Serotonin-Related Gene Polymorphisms and Asymptomatic Neurocognitive Impairment in HIV-Infected Alcohol Abusers

HIV-infected individuals continue to experience neurocognitive deterioration despite virologically successful treatments. While the cause remains unclear, evidence suggests that HIV-associated neurocognitive disorders (HAND) may be associated with neurobehavioral dysfunction. Genetic variants have been explored to identify risk markers to determine neuropathogenesis of neurocognitive deterioration. Memory deficits and executive dysfunction are highly prevalent among HIV-infected adults. These conditions can affect their quality of life and HIV risk-taking behaviors. Single nucleotide polymorphisms in the SLC6A4, TPH2, and GALM genes may affect the activity of serotonin and increase the risk of HAND. The present study explored the relationship between SLC6A4, TPH2, and GALM genes and neurocognitive impairment in HIV-infected alcohol abusers. A total of 267 individuals were genotyped for polymorphisms in SLC6A4 5-HTTLPR, TPH2 rs4570625, and GALM rs6741892. To assess neurocognitive functions, the Short Category and the Auditory Verbal Learning Tests were used. TPH2 SNP rs4570625 showed a significant association with executive function in African American males (odds ratio 4.8, 95% CI, 1.5–14.8; ). Similarly, GALM SNP rs6741892 showed an increased risk with African American males (odds ratio 2.4, 95% CI, 1.2–4.9; ). This study suggests that TPH2 rs4570625 and GALM rs6741892 polymorphisms may be risk factors for HAND

DRD2 and DRD4 genes related to cognitive deficits in HIV‑infected adults who abuse alcohol

Background HIV-infected individuals continue to experience neurocognitive deterioration despite virologically successful treatments. The causes of neurocognitive impairment are still unclear. However, several factors have been suggested including the role of genetics. There is evidence suggesting that neurocognitive impairment is heritable and individual differences in cognition are strongly driven by genetic variations. The contribution of genetic variants affecting the metabolism and activity of dopamine may influence these individual differences. Methods The present study explored the relationship between two candidate genes (DRD4 and DRD2) and neurocognitive performance in HIV-infected adults. A total of 267 HIV-infected adults were genotyped for polymorphisms, DRD4 48 bp-variable number tandem repeat (VNTR), DRD2 rs6277 and ANKK1 rs1800497. The Short Category (SCT), Color Trail (CTT) and Rey-Osterrieth Complex Figure Tests (ROCT) were used to measure executive function and memory. Results Results showed significant associations with the SNP rs6277 and impaired executive function (odds ratio = 3.3, 95 % CI 1.2–2.6; p = 0.004) and cognitive flexibility (odds ratio = 1.6, 95 % CI 2.0–5.7; p = 0.001). The results were further stratified by race and sex and significant results were seen in males (odds ratio = 3.5, 95 % CI 1.5–5.5; p = 0.008) and in African Americans (odds ratio = 3.1, 95 % CI 2.3–3.5; p = 0.01). Also, DRD4 VNTR 7-allele was significantly associated with executive dysfunction. Conclusion The study shows that genetically determined differences in the SNP rs6277 DRD2 gene and DRD4 48 bp VNTR may be risk factors for deficits in executive function and cognitive flexibility

Exploring substance use and HIV treatment factors associated with neurocognitive impairment among people living with HIV/AIDS

Neurocognitive (NC) impairment remains prevalent among people living with HIV (PLWH) and may be exacerbated by alcohol and drug use. This cross-sectional study assesses the degree to which alcohol and other drug use, time from HIV diagnosis to treatment, and years living with HIV affect three areas of NC functioning among HIV-seropositive adults. NC functioning in 370 PLWH living in Miami, FL was assessed using the Auditory Verbal Learning Test, the Short Category Test, Booklet Format, and the Color Trails Test 2 (CTT2). Participants reported the number of days using alcohol, marijuana, and cocaine over the previous 3 months, the number of known years living with HIV and length of time from HIV diagnosis to seeking care. Bivariate linear regression and multivariate linear regression were used to test associations between independent and dependent variables. Mean scores on NC measures were significantly lower than published norms; 39% of participants scored ≥1 standard deviation below normative sample means on \u3e2 NC tests. No significant associations were found between alcohol or cocaine use and any NC measure. Years living with HIV was associated with CTT2 in the bivariate analysis (β = 1.031; p = 0.007). In multivariate analysis, each day of marijuana use and years living with HIV were associated with a 0.32 (p = 0.05) point and 1.18 (p = 0.03) points poorer performance score on the CTT2, respectively. Results suggest that both marijuana use and duration of HIV infection may affect cognitive functioning among PLWH in ways that may impair their ability to follow important treatment guidance

