Prevalence and associated risk factors of hepatitis C antibody and RNA among people who inject drugs in Puerto Rico.

INTRODUCTION: As a public health crisis, hepatitis C viral infection (HCV) is highly prevalent among people who inject drugs (PWID). We aimed to assess factors associated with HCV antibody (Ab) and HCV ribonucleic acid (RNA) positivity among PWID in Puerto Rico. METHODS: The study recruited a total of 150 persons in rural and peri-urban community settings through the respondent-driven sampling method and administered a structured questionnaire. We conducted HIV and HCV testing using dried blood spots (DBS). We examined correlates of HCV infection with sociodemographics, drug use patterns, and injection practices using regression in bivariate and multivariable analysis. RESULTS: Of the 150 participants, 89 % were male; 11 % were female; 72 % identified as mixed race; and the median duration of drug injection was 17.8 years. The mean age was 43.1 years, with 64 % of the population being from 23 to 45 years old. Among study participants (n = 150), the prevalence of HCV Ab was 73 %, and HCV RNA was 53 %. Factors significantly associated with HCV Ab and RNA included older age, increasing years of injection, incarceration, injecting other people, and identifying as Black. The belief that syringe air blowing reduces HCV transmission was also independently associated with HCV Ab positivity. CONCLUSIONS: Our findings regarding risk factors associated with HCV infection show the need to enhance prevention and control strategies for reducing transmission among PWID. Direct-acting antiviral treatment, sustained access to harm reduction, and culturally tailored services will be required to substantially reduce rates of HCV. Community-based treatment models and treatment in correctional settings are needed.

Interface fails and Young's module approximation of multilayer flexible devices through finite element method.

Electronic flexible devices are prone to degrade their electrical performance or lose functionality when subjected to deformations. Brittle fracture is a common damaging effect observed in devices composed of low-thickness layered materials stacked onto a flexible substrate by dissimilar mechanical properties interaction. This work studies the mechanical behavior of Organic Flexible Solar Cells (OFSC) with a heterostructure PET/ITO/P3HT:PCBM/Ag subjected to uniaxial displacements through an experimental and numeric point of view. Experimental showed that damage proceeds in two ways. First, the formation of a grid crack pattern begins at the ITO layer, and second, the delamination in the ITO/P3HT:PCBM interface. The numerical model analyzed the force and displacements and the absorption/dissipation of strain energy on layers and interfaces of the device. The comparison of the global Young's module for experimental and numeric studies validated the numeric analysis, with results of 4.16 ± 0.05 GPa for experimental and 4.36 ± 0.15 GPa for numeric. Additionally, the model associates the ITO layer with the highest strain energy dissipation or the most prone to failure, which agrees with the experiments. Then, the model successfully predicts the mechanical behavior of OFSC and represents a valuable tool for studying flexible devices and predicting the appearance of mechanical damage when subjected to uniaxial deformations, even being able to avoid potential damage changing parameters such as the thickness of the layers.

Development and Validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale.

Despite the psychosocial strain of homonegative religious attitudes, many people with minoritized sexual identities also hold religious identities and benefit from integrating their sexual minority and religious identities. However, for research and clinical practice to advance, a reliable and valid measure of sexual and religious identity integration is needed. The present study reports on the development and validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale. Participants were comprised of two subsamples for whom sexual and religious identity is particularly salient (Latter-day Saints and Muslims) as well as a third subsample of the general sexual minority population-totaling 1,424 individuals (39% POC, 62% cisman, 27% ciswoman, 11% trans/non-binary/genderqueer). Exploratory and confirmatory factor analyses indicated that the 5-item scale measures a single unidimensional construct. This scale demonstrated good internal consistency in the total sample (α = .80) as well as metric and scalar invariance along relevant demographics. The SMRII also evidenced strong convergent and discriminant validity, significantly correlating with other measures of religious and sexual minority identity typically between r = .2 and r = .5. Taken together, initial findings indicate that the SMRII is a psychometrically sound measure that is brief enough to be utilized in research and clinical settings.Public Significance Statement: This article introduces the Sexual Minority and Religious Identity Integration Scale (SMRII) as a reliable and valid assessment of the degree to which individuals integrate their sexual minority and religious identities. This five-item measure is brief enough to be utilized in both research and clinical settings.

Hepatitis C virus care cascade among people who inject drugs in puerto rico: Minimal HCV treatment and substantial barriers to HCV care.

