HIV/STI testing facilities.

Animal derived waste, if not disposed properly, could pose a threat to the environment and its inhabitants. Recent advancements in biotechnological and biomedical interventions have enabled us to bioengineer these valuable waste substrates into biomaterials with diversified applications. Rearing and processing of poultry, cattle, sheep, goat, pig, and slaughterhouse waste can aid in effective waste valorization for the fabrication of biopolymers, composites, heart valves, collagen, scaffolds, pigments and lipids, among other industrially important biomaterials. Feathers and eggshell waste from the poultry industry can be used for producing keratinous proteins and biocomposites, respectively. Cattle dung, hoofs and cattle hide can be used for producing hydroxyapatite for developing scaffolds and drug delivery systems. Porcine derived collagen can be used for developing skin grafts, while porcine urinary bladder has antiangiogenic, neurotrophic, tumor-suppressive and wound healing properties. Sheep teeth can be used for the production of low-cost hydroxyapatite while goat tissue is still underutilized and requires more in-depth investigation. However, hydrolyzed tannery fleshings show promising potential for antioxidant rich animal feed production. In this review, the recent developments in the production and application of biomaterials from animal waste have been critically analyzed. Standardized protocols for biomaterial synthesis on a pilot scale, and government policy framework for establishing an animal waste supply chain for end users seem to be lacking and require urgent attention. Moreover, circular bioeconomy concepts for animal derived biomaterial production need to be developed for creating a sustainable system., Graphical abstract

While it is generally accepted in the leisure field that leisure has a role, and arguably a key one in wellness and wellbeing, this is largely at odds with the operations and funding frameworks of contemporary healthcare systems. Governments spend much less on leisure which involves social aspects of health than they do on healthcare systems which are focussed on biomedical interventions. Yet, many leisure and healthcare practitioners and academics are aware of the intersections between leisure, health and wellbeing and the aim of this edition was to offer a forum for overtly presenting these intersections. Here we set the scene for the papers in this special edition, summarizing the contribution of each paper to progressing discussions regarding the intersections of leisure and health and suggesting future directions for exploration. Refereed/Peer-reviewed

Abstract Infection is the predominant cause of mortality in early life, and immunization is the most promising biomedical intervention to reduce this burden. However, very young infants fail to respond optimally to most vaccines currently in use, especially neonates. In 2005, Stanley Plotkin proposed that new delivery systems would spur a new revolution in pediatric vaccinology, just as attenuation, inactivation, cell culture of viruses, genetic engineering, and adjuvantation had done in preceding decades. Recent advances in the field of immunoengineering, which is evolving alongside vaccinology, have begun to increasingly influence vaccine formulation design. Historically, the particulate nature of materials used in many vaccine formulations was empiric, often because of the need to stabilize antigens or reduce endotoxin levels. However, present vaccine delivery systems are rationally engineered to mimic the size, shape, and surface chemistry of pathogens, and are therefore often referred to as “pathogen-like particles”. More than a decade from his original assessment, we re-assess Plotkin’s prediction. In addition, we highlight how immunoengineering and advanced delivery systems may be uniquely capable of enhancing vaccine responses in vulnerable populations, such as infants. Impact Immunoengineering and advanced delivery systems are leading to new developments in pediatric vaccinology. Summarizes delivery systems currently in use and development, and prospects for the future. Broad overview of immunoengineering’s impact on vaccinology, catering to Pediatric Clinicians and Immunologists.