The Effect of Mentholated Cigarette Use on interleukin-6 Responses Across Different HIV Positive Race/Ethnic Subgroups

In this report, we analyze trends in interleukin-6 (IL-6) production in people living with human immunodeficiency virus (PLWH), as a function of smoking behaviors and race, using a clinic-based case-control design. Peripheral blood mononuclear cells (PBMCs) were collected from a multiethnic cohort of 120 PLWH to measure IL-6 in culture supernatant. The data indicated that stimulated PBMC produced significantly higher levels of IL-6 in smokers than nonsmokers. However, as expected, this relationship was substantially modified by race. The distinctive production of IL-6 across different racial groups highlights the need for additional studies and suggests that African American smokers have enhanced production of IL-6 than other groups. Additional analyses indicate that higher IL-6 levels are related to the predicted use of mentholated cigarettes, which are more frequently used by African Americans. These findings warrant further investigation and indicate the critical need for tailored preventive interventions

Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC) among a Sample of Health Care Providers in Haiti

Background Haiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC) has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti. Methods A convenience sample of 153 health care providers at the GHESKIO Centers in Haiti responded to an exploratory survey that collected information on several topics relevant to health providers about MMC. Descriptive statistics were calculated for the responses and multivariable logistic regression was conducted to determine opinions of health care providers about the best age to perform MMC on males. Bayesian network analysis and sensitivity analysis were done to identify the minimum level of change required to increase the acceptability of performing MMC at age less than 1 year. Results The sample consisted of medical doctors (31.0%), nurses (49.0%), and other health care professionals (20.0%). Approximately 76% showed willingness to offer MMC services if they received training. Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for MMC. More than 90% of participants said that MMC would reduce STIs. Physicians and nurses who were willing to offer MMC if provided with adequate training were 2.5 (1.15–5.71) times as likely to choose the best age to perform MMC as less than one year. Finally, if the joint probability of choosing “the best age to perform MMC” as one year or older and having the mistaken belief that MMC prevents HIV entirely is reduced by 63% then the probability of finding that performing MMC at less than one year acceptable to health care providers is increased by 35%. Conclusion Participants demonstrated high levels of knowledge and positive attitudes towards MMC. Although this study suggests that circumcision is acceptable among certain health providers in Haiti, studies with larger and more representative samples are needed to confirm this finding

Hormone replacement therapy is associated with improved survival in women with advanced heart failure

OBJECTIVES: We sought to determine whether hormone replacement therapy (HRT) is associated with an improved prognosis in women with advanced heart failure (HF) and systolic dysfunction. BACKGROUND: There are about two million postmenopausal women in the U.S. with HF. However, limited data are available to assess the effects of HRT on survival in this large group of patients. METHODS: A retrospective analysis of women age 50 years and over entered into the Beta-Blocker Evaluation of Survival Trial (BEST) was conducted using Cox regression analysis comparing survival in HRT users and non-users after correcting for baseline variables known to predict survival in women with HF and systolic dysfunction. RESULTS: In 493 women age 50 years and older, HRT was associated with a significant reduction in mortality-21% mortality in HRT users and 34% in non-users (p = 0.025). Multivariate analysis demonstrated a hazard ratio for mortality of 0.6 (95% confidence interval = 0.36 to 0.97) (p = 0.039) for HRT users. The benefits of HRT were noted only in women with a nonischemic etiology of HF (n = 237). CONCLUSIONS: Hormone replacement therapy is associated with a marked improvement in survival in postmenopausal women with advanced HF. A prospective, randomized trial of HRT should be performed in this large group of patients

