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Shigella species, which cause acute diarrheal disease, are transmitted via fecal-oral and sexual contact. To better understand the overlapping populations affected by Shigella infections and sexually transmitted infections (STIs) in the United States, we examined the occurrence of reported STIs within 24 months among shigellosis case-patients.Culture-confirmed Shigella cases diagnosed from 2007 to 2016 among residents of 6 US jurisdictions were matched to reports of STIs (chlamydia, gonorrhea, and all stages of syphilis) diagnosed 12 months before or after the shigellosis case. We examined epidemiologic characteristics and reported temporal trends of Shigella cases by sex and species.From 2007 to 2016, 10,430 shigellosis cases were reported. The annual number of reported shigellosis cases across jurisdictions increased 70%, from 821 cases in 2007 to 1398 cases in 2016; males saw a larger increase compared with females. Twenty percent of male shigellosis case-patients had an STI reported in the reference period versus 4% of female case-patients. The percentage of male shigellosis case-patients with an STI increased from 11% (2007) to 28% (2016); the overall percentage among females remained low.We highlight the substantial proportion of males with shigellosis who were diagnosed with STIs within 24 months and the benefit of matching data across programs. Sexually transmitted infection screening may be warranted for male shigellosis case-patients.

Purpose This paper aims to discuss the challenges of conducting research with homelessness services frontline workers during the COVID-19 pandemic. Design/methodology/approach Between 2015 and 2019, the research team surveyed frontline staff in three cities about their psychosocial stressors and needs. In 2020, the authors replicated the previous study and expanded data collection to seven cities across Canada to determine the extent to which the COVID-19 pandemic impacted the well-being of frontline staff. This report describes how the authors adapted the research methodologies to continue work throughout the pandemic, despite various restrictions. Findings The original studies had very high participation rates because of several methodological approaches that minimized barriers, especially in-person data collection. During the pandemic, distancing requirements precluded replication of these same methods. Research strategies that enabled staff participation during working hours, with designated time allotted for participation, was key for ensuring high participation rates, as access to technology, availability of free time and other factors frequently make online survey research a hardship for these staff. Restrictive interpretation and regional variations of COVID-19 guidelines by some research ethics boards were also a challenge to rapid and responsive data collection. Originality/value Few studies describe the experiences of frontline workers in the homelessness sector, and quantitative reports of their experiences are particularly scant. Consequently, little is known about specific methodologies that facilitate large-scale data collection in the homelessness services sector. The present research advances the field by providing lessons learned about best practice approaches in pre and post COVID-19 front line worker contexts. A strength of this research is the well-controlled design. The authors collected data within several of the organizations that had previously participated. This fortunate baseline provided opportunity for comparison before and during the pandemic; the authors can highlight factors that might have had influence during the pandemic.

Subversion of host cell apoptotic responses is a prominent feature of viral immune evasion strategies to prevent premature clearance of infected cells. Numerous poxviruses encode structural and functional homologs of the Bcl-2 family of proteins, and vaccinia virus harbors antiapoptotic F1L that potently inhibits the mitochondrial apoptotic checkpoint. Recently F1L has been assigned a caspase-9 inhibitory function attributed to an N-terminal α helical region of F1L spanning residues 1–15 (1) preceding the domain-swapped Bcl-2-like domains. Using a reconstituted caspase inhibition assay in yeast we found that unlike AcP35, a well characterized caspase-9 inhibitor from the insect virus Autographa californica multiple nucleopolyhedrovirus, F1L does not prevent caspase-9-mediated yeast cell death. Furthermore, we found that deletion of the F1L N-terminal region does not impede F1L antiapoptotic activity in the context of a viral infection. Solution analysis of the F1L N-terminal regions using small angle x-ray scattering indicates that the region of F1L spanning residues 1–50 located N-terminally from the Bcl-2 fold is an intrinsically unstructured region. We conclude that the N terminus of F1L is not involved in apoptosis inhibition and may act as a regulatory element in other signaling pathways in a manner reminiscent of other unstructured regulatory elements commonly found in mammalian prosurvival Bcl-2 members including Bcl-xL and Mcl-1.