Background: People who inject drugs (PWID) in Puerto Rico are disproportionately affected by the hepatitis C virus (HCV) epidemic. However, there is a scarcity of data on the HCV care cascade among PWID in Puerto Rico. This study aims to describe the HCV cascade of care among PWID in Puerto Rico, identify gaps, and explore barriers to HCV care. Methods: Participants were recruited using respondent-driven sampling and tested for both HCV antibodies (Ab) and RNA (ribonucleic acid) using rapid testing and dried blood spot samples (DBS). The cascade of care was estimated based on the DBS HCV Ab and RNA results, as well as self-reported data on HCV screening, linkage to care, treatment uptake and sustained virologic response collected through a questionnaire. The cascade was constructed sequentially, with each step using the number of people from the preceding step as the base denominator. The survey also assessed participants' perceived barriers to HCV care. Results: Out of 150 participants, 126 (84%) had previously been HCV screened, 87% (109/126) were HCV Ab positive, 72% (79/109) were RNA positive,48% (38/79) were linked to care, 32% (12/38) initiated treatment, 58% (7/12) finished treatment, and 71% (5/7) achieved SVR. Barriers to HCV care included concerns about drug abstinence requirements, access to transportation, stigma in healthcare settings, and lack of knowledge about HCV treatment sites. Conclusion: This study provides insights into the HCV cascade of care among PWID in Puerto Rico for the first time and highlights limited diagnosis, treatment uptake, and barriers to care.

Phytochemical analysis for ten Peruvian Mentheae (Lamiaceae) by liquid chromatography associated with high resolution mass spectrometry.

The profile of secondary metabolites in ten members of tribe Mentheae (Nepetoideae, Lamiaceae) from Peru by liquid chromatography associated with high resolution mass spectrometry, is presented. Salvianolic acids and their precursors were found, particularly rosmarinic acid, caffeic acid ester derivatives, as well as a diversity of free and glycosylated flavonoids as main substances. At all, 111 structures were tentatively identified.

Religion/Spirituality, Stress, and Resilience Among Sexual and Gender Minorities: The Religious/Spiritual Stress and Resilience Model.

Although many sexual and gender minorities (SGMs) consider themselves religious or spiritual, the impact of this religiousness or spirituality (RS) on their health is poorly understood. We introduce the religious/spiritual stress and resilience model (RSSR) to provide a robust framework for understanding the variegated ways that RS influences the health of SGMs. The RSSR bridges existing theorizing on minority stress, structural stigma, and RS-health pathways to articulate the circumstances under which SGMs likely experience RS as health promoting or health damaging. The RSSR makes five key propositions: (a) Minority stress and resilience processes influence health; (b) RS influences general resilience processes; (c) RS influences minority-specific stress and resilience processes; (d) these relationships are moderated by a number of variables uniquely relevant to RS among SGMs, such as congregational stances on same-sex sexual behavior and gender expression or an individual's degree of SGM and RS identity integration; and (e) relationships between minority stress and resilience, RS, and health are bidirectional. In this manuscript, we describe the empirical basis for each of the five propositions focusing on research examining the relationship between RS and health among SGMs. We conclude by describing how the RSSR may inform future research on RS and health among SGMs.

Characterizing patients hospitalized without an acute care indication: A retrospective cohort study.

BACKGROUND: Hospitalizations by patients who do not meet acute inpatient criteria are common and overburden healthcare systems. Studies have characterized these alternate levels of care (ALC) but have not delineated prolonged (pALC) versus short ALC (sALC) stays. OBJECTIVE: To descriptively compare pALC and sALC hospitalizations-groups we hypothesize have unique needs. DESIGNS, SETTINGS, AND PARTICIPANTS: A retrospective study of hospitalizations from March-April 2018 at an academic safety-net hospital. MAIN OUTCOME AND MEASURES: Levels of care for pALC (>3 days) and sALC (1-3 days) were determined using InterQual©, an industry standard utilization review tool for determining the clinical appropriateness of hospitalization. We examined sociodemographic and clinical characteristics. RESULTS: Of 2365 hospitalizations, 215 (9.1%) were pALC, 277 (11.7%) were sALC, and 1873 (79.2%) had no ALC days. There were 17,683 hospital days included, and 28.3% (n = 5006) were considered ALC. Compared to patients with sALC, those with pALC were older and more likely to be publicly insured, experience homelessness, and have substance use or psychiatric comorbidities. Patients with pALC were more likely to be admitted for care meeting inpatient criteria (89.3% vs. 66.8%, p < .001), had significantly more ALC days (median 8 vs. 1 day, p < .001), and were less likely to be discharged to the community (p < .001). CONCLUSIONS: Patients with prolonged ALC stays were more likely to be admitted for acute care, had greater psychosocial complexity, significantly longer lengths of stay, and unique discharge needs. Given the complexity and needs for hospitalizations with pALC days, intensive interdisciplinary coordination and resource mobilization are necessary.

