Patterns and Factors Associated With Alcohol Misuse Among Young Black Men Who Have Sex With Men in New York City

Alcohol misuse is a significant health concern among gay, bisexual, same-gender-loving, and other men who have sex with men (MSM). Yet, little is known about the severity and predictors of alcohol misuse among self-reported young Black MSM. This study aimed to identify patterns of and factors associated with alcohol misuse in a sample of young Black MSM living in New York City. Baseline data from a randomized controlled trial aimed at improving the uptake of HIV testing among 250 MSM aged 18 to 29 were analyzed. Log-binominal regression analyses were conducted to assess the association of demographic and psychosocial factors with alcohol misuse in the past year and past 3 months among young Black MSM. Overall, 33.2% and 28.0% of young Black MSM in the study experienced alcohol misuse in the past year and past 3 months, respectively. In the adjusted model, factors positively associated with past-year alcohol misuse included marijuana use, a history of drug use, and having one-two or more than two male sex partners. Likewise, participants who used marijuana and those with one-two or more than two male partners were more likely to report past 3-month alcohol misuse. No significant association was found between positive screening for depressive symptoms, chemsex, internalized homophobia, and the likelihood of having alcohol misuse. The high prevalence of alcohol misuse underscores the importance of raising awareness of alcohol misuse and designing alcohol risk reduction programs that jointly address HIV risk among young Black MSM.

Correlates of concordance between self-reported and lab-confirmed viral load among Black and Latine men who have sex with men (BLMSM) living with HIV in New York City

Sustained viral suppression is one of the four strategies in the U.S. Department of Health and Human Services' (HHS) plan to end the HIV epidemic in the United States. Individuals living with HIV must understand their viral load accurately for this strategy to be effective. We conducted cross-sectional analyses using baseline data from the NNHIV longitudinal study among men who have sex with men (MSM) living with HIV in New York City to identify factors associated with concordant knowledge between self-reported and lab-confirmed viral load. Of 164 Black and/or Latine participants, 67% (n = 110) reported that their viral load was undetectable, however lab tests showed only 44% (n = 72) had an undetectable viral load (<20 copies/ml). Overall, 62% of the sample (n = 102) had concordant HIV viral load knowledge (agreement of self-reported and lab viral load). In multivariable regression, those with unstable housing (PR = 0.52, 0.30-0.92) and those who had higher levels of beliefs of racism in medicine scale (PR = 0.76, 0.59-0.97) were less likely to have concordant knowledge. Our study underscores the need for implementing measures to improve viral load knowledge, U = U messaging, and strategies to achieve and maintain undetectable viral load status to reduce the burden of HIV at the population level.

Influence of different heat stress models on nutrient digestibility and markers of stress, inflammation, lipid, and protein metabolism in broilers

This experiment determined the effects of different HS models and pair-feeding (PF) on nutrient digestibility and markers of stress, inflammation, and metabolism in broilers. Birds (720 total) were allocated into 12 environmentally controlled chambers and reared under thermoneutral conditions until 20 d. Until 41 d birds were exposed to 4 treatments, including: thermoneutral at 24°C (TN-al), daily cyclic HS (12 h at 24 and 12 h at 35°C; cyHS), constant HS at 35°C (coHS), and PF birds maintained at 24°C and fed to equalize FI with coHS birds (TN-coPF). At d 41, ileal digesta were collected to determine nutrient apparent ileal digestibility (AID). Blood, liver, and breast tissues were collected from 8 birds per treatment to determine the mRNA expression of stress, inflammation, and metabolism markers. An additional 8 TN-al birds were sampled after acute HS exposure at 35°C for 4 h (aHS), and 8 cyHS birds were sampled either right before or 4 h after HS initiation. Data were analyzed by 1-way ANOVA and means were separated using Tukey's HSD test. Compared with TN-al birds, AID of nitrogen and ether extract were reduced in coHS birds, and both cyHS and coHS reduced (P < 0.05) AID of total essential amino acids. TNFα and SOD2 expression were increased (P < 0.05) under aHS, coHS, and TN-coPF conditions. IL6 and HSP70 were increased (P < 0.05) under coHS and aHS, respectively. Expression of lipogenic enzymes ACCα and FASN were reduced by coHS and TN-coPF, while coHS increased the lipolytic enzyme ATGL (P < 0.05). IGF1 was lowered in coHS birds, and p70S6K and MyoG were reduced under coHS and TN-coPF (P < 0.05). Interestingly, MuRF1 and MAFbx were increased (P < 0.05) under coHS only. Overall, these results indicate that coHS has a greater impact on nutrient digestibility and metabolism than aHS and cyHS. Interestingly, increased protein degradation during HS appears to be mostly driven by HS per se and not the reduced FI.

Demographic differences in the cascade of care for unhealthy alcohol use: A cross-sectional analysis of data from the 2015-2019 National Survey on Drug Use and Health

BACKGROUND

The screening, brief intervention, and referral to treatment (SBIRT) model is recommended by the U.S. Preventive Services Task Force to improve recognition of and intervention for unhealthy alcohol use. How SBIRT implementation differs by demographic characteristics is poorly understood.

METHODS

We analyzed data from the 2015-2019 National Survey on Drug Use and Health from respondents ≥18 years old who used an outpatient clinic and had at least one alcoholic drink within the past year. Respondents were grouped into one of three mutually exclusive groups: "no binge drinking or alcohol use disorder (AUD)," "binge drinking without AUD," or "AUD." Outcome variables were likelihood of screening, brief intervention (BI), referral to treatment (RT), and AUD treatment. The demographic predictors on which outcomes were regressed included gender, age, race and ethnicity, sexual orientation, insurance status, and history of military involvement. Consistent with SBIRT guidelines, the entire sample was included in the screening model; screened persons with either binge drinking without AUD or with AUD were included in the BI model; screened persons with AUD were included in the RT model, and persons referred to treatment with AUD were included in the AUD treatment model.

