Case Report: Neurobrucellosis Presenting as Malignancy.

Neurobrucellosis, caused by Brucella species, is a zoonotic infection that may involve the central nervous system. Although uncommon, it can manifest as a solitary intracranial mass. We report a case of neurobrucellosis in a 25-year-old woman from Peru who presented with headache, weight loss, and right-side hemiparesis and paresthesia. A contrast-enhanced magnetic resonance imaging scan revealed an intracerebral mass in the left temporal lobe. Serum testing subsequently were positive. Brain biopsy demonstrated non-necrotizing granulomas without malignant cells. Neurobrucellosis should be considered in the differential diagnosis of brain space occupying lesions in endemic countries.

"They think we wear loincloths": Spatial stigma, coloniality, and physician migration in Puerto Rico.

Puerto Rico (PR) is facing an unprecedented healthcare crisis due to accelerating migration of physicians to the mainland United States (US), leaving residents with diminishing healthcare and excessively long provider wait times. While scholars and journalists have identified economic factors driving physician migration, our study analyzes the effects of spatial stigma within the broader context of coloniality as unexamined dimensions of physician loss. Drawing on 50 semi-structured interviews with physicians throughout PR and the US, we identified how stigmatizing meanings are attached to PR, its people, and its biomedical system, often incorporating colonial notions of the island's presumed backwardness, lagging medical technology, and lack of cutting-edge career opportunities. We conclude that in addition to economically motivated policies, efforts to curb physician migration should also address globally circulating ideas about PR, acknowledge their roots in coloniality, and valorize local responses to the crisis that are in danger of being lost to history.

Lemierre-like syndrome after soft tissue infection due to methicillin-resistant Staphylococcus aureus: A case report and literature review.

RATIONALE: Lemierre-like syndrome (LLS) is characterized by bacteremia, septic thrombophlebitis of the internal jugular vein, and metastatic abscesses. In contrast to classic Lemierre syndrome, sources of infection are not related to oropharyngeal infections, as are frequent soft tissue infections. In recent years, Staphylococcus aureus has been identified as an emergent pathogen that causes this syndrome. The mortality rate of LLS caused by this pathogen is approximately 16%. Timely diagnosis, antibiotic treatment, and infection control are the cornerstones to treat LLS. Anticoagulant therapy as adjuvant treatment remains controversial. PATIENT CONCERNS: A 31-year-old woman from California, United States (US), was admitted to the emergency room with a history of 2 days of fever and severe throbbing pain in the left cervical region. Thorax and neck CT tomography revealed confluent cavities suggestive of septic embolism in the lungs and a filiform thrombus in the lumen of the left internal jugular vein, with moderate swelling of the soft and muscular tissues. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from the blood culture. DIAGNOSIS: The thrombus in the internal jugular vein associated with cellulitis in the neck and multiple cavitary lesions in the lungs support the diagnosis of LLS caused by MRSA with septic embolization. INTERVENTIONS: During treatment, the patient received vancomycin IV for 25 days and returned to the US with linezolid orally. In addition, assisted video-thoracoscopy and bilateral mini-thoracotomy with pleural decortication were performed for infectious source control, where 1700cc of purulent pleural fluid was drained. OUTCOMES: The patient was discharged with optimal evolution. LESSONS: LLS should be suspected in patients with skin and soft tissue infections who develop thrombosis or metastatic infections. MRSA infections should be considered in patients from areas where this pathogen is prevalent.

Effect of dietary inclusion of microalgae (Nannochloropsis gaditana and Schizochytrium spp) on non-specific immunity and erythrocyte maturity in Atlantic salmon fingerlings.

The parr-smolt transformation in salmonids involves a critical period characterized by systemic changes associated with the fish's immune response. In this context, as a dietary ingredient in functional diets, microalgae offer an alternative due to their nutritional and bioactive compounds that could strengthen the immune status. This study evaluated the effect of a diet supplemented with Schizochytrium spp and Nannochloropsis gaditana on the expression of genes associated with the antibacterial response. Additionally, the study assessed the effect on the leukocyte population and erythrocyte maturity in Salmo salar blood. Fish were fed for 30 days with a microalgal mixture (1:1) at a 10% inclusion. Each diet was randomly assigned to a tank using a completely randomized design (CRD) with four replications. Each tank was stocked with 70 Atlantic salmon fingerlings with an initial mean weight of 78.87 ± 0.84. Transcription levels were quantified and analyzed by qRT-PCR from cell isolates and mucus tissue. Furthermore, cell count and identification of leukocytes and classification of cellular maturity of erythrocytes using a neural network with a multilayer perceptron (MLP) were performed. Our results showed a significant (p < 0.05) increase in fold change expression of C3 (2.54 ± 0.65) and NK-Lysine (6.84 ± 0.94) in erythrocytes of microalgae-supplemented fish. Moreover, a significant increase of 1.59 and 2.35 times in monocytes and immature erythrocytes, respectively, was observed in the same group of fish (p < 0.05). This study's results indicate that dual microalgae (Schizochytrium spp and N. gaditana) supplementation can increase innate humoral antibacterial components, particularly in erythrocyte tissue, and increase phagocytic cells and immature erythrocytes in S. salar blood.

