The predominant relationship between sexual environment characteristics and HIV-serodiscordant condomless anal sex among HIV-positive men who have sex with men (MSM)

In some studies, situational factors have been shown to be stronger predictors of condomless sex than individual risk factors. Cross-sectional relationships between condomless anal sex (CAS) with HIV-serodiscordant partners and risk factors across ecological levels (individual, sexual environment) were examined using a sample (N = 60) of HIV-positive men who have sex with men (MSM) who reported multiple recent episodes of CAS. Negative binomial regressions were used to evaluate the association of contextual risk factors (e.g., substance use during sex, transactional sex, public sex, sex at a sex party) with recent condomless sex, controlling for demographics and mental health. Results demonstrated that sexual environment factors, particularly sex under the influence of drugs or alcohol (B = .019, p < .05), transactional sex (B = .035, p < .01), and public sex (B = .039, p < .01) explained a large proportion of the variance in CAS. Only sex at a sex party was not related to CAS (p = .39). For each additional sexual environment in which men engaged, their rates of CAS increased (B = .39, p < .01). Secondary prevention interventions that are tailored to the proximal sexual environment could be maximally effective, particularly if they address substance use and other challenging sexual situations.We are very grateful to the participants for their time and efforts in the study. Support for the current study came from a feasibility grant (PI: Conall O'Cleirigh) from the Harvard University Center for AIDS Research (Parent Grant: P30AI060354, PI: Bruce Walker, MD) awarded to Dr. Conall O'Cleirigh. Investigator support for Dr. Steven Safren also came from NIH Grant K24MH094214. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. (P30AI060354 - Harvard University Center for AIDS Research; K24MH094214 - NIH)Accepted manuscrip

Psychological morbidity and autonomic reactivity to emotional stimulus in parental cancer: a study with children caregivers

Literature suggests that parental cancer can provoke aversive emotional arousal in adult children, who may perceive caregiving as a traumatic experience. Limited research has been conducted on emotional and physiological impact of family caregiving for cancer patients undergoing chemotherapy. The aim of the present study was to examine psychological and physiological responses in parental cancer’s caregivers. Two matched groups of adult children, with 78 participants each (parental cancer vs. control), completed psychological measures of distress, post-traumatic stress disorder (PTSD) symptoms, and burden. Additionally, each participant visualised standardised pictures with different emotional valences, while cardiovascular (heart rate) and electrodermal responses (skin conductance) were recorded. Between-group analysis showed significant differences on all psychological variables, and on skin conductance for all types of pictures. However, for the heart rate responses, differences were found only for pictures with unpleasant emotional arousal. In the parental cancer group, the heart rate peak response stood out as a predictor of PTSD symptoms, after controlling for distress and burden. This study highlights the important role of psychophysiological measures of family caregiving in oncology. Physiological responses may explain a higher prevalence of PTSD symptoms. Therefore, biofeedback combined with targeted psychosocial interventions for relaxation could be of great clinical value for this populationFundação para a Ciência e a Tecnologia (FCT

Single Maintenance and Reliever Therapy (SMART) for Pediatric Asthma

Asthma is a commonly occurring pediatric condition managed in primary care. In 2020, asthma guidelines changed for treating mild persistent asthma. Now, experts recommend using Single Maintenance and Reliever Therapy (SMART) in children 4 years of age and older. With the SMART approach, patients use one inhaler to maintain and relieve symptoms, as the name implies. The combination inhaler contains budesonide, an inhaled corticosteroid (ICS), and formoterol, a long-acting beta-2 agonist (LABA). The most common brand name associated with this regimen in the United States is Symbicort. While there are various options for ICS therapy, formoterol is currently the sole LABA recommended for use in SMART. SMART is shown to decrease oral steroid use, increase growth rate, reduce emergency department visits and hospitalization, and improve overall asthma control. Although these benefits exist with SMART, there are associated challenges, which include a lack of provider adoption, financial constraints, and a lack of FDA approval for this indication. Despite these challenges, SMART care is efficient and symptom-altering and should be the standard of care for those with persistent asthma

Adolescent HIV Pre Exposure Prophylaxis Prescribing Practices Among Family Medicine Physicians: Limited Immediate Uptake

This study aims to: Examine the adolescent PrEP prescribing practices and knowledge of family medicine physicians. Begin to identify areas that might be key targets for interventions which may lead to increased adolescent PrEP prescribing uptake.https://jdc.jefferson.edu/fmposters/1005/thumbnail.jp

Symbolic management and the glass cliff. Evidence from the boardroom careers of female and male directors

This paper uses archival board data to demonstrate that women who take positions as directors of UK companies have shorter tenures than their male counterparts. We show that female directors face a much higher risk of dismissal as they approach nine years of service on the board when their long service deprives them of the all-important classifi- cation as ‘independent’. At this point, their position on the board becomes precarious. Male directors do not suffer the same increase in boardroom exit. This gender-specific difference is shown to be clearly linked to the independence status. It is argued that these observations are consistent with the notion that female directors are being used in the symbolic management of corporate governance and that at nine years, when the cloak of independence disappears, women directors are then exposed to the biases that arise from role congruity issues

Adolescent HIV Pre-Exposure Prophylaxis Prescribing Practices Among Family Medicine Physicians: Limited Immediate Uptake

