HOW DOES KNOWLEDGE OF THE TUSKEGEE SYPHILIS STUDY AND BELIEFS IN HIV CONSPIRACY THEORIES AFFECT AFRICAN AMERICAN'S PERCEPTION OF MEDICAL RESEARCH?

OBJECTIVES: The Tuskegee Syphilis Study and HIV conspiracy beliefs have continuing effects on perceptions of medical research in the African American community. This study was designed to explore how knowledge and beliefs concerning the Tuskegee Study and HIV impact African Americans' willingness to partake in medical research, how research incentives may influence that willingness and what level of importance they believe medical research has in their lives.METHODS: Responses to medical research questionnaires were assessed for 100 participants. Outcome measures included accuracy of Tuskegee study knowledge, likelihood of participation in research based on incentives, level of importance of research and enrollment into a recruitment database. Data concerning knowledge and beliefs of the Tuskegee Study and HIV, likelihood of participation and level of importance were analyzed via two-way correlation tables and chi-square analysis. RESULTS: Analysis revealed a relatively high level of inaccuracy of Tuskegee study knowledge and HIV. Influences of these topics in relation to willingness to participate in research and overall perceptions of medical research were minimal. However, there were associations indicating that individuals with moderate or greater knowledge of the Tuskegee Study were less likely to participate in research if free medical care was offered when compared to individuals who knew little or nothing regarding the study. CONCLUSIONS: In order to improve the likelihood of minority participation, the medical research community should tailor their recruitment efforts to take into account common beliefs in the African American community concerning medical research.PUBLIC HEALTH SIGNIFICANCE: The data have implications related to the ability to garner trust between the African American and medical research communities, with the ultimate goal to improve likelihood of minority participation in medical research. With a significant degree of misconceptions concerning both the Tuskegee Study and HIV being prevalent in the community, it is vital to take into account these beliefs in order to more effectively recruit African Americans. Outwardly dismissing these beliefs could result in further distrust between the scientific and African American community

A pilot randomized controlled trial for a videoconference-delivered mindfulness-based group intervention in a nonclinical setting

Technology is increasingly being integrated into the provision of therapy and mental health interventions. While the evidence base for technology-led delivery of mindfulness-based interventions is growing, one approach to understanding the effects of technology-delivered elements includes so-named blended programs that continue to include aspects of traditional face-to-face interaction. This arrangement offers unique practical advantages, and also enables researchers to isolate variables that may be underlying the effects of technology-delivered interventions. The present study reports on a pilot videoconference-delivered mindfulness-based group intervention offered to university students and staff members with wait-list controls. Apart from the first session of the six-week course, the main facilitator guided evening classes remotely via online videoconferencing, with follow-up exercises via email. Participants Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation were taught a variety of mindfulness-based exercises such as meditation, breathing exercises, mindful tasting, as well as the concepts underpinning such practice. Participants completed pre- and post-intervention questionnaires on depression, anxiety, repetitive negative thinking, dysfunctional attitudes, positive and negative affect, self-compassion, compassion for others, and mindfulness. For participants who attended at least five of the six sessions, scores on all outcome measures improved significantly post intervention and remained stable at three-week follow up. The videoconference-delivered mindfulness-based group intervention appears to provide a viable alternative format to standard mindfulness programs where the facilitator and participants need to live in close physical proximity with each other

A cross-disorder dosage sensitivity map of the human genome

Rare copy-number variants (rCNVs) include deletions and duplications that occur infrequently in the global human population and can confer substantial risk for disease. In this study, we aimed to quantify the prop-erties of haploinsufficiency (i.e., deletion intolerance) and triplosensitivity (i.e., duplication intolerance) throughout the human genome. We harmonized and meta-analyzed rCNVs from nearly one million individuals to construct a genome-wide catalog of dosage sensitivity across 54 disorders, which defined 163 dosage sensitive segments associated with at least one disorder. These segments were typically gene dense and often harbored dominant dosage sensitive driver genes, which we were able to prioritize using statistical fine-mapping. Finally, we designed an ensemble machine-learning model to predict probabilities of dosage sensitivity (pHaplo & pTriplo) for all autosomal genes, which identified 2,987 haploinsufficient and 1,559 trip-losensitive genes, including 648 that were uniquely triplosensitive. This dosage sensitivity resource will pro-vide broad utility for human disease research and clinical genetics

Second asymptomatic carotid surgery trial (ACST-2) : a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91-1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable