Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice to describe the assets and barriers to sexual and reproductive health among Latinos in North Carolina

Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a viable strategy to address disparities

The suitability of Zn–1.3% Fe alloy as a biodegradable implant material

Efforts to develop metallic zinc for biodegradable implants have significantly advanced following an earlier focus on magnesium (Mg) and iron (Fe). Mg and Fe base alloys experience an accelerated corrosion rate and harmful corrosion products, respectively. The corrosion rate of pure Zn, however, may need to be modified from its reported ~20 µm/year penetration rate, depending upon the intended application. The present study aimed at evaluating the possibility of using Fe as a relatively cathodic biocompatible alloying element in zinc that can tune the implant degradation rate via microgalvanic effects. The selected Zn–1.3wt %Fe alloy composition produced by gravity casting was examined in vitro and in vivo. The in vitro examination included immersion tests, potentiodynamic polarization and impedance spectroscopy, all in a simulated physiological environment (phosphate-buffered saline, PBS) at 37 °C. For the in vivo study, two cylindrical disks (seven millimeters diameter and two millimeters height) were implanted into the back midline of male Wister rats. The rats were examined post implantation in terms of weight gain and hematological characteristics, including red blood cell (RBC), hemoglobin (HGB) and white blood cell (WBC) levels. Following retrieval, specimens were examined for corrosion rate measurements and histological analysis of subcutaneous tissue in the implant vicinity. In vivo analysis demonstrated that the Zn–1.3%Fe implant avoided harmful systemic effects. The in vivo and in vitro results indicate that the Zn–1.3%Fe alloy corrosion rate is significantly increased compared to pure zinc. The relatively increased degradation of Zn–1.3%Fe was mainly related to microgalvanic effects produced by a secondary Zn11Fe phase

UNC Center for Environmental Health and Susceptibility: Understanding Healthy Homes Education and Policy Needs in Lenoir and Durham Counties and Developing Recommendations for Outreach

Background: Environmental exposures have been linked to increased risks of numerous health conditions, including asthma, cancer, obesity, and lead poisoning. The Community Outreach and Engagement Core (COEC) at the University of North Carolina Center for Environmental Health and Susceptibility (CEHS) received a three-year grant from the Centers for Disease Control and Prevention (CDC) to implement Healthy Homes programming across North Carolina in 2011. The Capstone team was tasked with assessing the home health-related educational needs of Durham and Lenoir County residents to help inform this programming. Methods: The Capstone team conducted demographic and epidemiological information reviews, qualitative formative research, community visits, assessments of the COEC's existing educational materials, and examination of existing Healthy Homes policies and current literature on effective environmental health outreach interventions and strategies. The Capstone team performed 14 key informant interviews with community leaders in Durham and Lenoir Counties, as well as three focus groups with community members in Lenoir County. Results: Data showed that poverty, unemployment, and safety were over-arching issues in both counties. In Durham, the most commonly mentioned environmental health issues were indoor air quality and mold. Lead was also indicated often and has historically been a problem in the county. Lenoir County's top environmental health issues were water quality, housing issues, outdoor air quality, and lead. Access to environmental health education and costs are frequent barriers to acting on environmental health risks. Organizations in the two areas vary in both their focus on environmental health issues and capacity to provide education and outreach. Discussion: The Capstone team's recommended improvements to the COEC's Healthy Homes-focused outreach and education strategies are organized into three areas: engagement, adult learning methods, and education. The COEC's engagement efforts could be improved by increasing their presence in Lenoir County. Healthy Homes trainings could be improved by increasing the use of participatory teaching methods. The education could be strengthened and tailored to the audience's needs by integrating cost-saving tips and conducting more evaluation of the trainings with participants.Master of Public Healt

Analyzing Non-Alcoholic Fatty Liver Disease Risk Using Time-Series Model

Non-alcoholic fatty liver disease (NAFLD) is the most global frequent liver disease, with a prevalence of almost 20% in the overall population. NAFLD may progress to fibrosis and later into cirrhosis in addition to other diseases. Our objective is to stratify patients\u27 risks for NAFLD and advanced fibrosis over time and suggest preventive medical decisions. We used a cohort of individuals from the Tel-Aviv medical center. Time-series clustering machine learning model (Hidden Markov Models (HMM)) was used to profile fibrosis risk by modeling patients’ latent medical status and trajectories over time. The best-fitting model had three latent HMM states. Initial results show that tracking individuals over time and their relative risk for fibrosis at each point of time provides significant clinical insights regarding each state (and its group of individuals). Thus, longitudinal risk stratification can enable the early identification of specific individual groups following distinct medical trajectories based on their routine visits

Inhibitory NK Receptor Recognition of HLA-G: Regulation by Contact Residues and by Cell Specific Expression at the Fetal-Maternal Interface