Preconception Care is an intervention starting from adolescence until near conception. Preconception Care refers to biomedical interventions and social preventive behaviors which can improve healthy babies and healthy mothers. Interventions carried out during adolescence are more effective in reducing the occurrence of pregnancies untimely, unplanned pregnancies. Preconception Care program has not run optimally so far. The purpose of this literature study is to present the research findings on how Preconception Care interventions in adolescents. The method used is the study of the research findings on Preconception Care published in the last ten years (2009-2019) in national and international reputable literature sources indexed by Scopus, Elsiver, Proquest, Plos One, and Google Scholar database. The keywords of Preconception Care, Adolescent, AKI, and AKB are used to facilitate the search for literature. The results of the study show that Preconception Care has a powerful impact on women's health and is part of Continuum Care, including Preconception Care, Antenatal Care, Intranatal, and Post Natal. Preconception Care in adolescents has a good impact on the preconception period and can reduce maternal mortality (AKI) and infant mortality (AKB), thus, it is necessary to optimize Preconception Care on adolescents.

In recent medical events and articles the hormone testosterone has emerged as a resource for treating problems related to female sexuality. This hormone is commonly defined as the “male hormone” and presented as the “hormone of desire”. This observation led to investigate if and how the use of testosterone is found in the realm of doctors’ offices and if it is being applied as a therapeutic resource for women. This article analyzes what types of approaches and treatments have been used by doctors in a large Brazilian city. The methodology involved sought out medical professionals indicated for their specialization in treating female “sexual problems”. Considering the statements of the professionals interviewed, sexual desire is defined emphatically as the presence or absence of a greater or lesser amount of testosterone. This standard is associated to gender differences that are expressed primarily in terms of biology. Em eventos e artigos médicos recentes, nota-se o surgimento do hormônio testosterona como recurso para o tratamento de problemas relacionados à sexualidade feminina. Este hormônio é comumente definido como o “hormônio masculino” e apresentado como o “hormônio do desejo”. Esta observação levou a investigar se, e como, o uso de testosterona aparece no domínio dos consultórios médicos e se está sendo aplicado como um recurso terapêutico para as mulheres. Este artigo analisa quais tipos de abordagens e tratamentos têm sido utilizados por médicos/as em uma grande cidade brasileira. A metodologia envolveu a busca por profissionais médicos/as que foram indicados/as por sua especialização no tratamento de “problemas sexuais” femininos. Considerando as declarações dos/as profissionais entrevistados/as, o desejo sexual é definido enfaticamente pela presença ou ausência de uma quantidade maior ou menor de testosterona. Este padrão está associado a diferenças de gênero que se expressam principalmente em termos de biologia.

We formulate an influenza model with treatment and vaccination. Both time invariant and time-dependent uncertainty analyses and sensitivity analysis of the model parameter values are carried out to understand the dependence of the reproduction numbers and model state variables on their components. Results show that the relationship between treatment and epidemic size is nonlinear and that there exists a critical threshold treatment rate under which treatment is beneficial. Sensitivity analysis suggests that the most significant parameters are those related to infection transmission, infectiousness, duration of infectiousness and waning immunity. Further, there are important instances when the relationship between some parameters and model outputs changes behavior from negatively to positively correlated or vice versa because all sensitivity indices, except [Formula: see text] are functions of other parameters and thus will change with the change in parameter values. For example, treatment helps to lower the epidemic size, but may then become a “source” of infection likely due to resistance de novo. This knowledge is critical for proper public health planning and guidance of control strategies.

While vigorously exploring new and improved external protection technologies, the US military has long focused on ways to internally armor the soldier through biomedical interventions. The goal of ...

Summary The emerging field of bioelectricity has revealed numerous new roles for ion channels beyond the nervous system, which can be exploited for applications in regenerative medicine. Developing such biomedical interventions for birth defects, cancer, traumatic injury, and bioengineering first requires knowledge of ion channel targets expressed in tissues of interest. This information can then be used to select combinations of small molecule inhibitors and/or activators that manipulate the bioelectric state. Here, we provide an overview of electroceutical design environment (EDEn), the first bioinformatic platform that facilitates the design of such therapeutic strategies. This database includes information on ion channels and ion pumps, linked to known chemical modulators and their properties. The database also provides information about the expression levels of the ion channels in over 100 tissue types. The graphical interface allows the user to readily identify chemical entities that can alter the electrical properties of target cells and tissues., Graphical Abstract, Highlights • Design of electroceuticals requires knowledge of ion channel targets and relevant drugs • EDEn allows rapid determination of which ion channels are expressed in a given tissue • EDEn also reveals what channel openers and blockers exist for any of the targets • This platform is a key enabling step for the design of bioelectric interventions, Bioinformatics; Biological Database