Transformative LGBTQ+ Growth and Leadership Within Greek Life.

Departing from extant deficit models, the present study qualitatively explored 50 LGBTQ+ college students' development within Greek Life from a Transformative Intersectional Psychology (TIP) approach. Amidst the heteronormative and gendernormative challenges of Greek Life, participants actively pursued an authentic self, friendship, leadership and transformative social change. Sixty-six percent of participants characterized their Greek Life experiences as positive, with 88% of participants reporting that their overall Greek Life engagement positively contributed to their college experience. Moreover, 74% of participants served in Greek Life leadership roles. Of the participants in leadership roles, 46% reported that their Greek Life experiences positively connected to their LGBTQ+ identity. Participants' dynamic Greek Life engagement required no external research prompt, illustrating LGBTQ+ emerging adults' agentive efforts to actively, collaboratively and transformatively direct their own development and create institutional change. Research, counseling and administrative recommendations on how to foster LGBTQ+ campus leadership and Greek Life inclusion are discussed.

The Endocannabinoid System as a Biomarker for Diagnostic and Therapeutic Applications in Depression and Anxiety.

BACKGROUND: Depression and anxiety belong to a family of mental disturbances that have increased significantly in recent years. The etiology of both disorders comprises multiple and complex factors, from genetic background to environmental influence. Since depression and anxiety present severe symptoms, they represent a greater clinical burden and greater therapeutic difficulty. Currently, standardized diagnostic procedures for depression and anxiety allow for the addition of further treatments, including psychotherapy and/or pharmacological intervention, with effective outcomes. However, further steps should be considered with regard to consideration of the endocannabinoid system's role in depression and anxiety. OBJECTIVE: This study aimed to review the evidence from animal research and clinical studies on the role of cannabinoid receptors, the major endocannabinoids -anandamide (AEA) and 2-arachidonoylglycerol (2-AG)- and the enzymes related to the synthesis and degradation of these chemicals as putative biomarkers for diagnostic and therapeutic elements of depression and anxiety. METHODS: This review included the online search, identification, and analysis of articles (basic and clinical trials) published in English in PubMed linked to the role of cannabinoid receptors, AEA, 2- AG, and the enzymes associated with the synthesis and degradation of these endocannabinoids in depression and anxiety. RESULTS: The neurobiological relevance of the endocannabinoid system offers genetic or pharmacological manipulation of this system as a potential strategy for the diagnostic and clinical management of mood disorders, including depression and anxiety. CONCLUSION: Although the described approach in this review is promising, no solid evidence is yet available, and along with additional experiments using animal models that mimic human depression and anxiety, clinical trials are needed to explore the role of the endocannabinoid system's elements as well as the anandamide membrane transporter, none of which have been adequately studied in depression and anxiety.

Evidence of sea level rise at the Peruvian coast (1942-2019).

The present work aims to analyze the variability of the sea level of the Peruvian coast with time series over a long observation period (Seventy-eight years, from 1942 to 2019). Data came from the Talara, Callao and Matarani tide gauge stations located at the north, center and south of the coast. Variations of sea level as well as air and seawater surface temperature were analyzed. Among the different scenarios studied, a sea level rise of 6.79, 4.21 and 5.16 mm/year for Talara, Callao and Matarani, respectively was found during the 1979-1997 nodal cycle. However, these results decreased significantly during the next cycle (1998-2016) until values of 1.53, 2.16 and 1.0 mm/year for Talara, Callao and Matarani, respectively. Thus, it has been demonstrated that sea level rise are highly dependent on the time interval chosen. Moreover, large interannual changes of up to 200 mm/year are observed, due to recurring phenomena, such as "El Niño". On the other hand, the trends obtained are slightly lower than those shown by the IPCC up until 2006 but significantly higher values have been observed. Finally, the results presented herein show the necessity of a local study of the sea level variability at the coastal areas.

Cognitive-communication disorder following right hemisphere damage: Narrative production.

