Development of an in-field voltammetric method for the determination of barium

This work presents a reliable, cost-effective, rapid and infield voltammetric method for the detection of barium. The optimized method consists of an ultrathin mercury film deposited in-situ on a glassy carbon electrode in 0.02 M potassium chloride without deoxygenation; a deposition potential of -2500 mV, pulse height = 50 mV, step duration = 10 ms and a scan rate of 100 mV/s using differential pulse anodic stripping voltammetry (DP-ASV). The linear working range for barium was determined to be 5 – 80 μg/L (r2 = 0.997), and limit of detection (LOD) was 1.6 μg/L, for 30 sec deposition time. Percent relative standard deviation for 10 measurements performed at 20 μg/L was 5.8%. Application of the method allowed for the quantitative determination of barium concentration in a variety of waters, brake pad dust and gunshot residue (GSR) samples. Comparative analysis of sample results from DP-ASV with inductively-coupled plasma mass spectroscopy (ICP-MS) showed a mean percent difference of 1.8%. The method also permitted the simultaneous measurement of barium and lead, crucial for GSR samples

Development of an in-field method for the detection of barium in various water samples using differential pulse anodic stripping voltammetry

This work presents a reliable, cost-effective, rapid and in-field voltammetric method for the detection of barium. The optimized method consists of an ultrathin mercury film deposited in situ on a glassy carbon electrode in dilute potassium chloride without deoxygenation, using differential pulse anodic stripping voltammetry (DP-ASV). Application of the method allowed for the quantitative determination of barium concentration in a variety of waters and brake pad dust samples. Comparative analysis of sample results from DP-ASV with inductively coupled plasma mass spectroscopy (ICP-MS) showed a mean percent difference of 1.8%

Evaluation of multiple data sources for predicting increased need for HIV prevention among cisgender women: Understanding missed opportunities for Pre-exposure Prophylaxis (PrEP)

Background: Ciswomen constitute a disproportionately low percentage of pre-exposure prophylaxis for HIV prevention (PrEP) users compared to men. Despite PrEP’s effectiveness, women are 5.25 times less likely to take PrEP than men. Identifying women who have increased reasons for HIV prevention and educating and offering PrEP to these women is crucial to reducing HIV transmission and overall health equity. However, the best method of identifying women at highest risk of acquiring HIV remains unknown. This study aimed to identify common HIV risk factors and data sources for identifying these common factors (e.g., electronic medical record data, open source neighborhood data), as well as potential intervention points and missed opportunities for PrEP linkage. Methods: We conducted an evaluation of multiple data sources: semi-structured qualitative interviews, electronic medical record (EMR) chart abstraction, and open source data abstraction. We accessed EMRs for enrolled participants and all participants signed a standard release of medical information (ROI) form for all institutions at which they had received medical care for the five-year period preceding their HIV diagnosis. Data were abstracted using a standardized procedure. Both structured and unstructured fields (i.e., narrative text of free notes) within the EMR were examined and included for analysis. Finally, open data sources (e.g., STI cases, HIV prevalence) were examined by community area of Chicago. Open data sources were used to examine several factors contributing to the overall Economic Hardship Index (EHI) score. We used these calculated scores to assess the economic hardship within participants’ neighborhoods. Results: A total of 18 cisgender women with HIV participated in our study. Participants were mostly Black/African American (55.6%) and young (median age of 34). Our analysis identified two main themes influencing HIV risk among participants: contextual factors and relationship factors. Further, potential pre-diagnosis intervention points and missed opportunities were identified during reproductive health/prenatal visits, behavioral/mental health visits, and routine STI testing. Our evaluation of multiple data sources included investigating the presence or absence of information in the EMR (STI history, HIV testing, substance use, etc.) as well as whether pertinent information could be gathered from open access sources. Conclusion: Ciswomen recently diagnosed with HIV identified many shared experiences, including syndemic conditions like mental illness and substance abuse, sex with men who have sex with men, and frequent moving in areas with high HIV incidence prior to their diagnosis. It is imperative that providers ask patients about social history, information about partners, and other key variables, in addition to the standardized questions. Findings can be used to better recognize ciswomen most vulnerable to HIV and offer PrEP to them, reducing HIV transmission.</p