The WHO's International Classification of Functioning, Disability and Health (ICF) provides an integrated framework for health for everyone. Several aspects of this approach to health allow us to see people's lives in a richer and more holistic manner than has traditionally been the case based on diagnosis alone. These features include the positive language (emphasizing in particular “activity,” “participation,” and “personal factors”); the interconnections of the parts of this “dynamic system,” in which every component can influence every other one; and the formal inclusion of “contextual factors”—personal and environmental—that are otherwise too easy to take for granted and then ignore. This paper addresses the “environmental” dimension of the ICF framework—specifically referring to “family” as the central environmental force in the lives of children and adolescents. The perspectives of the author are those of a developmental pediatrician, whose career has focused on children with conditions that challenge their development, and their families. Lessons learned from a lifetime of work—including teaching and research as well as clinical services—are offered. Particular emphases will be on (i) the importance of focusing on the family in a non-judgmental “family-centered” way; (ii) how conceptual ideas about child (and family) development and parenting are as important as technical approaches to intervention; and (iii) how the ICF framework “allows”—indeed encourages—such a focus to have value and importance equal to the best of biomedical interventions. Examples from current research will illustrate how these ideas can be implemented.

Gay, bisexual and other men who have sex with men (MSM) and transgender individuals face the highest burden of human immunodeficiency virus (HIV) infection. HIV pre-exposure prophylaxis (PrEP) is an effective evidence-based biomedical intervention to reduce acquisition of HIV infection but uptake has been suboptimal in lesbian, gay, bisexual, and transgender (LGBT) populations. Primary care providers play an integral role in addressing HIV disparities by educating patients and facilitating access to PrEP. After PrEP initiation, primary care providers should assess for and manage adverse effects, provide appropriate laboratory monitoring, support adherence, and assist patients with access to low-cost or free PrEP options if needed.

The rate of mother-to-child transmission (MTCT) of HIV from breastfeeding is increasing relative to other causes of MTCT. Early effective preconception and antenatal antiretroviral therapy (ART) reduces intrauterine and intrapartum MTCT, whereas maternal post-partum HIV acquisition, untreated maternal HIV, and suboptimal postnatal maternal ART adherence increase the risk of MTCT through breastfeeding. Although the absolute number of cases of MTCT acquired through breastfeeding is decreasing, the rate of decrease is less than the decrease in intrauterine and intrapartum MTCT. Unless current strategies are universally applied, they might not be sufficient to eliminate MTCT due to breastfeeding. Urgent action is needed to evaluate and implement additional preventive biomedical strategies in high HIV prevalence and incidence settings to eliminate MTCT from breastfeeding. Preventive strategies include: pre-exposure prophylaxis in breastfeeding women who have an increased risk of acquiring HIV; postnatal reinforcement strategies, such as maternal retesting for HIV, maternal care reinforcement, and prophylaxis in infants exposed to HIV via breastmilk; and active (vaccine) or passive immunoprophylaxis with long-acting broadly neutralising antibodies. acceptedVersion

Termination of the coronavirus pandemic by vaccination will be heralded as a triumph for science. Indeed, vaccines are an incredible intervention, freeing us from the harms caused by a swathe of diseases. A vaccine is a classical biomedical intervention, in this case targeted against a specific virus. The development of Koch’s postulates for determining whether a specific microorganism is the cause of a given disease, and the work of Louis Pasteur, were key elements in the development of the model, which didn’t just lay the basis for the development of vaccines, but also formed the bedrock of modern medicine. The biomedical approach relies on categorising patients through agreed, standardised criteria for diagnosis, thence providing a basis for the development of effective treatments. Infectious diseases and a wide range of other conditions have been classified …

Medicine, health care and philosophy (2021). doi:10.1007/s11019-021-10032-5, Published by Springer Science + Business Media B.V, Dordrecht [u.a.]