Multispectral Filter Array Design by Optimal Sphere Packing.

Multispectral imaging (MSI) collects a datacube of spatio-spectral information of a scene. Many acquisition methods for spectral imaging use scanning, preventing its widespread usage for dynamic scenes. On the other hand, the conventional color filter array (CFA) method often used to sample color images has also been extended to snapshot MSI using a Multispectral Filter Array (MSFA), which is a mosaic of selective spectral filters placed over the Focal Plane Array (FPA). However, even state-ofthe- art MSFAs coding patterns produce artifacts and distortions in the reconstructed spectral images, which might be due to the nonoptimal distribution of the spectral filters. To reduce the appearance of artifacts and provide tools for the optimal design of MSFAs, this paper proposes a novel mathematical framework to design MSFAs using a Sphere Packing (SP) approach. By assuming that each sampled filter can be represented by a sphere within the discrete datacube, SP organizes the position of the equal-size and disjoint spheres's centers in a cubic container. Our method is denoted Multispectral Filter Array by Optimal Sphere Packing (MSFA-OSP), which seeks filter positions that maximize the minimum distance between the spheres's centers. Simulation results show an image quality improvement of up to 2 dB and a remarkable boost in spectral similarity when using our proposed MSFA design approach for a variety of reconstruction algorithms. Moreover, MSFA-OSP notably reduces the appearance of false colors and zipper effect artifacts, often seen when using state-of-the-art demosaicking algorithms. Experiments using synthetic and real data prove that the proposed MSFA-OSP outperforms state-of-the-art MSFAs in terms of spatial and spectral fidelity. The code that reproduces the figures of this article is available at https://github.com/nelson10/DemosaickingMultispectral3DSpherePacking.git.

On leaving: Coloniality and physician migration in Puerto Rico.

Puerto Rico (PR) has a growing physician migration problem. As of 2009, the medical workforce was composed of 14,500 physicians and by 2020 the number had been reduced to 9,000. If this migration pattern continues, the Island will not be able to meet the recommended physicians per capita ratio proposed by the World Health Organization (WHO). Existing research has focused on the personal motivations for movement to, or permanence in, a particular setting, and social variables that encourage physicians to migrate (e.g., economic conditions). Few studies have addressed the role of coloniality in fostering physician migration. In this article we examine the role of coloniality and its impact on PR's physician migration problem. The data presented in this paper stem from an NIH-funded study (1R01MD014188) that aimed to document the factors associated with physician migration from PR to the US mainland and its impact on the Island's healthcare system. The research team used qualitative interviews, surveys, and ethnographic observations. This paper focuses on the data from the qualitative interviews with 26 physicians who had migrated to the USA and ethnographic observations, which were collected and analyzed between September 2020 and December 2022. The results evidence that participants understand physician migration as a consequence of three factors: 1) the historical and multidimensional deterioration of PR, 2) the idea that the current healthcare system is rigged by politicians and insurance companies, and 3) the specific challenges faced by physicians in training on the Island. We discuss the role of coloniality in fostering these factors and how it serves as the backdrop for the problem faced by the Island.

Spatial and Temporal Diversity Variation in the Anopheles Communities in Malaria-Endemic Regions of Colombia.

