Search

BackgroundNeisseria gonorrhoeae (commonly known as gonorrhea) has developed resistance to all first-line therapy in Southeast Asia. East Africa has historically had absent or rudimentary gonorrhea surveillance programs and, while the existence of antimicrobial-resistant gonorrhea is recognized, the extent of its resistance is largely unknown. In 2016, the World Health Organization’s Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) was initiated in Uganda to monitor resistance trends. ObjectiveThis study characterizes gonorrhea and antibiotic resistance in a large surveillance program of men with urethral discharge syndrome from Kampala, Uganda. MethodsMen attending sentinel clinics with urethritis provided demographic information, behavior data, and a urethral swab in line with the World Health Organization’s EGASP protocols for culture, identification, and antibiotic-sensitivity testing using 2 methods—disk diffusion (Kirby-Bauer test) and Etest (BioMérieux Inc). A subset of samples underwent detailed antimicrobial resistance testing. ResultsOf 639 samples collected from September 2016 to February 2018, 400 (62.6%) were culture-positive though 414 (64.8%) had microscopic evidence of gonorrhea. The mean age of the men from whom the samples were collected was 26.9 (SD 9.6) years and 7.2% (46/639) reported having HIV. There was high-level resistance to ciprofloxacin, tetracycline, and penicillin (greater than 90%) by Kirby-Bauer disk diffusion and 2.1% (4/188) had reduced azithromycin sensitivity by Etest. Of the early isolates that underwent detailed characterization, 60.3% (70/116) were culture-positive, 94% (66/69) isolates were either ciprofloxacin-resistant or ciprofloxacin-intermediate by Etest, 96% (65/68) were azithromycin-sensitive, and 96% (66/69) were gentamicin-sensitive. Resistance profiles were comparable between methods except for ceftriaxone (disk diffusion: 68/69, 99%; Etest: 67/69, 97%) and for gentamicin (disk diffusion: 2/8, 25%; Etest: 66/69, 96%) sensitivity. ConclusionsThis is the first report from a systematic gonorrhea surveillance program in Uganda. Findings demonstrated resistance or increased minimum inhibitory concentration to all key antigonococcal antibiotics. There was evidence of poor antibiotic stewardship, near-universal resistance to several antibiotics, and emerging resistance to others. Individuals in the population sampled were at exceptionally high risk of STI and HIV infection requiring intervention. Ongoing surveillance efforts to develop interventions to curtail antimicrobial-resistant gonorrhea are needed.

Traditional circuit board fabrication schemes are not directly applicable to the production of flexible, multi‐material circuits. This article reports a technique, microfluidic directed material patterning, which combines soft microfluidic stamps and low‐temperature solution‐phase deposition to generate multi‐material circuits on flexible, non‐planar polymeric supports. Specifically, metallic and semiconductive traces are combined on commodity plastic films to yield functional photosensitive circuits that can be used in the spectrophotometric detection and concentration measurement of microdroplets on 3D "e‐plates." The photoresistive material cadmium sulfide is used in these circuits because it is suitable for visible light detection and it can be deposited directly from aqueous solutions following established bath deposition procedures. This method can produce colorimetric devices capable of quantifying micromolar concentrations of Allura Red in microdroplets of Kool‐Aid. This technique presents the opportunity for producing single‐use or low‐use disposable/recyclable devices for flexible 3D sensors and detectors following a convenient, low‐waste fabrication scheme. The general capabilities of this approach, in terms of substrate geometry and device layout (e.g., the number, area, and pattern of photoresistive elements), can be applied to the design and manufacture of more intricate, multiplexed devices supportive of advanced and/or specialized functions that go beyond those reported in this initial demonstration. [ABSTRACT FROM AUTHOR]

The most effective health communication builds from evidence-based best practices and theory. In practice, health campaigns rely on considerations often under-discussed in health communication, such as consistent agency-style client service, image management, and community coalition-building. Health outcome progress often requires change at multiple levels, from individual cognition and behavior to policy creation. These multi-level needs further highlight the importance of effective practical health communication supporting a range of outcomes and building toward replication. This article covers the complexities of building and implementing a theory-informed health communication structure for a multifaceted, place-based cancer prevention initiative. Part of the overall process includes detailing the internal communications of a health communication group, interorganizational communication, engaging community partner support, the message creation process, and longitudinal efforts on program maintenance and assessment. Furthermore, this article seeks to offer an example of the client service role a health communication team can play to combine theory, empirical message development, and community goals in whole community efforts. Ultimately, the goal is to share experiences from seven years of program work to help guide future community-based efforts in other health contexts and foster progress in theoretical and practical understandings of health communication. [ABSTRACT FROM AUTHOR]