Background Influenza vaccination is the most effective way to prevent influenza and influenza-associated complications including those leading to hospitalization. Resources otherwise used for influenza could support caring for patients with coronavirus disease 2019 (COVID-19). The Health Resources and Services Administration (HRSA) Health Center Program serves 30 million people annually by providing comprehensive primary healthcare, including influenza vaccination, to demographically diverse and historically underserved communities. Because racial and ethnic minority groups have been disproportionately affected by COVID-19, the objective of this analysis was to assess disparities in influenza vaccination at HRSA-funded health centers during the COVID-19 pandemic. Methods The Centers for Disease Control and Prevention and HRSA analyzed cross-sectional data on influenza vaccinations from a weekly, voluntary health center COVID-19 survey after addition of an influenza-related question covering 7–11 November 2020. Results During the 3-week period, 1126 of 1385 health centers (81%) responded to the survey. Most of the 811 738 influenza vaccinations took place in urban areas and in the Western US region. There were disproportionately more health center influenza vaccinations among racial and ethnic minorities in comparison with county demographics, except among non-Hispanic blacks and American Indian/Alaska Natives. Conclusions HRSA-funded health centers were able to quickly vaccinate large numbers of mostly racial or ethnic minority populations, disproportionately more than county demographics. However, additional efforts might be needed to reach specific racial populations and persons in rural areas. Success in influenza vaccination efforts can support success in severe acute respiratory syndrome coronavirus 2 vaccination efforts.

This study described the utilisation of telemedicine during the COVID-19 pandemic in June to November 2020. In April 2020, the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) began administering a weekly survey to study the effects of COVID-19 on the testing capacity and operations of health centers. The survey was voluntary and available to 1,382 HRSA-funded centers. Urbanisation and region have been associated with higher rates of telehealth use. Health centers that responded to the COVID-19 surveys were more likely to report multiple visits than those that did not respond. The average percentage of weekly visits for all regions and urbanicity was calculated. The weekly changes were computed based on the number of visits during the first 10 weeks and the second 10 weeks. Week-to-week differences were calculated as the average number of telehealth visits during the first and second weeks of the study. The average percentage of weekly visits that were telehealth-related decreased 25% among the responding health centers during the study period. During the first 10 weeks of the study, the largest absolute change in the number of weekly telehealth visits was reported by health centers in the Northeast. Health centers in the Northeast maintained stable weekly telehealth visits during the second half of the study. Compared with the first 10 weeks, the second half of the study showed a significant change in the percentage of telehealth visits. The average percentage of weekly visits to a telehealth facility differed significantly among various regions. For instance, the South had the lowest percentage of visits. Urban health centers reported significantly higher average percentage of weekly visits for telehealth than rural health centers. The number of cases of COVID-19 in the Northeast also increased during the second quarter. The number of cases of COVID-19 increased in counties where urban health centers are located during the first 10 weeks of the study.

Early in the coronavirus disease 2019 (COVID-19) pandemic, in-person ambulatory health care visits declined by 60% across the United States, while telehealth* visits increased, accounting for up to 30% of total care provided in some locations (1,2). In March 2020, the Centers for Medicare & Medicaid Services (CMS) released updated regulations and guidance changing telehealth provisions during the COVID-19 Public Health Emergency, including the elimination of geographic barriers and enhanced reimbursement for telehealth services† (3-6). The Health Resources and Services Administration (HRSA) administers a voluntary weekly Health Center COVID-19 Survey§ to track health centers' COVID-19 testing capacity and the impact of COVID-19 on operations, patients, and staff. CDC and HRSA analyzed data from the weekly COVID-19 survey completed by 1,009 HRSA-funded health centers (health centers¶) for the week of July 11-17, 2020, to describe telehealth service use in the United States by U.S. Census region,** urbanicity,†† staffing capacity, change in visit volume, and personal protective equipment (PPE) supply. Among the 1,009 health center respondents, 963 (95.4%) reported providing telehealth services. Health centers in urban areas were more likely to provide >30% of health care visits virtually (i.e., via telehealth) than were health centers in rural areas. Telehealth is a promising approach to promoting access to care and can facilitate public health mitigation strategies and help prevent transmission of SARS-CoV-2 and other respiratory illnesses, while supporting continuity of care. Although CMS's change of its telehealth provisions enabled health centers to expand telehealth by aligning guidance and leveraging federal resources, sustaining expanded use of telehealth services might require additional policies and resources.