RESULTS

Analyses included 120,804 respondents. Women were more likely than men to be screened, but less likely to receive BI or RT. When referred to treatment, women were more likely than men to receive it. Persons aged ≥50 were least likely to be screened about alcohol, but most likely to receive BI, while persons aged 18-25 were least likely to receive BI or AUD treatment. Racial and ethnic minorities were less likely than White persons to be screened; Asians were less likely to receive RT, and Black persons were less likely to receive treatment than White persons. Persons identifying as gay, lesbian, or bisexual were equally as likely or more likely to receive SBIRT or AUD treatment as those identifying as heterosexual. Persons without insurance were less likely to be screened than those with insurance. Persons with a history of military involvement were more likely to be screened and receive BI and RT than persons who had not served in the military.

CONCLUSIONS

Demographic disparities in SBIRT implementation exist. Addressing the sources of these disparities and minimizing attrition from care could improve outcomes for persons with unhealthy alcohol use.

Dual IL-6 and CTLA-4 blockade regresses pancreatic tumors in a T cell and CXCR3-dependent manner

This study aimed to enhance anti-tumor immune responses to pancreatic cancer via antibody-based blockade of IL-6 and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). Mice bearing subcutaneous or orthotopic pancreatic tumors were treated with blocking antibodies to IL 6 and/or CTLA-4. In both tumor models, dual IL-6 and CTLA-4 blockade significantly inhibited tumor growth. Additional investigations revealed that dual therapy induced an overwhelming infiltration of T cells into the tumor as well as changes in CD4+ T cell subsets. Dual blockade therapy elicited CD4+ T cells to secrete increased IFN-γ in vitro. Likewise, in vitro stimulation of pancreatic tumor cells with IFN-γ profoundly increased tumor cell production of CXCR3 specific chemokines, even in the presence of IL-6. In vivo blockade of CXCR3 prevented orthotopic tumor regression in the presence of the combination treatment, demonstrating a dependence on the CXCR3 axis for anti-tumor efficacy. Both CD4+ and CD8+ T cells were required for the anti-tumor activity of this combination therapy, as their in vivo depletion via antibodies impaired outcomes. These data represent the first report of IL-6 and CTLA 4 blockade as a means to regress pancreatic tumors with defined operative mechanisms of efficacy. Given these results, this therapeutic combination has potential for immediate clinical translation.

129 RE-THINKING THE MEMORY CONSENSUS MEETING: A QUALITY IMPROVEMENT INITIATIVE

Background

As part of our memory clinic service, weekly consensus meetings are held to allow for multidisciplinary diagnostic evaluation of new cases. As part of a local Quality Improvement (QI) initiative, we reviewed how this meeting could be streamlined to maximise efficiency and improve diagnostic accuracy in light of increasing referrals and patient complexity. Here we describe the development and initial implementation of this QI project.

Methods

A structured QI approach was taken to develop SMART (Specific, Measurable, Achievable, Realistic, Timely) goals. All professional stakeholders (from disciplines including geriatric medicine, neurology and psychiatry of later life) who attend the weekly consensus meeting were surveyed anonymously with a response rate of 80% (n=8). Information was gathered on areas that worked well, areas that needed improvement and suggestions for meeting enhancement. In addition, participants were asked at a single meeting to subjectively rate the complexity of eleven cases presented into the following categories: low, medium and high. Data were collated and presented to the memory clinic staff for further refinement.

Results

Four key actions were identified for implementation: formal allocation of a meeting chair, improvement of access to imaging from outside hospitals, revision of current proforma to streamline case discussions, and proposal to discuss patients in order of new assessment, return assessment and review of significant results. During the rating of case complexity, there was substantial variation among respondents.

Conclusion

This initial phase has been used to develop SMART goals to improve the consensus meeting structure. We identified that patient complexity would be an inefficient method to order case discussion. Implementation of action steps are ongoing, with positive feedback from staff to date.

Phase Ib/II trial of siltuximab and spartalizumab in patients in metastatic pancreatic cancer

TPS626

Background: Interleukin-6 (IL-6) is associated with carcinogenesis, immune suppression, and poor prognosis in pancreatic adenocarcinoma (PDAC). Preclinical data demonstrated dual inhibition of IL-6 and (programmed death ligand-1) PD-L1 facilitates CD8+ T cell migration into pancreatic tumors and was effective in controlling tumor growth in syngeneic and genetically engineered PDAC mouse models. Siltuximab is a chimeric monoclonal antibody which targets the IL-6 molecule specifically and spartalizumab is a high-affinity ligand-blocking humanized IgG4 antibody against the PD-1 receptor. Based on this preclinical rationale, we developed a phase Ib/II trial to determine the recommended phase II dose (RP2D), evaluate the safety, toxicity profile, preliminary antitumor activity, and immunogenicity of the siltuximab and spartalizumab in patients with previously treated metastatic PDAC. Methods: The phase Ib trial design is standard 3+3. Primary endpoint is to determine RP2D. Siltuximab is administered intravenously (IV) in three dose levels of 6 mg/kg (DL1), 11 mg/kg (DL2), 9 mg/kg (only if 2 DLTs observed on DL2) every 3 weeks with spartalizumab at 300 mg IV every 3 weeks. Eligible patients must have stage IV PDAC who have failed at least one prior therapy age ≥18 years, ECOG PS 0-1, no prior anti PD-1 or anti-PD-L1 agent. After RP2D is established, an expansion phase will enroll 24 patients with PDAC. Pre and on-treatment biopsy will be performed in 24 patients in the expansion cohort for correlative analysis. Pre-treatment and on-treatment peripheral blood samples will be collected from all patients. In the expansion phase patients will receive initial cycle (every 3 weeks) treatment with either spartalizumab or spartalizumab plus siltuximab and then starting cycle 2 all patients receive the combination following the on-treatment research biopsy. This design will enable us to evaluate the immunological effects of spartalizumab alone versus the combination in the tumor microenvironment and peripheral blood. This study was activated in January 2020 and to date 12 patients were enrolled in dose escalation phase. The dose expansion phase has recently started accrual. Clinical trial information: NCT04191421.