Academic centers play a vital role in advancing knowledge, driving innovation, and fostering collaboration. The University of Texas at Austin Center for Health Communication was established in 2014 with the mission to improve public health through evidence-based communication research and practice. In this article, we reflect on the center history, explain our practice-oriented funding structure, and showcase examples of public health campaigns informed by theory and data, as well as professional-oriented educational programs. We also discuss the academic and community impact of our research, education, and practice and the benefits and challenges associated with this practice-led funding model. Although there are other approaches to operating academic centers, we hope the lessons we have learned can be of help to other centers dedicated to health communication research and practice. [ABSTRACT FROM AUTHOR]

Pre-eclampsia is one of the most common causes of maternal and perinatal death worldwide. It is a hypertensive pregnancy disease with reduced perfusion of numerous organs. The main symptoms of the disease include elevated blood pressure, proteinuria and the associated subcutaneous fluid retention in the fingers, hands and face of the pregnant woman. In this paper a concept of a portable prototype for early-detection of preeclampsia is presented. The assembled sensor systems enable portable monitoring of the main symptoms to detect changes at an early stage. The sensor system for determining blood pressure is based on photoplethysmography. The sensor system for detecting subcutaneous fluid retention uses the absorption bands of the fluid when illuminated with near-infrared light. For the validation experiments, finger models made of silicone with different fluid retention levels were produced. The results show a correlation between the measured transmitted light intensity and the fluid retention. The results represent a possibility for the portable measurement of important vital parameters in connection with preeclampsia. [ABSTRACT FROM AUTHOR]

Introduction: Homelessness is associated with an increased risk of syphilis, HIV, and other STIs and disproportionately impacts sexual and gender minorities. Method: Data for this analysis came from a longitudinal cohort study of 285 urban gay, bisexual, and other men who have sex with men (MSM). The study aimed to (1) describe the prevalence of homelessness over time (2) identify characteristics associated with homelessness, and (3) measure associations between recent homelessness and substance use and STI/HIV risk behaviors three months later. Participants were recruited from clinical and non-clinical settings and attended a baseline visit and study visits every three months for up to 18-months. Data was collected between July 2018 and September 2020. Descriptive analyses and mixed-effects logistic regression models were utilized. Results: One-third of participants (94) reported experiencing homelessness throughout the study. Homelessness was significantly and independently associated with increased risk for future drug/alcohol use before/during sex (aOR: 3.8, 95% CI: 1.7, 8.6), methamphetamine use (aOR: 6.3 95% CI: 2.6, 15.2), injection drug use (adjusted odds ratio (aOR): 3.7, 95% CI: 1.0, 13.1), and sex exchange (aOR: 12.7; 95% CI: 5.5, 29.4). Conclusion: Interventions to reduce homelessness are necessary to lower risk of substance use and STI/HIV risk behaviors. [ABSTRACT FROM AUTHOR]

Abstract: Background: With an estimated prevalence of 1 to 2 per 100 people, Fetal Alcohol Spectrum Disorders (FASD) are common in Europe and are associated with a high burden for people with FASD, their relatives and the society. They are complex disorders with limitations at various levels, including behavior, performance and independence. An S3 guideline is available for the diagnosis of FASD in children and adolescents. Aim: We present an author consensus on the diagnosis of FASD in adults. Conclusions: In addition to the weaker evidence for adulthood, a major problem is that only a few locations offer appropriate services. The result is an inadequate diagnostic and care structure in Germany. The following four approaches can be taken to improve the situation: (1) More consistent use of available screening tools in general medical, psychiatric and psychotherapeutic care; (2) Establishment of additional specialized diagnostic centers; (3) Establishment of additional specialized treatment and residential facilities; and (4) Promotion of research on FASD across the lifespan. These steps will lead to an improvement in the treatment and care of people with FASD. [ABSTRACT FROM AUTHOR]