Long-standing social inequities and health disparities have resulted in increased risk for coronavirus disease 2019 (COVID-19) infection, severe illness, and death among racial and ethnic minority populations. The Health Resources and Services Administration (HRSA) Health Center Program supports nearly 1,400 health centers that provide comprehensive primary health care* to approximately 30 million patients in 13,000 service sites across the United States.† In 2019, 63% of HRSA health center patients who reported race and ethnicity identified as members of racial ethnic minority populations (1). Historically underserved communities and populations served by health centers have a need for access to important information and resources for preventing exposure to SARS-CoV-2, the virus that causes COVID-19, to testing for those at risk, and to follow-up services for those with positive test results.§ During the COVID-19 public health emergency, health centers¶ have provided and continue to provide testing and follow-up care to medically underserved populations**; these centers are capable of reaching areas disproportionately affected by the pandemic.†† HRSA administers a weekly, voluntary Health Center COVID-19 Survey§§ to track health center COVID-19 testing capacity and the impact of COVID-19 on operations, patients, and personnel. Potential respondents can include up to 1,382 HRSA-funded health centers.¶¶ To assess health centers' capacity to reach racial and ethnic minority groups at increased risk for COVID-19 and to provide access to testing, CDC and HRSA analyzed survey data for the weeks June 5-October 2, 2020*** to describe all patients tested (3,194,838) and those who received positive SARS-CoV-2 test results (308,780) by race/ethnicity and state of residence. Among persons with known race/ethnicity who received testing (2,506,935), 36% were Hispanic/Latino (Hispanic), 38% were non-Hispanic White (White), and 20% were non-Hispanic Black (Black); among those with known race/ethnicity with positive test results, 56% were Hispanic, 24% were White, and 15% were Black. Improving health centers' ability to reach groups at increased risk for COVID-19 might reduce transmission by identifying cases and supporting contact tracing and isolation. Efforts to improve coordination of COVID-19 response-related activities between state and local public health departments and HRSA-funded health centers can increase access to testing and follow-up care for populations at increased risk for COVID-19.

Sacrificial moral dilemmas elicit a strong conflict between the motive to not personally harm someone and the competing motive to achieving the greater good, which is often described as the "utilitarian" response. Some prior research suggests that reasoning abilities and deliberative cognitive style are associated with endorsement of utilitarian solutions, but, as has more recently been emphasized, both conceptual and methodological issues leave open the possibility that utilitarian responses are due instead to a reduced emotional response to harm. Across 8 studies, using self-report, behavioral performance, and neuroanatomical measures, we show that individual differences in reasoning ability and cognitive style of thinking are positively associated with a preference for utilitarian solutions, but bear no relationship to harm-relevant concerns. These findings support the dual-process model of moral decision making and highlight the utility of process dissociation methods. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Abdurro’uf et al., This paper documents the seventeenth data release (DR17) from the Sloan Digital Sky Surveys; the fifth and final release from the fourth phase (SDSS-IV). DR17 contains the complete release of the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey, which reached its goal of surveying over 10,000 nearby galaxies. The complete release of the MaNGA Stellar Library accompanies this data, providing observations of almost 30,000 stars through the MaNGA instrument during bright time. DR17 also contains the complete release of the Apache Point Observatory Galactic Evolution Experiment 2 survey that publicly releases infrared spectra of over 650,000 stars. The main sample from the Extended Baryon Oscillation Spectroscopic Survey (eBOSS), as well as the subsurvey Time Domain Spectroscopic Survey data were fully released in DR16. New single-fiber optical spectroscopy released in DR17 is from the SPectroscipic IDentification of ERosita Survey subsurvey and the eBOSS-RM program. Along with the primary data sets, DR17 includes 25 new or updated value-added catalogs. This paper concludes the release of SDSS-IV survey data. SDSS continues into its fifth phase with observations already underway for the Milky Way Mapper, Local Volume Mapper, and Black Hole Mapper surveys., This publication uses data generated via the Zooniverse.org platform, development of which is funded by generous support, including a Global Impact Award from Google, and by a grant from the Alfred P. Sloan Foundation. This publication makes use of data products from the Two Micron All Sky Survey, which is a joint project of the University of Massachusetts and the Infrared Processing and Analysis Center/California Institute of Technology, funded by the National Aeronautics and Space Administration and the National Science Foundation. This work has made use of data from the European Space Agency (ESA) mission Gaia (https://www.cosmos.esa.int/gaia), processed by the Gaia Data Processing and Analysis Consortium (DPAC; https://www.cosmos.esa.int/web/gaia/dpac/consortium). Funding for the DPAC has been provided by national institutions, in particular the institutions participating in the Gaia Multilateral Agreement.