Persistence of anxiety symptoms after elective caesarean delivery

Background In the UK, 11.8% of expectant mothers undergo an elective caesarean section (ELCS) representing 92 000 births per annum. It is not known to what extent this procedure has an impact on mental well-being in the longer term. Aims To determine the prevalence and postpartum progression of anxiety and depression symptoms in women undergoing ELCS in Wales. Method Prevalence of depression and anxiety were determined in women at University Hospital Wales (2015–16; n = 308) through completion of the Edinburgh Postnatal Depression Scale (EPDS; ≥13) and State-Trait Anxiety Inventory (STAI; ≥40) questionnaires 1 day prior to ELCS, and three postpartum time points for 1 year. Maternal characteristics were determined from questionnaires and, where possible, confirmed from National Health Service maternity records. Results Using these criteria the prevalence of reported depression symptoms was 14.3% (95% CI 10.9–18.3) 1 day prior to ELCS, 8.0% (95% CI 4.2–12.5) within 1 week, 8.7% (95% CI 4.2–13.8) at 10 weeks and 12.4% (95% CI 6.4–18.4) 1 year postpartum. Prevalence of reported anxiety symptoms was 27.3% (95% CI 22.5–32.4), 21.7% (95% CI 15.8–28.0), 25.3% (95% CI 18.5–32.7) and 35.1% (95% CI 26.3–44.2) at these same stages. Prenatal anxiety was not resolved after ELCS more than 1 year after delivery. Conclusions Women undergoing ELCS experience prolonged anxiety postpartum that merits focused clinical attention. Declaration of interest None

MYC is a major determinant of mitotic cell fate

Taxol and other antimitotic agents are frontline chemotherapy agents but the mechanisms responsible for patient benefit remain unclear. Following a genome-wide siRNA screen, we identified the oncogenic transcription factor Myc as a taxol sensitizer. Using time-lapse imaging to correlate mitotic behavior with cell fate, we show that Myc sensitizes cells to mitotic blockers and agents that accelerate mitotic progression. Myc achieves this by upregulating a cluster of redundant pro-apoptotic BH3-only proteins and suppressing pro-survival Bcl-xL. Gene expression analysis of breast cancers indicates that taxane responses correlate positively with Myc and negatively with Bcl-xL. Accordingly, pharmacological inhibition of Bcl-xL restores apoptosis in Myc-deficient cells. These results open up opportunities for biomarkers and combination therapies that could enhance traditional and second-generation antimitotic agents

Five members of a mixed-sex group of bottlenose dolphins share a stereotyped whistle contour in addition to maintaining their individually distinctive signature whistles.

Most commonly, animal communication systems are driven by shared call repertoires, with some individual distinctiveness encoded as a byproduct of voice cues. We provide evidence that bottlenose dolphins produce both individually distinctive whistles, and a shared whistle type. A stereotyped whistle contour (termed the group whistle) is shared by five bottlenose dolphins that have lived, worked, and traveled together for at least 21 years. These five dolphins are members of a group of eight dolphins that work as a specialized team for the Navy Marine Mammal Program. Each dolphin is routinely recorded during periods when an individual is isolated from the others in above ground pools as part of their routine training. Each of the eight dolphins has an individually distinctive signature whistle. In addition, at least five of these dolphins share a distinct non-signature whistle type. This shared whistle contour was produced an average of 22.4% +/- 9.0% of the time during periods in which individuals were isolated. During these isolations the signature whistle was produced an average of 42.9% +/- 11.9% of the time. This is consistent with decades of signature whistle research. A group of 10 naïve observers rated the similarity of the different whistle contours. The observers rated the group whistle contour produced by all five dolphins as highly similar (P < 0.01). Their ratings further showed that the signature whistles of the five dolphins were very different (P < 0.01). These findings were further supported by discriminant function analyses. That said, the shared whistle contours still exhibited individual differences which may allow conspecifics to identify the producer even when a whistle contour is shared among multiple dolphins. This is the first in-depth analysis of a non-signature whistle type shared among multiple conspecifics