This study aimed to evaluate at a temporospatial scale, the influence of anthropogenic land cover changes in the Anopheles species community composition and diversity in two Colombian malaria-endemic regions, Bajo Cauca and Pacific. To determine variations over time, mosquitoes were collected in two time periods; land cover types were characterized on orthorectified aerial photographs, and landscape metrics were estimated for each locality and period. A temporal dissimilarity analysis to evaluated species replacement and the nestedness species loss/gain showed the influence of the species loss or gain component on Anopheles species assemblage (23%). The relationship between land cover variation and Anopheles beta diversity, evaluated by regression analysis, showed the effect of forest variation in the Anopheles community (ßsim and forest r2 = 0.9323; ßsne and forest r2 = 0.9425). Furthermore, a canonical correspondence analysis showed that the land cover types associated with Anopheles species presence were bare soil, shrub, wet areas, and forest. Results demonstrated the impact of land cover changes attributed to human activities on Anopheles population dynamics, over time; this was evidenced as species loss or gain, which was specific to each locality. Notably, the main malaria vectors were dominant in most localities over time, suggesting their tolerance to anthropogenic transformations; alternatively, the environmental changes are providing adequate ecological conditions for their persistence. Finally, the data generated are relevant for understanding the impact that environmental change may have on the dynamics of the neotropical malaria vectors. Thus, this research has potential implications for vector control interventions.

Entomological parameters and population structure at a microgeographic scale of the main Colombian malaria vectors Anopheles albimanus and Anopheles nuneztovari.

Population subdivision among several neotropical malaria vectors has been widely evaluated; however, few studies have analyzed population variation at a microgeographic scale, wherein local environmental variables may lead to population differentiation. The aim of the present study was to evaluate the genetic and geometric morphometric structure of Anopheles nuneztovari and Anopheles albimanus in endemic localities of northwestern Colombia. Genetic and phenetic structures were evaluated using microsatellites markers and wing geometric morphometrics, respectively. In addition, entomological indices of importance in transmission were calculated. Results showed that the main biting peaks of Anopheles nuneztovari were between 20:00 and 22:00, whereas Anopheles albimanus exhibited more variation in biting times among localities. Infection in An. nuneztovari by Plasmodium spp. (IR: 4.35%) and the annual entomological inoculation rate (30.31), indicated high vector exposure and local transmission risk. We did not detect Plasmodium-infected An. albimanus in this study. In general, low genetic and phenetic subdivision among the populations of both vectors was detected using a combination of phenotypic, genetic and environmental data. The results indicated high regional gene flow, although local environmental characteristics may be influencing the wing conformation differentiation and behavioral variation observed in An. albimanus. Furthermore, the population subdivision detected by microsatellite markers for both species by Bayesian genetic analysis provides a more accurate picture of the current genetic structure in comparison to previous studies. Finally, the biting behavior variation observed for both vectors among localities suggests the need for continuous malaria vector surveys covering the endemic region to implement the most effective integrated local control interventions.

Antioxidant Compound Adsorption in Polyvinylpolypyrrolidone from Chilean Carménère, Cabernet Sauvignon, and Merlot Grape Pomaces as Potential By-Products.

Grape pomace (GP) is a by-product resulting from the winemaking process and its potential use as a source of bioactive compounds is well known. The GP bioactive compounds can be retained in the well-known polyvinylpolypyrrolidone (PVPP), industrially used in the clarification and stabilization of wine and other drinks. Thus, the polyphenolic compounds (PC) from the Chilean Carménère, Cabernet Sauvignon, and Merlot GP were extracted, and their compositions and antioxidant capacities (ORAC-FL) were determined. In addition, the retention capacity of the PC on PVPP (PC-PVPP) was evaluated. The bioactivities of GP extracts and PC-PVPP were estimated by the agar plate inhibition assay against pathogenic microorganisms. Results showed a high amount of TPC and antioxidant capacity in the three ethanolic GPs extracts. Anthocyanins, flavan-3-ol, and flavonols were the most abundant compounds in the GP extract, with retentions between 70 and 99% on PVPP. The GP extracts showed inhibition activity against B. cereus and P. syringae pv. actinidiae but the GP-PVPP had no antimicrobial activity. The high affinity of the identified PCs from GPs on PVPP polymer could allow the design of new processes and by-products for the food or cosmeceutical industry, promoting a circular economy by reducing and reusing wastes (GPs and PVPP) and organic solvents.

Multilevel barriers to using assistive technology devices among older hispanics from poor and disadvantaged communities: the relevance of a gender analysis.

PURPOSE: To get a rich description of the barriers to using assistive technology (AT) among men and women ≥65 years living in poor and disadvantaged communities in Puerto Rico, an issue not well described among older people. METHODS: We conducted qualitative interviews assisted by videos of AT and guided by the Matching Person and Technology Model and the Gender Analysis Framework with a purposive sample of 23 men and women. Participants were asked questions regarding reasons for not using AT, willingness for using AT, their identified gender roles and gender-related activities, and bargaining positions. They were also asked about their access to resources to acquire AT, bargaining positions, the stigma associated with AT use, and the characteristics of AT. Directed content analysis with input from a Community Advisory Board was used for the interpretation of the results. RESULTS: The predominant barrier (for both men and women) to using AT devices were: lack of information about AT s and access to money for their purchase, lack of availability and cost of such devices, and (self)-stigma. More women than men experienced limited access to AT services, limited access to and control of money, limited skills for using AT, and less bargaining power for making independent decisions. More men than women expressed a lack of functional need and personal preferences other than using AT devices for managing difficulties in activities. CONCLUSION: There are gender differences concerning the multilevel barriers to using AT devices among older Hispanics residing in low-income communities.IMPLICATIONS FOR REHABILITATIONOlder Hispanic men and women in this study experienced different obstacles to using assistive technology (AT) they need for compensating their functional disabilities in daily living activities.Women in this study reported having less access to money and AT services, diminished skills for using AT devices, and less power to make independent decisions to access AT devices compared to men.To ensure the equitable provision of AT, cultural as well as gender-related factors concerning AT use need to be considered.Future research should focus on women's functional health, also should focus on the development of gender-sensitive and culturally competent AT interventions to improve older Hispanics from poor communities function and opportunities for ageing at their homes and in their communities.

Adapting and pilot testing an HIV and intersectional stigma reducing intervention for Dominican Republic healthcare contexts: Protocol for translational research.

Background: This protocol details the adaptation and pilot testing of the Finding Respect and Ending Stigma around HIV (FRESH) intervention in Dominican Republic. FRESH is a healthcare setting stigma-reduction intervention designed to reduce stigmas affecting people living with HIV (PLHIV), focusing on HIV and intersectional stigmas experienced by sexual and gender minority (SGM) people living with HIV. After the successful adaptation of the FRESH intervention, it will be pilot-tested through the conduct of a pilot stepped wedge cluster randomized controlled trial. Methods: Three aims are included in this study; Aim 1 includes exploratory qualitative assessment, specifically the conduct four focus groups with men who have sex with men (MSM) living with HIV (n = 24-32) and in-depth interviews with transgender women living with HIV to explore their experiences with stigma in clinics (n = 9-12). In-depth interviews will also be held with HIV healthcare workers to elucidate their perceptions and behaviors towards their SGM clients (n = 9-12). In Aim 2, informed by Aim 1 data, we will use the sequential phases of the ADAPT-ITT framework to iteratively adapt the FRESH intervention for the Dominican Republic. In Aim 3, the adapted intervention will be pilot-tested via a cluster stepped wedge randomized controlled trial to assess feasibility and acceptability of the intervention and study protocols. Conclusions: If this pilot trial is successful, next steps will include testing the adapted intervention across Dominican Republic or in similar Spanish-speaking Caribbean nations in a larger trial to assess effectiveness in reducing stigma in clinical settings towards PLHIV.

Red tape, slow emergency, and chronic disease management in post-María Puerto Rico.

This paper draws upon the notion of slow emergency as a framework to interpret ethnographic and qualitative findings on the challenges faced by Puerto Ricans with chronic conditions and health sector representatives throughout the island during and after Hurricane María. We conducted participant observation and qualitative interviews with chronic disease patients (n=20) health care providers and administrators (n=42), and policy makers (n=5) from across the island of Puerto Rico in 2018 and 2019. Many Puerto Ricans coping with chronic diseases during and after María experienced bureaucratic red tape as the manifestation of colonial legacies of disaster management and health care. They describe a precarious existence in perpetual "application pending" status, waiting for services that were not forthcoming. Drawing on ethnographically informed case examples, we discuss the effects of these bureaucratic barriers on persons with three chronic conditions: renal disease, opioid dependency, and HIV/AIDS. We argue that while emergency management approaches often presume a citizen-subject with autonomous capacity to prepare for presumably transient disasters and envision a 'post-disaster future' beyond the immediate crisis, Puerto Rican voices draw attention to the longer, sustained, slow emergency of colonial governance.

Anopheles blood meal sources and entomological indicators related to Plasmodium transmission in malaria endemic areas of Colombia.

