Training Community Health Workers to Address Disparities in Dementia Care: A Case Study From Oklahoma With National Implications.

The projected increase of dementia in the diverse aging US population calls for a well-prepared public health workforce. Community health workers (CHWs) can address dementia in culturally appropriate ways. Collaborating with stakeholders, we developed a train-the-trainer curriculum for CHWs and used a virtual training platform to test its feasibility with 77 CHWs. Pre-/post-evaluation data demonstrated modestly increased dementia knowledge scores. Training participants valued the resources shared and interacting with peers. Disseminating this training could contribute to closing gaps in dementia care in diverse communities, along with policies supporting CHWs as a workforce that reduces age-related disparities and promotes health equity.

Spontaneous pneumothorax and COVID-19: Precipitants to a complex HIV-AIDS diagnosis.

A 48-year-old male presented with spontaneous pneumothorax requiring chest tube placement in the setting of COVID-19 infection. CT chest revealed bilateral ground-glass opacities and multiple, large, gas-filled, cavitary lesions in the lungs bilaterally. These imaging findings led to an initial HIV diagnosis with the patient presenting at a CD4+ count of <32 cells/µL. He was found to additionally have infections with Mycobacterium kansasii, cytomegalovirus, Pneumocystis jirovecii, and Candida albicans. After developing worsening hypoxic respiratory failure, he developed additional pneumothoraces bilaterally, requiring repeated chest tube placement. He was treated with antimicrobial therapy for his underlying infections and subsequently started on combined antiretroviral therapy.

Factors impacting medication adherence in a birth cohort at higher risk for Hepatitis C infection.

Due to the high prevalence of Hepatitis C virus (HCV) infection among individuals born between 1945 and 1965, in 2012 the Centers for Disease Control and Prevention began recommending HCV screening for this birth cohort. As adherence to HCV treatment is essential for sustained virologic response, identifying factors influencing medication adherence is important. The validated Adherence to Refills and Medications Scale (ARMS) is used to study recent medication adherence in those with chronic disease. This cross-sectional pilot study assesses factors associated with reduced adherence, indicated by higher ARMS scores, among individuals in this birth cohort. To elucidate factors associated with medication adherence, measured by the ARMS score, among a birth cohort at higher risk for HCV to guide future treatment and improve adherence. Patients born between 1945 and 1965, accessing care at an academic family medicine clinic, were recruited between April and June 2019. Demographics, prior HCV diagnosis, HCV risk factors (prior imprisonment, tattoos, and intravenous drug use), depression assessment (Patient Health Questionnaire-9), adverse childhood experiences (ACEs), and ARMS scores were collected. Mean ARMS scores were compared using t tests and analysis of variance (α = 0.05), while multiple variable models were performed using linear regression. Women comprised 58% of participants (n = 76), 52% reported depression and 37% 4 or more ACEs. The mean ARMS score was 16.3 (SD = 3.43) and 10% reported prior diagnosis of HCV. In the final multiple variable model, ARMS scores were 2.3 points higher in those with mild depression (95% CI: 0.63, 4.04), 2.0 in those with at least 4 ACEs (95% CI: 0.55, 3.49), and 1.8 in those with tattoos (95% CI: 0.30, 3.28). ACEs and food insecurity were identified as confounding variables in those with moderate to severe depression. This study found medication adherence was related to depression, ACEs, tattoos, and food insecurity among patients in this birth cohort at higher risk for HCV.

Combined Hamartoma of the Retina and Retinal Pigment Epithelium in a Patient With Fragile X Syndrome.

A 13-year-old boy with fragile X syndrome presented with painless, decreased vision in his right eye. Funduscopy revealed fibrotic tissue and an epiretinal membrane. This patient with fragile X syndrome was diagnosed as having combined hamartoma of the retina and retinal pigment epithelium and treated with vitrectomy and epiretinal membrane peeling. [J Pediatr Ophthalmol Strabismus. 2022;59(4):e39-e41.].

Diabetes among Hispanics in Oklahoma: Assessing Disparities to Guide Basic and Applied Research.

Background ­: Diabetes, a leading cause of morbidity and mortality in the United States, disproportionally affects minority populations. In 2015, Hispanics, the largest minority in the country, had the third highest rate of diabetes prevalence and the third highest age-adjusted rate of diabetes-related mortality. Substantial progress in understanding diabetes disparities nationally and in many areas of the country has been made. However, little is known about diabetes and related mortality among Hispanics in Oklahoma, which is known as a Hispanic "new Settlement" state due to the relatively recent and substantial growth of this population. Methods ­: We used Oklahoma Behavioral and Risk Factor Surveillance Survey data (2011-2016) to calculate population estimates of diabetes prevalence and selected sociodemographic characteristics for Hispanic and Non-Hispanic adults in the state. We used Oklahoma Death Registry data to estimate diabetes-related mortality rates for Hispanic and Non-Hispanic adults for the same five-year period. We examined differences in diabetes prevalence and diabetes-related mortality across selected sociodemographic characteristics. Results ­: Hispanics are the largest minority group in Oklahoma. Spanish is the most common non-English language spoken in the state. Hispanics are younger, poorer, less educated and experience less access to health care compared to other populations in Oklahoma. While Hispanics had the fifth highest reported diabetes prevalence rate during the five-year period examined, they had the third highest diabetes-related mortality rate in the state. Discussion and Conclusions ­: There is a need for community engagement and basic and applied research to help identify and reduce diabetes disparities in the growing Hispanic population in Oklahoma.

A review of modeling interacting transient phenomena with non-equilibrium Green functions.

As experimental probes have matured to observe ultrafast transient and high frequency responses of materials and devices, so to have the theoretical methods to numerically and analytically simulate time- and frequency-resolved transport. In this review article, we discuss recent progress in the development of the time-dependent and frequency-dependent non-equilibrium Green function (NEGF) technique. We begin with an overview of the theoretical underpinnings of the underlying Kadanoff-Baym equations and derive the fundamental NEGF equations in the time and frequency domains. We discuss how these methods have been applied to a variety of condensed matter systems such as molecular electronics, nanoscale transistors, and superconductors. In addition, we survey the application of NEGF in fields beyond condensed matter, where it has been used to study thermalization in ultra-cold atoms and to understand leptogenesis in the early universe. Throughout, we pay special attention to the challenges of incorporating contacts and interactions, as the NEGF method is uniquely capable of accounting for such features.

High-performance nanoscale topological energy transduction.

The realization of high-performance, small-footprint, on-chip inductors remains a challenge in radio-frequency and power microelectronics, where they perform vital energy transduction in filters and power converters. Modern planar inductors consist of metallic spirals that consume significant chip area, resulting in low inductance densities. We present a novel method for magnetic energy transduction that utilizes ferromagnetic islands (FIs) on the surface of a 3D time-reversal-invariant topological insulator (TI) to produce paradigmatically different inductors. Depending on the chemical potential, the FIs induce either an anomalous or quantum anomalous Hall effect in the topological surface states. These Hall effects direct current around the FIs, concentrating magnetic flux and producing a highly inductive device. Using a novel self-consistent simulation that couples AC non-equilibrium Green functions to fully electrodynamic solutions of Maxwell's equations, we demonstrate excellent inductance densities up to terahertz frequencies, thus harnessing the unique properties of topological materials for practical device applications.