Following high levels of efficacy in PrEP clinical trials, demonstration projects were launched to assess its real-world effectiveness when rolled out as part of programmes. Based on an ethnographic study of a PrEP demonstration project in South India among female sex workers, we analyse a curious set of narratives in which participants claim PrEP as a ‘cure all’ for a range of physical ailments. What becomes clear is how participation in this project has intensified a relationship with their bodies, one that has led these women to reflect on and track various changes pertaining to bodily wellness. ‘The body’ becomes a highly reactive site that entangles global HIV science, sex workers’ engagements in health promotion, and regimes of self-care. Engaging with these local biologies holds important insights for designing and implementing future biomedical interventions.

Voluntary Medical Male Circumcision (VMMC) has been promoted as an effective biomedical intervention in the reduction of the risk of new HIV and STI infections. The government of Malawi and its stakeholders including the World Health Organization have committed a lot of resources to VMMC programming. However, research shows that its uptake among men is still low in Malawi. This study, therefore, investigated the communication-related factors that influence decision-making in the uptake of VMMC among men in Lilongwe, Malawi. To achieve this aim, twenty-five men, aged between 18 and 35 years old were interviewed on what influenced them to undergo VMMC. The study found that the respondents were influenced to uptake VMMC mostly by peer pressure and the need for conformity; partner/girlfriend demand and considerations; and advice from health personnel. The paper concludes that although the final decision was theirs to make, the men in the study underwent circumcision under duress and/or coercion. It cannot be said to be voluntary. The medical necessity of VMMC can be said to be voluntary if it is negotiated and consented to without duress. Although the respondents mentioned the HIV and STI infection risk reduction properties, hygienic advantages, and cervical cancer reduction properties of VMMC as benefits of VMMC, these had very little influence on their decision. It is recommended that current intervention messages be reviewed and modified to incorporate new ideas that can address the shortcomings that the current crop of messages has with the aim of increasing the uptake of VMMC programmes or other health focused behaviour change programmes.

PrEP, pre-exposure prophylaxis, is a novel HIV prevention strategy. Highly efficacious, its development and delivery has caused significant debate. This paper explores the ways in which PrEP is signified and some of the new identities it gives rise to through the analysis of PrEP discourses among ‘bugchasers’. Bugchasers comprise a niche group of gay men who eroticise HIV and fantasise with or seek to get infected. The research explores how bugchasers negatively conceptualise PrEP as a barrier to thrill and masculinity and discusses PrEP as a positive intervention that allows them to understand their own desires for risk-taking. Finally, it addresses a new identity position, the ‘poz pleaser’ who identifies as a bugchaser yet uses PrEP. Findings link to current debates about PrEP meanings and signification by using bugchasing as a niche yet illustrative example of how men make sense of this intervention based on their existing frameworks. Discussion highlights how this helps us understand how people make sense of biomedical interventions, the importance of emotional ‘side effects’, and the development of new identity positions. In so doing, it advances existing work on PrEP signification and contributes to ongoing debates about bugchasing.