Factors associated with liking of milk among preschool children

Background

Adequate calcium intake in childhood is essential for bone health, and dairy products are an important dietary source. However, children's milk consumption has reduced over the past decade in developing countries. Food preferences are a key determinant of consumption, and those developed in early life can persist into adulthood. Therefore, promoting a liking for milk before school age may be effective in improving milk consumption further into childhood. The aim of this analysis is to explore the factors associated with liking of milk among preschool children.

Methods

Questionnaires were completed by parents of 2-5 year-old children as part of a pilot intervention aiming to increase milk consumption in 12 preschools. Chi-squares and hierarchial logistic regression were used to examine the association between children's liking of milk, as reported by parents, and child-related factors (infant feeding; demographics; diet) and parent-related factors (attitudes; milk consumption and liking; education).

Results

Responses from 319 parents of 2-5 year-old children (50.5% male, 49.5% female) were analysed. Ninety-two percent of respondents were mothers and 85% of parents reported that their children liked the taste of milk. In a logistic regression model (N = 281) parents' belief that it is difficult to encourage their child to drink milk was associated with a lower likelihood of children liking the taste of milk (OR = 0.028; CI = 0.011, 0.075; P &lt; 0.001). Liking of milk was not significantly associated with other factors examined (P &lt; 0.05).

Conclusions

The present analysis suggests that parents' self-efficacy in encouraging their child to drink milk may be important in influencing their child's liking of its taste, and should be considered in interventions aiming to improve milk consumption. The taste of milk was well-liked in this cohort of preschool children and therefore, further research is necessary in a cohort with varying levels of milk consumption and liking of milk.

Key messages

Parental beliefs should be included as intervention targets when aiming to improve a liking for milk among preschool children. Further research on the determinants of milk consumption and liking of milk is necessary in diverse cohorts of preschool children.

"It's Like Plan B but for HIV!" Design and Evaluation of a Media Campaign to Drive Demand for PEP

Post-exposure Prophylaxis (PEP) is an effective yet underutilized HIV prevention tool. PEPTALK developed and evaluated a media campaign to drive demand for PEP among men who have sex with men (MSM) and transgender women (TW) living in high HIV prevalence areas in New York City. Formative qualitative research (38 in-depth interviews and five focus groups [N = 48]) with Black or African-American MSM or TW who reported condomless sex with a HIV-positive/unknown status man was conducted to inform campaign design. We assessed the impact of the campaign, 15 bus shelter ads and low or no-cost social media, by assessing change in the proportions of new PEP patient visits, to the clinical site where the campaign directed consumers, using one-sided z-test for proportions, before and after the media campaign. The proportion of new PEP patients increased significantly after the media campaign in the periods examined, suggesting that such campaigns may increase PEP demand.

Using social network analysis to examine alcohol use among adults: A systematic review

Background

Alcohol use and abuse constitute a major public health problem and identifying their determinants is a priority. Social network analysis can indicate how characteristics of social networks are related to individual health behaviors. A growing number of studies have used social network analysis to examine how social network characteristics influence adult alcohol consumption, but this literature has never been systematically reviewed and summarized. The current paper systematically reviews empirical studies that used social network analysis to assess the influence of social network characteristics on drinking behaviors in adults.

Methods

A literature search of PubMed/MEDLINE, EMBASE, PsycINFO and Web of Science databases and a review of the reference lists of retrieved articles was conducted in March 2019. Two reviewers independently screened 5,510 non-duplicate records, and further screened the full text of 150 articles to determine their eligibility for inclusion. Seventeen articles were judged eligible and included.

Results

Most studies were conducted among young adults (mean age<30), in university settings or follow up visits with adolescent networks moving into adulthood. The objectives and methods of the included studies were heterogeneous. All included studies reported a statistically significant association between a social network characteristic and an alcohol consumption-related outcome. Social network members drinking behaviors were associated with participants’ drinking behaviors in multiple ways.

Discussion

In young adults, among whom the majority of identified studies were conducted, with whom they socialize and how they socialize appears to be associated with alcohol consumption; this was observed across methodologies and settings. We still know very little about the relationship of social networks to drinking in older age groups, and in populations most impacted by alcohol. As social networks appear to play a role in the consumption of alcohol in young adulthood, interventions that utilize social networks to help reduce harmful alcohol consumption should be considered.

Impact of a Community-level Intervention on HIV Stigma, Homophobia and HIV Testing in New York City: Results from Project CHHANGE

BACKGROUND

HIV stigma and homophobia are barriers to access to HIV prevention and treatment services. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a multicomponent intervention designed to reduce community-level HIV stigma and homophobia via workshops, space-based events and bus shelter ads delivered to community-based organizations and neighborhood residents in a high HIV prevalence, primarily African-American, Black and/or Afro-Caribbean, neighborhood in New York City (NYC).

METHODS

Serial cross-sectional, street intercept surveys among residents of the invention neighborhood and matched control neighborhood were conducted before and after the intervention. Propensity score matching and generalized estimating equation regression models assessed the impact of CHHANGE on HIV stigma and homophobia. HIV testing service utilization data were assessed and multivariable models of self-reported HIV testing among post-intervention street survey respondents were built.

RESULTS

We did not find a significant treatment effect on HIV stigma and homophobia among residents of the intervention neighborhood as compared with control community residents. However, HIV testing increased by 350% at the testing site in the intervention community after the intervention implementation. Further, lower HIV stigma, attending an HIV stigma workshop and having friends or family living with HIV were independently associated with past six-month HIV testing among post-intervention respondents in both neighborhoods.

CONCLUSIONS

CHHANGE was feasible and acceptable to community residents. Evaluating community-level interventions is challenging. Our triangulated approach yielded somewhat conflicting results, which may be due to design limitations. Further research is needed to understand whether and how CHHANGE affected HIV testing.

