Search

BackgroundPre-exposure prophylaxis (PrEP), condom use, post-exposure prophylaxis (PEP), and sexual partner reduction help to prevent HIV acquisition but have low uptake among young people. We aimed to assess the efficacy of automated text messaging and monitoring, online peer support, and strengths-based telehealth coaching to improve uptake of and adherence to PrEP, condom use, and PEP among adolescents aged 12-24 years at risk of HIV acquisition in Los Angeles, CA, USA, and New Orleans, LA, USA.MethodsWe conducted a four-arm randomised controlled factorial trial, assessing interventions designed to support uptake and adherence of HIV prevention options (ie, PrEP, PEP, condom use, and sexual partner reduction). We recruited young people aged 12-24 years who were at risk of HIV acquisition from 13 community-based organisations, adolescent medicine clinics, and organisations serving people who are unstably housed, people who were previously incarcerated, and other vulnerable young people, and through dating apps, peer referrals, and social venues and events in Los Angeles, CA, USA, and New Orleans, LA, USA. Young people who tested seronegative and reported being gay, bisexual, or other men who have sex with men, transgender men or women, or gender diverse (eg. non-binary or genderqueer) were eligible for inclusion. Participants were randomly assigned to one of four intervention groups in a factorial design: automated text messaging and monitoring (AMMI) only, AMMI plus peer support via private social media, AMMI plus strengths-based telehealth coaching by near-peer paraprofessionals, or AMMI plus peer support and coaching. Assignment was further stratified by race or ethnicity and sexual orientation within each interviewer's group of participants. Participants were masked to intervention assignment until after baseline interviews when offered their randomly assigned intervention, and interviewers were masked throughout the study. Interventions were available throughout the 24-month follow-up period, and participants completed baseline and follow-up assessments, including rapid diagnostic tests for sexually transmitted infections, HIV, and substance use, at 4-month intervals over 24 months. The primary outcomes were uptake and adherence to HIV prevention options over 24 months, measured by self-reported PrEP use and adherence, consistent condom use with all partners, PEP prescription and adherence, and number of sexual partners in participants with at least one follow-up. We used Bayesian generalised linear modelling to assess changes in outcomes over time comparing the four study groups. This study is registered with ClinicalTrials.gov (NCT03134833) and is completed.FindingsWe screened 2314 adolescents beginning May 1, 2017, to enrol 1037 participants (45%) aged 16-24 years between May 6, 2017, and Aug 30, 2019, of whom 895 (86%) had follow-up assessments and were included in the analytical sample (313 assigned to AMMI only, 205 assigned to AMMI plus peer support, 196 assigned to AMMI plus coaching, and 181 assigned to AMMI plus peer support and coaching). Follow-up was completed on Nov 8, 2021. Participants were diverse in race and ethnicity (362 [40%] Black or African American, 257 [29%] Latinx or Hispanic, 184 [21%] White, and 53 [6%] Asian or Pacific Islander) and other sociodemographic factors. At baseline, 591 (66%) participants reported anal sex without a condom in the past 12 months. PrEP use matched that in young people nationally, with 101 (11%) participants reporting current PrEP use at baseline, increasing at 4 months to 132 (15%) and continuing to increase in the AMMI plus peer support and coaching group (odds ratio 2·31, 95% CI 1·28-4·14 vs AMMI control). There was no evidence for intervention effect on condom use, PEP use (ie, prescription or adherence), PrEP adherence, or sexual partner numbers. No unanticipated or study-related adverse events occurred.InterpretationResults are consistent with hypothesised synergistic intervention effects of evidence-based functions of informational, motivational, and reminder messaging; peer support for HIV prevention; and strengths-based, goal-focused, and problem-solving telehealth coaching delivered by near-peer paraprofessionals. These core functions could be flexibly scaled via combinations of technology platforms and front-line or telehealth HIV prevention workers.FundingAdolescent Medicine Trials Network for HIV/AIDS Interventions, US National Institutes of Health.

Student learning loss during the COVID-19 Pandemic became an issue nationally. When school systems were thrown into hybrid and virtual learning environments, some schools still saw success due to their culture and hard-wired improvement practices. This article will illustrate how those practices at one particular school led to an actual improvement in learning during the pandemic.