Introduction: In the United States, individuals aged 13-24 made up 21% of new HIV infections in 2016. In 2018, the FDA approved tenofovir/emtricitabine as HIV pre-exposure prophylaxis (PrEP) for adolescents aged 15-17. In 2019, we examined adolescent PrEP prescribing practices among family medicine physicians at an academic family medicine practice. Methods: Physicians were invited to complete an online questionnaire assessing PrEP knowledge, attitudes, and prescribing practices. Differences in PrEP knowledge and attitudes among providers who prescribe PrEP to adolescents versus those who do not were examined using independent samples t-tests. Results: 50 out of 99 surveys were completed. Respondents were 90% White, 84% heterosexual, 50% attendings, 50% residents/fellows, and 2% HIV specialists. All respondents had heard of PrEP before the survey, 76% had prescribed PrEP and 70% reported being aware of the FDA approval of PrEP for adolescents. While 86% reported treating patients aged 15-17, only 6% reported having prescribed PrEP to this demographic. Physicians who reported prescribing PrEP to adolescents reported greater comfort assessing for indications for PrEP, t(48)= -2.23, p \u3c 0.05, greater PrEP knowledge, t(47)= -3.34, p \u3c 0.005, and felt PrEP was safer, t(48)= -2.09, p \u3c 0.05, compared to physicians who had not. Conclusion: Despite universal awareness of PrEP, high rates of prescribing to adults, and awareness of FDA approval of PrEP for adolescents, PrEP prescribing to adolescents in our sample remains limited. Differences between providers who have and have not prescribed PrEP to adolescents suggest targeted training may boost prescribing to this demographic

Synthesis and electrokinetics of cationic spherical nanoparticles in salt-free non-polar media

Cationic diblock copolymer nanoparticles have been prepared in n-dodecane via polymerization-induced self-assembly (PISA). A previously reported poly(stearyl methacrylate)-poly(benzyl methacrylate) (PSMA-PBzMA) PISA formulation (Chem. Sci. 2016, 7, 5078-5090) was modified by statistically copolymerizing an oil-soluble cationic methacrylic monomer, (2-(methacryloyloxy)ethyl)trimethylammonium tetrakis[3,5-bis(trifluoromethyl)phenyl]borate, with either SMA or BzMA, to produce either charged shell or charged core nanoparticles. The electrokinetics were studied as a function of many variables (function of volume function, particle size, solvent viscosity, and number of ions per chain). These data are consistent with electrophoresis controlled by counterion condensation, which is typically observed in salt-free media. However, there are several interesting and unexpected features of interest. In particular, charged shell nanoparticles have a lower electrophoretic mobility than the equivalent charged core nanoparticles, and the magnitude of the electrophoretic mobility increases as the fraction of cationic stabilizer chains in the shell layer is reduced. These results show that cationic PSMA-PBzMA spheres provide an interesting new example of electrophoretic nanoparticles in non-polar solvents. Moreover, they should provide an ideal model system to evaluate new electrokinetic theories

Poly(dimethylsiloxane)-Stabilized Polymer Particles from Radical Dispersion Polymerization in Nonpolar Solvent: Influence of Stabilizer Properties and Monomer Type

Particles used in electrophoretic display applications (EPD) must possess a number of specific properties ranging from stability in a nonaqueous solvent, high reflectivity, low polydispersity, and high charge density to name but a few. The manufacture of such particles is best carried out in the solvent of choice for the EPD. This opens up new interests in the study of nonaqueous dispersion polymerization methods, which deliver polymer particles suspended in low dielectric constant solvents. We explore in this article the use of a poly(dimethylsiloxane) macromonomer for the stabilization of poly(methyl methacrylate) polymer particles in dodecane, a typical solvent of choice for EPDs. The use of this stabilizer is significant for this method as it is directly soluble in the reaction medium as opposed to traditionally used poly(12-hydroxystearic acid)-based stabilizers. Additionally, the present study serves as a baseline for subsequent work, where nonaqueous dispersion polymerization will be used to create polymer particles encapsulating liquid droplets and solid pigment particles. In this article, the influence of the macromonomer molecular weight and concentration on the properties of the synthesized particles is studied. In addition, we investigate the possibility of synthesizing polymer particles from other monomers both as a comonomer for methyl methacrylate and as the only monomer in the process. The influence of macromonomer concentration is also studied throughout all experiments

Myrf guides target gene selection of transcription factor Sox10 during oligodendroglial development

Oligodendrocytes generate myelin in the vertebrate central nervous system and thus ensure rapid propagation of neuronal activity. Their development is controlled by a network of transcription factors that function as determinants of cell identity or as temporally restricted stage-specific regulators. The continuously expressed Sox10 and Myrf, a factor induced during late development, are particularly important for terminal differentiation. How these factors function together mechanistically and influence each other, is not well understood. Here we show that Myrf not only cooperates with Sox10 during the induction of genes required for differentiation and myelin formation. Myrf also inhibits the activity of Sox10 on genes that are essential during earlier phases of oligodendroglial development. By characterization of the exact DNA-binding requirements of Myrf, we furthermore show that cooperative activation is a consequence of joint binding of Sox10 and Myrf to the same regulatory regions. In contrast, inhibition of Sox10-dependent gene activation occurs on genes that lack Myrf binding sites and likely involves physical interaction between Myrf and Sox10 followed by sequestration. These two opposite activities allow Myrf to redirect Sox10 from genes that it activates in oligodendrocyte precursor cells to genes that need to be induced during terminal differentiation