Background/Aims Early integration of behavioral and social sciences research into clinical trials can improve trial conduct and facilitate future implementation of biomedical interventions. We sought to examine participants’ experiences in clinical trials with broadly neutralizing antibodies and describe the development of educational materials for use in future broadly neutralizing antibody research. Methods We conducted semi-structured interviews with trial participants in phase 1 trials evaluating safety and efficacy of broadly neutralizing antibodies for HIV prevention and treatment and key informants (i.e. trial staff involved in broadly neutralizing antibody research). Semi-structured interviews were transcribed and analyzed thematically. Based on findings from the interviews, we developed educational materials addressing concerns and misconceptions identified among trial participants with input from community and research stakeholders. Educational materials were used in subsequent clinical trials with broadly neutralizing antibodies. We evaluated trial staff’s experiences with newly developed educational materials in follow-up key informant interviews. Results Although most participants were concerned about long-term harms related to the investigational product upon enrollment, absence of severe side effects in the trial led to an underestimation of risks related to the study during trial participation. Participants showed a poor understanding of what broadly neutralizing antibodies are and the differences between broadly neutralizing antibodies and other HIV prevention and treatment products, such as antiretrovirals. Many trial participants overestimated the possible public health impact of the broadly neutralizing antibody trials in which they were enrolled, associating broadly neutralizing antibody research with the development of vaccine or cure for HIV in the near future. Based on these concerns and misconceptions among trial participants, we developed a frequently asked questions document and adapted an existing educational video about broadly neutralizing antibodies. In follow-up interviews, key informants reported that materials helped address trial participants’ concerns and questions related to the trial. Key informants reported using the educational materials not only during informed consent but also throughout trial participation, which contributed to making informed consent an “ongoing” process. Conclusion Integration of behavioral research into clinical trials with broadly neutralizing antibodies is key to identify and address key concerns among trial participants. Behavioral and social sciences research promotes communication between trial participants and biomedical researchers, facilitates engagement of participants and trial staff, and strengthens trial conduct. Development of educational materials collaboratively by behavioral and clinical scientists, trial staff, and community stakeholders is feasible and may help to address trial participants’ concerns and misconceptions. Future research should evaluate the impact of educational materials in recruitment and retention of trial participants.

Transgender people, i.e., those whose gender identity differs from the sex they were assigned at birth, have been shown to be disproportionately affected by HIV. Transgender women have an estimated...

With widespread treatment, HIV is now considered a chronic, manageable condition, yet little is known of the social networks that support people living with HIV (PLHIV) to transition toward self-management. Using a person-centred, qualitative social network approach, this study examined the role, characteristics and evolution of social support networks from the perspective of PLHIV and key support providers in Queensland, Australia. Beyond treatment and monitoring, HIV self-management involves negotiating disclosures and navigating stigma. Alongside biomedical interventions, facilitating recently diagnosed PLHIV to develop strong and sustainable personal support networks, including linkage with peers, is an important aspect of contemporary HIV care.

CRISPR gene technology has been scientifically exciting because of its great potential to alter any DNA. There are scientific risks with CRISPR gene editing, but risk assessment is not impossible and is currently in progress. Space travel presents a unique set of challenges and opportunities for CRISPR gene editing. Biomedically, space travel is a major health hazard for astronauts. Research on the genetic and molecular mechanisms behind these biomedical challenges presents opportunities for CRISPR to serve as a biomedical intervention for astronauts. This article gives several examples where such mechanisms have been reported. However, the guidelines regarding CRISPR applications are still very generic and difficult to implement in specific cases. The focus of this paper is on the therapy/enhancement distinction, which many guidelines mention, to help us discern when CRISPR applications are justifiable. I propose a reworking of the definition of normal in order to be able to distinguish therapy from enhancement, where the former is deemed more appropriate for CRISPR applications than the latter. Space travel is a unique and interesting scenario to test the applications of the therapy/enhancement distinction as guidelines for CRISPR gene editing.

Youths are disproportionately affected by HIV infection. This article presents the achievements and implications of HIV Programme Development Project among Out-of-School Youths (OSY) in Osun State, Nigeria. A total of 5934 peer educators from randomly selected areas of the State were trained. The Minimum Prevention Package for Intervention (MPPI) strategy including structural, behavioural and biomedical interventions was used. Data from DHIS2 platform was analysed with Microsoft Excel and qualitative interviews with the stakeholders was reported. Two hundred and sixty-three community dialogues were held within the period of the project with 2406 participants and 27,449 peers recruited by the peer educators. A total of 15,984 OSY were counselled, tested and received results for HIV and 167 (1.05%) of them tested positive to HIV infection. There is a need to scale-up this programme in Osun State and efforts at reaching the OSY based on MPPI should be intensified.