A missionary religious tradition such as Christianity is distinguished from some other traditions by a commitment to the goal of converting others. However, the very nature of this goal and the norms that govern the successful realization of this goal are not often explored. In this article, I argue that evangelization can be undertaken for several distinct reasons, including epistemic reasons, particularly in cases in which evangelizers are aiming at the multivalent goal of fellowship. I argue that this account illuminates several possible models of mission, that it can provide resources for further evaluation and modeling of evangelical efforts, and that it might signify the need for theologically informed positions in the contemporary meta-epistemological debate about epistemic reasons.

Peanut (Arachis hypogaea L.) growers use different tillage systems in the Southeastern United States, the impact of which needs to be assessed with regard to evapotranspiration (ET), carbon uptake, and water-use efficiency (WUE). The eddy-covariance method was used to measure these fluxes in peanut in two common tillage systems (strip tillage vs. conventional tillage) over the course of three consecutive growing seasons (2019–2021). Results suggest that during the dry year of 2019 with rainfall of only 30 cm, strip tillage peanut had a significantly higher daytime ecosystem WUE, 105%, 51%, and 32% higher than that of the conventional tillage in early, mid, and late growth stages, respectively. In 2020, with mean rainfall the overall difference in average WUE was nonsignificant between the tillage systems. Heavy rainfall of 112 cm in 2021 led to waterlogged conditions in the conventional tillage field due to poorer infiltration. This likely reduced the CO2 uptake. Waterlogging did not occur in the strip tillage field due to improved infiltration. As a result, in 2021, 18%, 33%, and 48% greater ecosystem WUE in strip tillage during early, mid, and later stages was found. Thus, this study suggests that strip tillage fields can achieve higher net CO2 uptake and WUE in Georgia during dry or very wet years. However, no difference in WUE was found between different tillage systems in a typical year with average rainfall for Georgia. The present study has implications for regions characterized by long growing seasons and low rainfall.

Peanut is planted in a pattern of either single or twin rows in Georgia, USA. However, limited attention has been paid to the impact of planting pattern on the carbon footprint and how the net carbon uptake is intertwined with the amount of water used to determine the ecosystem water-use efficiency (WUE) in peanut. This paper reports on the relationship between the amount of carbon produced to the amount of water used in peanut, carbon dioxide flux, and crop evapotranspiration of peanut in a single- or in a twin-row planting pattern measured using the eddy-covariance method. To the best of our knowledge, the present study is unique in that it examines for the first time the effect of planting pattern on the net carbon uptake and WUE. The two-year study took place in contrasting weather conditions with the 2016 year experiencing a higher vapor pressure deficit and lower precipitation than in the 2018 year. In this study, field-scale daytime net carbon ecosystem exchange (CO2 fluxes), ET and WUE of single- and twin-row peanut were compared using the eddy-covariance technique. Results showed that in 2018, both the net carbon uptake from the atmosphere and the WUE of twin-row peanut were significantly greater than those in the single-row peanut by 7-10% and ~9% respectively, for pod filling and seed maturity growth stages (aGDD 1000-2000 and aGDD > 2000). In 2016, the net daytime carbon uptake and WUE of peanut were similar for both planting patterns during pod filling (aGDD 1000-2000). Higher precipitation and lower VPD in 2018 likely resulted in greater peanut yield in twin-row as compared to single-row with abundant precipitation. Owing to the fast canopy growth rate in twin-row peanut, results suggest that during the vegetative stage (aGDD

The global COVID-19 pandemic has spotlighted several instances of churches violating state issued and scientifically recommended guidelines designed to keep populations healthy and to prevent the further spread of the disease. While these instances are minority responses to these orders, they nonetheless raise questions about the rationality of ecclesial belonging in response to the COVID-19 pandemic. In this article, I draw on the work of William James and W. E. B. Du Bois to articulate a conception of ecclesial belonging as a social epistemological process engaging a complex, fluid multiplicity of knowers of various scales. I argue that, in this view, ecclesial rationality involves the construction of a concatenation of internal and external practices individual believers and groups can traverse so long as they consistently satisfy a plurality of desiderata. I suggest that what is irrational about religious-based defiance of COVID-19 guidelines is the church-sanctioned severance of internal from external practices. I suggest that this behavior is supported by a failure to grasp the demands of ecclesial rationality rather than embrace them, and that this conception of rationality may have been eroded by the value-neutral skepticism of secular rationality.