Medical marijuana laws and adolescent marijuana use in the United States: a systematic review and meta-analysis

AIMS

To conduct a systematic review and meta-analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past-month marijuana use prevalence among adolescents.

METHODS

A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta-analyzed. Estimates of MML effects on any past-month marijuana use prevalence from included studies were obtained from comparisons of pre-post MML changes in MML states to changes in non-MML states over comparable time-periods. These estimates were standardized and entered into a meta-analysis model with fixed-effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F-test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

RESULTS

None of the 11 studies found significant estimates of pre-post MML changes compared with contemporaneous changes in non-MML states for marijuana use prevalence among adolescents. The meta-analysis yielded a non-significant pooled estimate (standardized mean difference) of -0.003 (95% confidence interval = -0.012, +0.007). Four studies compared MML with non-MML states on pre-MML differences and all found higher rates of past-month marijuana use in MML states pre-MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non-significant results, although limited heterogeneity may warrant further study.

CONCLUSIONS

Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions.

Secure Sharing of mHealth Data Streams through Cryptographically-Enforced Access Control

Owners of mobile-health apps and devices often want to share their mHealth data with others, such as physicians, therapists, coaches, and caregivers. For privacy reasons, however, they typically want to share a limited subset of their information with each recipient according to their preferences. In this paper, we introduce ShareHealth, a scalable, usable, and practical system that allows mHealth-data owners to specify access-control policies and to cryptographically enforce those policies so that only parties with the proper corresponding permissions are able to decrypt data. The design and prototype implementation of this system make three contributions: (1) they apply cryptographically-enforced access-control measures to stream-based (specifically mHealth) data, (2) they recognize the temporal nature of mHealth data streams and support revocation of access to part or all of a data stream, and (3) they depart from the vendor- and device-specific silos of mHealth data by implementing a secure end-to-end system that can be applied to data collected from a variety of mHealth apps and devices.

Preferences for HIV test characteristics among young, Black Men Who Have Sex With Men (MSM) and transgender women: Implications for consistent HIV testing

BACKGROUND

Promoting consistent HIV testing is critical among young, Black Men Who Have Sex With Men (MSM) and transgender women who are overrepresented among new HIV cases in the United States. New HIV test options are available, including mobile unit testing, one-minute testing, at home or self-testing and couples HIV testing and counseling (CHTC). In the context of these newer options, the objective of this study was to explore whether and how preferences for specific characteristics of the tests acted as barriers to and/or facilitators of testing in general and consistent testing specifically among young Black MSM and transgender women aged 16 to 29.

METHODS

We conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were primarily recruited from online and mobile sites, followed by community-based, face-to-face recruitment strategies to specifically reach younger participants. Thematic coding was utilized to analyze the qualitative data based on a grounded theoretical approach.

RESULTS

We identified how past experiences, perceived test characteristics (e.g., accuracy, cost, etc.) and beliefs about the "fit" between the individual, and the test relate to preferred testing methods and consistent testing. Three major themes emerged as important to preferences for HIV testing methods: the perceived accuracy of the test method, venue characteristics, and lack of knowledge or experience with the newer testing options, including self-testing and CHTC.

CONCLUSIONS

These findings suggest that increasing awareness of and access to newer HIV testing options (e.g., free or reduced price on home or self-tests or CHTC available at all testing venues) is critical if these new options are to facilitate increased levels of consistent testing among young, Black MSM and transgender women. Addressing perceptions of test accuracy and supporting front line staff in creating welcoming and safe testing environments may be key intervention targets. Connecting young Black MSM and transgender women to the best test option, given preferences for specific characteristics, may support more and more consistent HIV testing.

A Study To Assess The Prevalence Of Exercise-Induced Bronchoconstriction In Inter-County Hurling

Exercise-Induced Bronchoconstriction (EIB) is an acute, transient airway narrowing occurring after exercise which may impact athletic performance. Studies report 10% of the general population and up to 90% of asthmatics experience EIB. Ninety-two players from three elite hurling squads underwent a spirometric field-based provocation test with real-time heart rate monitoring and lactate measurements to ensure adequate exertion. Players with a new diagnosis of EIB and those with a negative field-test but with a previous label of EIB or asthma underwent further reversibility testing and if negative, methacholine challenge. Eight (8.7%) of players had EIB, with one further athlete having asthma with a negative field test. Interestingly, only three out of 12 players who had previously been physician-labelled with EIB or asthma had their diagnosis objectively confirmed. Our study highlights the role of objective testing in EIB.

Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model

HIV/AIDS stigma and homophobia are associated with significant negative health and social outcomes among people living with HIV/AIDS (PLWHA) and those at risk of infection. Interventions to decrease HIV stigma have focused on providing information and education, changing attitudes and values, and increasing contact with people living with HIV/AIDS (PLWHA), activities that act to reduce stereotyped beliefs and prejudice, as well as acts of discrimination. Most anti-homophobia interventions have focused on bullying reduction and have been implemented at the secondary and post-secondary education levels. Few interventions address HIV stigma and homophobia and operate at the community level. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a community-level, multi-component anti-HIV/AIDS stigma and homophobia intervention designed to reduce HIV stigma and homophobia thus increasing access to HIV prevention and treatment access. The theory-based intervention included three primary components: workshops and trainings with local residents, businesses and community-based organizations (CBO); space-based events at a CBO-partner drop-in storefront and "pop-up" street-based events and outreach; and a bus shelter ad campaign. This paper describes the intervention design process, resultant intervention and the study team's experiences working with the community. We conclude that CHHANGE was feasible and acceptable to the community. Promoting the labeling of gay and/or HIV-related "space" as a non-stigmatized, community resource, as well as providing opportunities for residents to have contact with targeted groups and to understand how HIV stigma and homophobia relate to HIV/AIDS prevalence in their neighborhood may be crucial components of successful anti-stigma and discrimination programming.