Objectives To evaluate how often reproducible research practices, which allow others to recreate the findings of studies, given the original data, are used in systematic reviews (SRs) of biomedical research. Study Design and Setting We evaluated a random sample of SRs indexed in MEDLINE during February 2014, which focused on a therapeutic intervention and reported at least one meta-analysis. Data on reproducible research practices in each SR were extracted using a 26-item form by one author, with a 20% random sample extracted in duplicate. We explored whether the use of reproducible research practices was associated with an SR being a Cochrane review, as well as with the reported use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results We evaluated 110 SRs of therapeutic interventions, 78 (71%) of which were non-Cochrane SRs. Across the SRs, there were 2,139 meta-analytic effects (including subgroup meta-analytic effects and sensitivity analyses), 1,551 (73%) of which were reported in sufficient detail to recreate them. Systematic reviewers reported the data needed to recreate all meta-analytic effects in 72 (65%) SRs only. This percentage was higher in Cochrane than in non-Cochrane SRs (30/32 [94%] vs. 42/78 [54%]; risk ratio 1.74, 95% confidence interval 1.39–2.18). Systematic reviewers who reported imputing, algebraically manipulating, or obtaining some data from the study author/sponsor infrequently stated which specific data were handled in this way. Only 33 (30%) SRs mentioned access to data sets and statistical code used to perform analyses. Conclusion Reproducible research practices are underused in SRs of biomedical interventions. Adoption of such practices facilitates identification of errors and allows the SR data to be reanalyzed.

In the debates regarding the ethics of human enhancement, proponents have found it difficult to refute the concern, voiced by certain bioconservatives, that cognitive enhancement violates the autonomy of the enhanced. However, G. Owen Schaefer, Guy Kahane and Julian Savulescu have attempted not only to avoid autonomy-based bioconservative objections, but to argue that cognition-enhancing biomedical inter-ventions can actually enhance autonomy. In response, this paper has two aims: firstly, to explore the limits of their argument; secondly, and more importantly, to develop a more complete understanding of autonomy and its relation to cognitive enhance-ment. By drawing a distinction between the capacity for autonomy and the exercise and achievement of autonomy, and by exploring the possible effects of cognitive en-hancement on both competence and authenticity conditions for autonomy, the paper identifies and explains which dimensions of autonomy can and cannot, in principle, be enhanced via direct cognitive interventions. This allows us to draw conclusions regarding the limits of cognitive enhancement as a means for enhancing autonomy.

In Ghana, men who have sex with men (MSM) are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is an intervention that reduces risk for HIV infection but is not currently available in Ghana. This paper explores knowledge and acceptability of HIV PrEP among Ghanaian MSM. Qualitative content analysis was conducted on 22 focus group discussions(N=137) conducted between March-June 2012 in Accra, Kumasi, and Manya Krobo. Overall, participants reported low knowledge of PrEP. However, once information about PrEP was provided, there was high acceptability. The primary reason for acceptability was that PrEP provided an extra level of protection against HIV. Acceptability of PrEP was conditioned on it having minimal side effects, being affordable and efficient in preventing HIV infection. No acceptability of PrEP was attributed to limited knowledge of side effects and perceived lack of effectiveness. The reasons provided to utilize PrEP and condoms was condoms protect against other STIs, and sexual partner factors. This is the first known study to explore PrEP knowledge and acceptability among Ghanaian MSM. It is important that key stakeholders preemptively address potential barriers to PrEP acceptability, uptake, and adherence, especially among MSM, once PrEP becomes available in Ghana.