Background: Cognitive-communication disorder (CCD) results from the association of language and cognition impairment that may follow right hemisphere (RH) damage and impair the quality of life of affected persons. Objective: We studied a set of 1,625 narratives produced by a cohort of 125 individuals (50 with a single right vascular lesion in the MCA territory and 75 cognitively healthy controls) using a task of picture-based discourse production. Discourse production was analyzed in its macro-and microlinguistic aspects to characterize better the linguistic mechanisms underlying RH patients' performance. Results: The RH group produced more words and elocutions than controls, with a lower rate of informational content and a higher percentage of global coherence errors (all p-values <0.0001). Conclusion: Individuals with RH lesions showed formal lexical and syntactic aspects of discourse mostly preserved. Alterations in the macrostructure of discourse prevailed over microstructural alterations in our sample, according to most literature studies. The group of individuals with RH lesions produced narratives containing more words and utterances, with a lesser degree of lexical information and more global coherence errors.

Dataset for electronic and optical properties of Y2O2S and Er dopped Y2O2S calculated using density functional theory and simulated x-ray near edge spectra.

The computational data presented in this paper refer to the research article "Optical properties and simulated x-ray near edge spectra for Y2O2S and Er doped Y2O2S". We present the data used to calculate the structural, electronic, and optical properties of the Y2O2S and its Er+3 doped counterparts at various concentrations using density functional theory (DFT) and simulated X-ray near edge (XANES) spectra. We report electronic information from DFT and DFT+U generated from the Vienna Ab initio Simulation Package (VASP) using PAW pseudopotentials. We also report VASP calculated optical properties for the host Y2O2S using the independent particle approximation (IPA), the random phase approximation (RPA), the many-body GW0 approximation, and the Bethe-Salpeter equation (BSE) approximation, under the 10-atom unit cell. The IPA calculations are repeated using the 80-atom unit cell for both the host Y2O2S and the Y2O2S:Er+3 counterparts. The optical properties data include the frequency-dependent real and imaginary parts of the dielectric function, the absorption and extinction coefficients, the refractive index, and the reflectivity. FEFF10 XANES calculations are performed on the Y K-, L1-, L2-, and L3-edges, as well as on the Er M5-edge.

Clinical applications of exercise in Parkinson's disease: what we need to know?

INTRODUCTION: Exploring the potential of exercise in the rehabilitation process of patients with Parkinson's (PD) may be an interesting treatment perspective. Exercise-induced responses derived from neurotrophic elements appear to ameliorate the decline in neurodegeneration. Despite this understanding, the literature needs to be updated. AREAS COVERED: Our review focuses on: a) the key mechanisms of exercise on PD, highlighting mainly the responses related to neuroplasticity; b) the effects induced by different traditional types of exercise, also highlighting the effects of complementary therapies related to movement; c) the volume of exercise required to support efficient results are explored in the context of PD. Additionally, the proposition of new clinical application strategies in the context of PD will also be determined. EXPERT OPINION: It is suggested that different intensities of aerobic exercise be explored for the treatment of PD. The results associated with high intensity seem promising for performance, physiological and clinical parameters, such as BDNF production and cognition. On the other hand, the diversification of tasks and repetition of motor gestures appear as consistent arguments to exercise prescription. Finally, for future investigations, the neuromodulation strategy in association with aerobic exercise appears as a potential inducer of benefits on gait and cognitive function.

Neurobiology of Dream Activity and Effects of Stimulants on Dream.

The sleep-wake cycle is the result of the activity of multiple neurobiological network interactions. The dreaming feature is one interesting sleep on that represents sensorial components, mostly visual perceptions, accompaniedby intense emotions. Further complexity has been added to the topic of the neurobiological mechanism of dream generation by the current data suggesting drugs' influence on dream generation. Here, we discuss the review of some of the neurobiological mechanisms of the regulation of dream activity, with special emphasis on the effects of stimulants on dreaming.

Mental health and social isolation under repeated mild lockdowns in Japan.

The influence of repeated lockdowns on mental health and social isolation is unknown. We conducted a longitudinal study of the influence of repeated mild lockdowns during two emergency declarations in Japan, in May 2020 and February 2021. The analyses included 7893 people who participated in all online surveys. During repeated mild lockdowns, mental and physical symptoms decreased overall, while loneliness increased and social networks decreased. Subgroup analyses revealed that depression and suicidal ideation did not decrease only in the younger age group (aged 18-29 years) and that younger and middle-aged people (aged 18-49 years), women, people with a history of treatment for mental illness, and people who were socially disadvantaged in terms of income had higher levels of mental and physical symptoms at all survey times. Additionally, comprehensive extraction of the interaction structure between depression, demographic attributes, and psychosocial variables indicated that loneliness and social networks were most closely associated with depression. These results indicate that repeated lockdowns have cumulative negative effects on social isolation and loneliness and that susceptible populations, such as young people and those with high levels of loneliness, require special consideration during repeated lockdown situations.