Surface wetting strategy prevents acute heat exposure-induced alterations of hypothalamic stress- and metabolic-related genes in broiler chickens

Heat stress (HS) is devastating to poultry production worldwide, yet its biology and molecular responses are not well defined. Although advances in management strategy have partially alleviated the negative impact of HS, productivity still continues to decline when the ambient temperature rises. Therefore, identifying mechanism-based approaches to decrease HS susceptibility while improving production traits is critical. Recently, we made a breakthrough by applying a surface wetting strategy and showing that it improves growth performance compared with the current conventional cooling system. In the present study, we aimed to further define molecular mechanisms associated with surface wetting in ameliorating HS productivity loss in broilers. Five-week-old broiler chickens were exposed to acute HS (35°C for 2 h) alone or in combination with surface wetting. A control group was maintained at thermoneutral conditions (25°C). Core body temperature (BT) and feed intake were recorded. Blood was collected and hypothalamic tissues (main site involved in the regulation of energy homeostasis) were harvested to determine the expression profile of stress- and metabolic-related genes. Surface wetting prevents HS from increasing BT and plasma corticosterone levels ( < 0.05) and improves feeding and drinking behaviors. At molecular levels, surface wetting blocks the activation of hypothalamic heat shock protein and adenosine monophosphate-activated protein-induced by HS and significantly modulates the expression of feeding-related hypothalamic neuropeptides (agouti-related protein, proopiomelanocortin, orexin, orexin receptor, and leptin receptor). Taken together, our data represent the first evidence that surface wetting alleviates systemic and intracellular stress induced by HS and preserves the intracellular energy status, which, in turn, may result in improved broiler well-being and growth performance.

Neighborhood determinants of mood and anxiety disorders among men who have sex with men in New York City

PURPOSE

We examined the relationship between economic, physical, and social characteristics of neighborhoods, where men who have sex with men (MSM) lived and socialized, and symptom scores of depression and generalized anxiety disorder (GAD).

METHODS

Participants came from a cross-sectional study of a population-based sample of New York City MSM recruited in 2010-2012 (n = 1126). Archival and survey-based data were obtained on neighborhoods, where the men lived and where they socialized most often.

RESULTS

MSM who socialized in neighborhoods with more economic deprivation and greater general neighborhood attachment experienced higher GAD symptoms. The relationship between general attachment to neighborhoods where MSM socialized and mental health depended on the level of gay community attachment: in neighborhoods characterized by greater gay community attachment, general neighborhood attachment was negatively associated with GAD symptoms, while in low gay community attachment neighborhoods, general neighborhood attachment had a positive association with GAD symptoms.

CONCLUSIONS

This study illustrates the downsides of having deep ties to social neighborhoods when they occur in the absence of broader access to ties with the community of one's sexual identity. Interventions that help MSM cross the spatial boundaries of their social neighborhoods and promote integration of MSM into the broader gay community may contribute to the reduction of elevated rates of depression and anxiety in this population.

Associations Among Neighborhood Characteristics and Sexual Risk Behavior Among Black and White MSM Living in a Major Urban Area

Identifying neighborhood characteristics associated with sexual HIV risk behavior among gay, bisexual and other men who have sex with men (MSM) living in urban areas may inform the development of policies and programs to reduce risk and subsequently HIV prevalence in urban areas. New York City M2M was a cross-sectional study designed to identify neighborhood-level characteristics associated with sexual risk behaviors among MSM living in New York City. This paper presents results of an analysis of neighborhood-level indicators of three distinct social theories of influence of the neighborhood environment on human behavior: physical disorder, social disorganization and social norms theories. Using multilevel modeling on a sample of 766 MSM stratified by race/ethnicity, we found little support for the role of social disorganization on the sexual risk behavior of MSM, whereas different indicators of physical disorder exerted negative effects across race groups. Our results suggest that the beneficial effects of housing stock maintenance and general neighborhood physical orderliness and cleanliness may have positive effects beyond those traditionally studied for African American MSM and that the field needs novel theorizing regarding whether and how neighborhood or virtual community-level factors relate to sexual behavior among MSM.

Modifiers of Neighbors' Bystander Intervention in Intimate Partner Violence: A Concept Mapping Study

Encouraging bystander intervention in intimate partner violence (IPV) against women is potentially an important method of reducing the prevalence of such violence in urban communities. Most existing research has been conducted on campuses and in relation to sexual violence among teens or young adults. Our understanding of which bystander behaviors are feasible is nascent, and our knowledge of which situational factors influence neighbors' self-reported willingness to intervene is underdeveloped. We conducted a concept mapping study to identify potential bystander intervention behaviors in IPV among neighbors in urban settings; we also assessed whether perceived feasibility and effectiveness of those behaviors varied by situational characteristics. Using data collected from 41 residents of a low-income New York City neighborhood in late 2011, concept mapping was used to create a conceptual map of the 74 behaviors identified by participants. We examined participant differences in mean feasibility (i.e., that the participants "could" or "would" enact a behavior), feasibility given two situational characteristics (if the couple was perceived to have a history of IPV, and if children were believed to be involved or present), and perceived effectiveness of bystander behaviors. Differences across select sociodemographic factors of participants were also analyzed. A 13-cluster solution emerged, with clusters of bystander behaviors grouped into four larger cluster areas: victim focused, parenting/education focused, perpetrator focused, and community involvement focused. Bivariate analyses revealed that participants rated the four cluster areas as more feasible when a child was believed to be involved. Male participants rated intervention as less feasible when the couple was believed to have a history of IPV. Participants who reported a history of IPV victimization rated all four cluster areas as less effective on average, as compared with participants without a history of IPV. This study explored bystander intervention into IPV outside of a college context and among urban adults living in high-poverty areas. Results suggest that the presence of children and perceived history of IPV may affect bystander intervention. Specific recommendations to build the research base on bystander intervention in adult IPV as well as what situational, sociodemographic, and other factors mitigate against intervention among potential responders are offered.