Spatially resolved spectroscopy from SDSS-IV MaNGA survey has revealed a class of quiescent, relatively common early-type galaxies, termed "red geysers", that possibly host large scale active galactic nuclei driven winds. Given their potential importance in maintaining low level of star formation at late times, additional evidence confirming that winds are responsible for the red geyser phenomenon is critical. In this work, we present follow-up observations with the Echellette Spectrograph and Imager (ESI) at the Keck telescope of two red geysers (z$, Comment: 20 pages, 23 figures, accepted for publication in the Astrophysical journal

We assessed the psychometric properties of standard Western-derived instruments, the prevalence of depression and anxiety symptoms, and their associations with sociodemographic and wellbeing variables in a large sample of Kenyan adolescents. We administered self-report measures of depression (PHQ-8) and anxiety (GAD-7) symptoms, social support, gratitude, happiness, optimism, and perceived control to 2,192 Kenyan youths (57.57% female) aged 12-19. Both the PHQ-8 (α = 0.78) and GAD-7 (α = 0.82) showed adequate internal consistency. EFA with a sub-sample (N = 1096) yielded a 1-factor structure for both the PHQ-8 and GAD-7, a subsequent CFA conducted on the basis of the 1-factor model on another sub-sample (N = 1096) yielded good and moderate goodness of fit, respectively, for the PHQ-8 (2=76.73; p

Background The extent to which psychological wellbeing may play a preventive and therapeutic role in the development and maintenance of adolescent emotional disorders depends, in part, on the nature of the overlap between these two constructs. We used network analysis to examine the relationship between adolescent psychopathology (measured by depression and anxiety symptoms) and psychological wellbeing (measured by happiness, optimism, social support, perceived control, and gratitude). Methods This was a cross-sectional study with a in a large community sample of Kenyan adolescents (N = 2,192, ages 13-to-18). Network analyses was conducted to examine the topology, stability, centrality, and bridge nodes of a network of psychopathology and psychological wellbeing measures. Results Two distinct community clusters emerged, one for psychopathology nodes and another for wellbeing nodes, suggesting that these are two distinct but connected concepts. Central and bridge nodes of the wellbeing and psychopathology network are identified. The most central nodes in the network were general gratefulness and worry; the strongest negative edges between psychopathology and psychological wellbeing were depressed mood—I love life and irritability—I am a joyful person; the main bridge nodes were optimistic about future and special person around for me. Conclusions Our findings expand understanding of the relationship between wellbeing and psychopathology in an understudied population and are suggestive of how psychological wellbeing can inform psychopathological treatment/preventive efforts in low-income regions such as those in Sub Saharan Africa.

Adolescent depression and anxiety—which are linked with many negative life outcomes—are prevalent around the world, particularly in low-income countries such as those in Sub Saharan Africa (SSA). We used network analysis to examine the topology, stability, and centrality of depression and anxiety symptoms. We analyzed data from a large community sample (N = 2,192) of Kenyan adolescents aged 13-18, using the Patient Health Questionnaire and the Generalized Anxiety Disorder Screener. We identified the central symptoms of the depression and anxiety symptom networks, and we compared the structure and connectivity of these networks between low-symptom and elevated-symptom sub-samples. Our findings indicate the most central depression symptoms were “self-blame” and “depressed mood”, while the strongest depression symptom associations were “self-blame” ––“depressed mood” and “trouble concentrating” ––“little interest/pleasure”. Similarly, the most central anxiety symptoms were “too much worry” and “uncontrollable worry”, while strongest anxiety symptom associations were “too much worry” ––“uncontrollable worry” and “trouble relaxing” ––“restlessness”. We found a statistical difference in the network structure between low-symptom and elevated-symptom adolescents. The low-symptom sample had higher network connectivity scores for both depression (global strength difference = 0.30; low-symptom = 0.49; high-symptom = 0.19; p = .003) and anxiety symptoms (global strength difference = 1.04; low-symptom = 1.57; high-symptom = 0.53; p < .001). This is the first report that uses network analysis techniques to identify central symptoms of adolescent depression and anxiety in SSA. Our findings illustrate how network analysis may inform understanding of psychopathology within cultures and suggest promising treatment targets.