Personalization of Pharmacological Treatments for ADHD: Why it is Advisable and Possible Options to Achieve it.

Attention-deficit hyperactivity disorder is a neurodevelopmental disorder diagnosed primarily in children, although it is also present in adults. Patients present inattention, impulsivity, and hyperactivity symptoms that create difficulties in their daily lives. Pharmacological treatment with stimulants or non-stimulants is used most commonly to reduce ADHD symptoms. Although generally effective and safe, pharmacological treatments have different effects among patients, including lack of response and adverse reactions. The reasons for these differences are not fully understood, but they may derive from the highly diverse etiology of ADHD. Strategies to guide optimal pharmacological treatment selection based on individual patients' physiological markers are being developed. In this review, we describe the main pharmacological ADHD treatments used and their main drawbacks. We present alternatives under study that would allow the customization of pharmacological treatments to overcome these drawbacks and achieve more reliable improvement of ADHD symptoms.

Decreased Resting State Inter- and Intra-Network Functional Connectivity Is Associated with Perceived Stress in a Sample of University Students: An eLORETA Study.

INTRODUCTION: Although the study of the Triple Network (TN) model has gained attention in the exploration of stress-related processes, the neurophysiological mechanisms of TN in relation to perceived stress have been relatively understudied in nonclinical samples so far. The main objective of the present study was to investigate, in a sample of university students, the association of perceived stress with resting state electroencephalography (EEG) functional connectivity in the TN. METHODS: Ninety university students (40 males and 50 females; mean age 22.30 ± 2.43 years; mean educational level 16.60 ± 1.62 years) were enrolled. EEG data were analyzed through the exact low-resolution electromagnetic tomography (eLORETA). RESULTS: Higher levels of perceived stress were associated with decreased delta EEG connectivity within the central executive network (CEN) and between the CEN and the salience network (SN). Higher levels of perceived stress were also associated with decreased theta EEG connectivity between the CEN and the SN. The associations between perceived stress and EEG connectivity data were significant even when relevant confounding factors (i.e., sex, age, educational level, and psychopathological symptoms) were controlled for. DISCUSSION: Taken together, our results suggest that higher levels of perceived stress are associated with a dysfunctional synchronization within the CEN and between the SN and the CEN. This functional pattern might in part reflect the negative impact of high levels of perceived stress on cognitive functioning.

Stimulants and Depressor Drugs in the Sleep-wake Cycle Modulation: The Case of Alcohol and Cannabinoids.

A complex neurobiological network drives the sleep-wake cycle. In addition, external stimuli, including stimulants or depressor drugs, also influence the control of sleep. Here we review the recent advances that contribute to the comprehensive understanding of the actions of stimulants and depressor compounds, such as alcohol and cannabis, in sleep regulation. The objective of this review is to highlight the neurobiological mechanism engaged by alcohol and cannabis in sleep control.

Can regular physical exercise be a treatment for panic disorder? A systematic review.

INTRODUCTION: In the last few decades, exercise has been explored as a potential tool to reduce symptoms experienced by patients with panic disorder (PD). This systematic review aims to assess the effects of regular exercise interventions on panic severity, global anxiety, and depression symptoms of these patients. AREAS COVERED: A search was conducted on PubMed, ISI Web of Science, and Cochrane Central Register of Controlled Trials using search terms related to PD and exercise. Eight trials were included, Furthermore, regular exercise programs presented different methodological characteristics. There is o clear evidence indicating that regular exercise programs (at least two 20-minute sessions per week for at least 6 weeks) reduce panic-related symptoms. Regular exercise is effective in improving global anxiety measures and depression. EXPERT OPINION: Continuous aerobic exercise is the main type of intervention in the literature, generally providing a limited prescription. Currently, it is recommended the interval training, with intense and shorter stimuli, and long-term duration trials. However, despite the use of self-selected intensities and control based on the internal load be interesting as recommendation to increase adherence, careful is needed regarding training prescription due to scarce evidence.