Malaria is an important public health problem, caused by Plasmodium parasites which are transmitted by female Anopheles mosquitoes that bite humans to obtain blood. The aim of this work was to identify the blood feeding sources of Anopheles female mosquitoes and calculate their entomological indices in relation to Plasmodium transmission. Mosquitoes were collected in malaria endemic localities of the Bajo Cauca and Pacific regions of Colombia using human landing catch and barrier screens, from 18:00 to 24:00 hr, in 2018-2021. Animal censuses within a radius of ∼250 m were carried out at each sampling site. A total of 2018 Anopheles specimens were collected and the most abundant species were Anopheles (Nys.) darlingi and Anopheles (Nys.) nuneztovari. The highest human biting rate was 77.5 bites per person per night (b/p/n) for An. nuneztovari in Córdoba-Pacific and 17.5 b/p/n for An. darlingi in Villa Grande-Bajo Cauca. Both species were active mainly in indoor unwalled rooms of the houses. Only An. nuneztovari from Córdoba-Pacific was infected with Plasmodium, with an entomological inoculation rate of 91.25 infective bites per year. Detection of blood feeding sources demonstrate that humans were the most common host, however, An. nuneztovari showed a preference for feeding on dogs and An. darlingi on pigs, dogs and Galliformes, rather than humans. These results contribute to entomological surveillance information and provide valuable data that can be used to tailor effective control interventions to minimize human-vector contact in these malaria endemic regions.

Shuffled rolling shutter for snapshot temporal imaging.

We propose a modification to the rolling shutter mechanism found in CMOS detectors by shuffling the pixels in every scanline. This potential hardware modification improves the sampling of the space-time datacube, allowing the recovery of high-speed videos from a single image using either tensor completion methods or reconstruction algorithms often used for compressive temporal video. We also present a design methodology for optimal sampling schemes and compare them to random shuffling. Simulations, and experimental results obtained by optically emulating the hardware, demonstrate the ability of the shuffled rolling shutter to capture images that allow reconstructing videos, which would otherwise be impossible when using the traditional rolling shutter mechanism.

New records of Sabethini (Diptera: Culicidae) from Colombia.

BACKGROUND: In the Neotropical Region, the mosquitoes, grouped in the tribe Sabethini (Arthropoda, Insecta, Diptera: Culicidae) are considered of medical importance by the role that some species may have in arbovirus transmission; also, because they are good bioindicators. More than 400 species are currently recognised and are mainly associated with forest areas. The tribe Sabethini is poorly studied and the information about diversity and distribution for species relating to it is scarce. In Colombia, 54 species of the tribe are known; however, several geographical areas have not been included in the studies for this group and data for recent field collections are not available; therefore, the records are outdated. NEW INFORMATION: This study presents the species list of the Sabethini tribe in Colombia, based on a review of previous publications and recent unpublished data. The list includes 68 species of nine genera and 16 subgenera. The genus Wyeomyia has the highest species number (39), followed by Sabethes (14). A total of 29 new records are registered and actualized information related to the local distribution in some Departments is presented, including geographic coordinates. In this paper, the distribution records of Sabethini for Colombia are updated, revealing the high diversity of this group in the country and providing some useful information for species that may need surveillance or control.

Minerals in edible seaweed: health benefits and food safety issues.

An adequate daily intake of minerals is essential for the prevention of chronic nutrition-related and degenerative diseases, including cancer, cardiovascular disease, and obesity. Seaweeds are marine aquatic vegetable that are rich in nutrients. They also have a natural and sustainable origin and clean and renewable sources when they come from marine aquaculture or controlled fisheries. Seaweeds have high nutritional value as a source of polyunsaturated fatty acids, proteins, carbohydrates, vitamins, and especially minerals. They are known for their high mineral content, which is gathered from seawater depending on the seasonal variation and the environment. Seaweeds are consequently rich in macro-elements and trace elements, with a mineral content at least 10 times higher than terrestrial plants and reaching 20-50% of its dry weight. Therefore, seaweeds can make an important contribution to the daily intake of minerals and are a promising source of essential minerals for functional food, food supplements, and nutraceuticals. The aim of the present review is to compare the contents of essential minerals (K, Ca, Na, P, Cu, Fe, Se, Mn, Zn, Mg, Cr, and I) as well as potential toxic minerals (Hg, Pb, Cd, As, and Al) in 14 main edible seaweeds that have availability of biomass from harvest and aquaculture. Another goal is to establish their safety in foods and contributions to the Recommended Dietary Allowance (RDA) and adequate intake (AI) values.

The impact of Hurricane Maria on Puerto Rico's health system: post-disaster perceptions and experiences of health care providers and administrators.