Från fåglar till Pipping

Från fåglar till Pipping Innehållsförteckning – Inledaren: Naturen som bas för skärgårdsidentiteten av Nina Söderlund – Knut Pipping och kärleken till Kumlinge av Thomas Rosenberg – Fågelåret i skärgården för nybörjare av Emilia Nordling – Humor och hundar i Tidis keramik av Thure Malmberg – Topelius, skärgården och havet av Birgitta Sarelin – Veteran i pension efter 40 år: ”Kulturarv med unik natur” av Thure Malmberg – Elina kliver in i stora stövlar av Nina Söderlund – Samhällsvetenskaperna i havsforskningen av Nina Tynkkynen & Marko Joas –Comhdháil Oileáin na hÉireann arbetar för Irlands öar av Rhoda Twombly – Skärgårdsfotograf Maria Carling – Havsgymnasiet i Åbo seglade till Shetlandsöarna av Pia Prost Bokhörnan: – Sandvikharun – säsongfisket vid Jurmo – Restaurerad fyr lever upp i bok – Det kyrkliga livet på Bergö – Piga, klockare, inhysing, lots – en bok om att hitta sina rötter – Skärinytt – Sista bilde

Small-Bodied Humans from Palau, Micronesia

UNLABELLED: Newly discovered fossil assemblages of small bodied Homo sapiens from Palau, Micronesia possess characters thought to be taxonomically primitive for the genus Homo. BACKGROUND: Recent surface collection and test excavation in limestone caves in the rock islands of Palau, Micronesia, has produced a sizeable sample of human skeletal remains dating roughly between 940-2890 cal ybp. PRINCIPLE FINDINGS: Preliminary analysis indicates that this material is important for two reasons. First, individuals from the older time horizons are small in body size even relative to "pygmoid" populations from Southeast Asia and Indonesia, and thus may represent a marked case of human insular dwarfism. Second, while possessing a number of derived features that align them with Homo sapiens, the human remains from Palau also exhibit several skeletal traits that are considered to be primitive for the genus Homo. SIGNIFICANCE: These features may be previously unrecognized developmental correlates of small body size and, if so, they may have important implications for interpreting the taxonomic affinities of fossil specimens of Homo

Tailoring youth-friendly health services in Nigeria: a mixed-methods analysis of a designathon approach

BACKGROUND: Young people in low- and middle-income countries are often neglected in designing youth-friendly health services, especially HIV testing and preventive services. Designathons, which are time-bounded co-creation events where individuals gather in teams to develop solutions to a problem, could promote youth participation and ownership of health services. OBJECTIVE: The purpose of this study is to examine youth participation in a designathon to create youth-friendly health services in Nigeria. METHODS: Our designathon was based on crowdsourcing principles and informed by a human-centered design approach. The designathon included an open call for Nigerian youths between 14 and 24 years to share ideas on how to promote uptake of HIV self-testing services and a three-day sprint event that brought together diverse teams to develop strategies enhancing linkage to care. Teams pitched their solutions to a panel of five independent experts who scored ideas based on the desirability, feasibility, potential impact, and teamwork. We used descriptive statistics to summarize participants' demographics and conducted a content analysis to synthesize themes from youth proposals. RESULTS: Nine hundred seventy-six youth across Nigeria applied to join the designathon. Forty-eight youth in 13 teams participated in the designathon with a median age of 20 years (IQR: 17-22]. Boys and young men were 48.5% (446/919) of the total applicants, 62.5% (30/48) of the designathon participants, and 63.6% (7/11) of the finalists. Students, from all educational levels, represented 91.2% (841/922) of the total applicants, 88.4% (38/43) of the designathon participants, and 90.0% (9/10) of the finalists. About twenty-three percent (3/13) of the final proposals were top ranked. The three finalist approaches to optimize youth-friendly health services centered on decentralizing service delivery to young people through mobile health technologies, use of mobile tents, or peer support services. CONCLUSIONS: Our open call engaged diverse groups of Nigerian youth, including young women and students. Our data suggest that designathons may be useful for developing tailored youth-friendly health services. Further research is needed to understand the designathon process and the effectiveness of the finalist submissions