Transcranial direct current stimulation (tDCS) has been shown to modulate neuroplasticity. Beneficial effects are observed in patients with psychiatric disorders and enhancement of brain performance in healthy individuals has been observed following tDCS. However, few studies have attempted to elucidate the underlying molecular mechanisms of tDCS in the brain. This study was conducted to assess the impact of tDCS on gene expression within the rat cerebral cortex. Anodal tDCS was applied at 3 different intensities followed by RNA-sequencing and analysis. In each current intensity, approximately 1,000 genes demonstrated statistically significant differences compared to the sham group. A variety of functional pathways, biological processes, and molecular categories were found to be modified by tDCS. The impact of tDCS on gene expression was dependent on current intensity. Results show that inflammatory pathways, antidepressant-related pathways (GTP signaling, calcium ion binding, and transmembrane/signal peptide pathways), and receptor signaling pathways (serotonergic, adrenergic, GABAergic, dopaminergic, and glutamate) were most affected. Of the gene expression profiles induced by tDCS, some changes were observed across multiple current intensities while other changes were unique to a single stimulation intensity. This study demonstrates that tDCS can modify the expression profile of various genes in the cerebral cortex and that these tDCS-induced alterations are dependent on the current intensity applied.

Objective: Despite declining cigarette smoking rates in the US, there is a continued need for tobacco prevention education campaigns to reach young adults. Recognizing the need for improved tobacco control messaging, the University of Texas (UT) System engaged The University of Texas at Austin Center for Health Communication to develop a brand and message that would strengthen tobacco control efforts at its 14 institutions. Methods: This article describes the iterative process involved in creating a brand for tobacco control, including an environmental scan, identifying potential message themes, and creating and refining logos. Results: This article highlights the process of developing a system-wide tobacco control brand. Specifically, the process included coordinating an interdisciplinary team with content and design experts, and presenting ideas to stakeholders for serial feedback and refinement, among others. Conclusions: Ultimately, this project offers a model for other systems of higher education interested in pursuing similar initiatives.

Introduction We previously identified ONC201/TIC10 as a small molecule that upregulates endogenous TNF-related apoptosis-inducing ligand (TRAIL) in tumor and normal cells, and restores autocrine and paracrine antitumor activity within tumor [...], ONC201 is a first-in-class, orally active antitumor agent that upregulates cytotoxic TRAIL pathway signaling in cancer cells. ONC201 has demonstrated safety and preliminary efficacy in a first-in-human trial in which patients were dosed every 3 weeks. We hypothesized that dose intensification of ONC201 may impact antitumor efficacy. We discovered that ONC201 exerts dose--and schedule-dependent effects on tumor progression and cell death signaling in vivo. With dose intensification, we note a potent anti-metastasis effect and inhibition of cancer cell migration and invasion. Our preclinical results prompted a change in ONC201 dosing in all open clinical trials. We observed accumulation of activated [NK.sup.+] and [CD3.sup.+] cells within ONC201-treated tumors and that NK cell depletion inhibits ONC201 efficacy in vivo, including against TRAIL/ONC201-resistant [Box.sup.-/-] tumors. Immunocompetent NCR1-GFP mice, in which NK cells express GFP, demonstrated [GFP.sup.+] NK cell infiltration of syngeneic MC38 colorectal tumors. Activation of primary human NK cells and increased degranulation occurred in response to ONC201. Coculture experiments identified a role for TRAIL in human NK-mediated antitumor cytotoxicity. Preclinical results indicate the potential utility for ONC201 plus anti-PD-1 therapy. We observed an increase in activated TRAIL-secreting NK cells in the peripheral blood of patients after ONC201 treatment. The results offer what we believe to be a unique pathway of immune stimulation for cancer therapy.

Families play an important role in addressing substance misuse and addiction. Extant literature suggests patterns of communication within families influence the ways in which they engage loved ones who may be misusing substances like prescription opioids. However, little is known regarding how strategic health messages about family communication influence individuals' intentions to engage in conversations about substance misuse. Applying a normative approach, we conducted a (2 × 2) between-participants experiment examining whether messages advocating indirect (versus direct) communication are more effective for individuals (n = 613) who describe their family as having a low (versus high) conversation orientation. Univariate analysis of variance tests show match effects for message attitudes and message elaboration. For intentions to talk with a loved one about the risks of OUD, there was only evidence of a matching effect between the message advocating indirect communication with low conversation audiences. Both message types were equally effective at influencing intentions for high conversation participants. These findings suggest message designers should consider the kinds of communication behaviors and actions advocated in appeals targeting family members. Messages that are inclusive of the conversation dynamics of particular audiences may have greater effect. In particular, for low conversation audiences, messages advocating an indirect approach may be more effective at motivating intentions to engage someone who is misusing opioids. [ABSTRACT FROM AUTHOR]