Assessing influenza vaccination coverage and predictors in persons living with HIV/AIDS in Louisiana, June 2002-June 2013.

Background: Despite the burden of disease and increased risk of influenza-associated morbidity and mortality among PLWHA, influenza vaccination has been understudied in this population. Methods: We built an 11-year cohort of HIV-infected adults from medical records of PLWHA seeking care within the Louisiana State University medical system from June 2002-June 2013. Influenza vaccination uptake among PLWHA was calculated overall and for each medical facility for each influenza season. Linear regression was used to assess influenza vaccination uptake over time both overall and by facility. Data were restricted to the final influenza season (2012-13) to assess predictors of PLWHA vaccination. Individuals were nested within medical facilities in order to assess the amount of variability in influenza vaccination rates across medical facilities. Results: Influenza vaccination uptake among PLWHA increased over the study period (p<0.01). The overall proportion of PLWHA vaccinated during the 2012-13 influenza season was 33.7%. 37.9% of the variability in the model occurred at the facility-level. Conclusions: Although there was an increase in influenza vaccination within the PLWHA cohort over the course of the study, vaccination rates remained low overall. Special efforts must be made to increase vaccination uptake among PLWHA, with particular focus on those within the population who are likely to be at highest risk. The substantial variability at the facility-level indicates that there are unmeasured facility-level factors that contribute significantly to PLWHA vaccination.&nbsp

The Relationship Between Social Vulnerability and COVID-19 Incidence Among Louisiana Census Tracts

Objective: To examine the association between the Centers for Disease Control and Prevention (CDC)\u27s Social Vulnerability Index (SVI) and COVID-19 incidence among Louisiana census tracts. Methods: An ecological study comparing the CDC SVI and census tract-level COVID-19 case counts was conducted. Choropleth maps were used to identify census tracts with high levels of both social vulnerability and COVID-19 incidence. Negative binomial regression with random intercepts was used to compare the relationship between overall CDC SVI percentile and its four sub-themes and COVID-19 incidence, adjusting for population density. Results: In a crude stratified analysis, all four CDC SVI sub-themes were significantly associated with COVID-19 incidence. Census tracts with higher levels of social vulnerability were associated with higher COVID-19 incidence after adjusting for population density (adjusted RR: 1.52, 95% CI: 1.41-1.65). Conclusions: The results of this study indicate that increased social vulnerability is linked with COVID-19 incidence. Additional resources should be allocated to areas of increased social disadvantage to reduce the incidence of COVID-19 in vulnerable populations

The mediating effects of barriers to vaccination on the relationship between race/ethnicity and influenza vaccination status in a rural Southeastern Louisiana medical center.

Introduction: Persistent disparities in influenza vaccination rates exist between racial/ethnic minorities and Whites. The mechanisms that define this relationship are under-researched. Objectives: (1) To evaluate racial/ethnic disparities in influenza vaccination and (2) to assess the mediating effects of barriers to influenza vaccination on the relationship between race/ethnicity and receipt of influenza vaccination. Methods: Surveys assessing barriers to vaccination were administered to outpatients in a rural medical center in Southeastern Louisiana. Survey responses were matched to patient medical records. Likert-style statements were used to measure barriers to vaccination.. A mediation analysis assessing the relationship between race and influenza vaccination mediated by vaccination barriers was conducted.  Results: The self-reported influenza vaccination rate in those surveyed was 40.4%. Whites (45.5%) were more likely than racial/ethnic minorities (36.3%) to report receipt of an influenza vaccination (p=0.02). Racial/ethnic minorities reported significantly higher vaccination barrier scores (p<0.01). The relationship between race/ethnicity and vaccination was mediated by vaccination barriers, when controlling for provider recommendation and having at least one comorbid medical condition (natural indirect effect [NIE] p-value=0.02, proportion mediated=0.71). Conclusions: Barriers to vaccination mediates the relationship between race/ethnicity and vaccination status. Providers should focus on minimizing fears that the vaccine will cause illness and emphasize that the vaccine is safe and effective at preventing severe influenza-associated illness. Additional efforts should be made to improve accessibility of the influenza vaccine, including addressing costs of vaccination and expanding the number and types of settings where the vaccine is offered

