Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

In Lusaka, Zambia, where malaria prevalence is low, national guidelines continue to recommend that all pregnant women receive sulfadoxine–pyrimethamine (SP) for malaria prophylaxis monthly at every scheduled antenatal care visit after 16 weeks of gestation. Human immunodeficiency virus (HIV)–positive women should receive co-trimoxazole prophylaxis for HIV and not SP, but many still receive SP. We sought to determine whether increased dosage of SP is still associated with a reduced risk of low birth weight (LBW) in an area where malaria transmission is low. Our secondary objective was to determine whether any association between SP and LBW is modified by receipt of antiretroviral therapy (ART). We analyzed data routinely collected from a cohort of HIV-positive pregnant women with singleton births in Lusaka, Zambia, between February 2006 and December 2012. We used a log-Poisson model to estimate the risk of LBW by dosage of SP and to determine whether the association between SP and LBW varied by receipt of ART. Risk of LBW declined as the number of doses increased and appeared lowest among women who received three doses (adjusted risk ratio [ARR] = 0.78; 95% confidence interval [CI] = 0.64–0.95). In addition, women receiving combination ART had a higher risk of delivering an LBW infant compared with women receiving no treatment or prophylaxis (ARR = 1.18; 95% CI = 1.09–1.28), but this risk was attenuated among women who were receiving SP (risk ratio = 1.09; 95% CI = 0.99–1.21). SP was associated with a reduced risk of LBW in HIV-positive women, including those receiving ART, in a low malaria prevalence region

A retrospective study of HIV, antiretroviral therapy, and pregnancy-associated hypertension among women in Lusaka, Zambia

To investigate the association between HIV, antiretroviral therapy (ART), and pregnancy-associated hypertension (PAH) in an HIV-endemic setting

Maternal and newborn outcomes at a tertiary care hospital in Lusaka, Zambia, 2008-2012

To measure key obstetric and neonatal outcomes recorded at a tertiary hospital in Zambia over a 5-year period

Itinerant Ferromagnetism in the Periodic Anderson Model

We introduce a novel mechanism for itinerant ferromagnetism, based on a simple two-band model. The model includes an uncorrelated and dispersive band hybridized with a second band which is narrow and correlated. The simplest Hamiltonian containing these ingredients is the Periodic Anderson Model (PAM). Using quantum Monte Carlo and analytical methods, we show that the PAM and an extension of it contain the new mechanism and exhibit a non-saturated ferromagnetic ground state in the intermediate valence regime. We propose that the mechanism, which does not assume an intra atomic Hund's coupling, is present in both the iron group and in some f electron compounds like Ce(Rh_{1-x} Ru_x)_3 B_2, La_x Ce_{1-x} Rh_3 B_2 and the uranium monochalcogenides US, USe, and UTe

Triggering Threshold Spacecraft Charging with Changes in Electron Emission from Materials

Modest changes in spacecraft charging conditions can lead to abrupt changes in the spacecraft equilibrium, from small positive potentials to large negative potentials relative to the space plasma; this phenomenon is referred to as threshold charging. It is well known that temporal changes of the space plasma environment (electron plasma temperature or density) can cause threshold charging. Threshold charging can also result from by temporal changes in the juxtaposition of the spacecraft to the environment, including spacecraft orbit, orientation, and geometry. This study focuses on the effects of possible changes in electron emission properties of representative spacecraft materials. It is found that for electron-induced emission, the possible threshold scenarios are very rich, since this type of electron emission can cause either positive or negative charging. Alternately, modification of photon- or ion-induced electron emission is found to induce threshold charging only in certain favorable cases. Changes of emission properties discussed include modifications due to: contamination, degradation and roughening of surfaces and layered materials; biasing and charge accumulation; bandstructure occupation and density of states caused by heat, optical or particle radiation; optical reflectivity and absorptivity; and inaccuracies and errors in measurements and parameterization of materials properties. An established method is used here to quantitatively gauge the relative extent to which these various changes in electron emission alter a spacecraft’s charging behavior and possibly lead to threshold charging. The absolute charging behavior of a hypothetical flat, two-dimensional satellite panel of a single material (either polycrystalline conductor Au or the polymeric polyimide Kapton™ H) is modeled as it undergoes modification and concomitant changes in spacecraft charging in three representative geosynchronous orbit environments, from full sunlight to full shade (eclipse) are considered

Using narratives to inform the development of a digital health intervention related to COVID-19 vaccination in Black young adults in Georgia, North Carolina and Alabama