Cognitive screening in the acute hospital: Preliminary findings from a cognitive screening program in a university-affiliated, tertiary-referral hospital with 6-month interval outcomes

Introduction

Cognitive impairment impacts on patient outcomes [1] but is under-recognised in acute hospitals [2]. Data on rates and degree of impairment among hospital inpatients remain sparse. This information is vital for strategic planning of health services as the European population ages.

Objectives

To examine the rates and degree of cognitive impairment among patients aged 65 and older who were admitted to an acute general hospital and to assess its impact on patient outcomes.

Methods

All patients aged over 65 who were admitted over a 2-week period were invited to participate. Those who met the inclusion criteria were screened for delirium then underwent a cognitive screening battery. Normative values for age and level of education were obtained from the TILDA study [3]. Demographic and outcome data were obtained from medical records.

Results

One hundred and forty-eight patients underwent cognitive screening. Thirty-nine over 148 (26%) met the DSM-IV criteria for dementia of whom only 16 (41%) had a previously-documented impairment. Thirty over 148 (20%) had evidence of cognitive impairment that did not meet criteria for dementia, only 3 (10%) of whom were previously documented. Seventy-three over 148 (49%) were normal. Six over 148 (4%) were not classifiable. The impact of cognitive status on length of hospital stay, number of readmissions in 6 months and discharge destination was investigated. Impact on length of stay was significant (P = 0.017) but significance was not achieved against number of readmissions or discharge destination.

Conclusions

Cognitive impairment is pervasive and under-recognised in the acute hospital and impacts on length of hospital stay. Longer interval analysis is necessary to investigate further implications.

References 1–3 available upon request.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

"Just Because It's Out There, People Aren't Going to Use It." HIV Self-Testing Among Young, Black MSM, and Transgender Women

HIV disproportionately affects young black MSM and transgender women in the US. Increasing HIV testing rates among these populations is a critical public health goal. Although HIV self-tests are commercially available, there is a need to better understand access to and uptake of HIV self-testing among this population. Here, we report results of a qualitative study of 30 young black MSM and transgender women residing in the New York City area to understand facilitators of and barriers to a range of HIV testing approaches, including self-testing. Mean age was 23.7 years (SD = 3.4). Over half (54%) had some college or an associate's degree, yet 37% had an annual personal income of less than $10,000 per year. Most (64%) participants had tested in the past 6 months; venues included community health/free clinics, medical offices, mobile testing units, hospitals, emergency departments, and research sites. Just one participant reported ever using a commercially available HIV self-test. Facilitators of self-testing included convenience, control, and privacy, particularly as compared to venue-based testing. Barriers to self-testing included the cost of the test, anxiety regarding accessing the test, concerns around correct test operation, and lack of support if a test result is positive. Participants indicated that instruction in correct test operation and social support in the event of a positive test result may increase the likelihood that they would use the self-test. Alongside developing new approaches to HIV prevention, developing ways to increase HIV self-testing is a public health priority for young, black MSM, and transgender women.

Sexual orientation- and race-based discrimination and sexual HIV risk behavior among urban MSM

Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner ("HIV transmission risk"). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner ("HIV acquisition risk"). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts.

Expression profile of hypothalamic neuropeptides in chicken lines selected for high or low residual feed intake

The R(+) and R(-) chicken lines have been divergently selected for high (R(+)) or low (R(-)) residual feed intake. For the same body weight and egg production, the R(+) chickens consume 40% more food than their counterparts R(-) lines. In the present study we sought to determine the hypothalamic expression profile of feeding-related neuropeptides in these lines maintained under fed or food-deprived conditions. In the fed condition, the suppressor of cytokine signaling 3 (SOCS3) was 17-fold lower (P<0.05) and the ghrelin receptor was 7-fold higher (P<0.05) in R(+) compared to R(-) chicken lines. The hypothalamic expression of the other studied genes remained unchanged between the two lines. In the fasted state, orexigenic neuropeptide Y and agouti-related peptide were more responsive, with higher significant levels in the R(+) compared to R(-) chickens, while no significant differences were seen for the anorexigenic neuropeptides pro-opiomelanocortin and corticotropin releasing hormone. Interestingly, C-reactive protein, adiponectin receptor 1 and ghrelin receptor gene expression were significantly higher (12-, 2- and 3-folds, respectively), however ghrelin and melanocortin 5 receptor mRNA levels were lower (4- and 2-folds, P=0.05 and P=0.03, respectively) in R(+) compared to R(-) animals. We identified several key feeding-related genes that are differently expressed in the hypothalamus of R(+) and R(-) chickens and that might explain the difference in feed intake observed between the two lines.

Methods to measure the impact of home, social, and sexual neighborhoods of urban gay, bisexual, and other men who have sex with men

Men who have sex with men (MSM) accounted for 61% of new HIV diagnoses in the United States in 2010. Recent analyses indicate that socio-structural factors are important correlates of HIV infection. NYCM2M was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use and depression among MSM living in New York City. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications.

This paper describes novel methodological approaches used to improve the quality of data collected for analysis of the impact of neighborhoods on MSM health. Previous research has focused predominately on residential neighborhoods and used pre-determined administrative boundaries (e.g., census tracts) that often do not reflect authentic and meaningful neighborhoods. This study included the definition and assessment of multiple neighborhoods of influence including where men live (home neighborhood), socialize (social neighborhood) and have sex (sexual neighborhood). Furthermore, making use of technological advances in mapping, we collected geo-points of reference for each type of neighborhood and identified and constructed self-identified neighborhood boundary definitions. Finally, this study collected both perceived neighborhood characteristics and objective neighborhood conditions to create a comprehensive, flexible and rich neighborhood-level set of covariates. This research revealed that men perceived their home, social and sexual neighborhoods in different ways. Few men (15%) had the same home, social and sexual neighborhoods; for 31%, none of the neighborhoods was the same. Of the three types of neighborhoods, the number of unique social neighborhoods was the lowest; the size of sexual neighborhoods was the smallest. The resultant dataset offers the opportunity to conduct analyses that will yield context-specific and nuanced understandings of the relations among neighborhood space, and the well-being and health of urban MSM.