The effects of obesity on resuscitation after severe burn are not well understood. Formulas to calculate 24-h resuscitation volumes incorporate body weight, which in obese patients often leads to excessive fluid administration and potential complications such as pulmonary edema, extremity or abdominal compartment syndrome, and longer mechanical ventilation. We evaluated the impact of obesity on 24-h fluid resuscitation after severe burn using a cohort of 145 adults admitted to the burn ICU from January 2014 to March 2017 with20% total body surface area burns. Patients were divided into four groups based on body mass index: normal weight (index of25), overweight (25-29.9), obese (30-39.9), and morbidly obese (40). Median total body surface area burn was 39.4% (interquartile range: 23.5%-49.5%). Patients were 74.5% male and demographics and injury characteristics were similar across groups. Resuscitation volumes exceeded the predicted Parkland formula volume in the normal and overweight groups but were less than predicted in the obese and morbidly obese categories (p0.001). No difference was found in 24-h urine output between groups (p=0.08). Increasing body mass index was not associated with increased use of renal replacement therapy. Only total body surface area burned, and age were independent predictors of hospital mortality (p0.001). We conclude that using body weight to calculate resuscitation in obese patients results in a predicted fluid volume that is higher than the volume actually given, which can lead to over-resuscitation if rates are not titrated regularly to address fluid responsiveness.

This contribution presents exemplary approaches on how to improve the most time-limiting part of polymerase chain reactions, the heating and cooling steps. A new technology, Laser PCR®, promises to deliver a solution fast enough for point-of-care applications.

Introduction Programs supporting adolescent parents have been shown to increase socio-economic opportunities and promote healthy child development for young families, but retaining young parents is challenging. The Massachusetts Pregnant and Parenting Teen Initiative (MPPTI) offers case management and linkages to community and clinical services to young families. We examine engagement strategies identified by MPPTI participants and staff members in relation to participant retention by program site to identify potential strategies for increasing program engagement. Methods We employed a mixed-methods approach incorporating quantitative data on program participant characteristics and program retention by site with qualitative data from staff and participant interviews and focus groups. Results Key program engagement strategies identified by both MPPTI staff and youth participants were social-emotional supports, staffing model, and concrete supports. We found significant differences in program retention by site; the two sites with the highest levels of program retention offered all engagement strategies identified. Discussion Quantitative data on program retention coupled with qualitative data from staff and youth interviews suggests that in our program, there may be an association between the engagement strategies identified and levels of program retention.

AimsThe restrictions experienced due to the COVID-19 pandemic had impacts on how clinical teaching and assessment is conducted. The Royal College of Psychiatrists decided to run the final part of the membership exam, the Clinical Assessment of Skills and Competencies (CASC) online for the first time in September 2020. We aimed to prepare candidates in the Northern Ireland deanery for this by developing a virtual mock examination using the Zoom platform.MethodIn previous years, higher psychiatry trainees in the Northern Ireland deanery have run successful face to face mock examinations to help pre-membership trainees prepare for the CASC. We adapted some of this material to our virtual examination. 16 stations were run in total, in two circuits of eight. These stations were mapped to the Royal College CASC blueprint. Higher trainees were recruited to act as examiners, with core trainees acting as simulated patients. The mock examination was advertised through the local deanery and all candidates sitting in September availed of the opportunity (a total of 8 trainees).Zoom was used as the platform due to ease of use, familiarity and breakout room function. Each station formed one breakout room, and a facilitator moved candidates between rooms and provided timing prompts. Instructions were emailed to candidates in advance.A comfort break was provided between circuits. At the end of the mock examination, everyone was returned to the main room and examiners gave general feedback and tips. Individual feedback was provided by collating mark schemes for each candidate, which included free text feedback, and sending these via email.ResultDespite the evident challenges involved, the mock CASC ran smoothly. There was one minor delay of approximately 3 minutes due to technical difficulties, which was easily recouped. We obtained qualitative feedback from candidates which was positive, with trainees commenting that they felt “more at ease … less worried” about a digital exam, and that it was “efficient and effective”.All candidates who sat the mock examination were successful in the face to face CASC sitting which followed in September.ConclusionWe were able to successfully adapt what was previously an in-person mock CASC exam to the new digital format in a way that reflected how the actual CASC exam will run, and it was considered beneficial preparation by the candidates who sat this mock. This has improved trainee experience at a time when many teaching opportunities have been suspended.