SARS-CoV-2 percent positivity and risk factors among people with HIV at an urban academic medical center

Since the onset of the COVID-19 pandemic, it has been unclear how vulnerable people with HIV (PwH) are to SARS-CoV-2 infection. We sought to determine if PwH are more likely to test positive for SARS-CoV-2 than people without HIV, and to identify risk factors associated with SARS-CoV-2 positivity among PwH. We conducted a cross-sectional study in which we collected electronic medical record data for all patients who underwent SARS-CoV-2 PCR testing at an academic medical center. Presence of HIV and other chronic diseases were based on the presence of ICD-10 diagnosis codes. We calculated the percent positivity for SARS-CoV-2 among PwH and among people without HIV. Among PwH, we compared demographic factors, comorbidities, HIV viral load, CD4 T-cell count, and antiretroviral therapy (ART) regimens between those who tested positive for SARS-CoV-2 and those who tested negative. Comparisons were made using chi squared tests or Wilcoxon rank sum tests. Multivariate models were created using logistic regression. Among 69,763 people tested for SARS-CoV-2, 0.6% (431) were PwH. PwH were not significantly more likely to test positive for SARS-CoV-2 than people without HIV (7.2% (31/431) vs 8.4% (5820/69763), p = 0.35), but were more likely to be younger, Black, and male (p-values < .0001). There were no significant differences in HIV clinical factors, chronic diseases, or ART regimens among PwH testing positive for SARS-CoV-2 versus those testing negative. In our sample, PwH were not more likely to contract SARS-CoV-2, despite being more likely to be members of demographic groups known to be at higher risk for infection. Differences between PwH who tested positive for SARS-CoV-2 and those who tested negative were only seen in Hispanic/Latino ethnicity (non-Hispanic or Latino vs unknown Hispanic or Latino ethnicity (OR 0.2 95% CI (0.6, 0.9)) and site of testing(inpatient vs outpatient OR 3.1 95% CI (1.3, 7.4)).</p

A system for monitoring acoustics to supplement an animal welfare plan for Bottlenose dolphins

The authors are extremely grateful to the Office of Naval Research (ONR) for their support of Sound as Indicators of Health and Welfare of the Navy’s Dolphin; ONR Grant# N00014-18-1-2643.Animal sounds are commonly used by humans to infer information about their motivations and their health, yet, acoustic data is an underutilized welfare biomarker especially for aquatic animals. Here, we describe an acoustic monitoring system that is being implemented at the U.S. Navy Marine Mammal Program where dolphins live in groups in ocean enclosures in San Diego Bay. A four-element bottom mounted hydrophone array is used to continuously record, detect and localize acoustic detections from this focal group. Software provides users an automated comparison of the current acoustic behavior to group historical data which can be used to identify periods of normal, healthy thriving dolphins, and allows rare instances of deviations from typical behavior to stand out. Variations in a group or individual’s call rates can be correlated with independent veterinary examinations and behavioral observations in order to better assess dolphin health and welfare. Additionally, the monitoring system identifies time periods in which a sound source from San Diego Bay is of high-enough amplitude that the received level at our array is considered a potential concern for the focal animals. These time stamps can be used to identify and potentially mitigate exposures to acoustic sources that may otherwise not be obvious to human listeners. We hope this application inspires zoos and aquaria to innovate and create ways to incorporate acoustic information into their own animal welfare management programs.Publisher PDFPeer reviewe

“There hasn’t been a push to identify patients in the emergency department”—Staff perspectives on automated identification of candidates for pre-exposure prophylaxis (PrEP): A qualitative study