Scientific mindfulness: a foundation for future themes in international business

We conceptualize new ways to qualify what themes should dominate the future IB research agenda by examining three questions: Whom should we ask? What should we ask and which selection criteria should we apply? What are the contextual forces? We propose scientific mindfulness as the way forward for generating themes in IB research

Microvascular significance of TGF-β axis activation in COVID-19

As 2023 approaches, the COVID-19 pandemic has killed millions. While vaccines have been a crucial intervention, only a few effective medications exist for prevention and treatment of COVID-19 in breakthrough cases or in unvaccinated or immunocompromised patients. SARS-CoV-2 displays early and unusual features of micro-thrombosis and immune dysregulation that target endothelial beds of the lungs, skin, and other organs. Notably, anticoagulation improves outcomes in some COVID-19 patients. The protein transforming growth factor-beta (TGF-β1) has constitutive roles in maintaining a healthy microvasculature through its roles in regulating inflammation, clotting, and wound healing. However, after infection (including viral infection) TGF-β1 activation may augment coagulation, cause immune dysregulation, and direct a path toward tissue fibrosis. Dysregulation of TGF-β signaling in immune cells and its localization in areas of microvascular injury are now well-described in COVID-19, and such events may contribute to the acute respiratory distress syndrome and skin micro-thrombosis outcomes frequently seen in severe COVID-19. The high concentration of TGF-β in platelets and in other cells within microvascular thrombi, its ability to activate the clotting cascade and dysregulate immune pathways, and its pro-fibrotic properties all contribute to a unique milieu in the COVID-19 microvasculature. This unique environment allows for propagation of microvascular clotting and immune dysregulation. In this review we summarize the physiological functions of TGF-β and detail the evidence for its effects on the microvasculature in COVID-19. In addition, we explore the potential role of existing TGF-β inhibitors for the prevention and treatment of COVID-19 associated microvascular thrombosis and immune dysregulation

X-Ray Searches for Emission from the WHIM in the Galactic Halo and the Intergalactic Medium

At least 50% of the baryons in the local universe are undetected and predicted to be in a hot dilute phase (1E5-1E7 K) in low and moderate overdensity environments. We searched for the predicted diffuse faint emission through shadowing observations whereby cool foreground gas absorbs more distant diffuse emission. Observations were obtained with Chandra and XMM-Newton. Using the cold gas in two galaxies, NGC 891 and NGC 5907, shadows were not detected and a newer observation of NGC 891 fails to confirm a previously reported X-ray shadow. Our upper limits lie above model predictions. For Local Group studies, we used a cloud in the Magellanic Stream and a compact high velocity cloud to search for a shadow. Instead of a shadow, the X-ray emission was brighter towards the Magellanic Stream cloud and there is a less significant brightness enhancement toward the other cloud also. The brightness enhancement toward the Magellanic Stream cloud is probably due to an interaction with a hot ambient medium that surrounds the Milky Way. We suggest that this interaction drives a shock into the cloud, heating the gas to X-ray emitting temperatures.Comment: 10 ApJ pages with 10 figure

The Lantern Vol. 5, No. 1, December 1936

• All of Us • Public Dance • In Tibet, of All Places • Thoughts • Subterranean Conflict on the Campus • Out, Out Into Fragrance and Sweetness • My Soul Steals Out to Meet You In the Night • Bored Young Lady • Guay Shin\u27s Prayer • On Playing Ping-Pong • The Love-Life of One Cat and the Death of Another • My Lady • Danger! Germs Working! • The Wolves • Letters from India • With Apologies to Hamlet • The Dreamhttps://digitalcommons.ursinus.edu/lantern/1015/thumbnail.jp