Interactive stories are a relatively newer form of storytelling with great potential to correct misinformation while increasing self-efficacy, which is crucial to vaccine acceptance. To address COVID-19 vaccine hesitancy and medical mistrust in young Black adults (BYA), we sought to adapt a pre-existing application (“app”; Tough Talks) designed to address HIV disclosure decision-making through choose-your-own adventure (CYOA) narratives and other activities. The adapted app (Tough Talks – COVID) uses a similar approach to situate COVID-19 vaccination decision-making within social contexts and to encourage greater deliberation about decisions. To inform content for the CYOA narratives, we conducted an online survey that was used to elicit the behavioral, cognitive, and environmental determinants influencing COVID-19 vaccine hesitancy among 150 BYA (ages 18–29) in Georgia, Alabama, and North Carolina. The survey included scenario questions that were developed with input from a youth advisory board to understand responses to peer and family influences. In two scenarios that involved discussions with family and friends about vaccination status, most respondents chose to be honest about their vaccination status. However, vaccinated individuals perceived more social pressure and stigma about not being vaccinated than unvaccinated respondents who were not as motivated by social pressure. Personal choice/agency in the face of perceived vaccine risks was a more common theme for unvaccinated respondents. Results suggest that relying on changing social norms alone may not impact barriers to vaccination in unvaccinated young adults without also addressing other barriers to vaccination such as concerns about autonomy and vaccine safety. Based on these findings, CYOA narratives in the app were adapted to include discussions with family and friends but also to touch on themes of personal choice as well as other topics that influence behaviors besides norms such as safety, side effects, and risk of COVID-19 in an evolving pandemic

Intimate partner violence is associated with cytomegalovirus among young women in rural South Africa : An HPTN 068 analysis

Stressful life circumstances (e.g. violence and poverty) have been associated with elevated biomarkers, including C-reactive protein (CRP), cytomegalovirus (CMV), and herpes simplex virus type-1 (HSV-1), among older adults in high-income settings. Yet, it remains unknown whether these relationships exist among younger populations in resource-limited settings. We therefore utilised a cohort of 1,279 adolescent girls and young women (AGYW) from the HIV Prevention Trials Network 068 study in rural South Africa to examine the associations between 6 hypothesized stressors (intimate partner violence (IPV), food insecurity, depression, socioeconomic status (SES), HIV, childhood violence) and 3 biomarkers that were measured using dried blood spots (CRP, CMV, and HSV-1). Ordinal logistic regression estimated the lagged and cross-sectional associations between each stressor and each biomarker. IPV was cross-sectionally associated with elevated CMV (OR = 2.45, 95% CI = 1.05,5.72), while low SES was cross-sectionally associated with reduced CMV (OR = 0.73, 95% CI = 0.58,0.93). AGYW with HIV had elevated biomarkers cross-sectionally (CRP: OR = 1.51, 95% CI = 1.08,2.09; CMV: OR = 1.86, 95% CI = 1.31,2.63; HSV-1: OR = 1.68, 95% CI = 1.17,2.41) and in a lagged analysis. The association between violence and CMV could help explain how violence results in stress and subsequently worse health among AGYW; however, additional research is needed to disentangle the longitudinal nature of IPV and stress

Incorporation of near-real-time hospital occupancy data to improve hospitalization forecast accuracy during the COVID-19 pandemic

Public health decision makers rely on hospitalization forecasts to inform COVID-19 pandemic planning and resource allocation. Hospitalization forecasts are most relevant when they are accurate, made available quickly, and updated frequently. We rapidly adapted an agent-based model (ABM) to provide weekly 30-day hospitalization forecasts (i.e., demand for intensive care unit [ICU] beds and non-ICU beds) by state and region in North Carolina for public health decision makers. The ABM was based on a synthetic population of North Carolina residents and included movement of agents (i.e., patients) among North Carolina hospitals, nursing homes, and the community. We assigned SARS-CoV-2 infection to agents using county-level compartmental models and determined agents’ COVID-19 severity and probability of hospitalization using synthetic population characteristics (e.g., age, comorbidities). We generated weekly 30-day hospitalization forecasts during May–December 2020 and evaluated the impact of major model updates on statewide forecast accuracy under a SARS-CoV-2 effective reproduction number range of 1.0–1.2. Of the 21 forecasts included in the assessment, the average mean absolute percentage error (MAPE) was 7.8% for non-ICU beds and 23.6% for ICU beds. Among the major model updates, integration of near-real-time hospital occupancy data into the model had the largest impact on improving forecast accuracy, reducing the average MAPE for non-ICU beds from 6.6% to 3.9% and for ICU beds from 33.4% to 6.5%. Our results suggest that future pandemic hospitalization forecasting efforts should prioritize early inclusion of hospital occupancy data to maximize accuracy