BACKGROUND: After its landfall in Puerto Rico in 2017, Hurricane Maria caused the longest blackout in United States history, producing cascading effects on a health care system that had already been weakened by decades of public sector austerity and neoliberal health reforms. This article addresses how health care professionals and administrators experienced the health care system's collapse and the strategies used by them to meet their communities' health needs. METHODS: Data were collected between September 2018 and February 2020. Ethnographic observations in health care facilities and semi-structured qualitative interviews with representatives of the health care system were conducted. This paper focuses on data from interviews with health care providers (n = 10) and administrators (n = 10), and an ethnographic visit to a pop-up community clinic. The analysis consisted of systematic thematic coding of the interview transcripts and ethnographic field notes. RESULTS: Results provide insight on how participants, who witnessed first-hand the collapse of Puerto Rico's health care system, responded to the crisis after Maria. The prolonged power outage and lack of a disaster management plan were partly responsible for the death of 3,052 individuals who experienced extended interruptions in access to medical care. Participants reported a sense of abandonment by the government and feelings of mistrust. They also described the health sector as chaotic and lacking clear guidelines on how to provide services or cope with personal crises while working under extreme conditions. In such circumstances, they developed resilient responses to meet communities' health needs (e.g., itinerant acupuncture services, re-locating physicians to local pharmacies). CONCLUSIONS: Participants' narratives emphasize that the management of Hurricane Maria was fraught with political and economic constraints affecting Puerto Rico. Ineffective planning and post-Maria responses of the local and federal governments were determinants of the disaster's impact. The findings contribute to a growing scientific literature indicating that Hurricane Maria revealed 'the collapse before the collapse,' alluding to the structural deficiencies that presaged the catastrophic event. In the context of governmental abandonment, the authors argue for the importance of developing alternative strategies in post-disaster health care provision among health professionals and administrators who work at the front lines of recovery.

Sex disparities in the prevalence of physical function disabilities: a population-based study in a low-income community.

BACKGROUND: Functional disability continues to be a significant public health problem that increases older adults' vulnerability to experience a diminished quality of life, loss of independence, higher healthcare costs and health services utilization, and increased risks of mortality. Thus, we aimed to study the prevalence of functional disabilities by sex according to the types of daily living activities, controlling for specific sociodemographic variables among older Hispanics from low-income communities. METHODS: We used a cross-sectional epidemiological research design, considering a complex sampling design of households to interview adults ≥65 years living in low-income communities in Puerto Rico. Functional disability was measured by the PROMIS® Physical Function Short Form-20 T-score. The selected community was reported to have 5980 adult residents ≥65 years, according to the USA Census. The prevalence of functional disability was estimated using the logistic regression model, weighting by the effect of the sampling. Our estimated prevalence was compared between sexes using the prevalence ratio (PR), which was estimated with logistic regression models, controlling for age, income, number of chronic conditions, high and low impact of chronic conditions in functional disabilities, marital status, and sampling design. RESULTS: We recruited 211 older Hispanics from a randomly selected sample. Their mean age was 74.4 ± 7.1 years, with female predominance (57.3%). The overall estimated prevalence of physical function disability using T-score among females was 2.70 (95% CI: 1.4, 5.1) times the estimated prevalence of physical function disability among males. Women were more likely to report functional disabilities in instrumental activities of daily living, self-care activities, and functional mobility compared to males. However, sex differences were largely explained by the presence of musculoskeletal conditions of high impact in functional disability. CONCLUSIONS: The females in our study bear the greater burden of physical function disability in their adult age. Health policies, as well as future studies, should be targeted at reducing the burden of physical function disabilities in different types of daily activities through gender-sensitive disability self-management programs.

Development and Validation of the Community PrEP-Related Stigma Scale (Community-PSS).

Despite increasing availability of pre-exposure prophylaxis (PrEP), HIV prevention efforts have stalled. It is important to study potential barriers to HIV prevention methods, such as pre-exposure prophylaxis stigma. This study aims to develop and validate the Community PrEP-related Stigma Scale (Community-PSS) to address gaps in the literature. Participants were 108 sexual and gender minority men recruited through virtual and community-posted advertisements in Florida. The authors assessed reliability using Cronbach's alpha analysis, determined scale components using principal component analysis, and assessed construct validity based on five a priori hypotheses. The scale had high internal consistency (α = 0.86) and four components (stigma of actions outside of sex, stigma of sexual actions, extreme stigma perceptions, and positive community perception). The Community-PSS was valid, supporting four out of five hypotheses and in the expected directions. The Community-PSS was a valid and reliable tool in the sample and correlates with a previously validated PrEP stigma scale, HIV knowledge, PrEP knowledge, and likelihood of condom use with a partner on PrEP.