"Straight Talk" for African-American heterosexual men: results of a single-arm behavioral intervention trial

In the United States, heterosexual transmission is the second leading cause of HIV/AIDS, and two-thirds of all heterosexually acquired cases diagnosed between 2005 and 2008 occurred among African-Americans. Few HIV prevention interventions have been designed specifically for African-American heterosexual men not seeking clinical treatment. Here we report results of a single-arm intervention trial of a theory-based HIV prevention intervention designed to increase condom use, reduce concurrent partnering and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. We tested our hypothesis using McNemar discordant pairs exact test for binary variables and paired t-tests for continuous variables. We observed statistically significant declines in mean number of total and new female partners, unprotected sex partners, and partner concurrency in both primary and nonprimary sex partnerships between baseline and 3 months postintervention.

Esca Studies of the Valence band and Loss Spectra of Semiconductor Films: Ionicity and Chemical Bonding

ESCA valence band and core level loss results have been determined that appear to be directly related to the degree of covalency/ionicity and other bonding features of certain semi-conductor systems. Specific applications are presented that aid in the characterization of the key chemistry of dielectric oxide/semiconductor interfaces and also may help to determine the relative metastability of the solid solution of Group IV elements (e.g., Ge) into certain III-V lattices (e.g., GaAs). It is shown that these features are not detectable through conventional core level shift arguments, and that the aforementioned novel approaches often require high resolution ESCA.

A tephritid fly mimics the territorial displays of its jumping spider predators

The tephritid fly Zonosemata vittigera (Coquillett) has a leg-like pattern on its wings and a wing-waving display that together mimic the agonistic territorial displays of jumping spiders (Salticidae). Zonosemata flies initiate this display when stalked by jumping spiders, causing the spiders to display back and retreat. Wing transplant experiments showed that both the wing pattern and wing-waving displays are necessary for effective mimicry: Zonosemata flies with transplanted house fly wings and house flies with transplanted Zonosemata wings were attacked by jumping spiders. Similar experiments showed that this mimicry does not protect Zonosemata against nonsalticid predators. This is a novel form of sign stimulus mimicry that may occur more generally.

Interplay of structure, hydration and thermal stability in formacetal modified oligonucleotides: RNA may tolerate nonionic modifications better than DNA

DNA and RNA oligonucleotides having formacetal internucleoside linkages between uridine and adenosine nucleosides have been prepared and studied using UV thermal melting, osmotic stress, and X-ray crystallography. Formacetal modifications have remarkably different effects on double helical RNA and DNA-the formacetal stabilizes the RNA helix by +0.7 degrees C but destabilizes the DNA helix by -1.6 degrees C per modification. The apparently hydrophobic formacetal has little effect on hydration of RNA but decreases the hydration of DNA, which suggests that at least part of the difference in thermal stability may be related to differences in hydration. A crystal structure of modified DNA shows that two isolated formacetal linkages fit almost perfectly in an A-type helix (decamer). Taken together, the data suggest that RNA may tolerate nonionic backbone modifications better than DNA. Overall, formacetal appears to be an excellent mimic of phosphate linkage in RNA and an interesting modification for potential applications in fundamental studies and RNA-based gene control strategies, such as RNA interference.

Twenty-four hour hypothermic machine perfusion preservation of porcine pancreas facilitates processing for islet isolation

Procurement of donor pancreata for islet isolation and transplantation is not yet widely practiced due to concerns about the impact of postmortem ischemia on functional islet yields. Perfusion/preservation technology may help to circumvent ischemic injury as applied in this study of porcine pancreata prior to islet isolation. Pancreata harvested from adult pigs were assigned to 1 of 3 preservation treatment groups: G1, fresh controls, processed immediately with minimum cold ischemia (<1 hour); G2, static cold storage, flushed with cold UW-Viaspan and stored at 2 degrees -4 degrees C for 24 hours; and G3, hypothermic machine perfusion (HMP) on a pulsatile LifePort machine Organ Recovery Systems, Inc., Des Plaines, Ill, United States with KPS1 solution at 4-7 degrees C and low pressure (10 mm Hg) for 24 hours. Islet isolation was then accomplished using conventional methods. Product release criteria were used to assess islet yield and function. Islet yield was markedly different between the treatment groups. There was a statistically significant increased yield in the HMP group over static cold storage in UW-Viaspan (P < .05). Functionally, the islets from each experimental group were equivalent and not significantly different from fresh controls (G1). Dithizone staining of islets showed consistently more uniform digestion of pancreata from G3 compared with G1 and G2, with greater separation of the tissue and fewer entrapped islets. HMP for 24 hours was well tolerated, leading to moderate edema but no loss of function of the harvested islets. The edema appeared to aid in enzymatic digestion, producing a greater yield and purity of islets compared with pancreata subjected to 24 hours of static cold storage.

Transcription defects induced by repeat expansion: fragile X syndrome, FRAXE mental retardation, progressive myoclonus epilepsy type 1, and Friedreich ataxia

Fragile X mental retardation syndrome, FRAXE mental retardation, Progressive myoclonus epilepsy Type I, and Friedreich ataxia are members of a larger group of genetic disorders known as the Repeat Expansion Diseases. Unlike other members of this group, these four disorders all result from a primary defect in the initiation or elongation of transcription. In this review, we discuss current models for the relationship between the expanded repeat and the disease symptoms.