The non-classical HLA-G protein is distinguished from the classical MHC class I molecules by its expression pattern, low polymorphism and its ability to form complexes on the cell surface. The special role of HLA-G in the maternal-fetal interface has been attributed to its ability to interact with specific receptors found on maternal immune cells. However this interaction is restricted to a limited number of receptors. In this study we elucidate the reason for this phenomenon by comparing the specific contact residues responsible for MHC-KIR interactions. This alignment revealed a marked difference between the HLA-G molecule and other MHC class I molecules. By mutating these residues to the equivalent classical MHC residues, the HLA-G molecule regained an ability of interacting with KIR inhibitory receptors found on NK cells derived either from peripheral blood or from the decidua. Functional NK killing assays further substantiated the binding results. Furthermore, double immunofluorescent staining of placental sections revealed that while the conformed form of HLA-G was expressed in all extravillous trophoblasts, the free heavy chain form of HLA-G was expressed in more distal cells of the column, the invasion front. Overall we suggest that HLA-G protein evolved to interact with only some of the NK inhibitory receptors thus allowing a control of inhibition, while permitting appropriate NK cell cytokine and growth factor production necessary for a viable maternal fetal interface

The Suitability of Zn–1.3%Fe Alloy as a Biodegradable Implant Material

Efforts to develop metallic zinc for biodegradable implants have significantly advanced following an earlier focus on magnesium (Mg) and iron (Fe). Mg and Fe base alloys experience an accelerated corrosion rate and harmful corrosion products, respectively. The corrosion rate of pure Zn, however, may need to be modified from its reported ~20 µm/year penetration rate, depending upon the intended application. The present study aimed at evaluating the possibility of using Fe as a relatively cathodic biocompatible alloying element in zinc that can tune the implant degradation rate via microgalvanic effects. The selected Zn–1.3wt %Fe alloy composition produced by gravity casting was examined in vitro and in vivo. The in vitro examination included immersion tests, potentiodynamic polarization and impedance spectroscopy, all in a simulated physiological environment (phosphate-buffered saline, PBS) at 37 °C. For the in vivo study, two cylindrical disks (seven millimeters diameter and two millimeters height) were implanted into the back midline of male Wister rats. The rats were examined post implantation in terms of weight gain and hematological characteristics, including red blood cell (RBC), hemoglobin (HGB) and white blood cell (WBC) levels. Following retrieval, specimens were examined for corrosion rate measurements and histological analysis of subcutaneous tissue in the implant vicinity. In vivo analysis demonstrated that the Zn–1.3%Fe implant avoided harmful systemic effects. The in vivo and in vitro results indicate that the Zn–1.3%Fe alloy corrosion rate is significantly increased compared to pure zinc. The relatively increased degradation of Zn–1.3%Fe was mainly related to microgalvanic effects produced by a secondary Zn11Fe phase

Gastric Acid Suppression Therapy and its Association with Peritoneal Dialysis-Associated Peritonitis in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

Background: Peritonitis is a major peritoneal dialysis (PD) related complication. We determined whether gastric acid suppression (GAS) (proton pump inhibitor (PPI) or histamine-2 receptor antagonists (H2RA)) use was associated with all-cause and organism-specific peritonitis in PD patients. Methods: In the Peritoneal Dialysis Outcomes and Practice Patterns Study (595 facilities, 8 countries, years 2014-2022), associations between GAS use and time to first episode of all-cause peritonitis were examined using Cox proportional hazards models. The primary exposure of interest was GAS, and secondarily PPI or H2RA use. Secondary outcomes were organism-specific peritonitis, peritonitis cure rates, and death. Results: Among patients (n=23 797) at study baseline, 6020 (25.3%) used PPIs, and 1382 (5.8%) used H2RAs. Overall risks of GAS use and peritonitis risk [adjusted hazard ratio (AHR)=1.05 (95% CI 0.98-1.13)], and use of PPI [AHR 1.06 (95% CI 0.99-1.14)] or H2RA [AHR 1.02 (95% CI 0.88-1.18)] did not reach statistical significance. In organism-specific analyses, GAS users displayed higher peritonitis risks for gram-negative (AHR 1.29, 95% CI 1.05-1.57), gram-positive (AHR 1.15, 95% CI 1.01-1.31), culture-negative (AHR 1.20, 95% CI 1.01-1.42), enteric (AHR 1.23, 95% CI 1.03-1.48), and particularly Streptococcal (AHR 1.47, 95% CI 1.15-1.89) peritonitis episodes. GAS was also associated with higher overall mortality [AHR 1.13 (95% CI 1.05-1.22)]. Conclusion: The association between GAS use and peritonitis risk was weaker (HR 1.05 [0.98-1.13]) than for streptococcal (HR 1.57 [1.15-1.89]) and gram-negative (HR 1.29 [1.05-1.57]) peritonitis. A better understanding of mechanisms surrounding the differential effects of GAS subtype on peritonitis risks is needed. Clinicians should be cautious when prescribing GAS. The impact of GAS deprescribing on peritonitis risk requires further evaluation

The triple HLA-G contact residues mutants affect peripheral NK clones killing activity.

<p>Various S³⁵-labeled cells were incubated with (A) LIR-1⁺, (B) KIR2DL1⁺ or (C) KIR2DL2⁺ peripheral NK clone in effector to target ratio (E∶T) of 4∶1. The expression of a particular NK receptor on each of the clones is presented in A–C. Shown is one representative experiment out of four performed.</p