Automated algorithms for identifying potential pre-exposure prophylaxis (PrEP) candidates are effective among men, yet often fail to detect cisgender women (hereafter referred to as “women”) who would most benefit from PrEP. The emergency department (ED) is an opportune setting for implementing automated identification of PrEP candidates, but there are logistical and practical challenges at the individual, provider, and system level. In this study, we aimed to understand existing processes for identifying PrEP candidates and to explore determinants for incorporating automated identification of PrEP candidates within the ED, with specific considerations for ciswomen, through a focus group and individual interviews with ED staff. From May to July 2021, we conducted semi-structured qualitative interviews with 4 physicians and a focus group with 4 patient advocates working in a high-volume ED in Chicago. Transcripts were coded using Dedoose software and analyzed for common themes. In our exploratory study, we found three major themes: 1) Limited PrEP knowledge among ED staff, particularly regarding its use in women; 2) The ED does not have a standardized process for assessing HIV risk; and 3) Perspectives on and barriers/facilitators to utilizing an automated algorithm for identifying ideal PrEP candidates. Overall, ED staff had minimal understanding of the need for PrEP among women. However, participants recognized the utility of an electronic medical record (EMR)-based automated algorithm to identify PrEP candidates in the ED. Facilitators to an automated algorithm included organizational support/staff buy-in, patient trust, and dedicated support staff for follow-up/referral to PrEP care. Barriers reported by participants included time constraints, hesitancy among providers to prescribe PrEP due to follow-up concerns, and potential biases or oversight resulting from missing or inaccurate information within the EMR. Further research is needed to determine the feasibility and acceptability of an EMR-based predictive HIV risk algorithm within the ED setting

Predictive Modeling of Lapses in Care for People Living with HIV in Chicago: Algorithm Development and Interpretation

BackgroundReducing care lapses for people living with HIV is critical to ending the HIV epidemic and beneficial for their health. Predictive modeling can identify clinical factors associated with HIV care lapses. Previous studies have identified these factors within a single clinic or using a national network of clinics, but public health strategies to improve retention in care in the United States often occur within a regional jurisdiction (eg, a city or county). ObjectiveWe sought to build predictive models of HIV care lapses using a large, multisite, noncurated database of electronic health records (EHRs) in Chicago, Illinois. MethodsWe used 2011-2019 data from the Chicago Area Patient-Centered Outcomes Research Network (CAPriCORN), a database including multiple health systems, covering the majority of 23,580 people with an HIV diagnosis living in Chicago. CAPriCORN uses a hash-based data deduplication method to follow people across multiple Chicago health care systems with different EHRs, providing a unique citywide view of retention in HIV care. From the database, we used diagnosis codes, medications, laboratory tests, demographics, and encounter information to build predictive models. Our primary outcome was lapses in HIV care, defined as having more than 12 months between subsequent HIV care encounters. We built logistic regression, random forest, elastic net logistic regression, and XGBoost models using all variables and compared their performance to a baseline logistic regression model containing only demographics and retention history. ResultsWe included people living with HIV with at least 2 HIV care encounters in the database, yielding 16,930 people living with HIV with 191,492 encounters. All models outperformed the baseline logistic regression model, with the most improvement from the XGBoost model (area under the receiver operating characteristic curve 0.776, 95% CI 0.768-0.784 vs 0.674, 95% CI 0.664-0.683; P<.001). Top predictors included the history of care lapses, being seen by an infectious disease provider (vs a primary care provider), site of care, Hispanic ethnicity, and previous HIV laboratory testing. The random forest model (area under the receiver operating characteristic curve 0.751, 95% CI 0.742-0.759) revealed age, insurance type, and chronic comorbidities (eg, hypertension), as important variables in predicting a care lapse. ConclusionsWe used a real-world approach to leverage the full scope of data available in modern EHRs to predict HIV care lapses. Our findings reinforce previously known factors, such as the history of prior care lapses, while also showing the importance of laboratory testing, chronic comorbidities, sociodemographic characteristics, and clinic-specific factors for predicting care lapses for people living with HIV in Chicago. We provide a framework for others to use data from multiple different health care systems within a single city to examine lapses in care using EHR data, which will aid in jurisdictional efforts to improve retention in HIV care