Neighborhoods, Stress, And Cvd Risk Among Women With Hiv In Chicago Wihs

As women living with HIV (WLWH) have aged in the United States, more and more are experiencing common comorbidities associated with aging. Cardiovascular diseases (CVDs) are among the most common chronic diseases that WLWH experience. HIV-positive women are uniquely vulnerable to CVD as they age due to a mix of intersecting circumstances, including general- and HIV-associated factors. Since an individual’s perception of their neighborhood environment is a key contributor to cardiovascular health, it is important to examine the relationship between neighborhoods and cardiovascular health among WLWH. The purpose of this dissertation study was to examine associations between perception of neighborhood environment, stress, and cardiovascular disease risk among HIV-positive women. In order to describe the existing evidence regarding perception of neighborhood environment, chronic stress, and CVD risk among WLWH, I developed a conceptual framework of the interaction between neighborhood environment, and various HIV-associated and general factors linked to stress and CVD risk. Further, this study was completed as a secondary analysis of a data set from the Chicago site of the Women\u27s Interagency HIV Study (WIHS) in 2012. A total of 147 HIV-positive women were included in this study. I examined associations between neighborhood perception, chronic stress, and risk for cardiovascular disease with multivariable linear regression analyses. Results from this study did not demonstrate significant associations between neighborhood perception, chronic stress, and CVD risk among WLWH. This study can be used to develop clinical, behavioral, and policy interventions to promote cardiovascular health among women with HIV

Impaired coordination of nutrient intake and substrate oxidation in melanocortin-4 receptor knockout mice

Mutations in the melanocortin-4 receptor (MC4R) are associated with obesity. The obesity syndrome observed in humans with MC4R haploinsufficiency is similar to that observed in MC4R knockout mice: increased longitudinal growth, hyperphagia, and fasting hyperinsulinemia. For comparison with other commonly investigated models of obesity and insulin resistance, we have backcrossed Mc4r-/- mice into the C57BL/6J (B6) background. Female obese Mc4r-/- mice exhibit reduced energy expenditure and an attenuated increase in fatty acid oxidation following exposure to high fat diets compared to obese Lep ob/Lepob mice. The reduced energy expenditure and fatty acid oxidation correlates with changes in hepatic gene expression. The expression of genes involved in fatty acid oxidation increased in obese Lep ob/Lepob mice compared to wild type and obese Mc4r-/- mice. In contrast, a key lipogenic enzyme (fatty acid synthase) is increased in obese Mc4r-/- mice compared to obese Lepob/Lepob mice. Hyperinsulinemia, increased FAS mRNA expression and hepatic steatosis appear to be secondary to obesity in B6 Mc4r-/- mice. However, Mc4r-/- mice in a mixed genetic background develop severe hepatic steatosis at an early age. This might suggest an important role of the MC4R in regulating liver fatty acid metabolism this is masked on the B6 background. Interestingly, the 10- to 20-fold increase in liver triglyceride in this strain of Mc4r-/- mice is not always associated with fasting hyperinsulinemia or increased FAS mRNA expression. This observation suggests changes in liver secondary to triglyceride accumulation lead to hyperinsulinemia and increased hepatic FAS expression in Mc4r-/- mice

The association of burnout with work absenteeism and the frequency of thoughts in leaving their job in a cohort of healthcare workers during the COVID-19 pandemic

IntroductionDuring the coronavirus disease 2019 pandemic, high levels of burnout were reported among healthcare workers. This study examines the association of work absenteeism and frequency of thoughts in leaving current job with burnout among a cohort of healthcare workers during the COVID-19 pandemic.MethodsA cross-sectional survey of healthcare workers was conducted from April-May, 2022 on healthcare workers from 10 hospitals, 18 immediate care centers, and 325 outpatient practices in the Chicago area and surrounding Illinois suburbs. Logistic regression models were used to assess the association of burnout scores (Oldenburg Burnout Inventory—OLBI) and its sub-scores (exhaustion and disengagement scores) with work absenteeism and thoughts of leaving work.ResultsOne-fifth and 60% of respondents (n = 1,825) reported unplanned absenteeism and thoughts of leaving their job, respectively. After adjusting for covariates, higher burnout scores, especially exhaustion scores, were associated with increased odds of unplanned absenteeism (OR = 1.04, 95% CI: 1.01–1.08). Burnout scores and both sub-scores were also positively associated with the frequency of thoughts of leaving work, e.g., each unit increase in the OLBI burnout score was associated with 1.39 (95% CI: 1.34–1.43) times higher odds of thinking about leaving work “a lot/constantly” vs. “never”.DiscussionOverall, this study cohort showed a positive association between burnout scores and unplanned work absenteeism (and frequency of thoughts in leaving job) during the COVID-19 pandemic. More research is needed to support healthcare worker well-being during times of stress and direct solutions to addressing unplanned absenteeism in the light of a pandemic

Synaptic Zn2+ potentiates the effects of cocaine on striatal dopamine neurotransmission and behavior