Idiosyncratic profiles of collinearity error using segments and dot pairs

It is well known that judgments of oblique line segments are more variable and less accurate than are judgments of horizontal or vertical segments, i.e., the "oblique effect." A prior study from our laboratories confirmed these differentials for a task in which the collinearity of segments at various angular positions was judged. Further, that study found that each observer manifests a distinct, idiosyncratic profile of errors across the 360 degrees range. These error tendencies are conspicuous in models derived by harmonic analysis, and we describe significant excursions of a given model as "delta errors." The present experiments found complex profiles of delta error with various stimulus and test conditions. A given subject manifested similar models of delta error when judging collinearity of dot pairs versus line segments. In the prior work the segments to be judged were asymmetrically positioned upon the test sheet. However, the asymmetric positioning is not responsible for the errors, as the present work found errors excursions with a round display field. Similar profiles of delta error were found when subjects were allowed to mark an open space, versus being required to respond at a specific distance (indicated by a target circle). This addresses questions of whether the error should be measured as an angle. In the two final experiments, we present evidence that the source of delta error within the nervous system is at the point of binocular synthesis of the information from the two eyes, or beyond, and the effects are not due to errors of reaching. Potential neural substrates for these complex, idiosyncratic error tendencies are discussed.

Recurrent falls are associated with increased length of stay in elderly psychiatric inpatients

OBJECTIVES

To identify factors which may contribute to prolonged length of stay in an elderly psychiatric inpatient setting.

DESIGN

Retrospective case note study.

METHODS

A list of all patients over the age of 65 discharged from a private psychiatric hospital over a three-year period excluding those with a length of stay of over 365 days was obtained (n = 1147). A random sample of 150 patients was selected from the study population. A case note study was then performed looking at a number of variables which have been postulated to affect length of stay. The resulting data was analysed using multivariate statistics.

RESULTS

There was no statistically significant association found between baseline factors (including age, gender, cognitive impairment, marital status, order of admission and preadmission living arrangement) and length of stay. Having recurrent falls whilst an inpatient was associated with prolonged hospital stay (p = 0.0006).

CONCLUSION

Experiencing recurrent falls whilst an inpatient is associated with prolonged length of stay. Recurrent falls in the elderly may be associated with both physical illness and the use of psychotropic medications. A prospective study examining factors contributing to falls would be important in decreasing fall risk and reducing length of stay.

Verbal aggression in Alzheimer's disease. Clinical, functional and neuropsychological correlates

OBJECTIVES

To determine the clinical, functional and neuropsychological correlates of verbal aggression in Alzheimer's disease in a group of consecutive first attendees to a memory clinic.

METHODS

150 people were evaluated and diagnosed as suffering with probable Alzheimer's disease. These people were tested using the Behave-AD for the presence of verbal aggression, delusions, depression and agitation. They were also assessed with cognitive, functional and neuropsychological scales.

RESULTS

Twenty-eight per cent of this group of Alzheimer patients had exhibited some verbal aggression in the preceding month. Male gender (p = 0.022), the presence of paranoid and delusional ideation (p = 0.003) and agitation (p = 0.042) were significantly associated with verbal aggression in a stepwise backward logistic regression analysis.

CONCLUSION

The presence of verbal aggression should prompt the clinician to search for delusional ideation, which may respond to pharmacotherapy.

Evaluating models of collinearity judgment for reliability and scale

In prior work from this laboratory, we have examined how accurately subjects can judge collinearity, i.e. alignment, as a function of the angular position of stimulus elements. In those experiments, subjects were presented with a line segment (or a pair of dots) which varied across the 360 degrees range of angular positions, and were required to select and mark a point which was perceived as being collinear. We found that the models of error for each subject consisted of a complex set of peaks and valleys which are herein described as delta excursions. The error tendencies appeared to be idiosyncratic, in that each subject manifested a different profile of these excursions. Here we report the results of three experiments. In the first, we tested subjects across five sessions, and found that the five models of error were fairly comparable for a given subject. In the second and third experiments, we tested at close intervals of angular position, and found evidence for localized sources of error. We continue to find that the error model for each subject is idiosyncratic, and argue that the excursions may be due to defects in a system which combines responses from position-encoding fields that vary in size.

Further consideration of size illusions in random dot stereograms

It has been suggested that many geometric illusions are caused by the application of depth or size constancy rules to an image which does not have sufficient cues to establish that the elements lie in a flat plane. Thus, converging lines are taken as depth cues, and the attributed depth provides the basis for adjusting the perceived size of stimulus elements. It this is the case, one should not see a distortion of relative size if the disparity cues provide for strong statification, i.e., localization in depth of the linear perspective cues. This expectation is challenged by demonstrations that show distortions of relative size using random-dot stereograms. In 1971 Julesz provided such examples but did not comment on the implications for theories of depth. Here we redemonstrate these distortion of length and size in autostereograms which contain the Ponzo and Corridor configurations. The illusory distortions can be seen in the cyclopean view even though the linear perspective elements are well stratified. We suggest that the processing of binocular disparity cues, as required for judgments of absolute distance, may involve the dorsal stream of vision, i.e., activity passing into and including the parietal lobe. Pictorial cues, on the other hand, are likely passed through the ventral stream into the temporal lobe. The analysis of depth by this system provides for size constancy and, possibly, the calibration of relative motion.

The effects of limiting punitive damage awards

In response to concerns that jury awards in tort cases are excessive and unpredictable, nearly every state legislature has enacted some version of tort reform that is intended to curb extravagant damage awards. One of the most important and controversial reforms involves capping (or limiting) the maximum punitive damage award. We conducted a jury analogue study to assess the impact of this reform. In particular, we examined the possibility that capping punitive awards would cause jurors to inflate their compensatory awards to satisfy their desires to punish the defendant, particularly in situations where the defendant's conduct was highly reprehensible. Relative to a condition in which punitive damages were unlimited, caps on punitive damages did not result in inflation of compensatory awards. However, jurors who had no option to award punitive damages assessed compensatory damages at a significantly higher level than did jurors who had the opportunity to do so. We discuss the policy implications of these findings.