Many central creedal statements in Christianity presuppose the existence of a substantial self, even though Christian tradition has not always explicitly used this terminology. However, in contemporary philosophy, the traditional Christian view has been charged with empirical inadequacy, an objection often motivated by neuroscientific considerations. In this paper, I examine the empirical adequacy of the traditional Christian view from a phenomenological perspective and from emerging contemporary cognitive scientific perspectives that downplay or de-emphasize the brain’s role in cognition. I argue that neither perspective supports fatal objections to the traditional view and I explain how the traditional Christian view of the self can be synthesized with some novel philosophical developments that suggest the continued relevance of the view.

Background and Objective: Dementia is a broad term for a complex range of conditions that affect the brain, such as Alzheimer’s disease (AD). Dementia affects a lot of people in the elderly community, hence there is a huge demand to better understand this condition by using cost effective and quick methods, such as neuropsychological tests, since pathological assessments are invasive and demand expensive resources. One of the promising initiatives that deals with dementia and Mild Cognitive Impairment (MCI) is the Alzheimer’s Disease Neuroimaging Initiative (ADNI), which includes cognitive tests, such as Clinical Dementia Rating (CDR) scores. The aim of this research is to investigate non-invasive dementia indicators, such as cognitive features, that are typically diagnosed by clinical assessment within ADNI’s data to understand their effect on dementia. Methods: To achieve the aim, machine learning techniques have been utilized to classify patients into Cognitively Normal (CN), MCI, or having dementia, based on the sum of CDR scores (CDR-SB) besides demographic variables. Particularly, the performance of Support Vector Machine (SVM), K-nearest neighbors (KNN), Decision Trees (C4.5), Probabilistic Naïve Bayes (NB), and Rule Induction (RIPPER) is measured with respect to different evaluation measures, including specificity, sensitivity, and harmonic mean (F-measure), among others, on a large number of cases and controls from the ADNI dataset. Results: The results indicate competitive performance when classifying subjects from the baseline selected variables using machine learning technology. Though we observed fairly good results across all machine learning algorithms utilized, there was still variation in the performance ability, indicating that some algorithms, such as NB and C4.5, are better suited to the task of classifying dementia status based on our baseline data. Conclusions: Using cognitive tests, such as CDR-SB scores, with demographic attributes to pinpoint to dementia using machine learning can be seen a less invasive approach that could be good for clinical use to aid in the diagnosis of dementia. This study gives an indication that a comprehensive assessment tool, such as CDR, may be adequate in assessing and assigning a dementia class to patients, upon their visit, in order to speed further clinical procedures.

A missionary religious tradition such as Christianity is distinguished from some other traditions by a commitment to the goal of converting others. However, the very nature of this goal and the norms that govern the successful realization of this goal are not often explored. In this article, I argue that evangelization can be undertaken for several distinct reasons, including epistemic reasons, particularly in cases in which evangelizers are aiming at the multivalent goal of fellowship. I argue that this account illuminates several possible models of mission, that it can provide resources for further evaluation and modeling of evangelical efforts, and that it might signify the need for theologically informed positions in the contemporary meta-epistemological debate about epistemic reasons. [ABSTRACT FROM AUTHOR]

In Religious Experience, Wayne Proudfoot argued that a tout court rejection of reductionism in accounts of religious experience was not viable. According to Proudfoot, it’s possible to distinguish between an illegitimate practice of descriptive reductionism and the legitimate practice of explanatory reductionism. The failure to distinguish between these two forms of reductionism resulted in a protective strategy, or an attempt to protect religious experience from the reach of scientific explanation. Among the theorists whom he accused of deploying this illegitimate strategy Proudfoot included William James and his work in The Varieties of Religious Experience. In this article, I argue that while James does occasionally deploy a protective strategy in Varieties, this is not the only nor most important method of treating religious experience James developed. Implicit in his rejection of medical materialism, James not only deploys the protective strategy Proudfoot criticizes, but the pragmatic method with which he treats all claims. I argue that James’s pragmatic method leads to what James called noetic pluralism, or the view that there is no privileged knowledge practice, but a plurality of knowledge practices, and that this method puts pressure on the explanatory reductionist, who is implicitly committed to noetic monism.