Cocaine binds to the dopamine (DA) transporter (DAT) to regulate cocaine reward and seeking behavior. Zinc (Zn2+) also binds to the DAT, but the in vivo relevance of this interaction is unknown. We found that Zn2+ concentrations in postmortem brain (caudate) tissue from humans who died of cocaine overdose were significantly lower than in control subjects. Moreover, the level of striatal Zn2+ content in these subjects negatively correlated with plasma levels of benzoylecgonine, a cocaine metabolite indicative of recent use. In mice, repeated cocaine exposure increased synaptic Zn2+ concentrations in the caudate putamen (CPu) and nucleus accumbens (NAc). Cocaine-induced increases in Zn2+ were dependent on the Zn2+ transporter 3 (ZnT3), a neuronal Zn2+ transporter localized to synaptic vesicle membranes, as ZnT3 knockout (KO) mice were insensitive to cocaine-induced increases in striatal Zn2+. ZnT3 KO mice showed significantly lower electrically evoked DA release and greater DA clearance when exposed to cocaine compared to controls. ZnT3 KO mice also displayed significant reductions in cocaine locomotor sensitization, conditioned place preference (CPP), self-administration, and reinstatement compared to control mice and were insensitive to cocaine-induced increases in striatal DAT binding. Finally, dietary Zn2+ deficiency in mice resulted in decreased striatal Zn2+ content, cocaine locomotor sensitization, CPP, and striatal DAT binding. These results indicate that cocaine increases synaptic Zn2+ release and turnover/metabolism in the striatum, and that synaptically released Zn2+ potentiates the effects of cocaine on striatal DA neurotransmission and behavior and is required for cocaine-primed reinstatement. In sum, these findings reveal new insights into cocaine's pharmacological mechanism of action and suggest that Zn2+ may serve as an environmentally derived regulator of DA neurotransmission, cocaine pharmacodynamics, and vulnerability to cocaine use disorders

Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

Background Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. Methods Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0-14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995-99, 2000-04, and 2005-09), sex, and age at diagnosis (< 1, 1-4, 5-9, and 10-14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Findings We analysed data from 89 828 children from 198 registries in 53 countries. During 1995-99, 5-year agestandardised net survival for all lymphoid leukaemias combined ranged from 10.6% (95% CI 3.1-18.2) in the Chinese registries to 86.8% (81.6-92.0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005-09, when age-standardised survival for lymphoid leukaemias ranged from 52.4% (95% CI 42.8-61.9) in Cali, Colombia, to 91.6% (89.5-93.6) in the German registries, and for AML ranged from 33.3% (18.9-47.7) in Bulgaria to 78.2% (72.0-84.3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000-04 and 2005-09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1-4 and 5-9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls. Interpretation Global inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood survival

The mentor match: A new approach to implementing formal mentorship in general surgery residency.

Mentorship is a vital component within general surgery residency that fosters success extending into future practices. Recognizing the need for formalized mentorship within our general surgery residency, a survey based match process was developed. The Mentor Match was developed by creating resident and faculty surveys using the six ACGME core competencies of patient care, medical knowledge, communication skills, practice based learning, system based practice and professionalism. Surveys focused on resident areas of weakness correlating to areas in which faculty expressed subjective strength. Survey results were used to match faculty mentors with resident mentees. One year after implementation, residents were surveyed to evaluate the perceived success of the match process and mentorship program. Resident participation was 100% with a survey response of 78%. Ninety-two percent of residents were satisfied with the program, 83% saw improvement in their areas of weakness and 75% felt the match process was effective in pairing mentors with mentees. In conclusion, the Mentor Match was an effective tool in developing a formalized mentorship program with positive results after one year of implementation

From virus to viral: content analysis of HIV-related Twitter messages among young men in the U.S.

Abstract Background Adolescents and young adults account for over 21% of new HIV infections in the U.S. with most new cases among young men. As an important information source for this group, social media can uniquely reveal the perspectives and communicative patterns of this key population. We identified 6,439 young male Twitter users (ages 13–24) in the U.S. using an NLP pipeline with geolocations. From their Twitter timelines, we collected 24,600 HIV-related tweets, among which the most retweeted and favorited tweets (n = 472) were analyzed through a content analysis. Results Three themes arose in this online viral discourse around HIV among young men: (i) othering, (ii) politics and activism, (iii) risk and wellness. Othering tweets contained stigmatizing jokes and insults alienating individuals who identify as lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, or being elsewhere on the gender and sexuality spectrum (LGBTQIA +), and people with HIV. Politics and activism tweets discussed awareness, stigma, HIV criminalization, violence, LGBTQIA + , and women’s rights. Risk and wellness tweets discussed risk behaviors for sexually transmitted infections (STIs) (e.g., condomless sex, transactional sex, multiple sexual partners), or safer sex and preventive practices (e.g., pre-exposure prophylaxis [PrEP], condom use, achieving undetectable viral load, medication adherence, and STI testing). Conclusion The social acceptability of high-risk sex behaviors is high among young male Twitter users. Given the double-edged nature of social media—health-promoting (e.g., awareness, health activism) as well as risk-promoting (e.g., risky behavior endorsement, identity attacks)— this population may benefit from targeted health communication intervention. Future HIV prevention efforts should counter the stigma, misinformation, and risk-promoting viral messages prevalent on social media