Reduction of Injection-Related Risk Behaviors After Emergency Implementation of a Syringe Services Program During an HIV Outbreak

Objective: To describe injection-related HIV risk behaviors preimplementation and postimplementation of an emergency syringe services program (SSP) in Scott County, Indiana, after an HIV outbreak among persons who inject drugs (PWID). Design: Mixed methods retrospective pre–post intervention analysis. Methods: We analyzed routine SSP program data collected at first and most recent visit among clients with ≥2 visits, ≥7 days apart from April 4 to August 30, 2015, to quantify changes in injection-related risk behaviors. We also analyzed qualitative data collected from 56 PWID recruited in Scott County to understand factors contributing to these behaviors. Results: SSP clients included in our analysis (n = 148, 62% of all SSP clients) reported significant (P < 0.001) reductions over a median 10 weeks (range 1–23) in syringe sharing to inject (18%–2%) and divide drugs (19%–4%), sharing other injection equipment (eg, cookers) (24%–5%), and number of uses of the same syringe [2 (interquartile range: 1–4) to 1 (interquartile range: 1–1)]. Qualitative study participants described access to sterile syringes and safer injection education through the SSP, as explanatory factors for these reductions. Injection frequency findings were mixed, but overall suggested no change. The number of syringes returned by SSP clients increased from 0 at first visit to median 57. All qualitative study participants reported using sharps containers provided by the SSP. Conclusions: Analyses of an SSP program and in-depth qualitative interview data showed rapid reduction of injection-related HIV risk behaviors among PWID post-SSP implementation. Sterile syringe access as part of comprehensive HIV prevention is an important tool to control and prevent HIV outbreaks

Deriving household composition using population-scale electronic health record data—A reproducible methodology

BackgroundPhysical housing and household composition have an important role in the lives of individuals and drive health and social outcomes, and inequalities. Most methods to understand housing composition are based on survey or census data, and there is currently no reproducible methodology for creating population-level household composition measures using linked administrative data.MethodsUsing existing, and more recent enhancements to the address-data linkage methods in the SAIL Databank using Residential Anonymised Linking Fields we linked individuals to properties using the anonymised Welsh Demographic Service data in the SAIL Databank. We defined households, household size, and household composition measures based on adult to child relationships, and age differences between residents to create relative age measures.ResultsTwo relative age-based algorithms were developed and returned similar results when applied to population and household-level data, describing household composition for 3.1 million individuals within 1.2 million households in Wales. Developed methods describe binary, and count level generational household composition measures.ConclusionsImproved residential anonymised linkage field methods in SAIL have led to improved property-level data linkage, allowing the design and application of household composition measures that assign individuals to shared residences and allow the description of household composition across Wales. The reproducible methods create longitudinal, household-level composition measures at a population-level using linked administrative data. Such measures are important to help understand more detail about an individual's home and area environment and how that may affect the health and wellbeing of the individual, other residents, and potentially into the wider community

2020 North Carolina Election Protection Report

North Carolinians -- particularly our Black and Latiné neighbors -- have always faced an evolving array of barriers that prevented them from exercising their freedom to vote. Last century's literacy tests and poll taxes, used to keep Black and low-resourced voters away from the polls, have evolved into more insidious tactics like complex vote-by-mail procedures, intimidation, and felony disenfranchisement.Each year, Democracy North Carolina and the Southern Coalition for Social Justice (SCSJ) work to identify and remove voting barriers. The 2020 Election Protection report documents our work during one of the state's highest turnout and safest elections on record. Central to our report is an analysis of over 13,000 phone calls voters made to our statewide voter assistance hotline (888-OUR-VOTE) as well as from thousands of volunteers (also known as "Vote Protectors"), who observed polling places and helped voters during the 2020 elections

Clustering of Dust-Obscured Galaxies at z ~ 2

We present the angular autocorrelation function of 2603 dust-obscured galaxies (DOGs) in the Bootes field of the NOAO Deep Wide-Field Survey. DOGs are red, obscured galaxies, defined as having R-[24] \ge 14 (F_24/F_R \ga 1000). Spectroscopy indicates that they are located at 1.5 \la z \la 2.5. We find strong clustering, with r_0 = 7.40^{+1.27}_{-0.84} Mpc/h for the full F_24 > 0.3 mJy sample. The clustering and space density of the DOGs are consistent with those of submillimeter galaxies, suggestive of a connection between these populations. We find evidence for luminosity-dependent clustering, with the correlation length increasing to r_0 = 12.97^{+4.26}_{-2.64} Mpc/h for brighter (F_24 > 0.6 mJy) DOGs. Bright DOGs also reside in richer environments than fainter ones, suggesting these subsamples may not be drawn from the same parent population. The clustering amplitudes imply average halo masses of log M = 12.2^{+0.3}_{-0.2} Msun for the full DOG sample, rising to log M = 13.0^{+0.4}_{-0.3} Msun for brighter DOGs. In a biased structure formation scenario, the full DOG sample will, on average, evolve into ~ 3 L* present-day galaxies, whereas the most luminous DOGs may evolve into brightest cluster galaxies.Comment: ApJL in press; 4 pages, 3 figures, 1 tabl

Tissue Localization and Extracellular Matrix Degradation by PI, PII and PIII Snake Venom Metalloproteinases: Clues on the Mechanisms of Venom-Induced Hemorrhage

20 páginas, 4 figuras, 3 tablas y 7 tablas en material suplementario.Snake venom hemorrhagic metalloproteinases (SVMPs) of the PI, PII and PIII classes were compared in terms of tissue localization and their ability to hydrolyze basement membrane components in vivo, as well as by a proteomics analysis of exudates collected in tissue injected with these enzymes. Immunohistochemical analyses of co-localization of these SVMPs with type IV collagen revealed that PII and PIII enzymes co-localized with type IV collagen in capillaries, arterioles and post-capillary venules to a higher extent than PI SVMP, which showed a more widespread distribution in the tissue. The patterns of hydrolysis by these three SVMPs of laminin, type VI collagen and nidogen in vivo greatly differ, whereas the three enzymes showed a similar pattern of degradation of type IV collagen, supporting the concept that hydrolysis of this component is critical for the destabilization of microvessel structure leading to hemorrhage. Proteomic analysis of wound exudate revealed similarities and differences between the action of the three SVMPs. Higher extent of proteolysis was observed for the PI enzyme regarding several extracellular matrix components and fibrinogen, whereas exudates from mice injected with PII and PIII SVMPs had higher amounts of some intracellular proteins. Our results provide novel clues for understanding the mechanisms by which SVMPs induce damage to the microvasculature and generate hemorrhage.This work was performed in partial fulfillment of the requirements for the PhD degree for Cristina Herrera at Universidad de Costa Rica.Peer reviewe