Bigotry, bills, and medicine: lessons from the USA

Lesbian, gay, bisexual, and transgender (LGBT) individuals in the USA have benefited recently from unprecedented expansions in rights, with attendant improvements in health outcomes. This evolving story highlights the links between rights and health, creating opportunities to better serve the unique medical needs of transgender people. Yet the passage of House Bill-2 (HB2) in the US state of North Carolina exposes the fragility of these hard-fought gains, reminding onlookers how the policy effects of bigotry can quickly ripple through to all patients

The Old Foe Syphilis Strikes Again: Social Responses and Collective Mobilization

Syphilis is an ancient sexually transmitted spirochetal infection that causes a wide variety of clinical outcomes, including severe disability and death. At various times over the course of human history, syphilis has become so common in selected countries that it attracts great public attention. In this issue of AJPH, Kosenko and Polianski (p. 1318) review the use of unique communication tools to attract attention to syphilis in the first half of the 20th century in the USSR and the United States. They describe the use of stage plays called “Living Newspapers,” which the Federal Theater Project organized during the Great Depression in the United States

Ethical considerations for HIV remission clinical research involving participants diagnosed during acute HIV infection

HIV remission clinical researchers are increasingly seeking study participants who are diagnosed and treated during acute HIV infection—the brief period between infection and the point when the body creates detectable HIV antibodies. This earliest stage of infection is often marked by flu-like illness and may be an especially tumultuous period of confusion, guilt, anger, and uncertainty. Such experiences may present added ethical challenges for HIV research recruitment, participation, and retention. The purpose of this paper is to identify potential ethical challenges associated with involving acutely diagnosed people living with HIV in remission research and considerations for how to mitigate them. We identify three domains of potential ethical concern for clinicians, researchers, and ethics committee members to consider: 1) Recruitment and informed consent; (2) Transmission risks and partner protection; and (3) Ancillary and continuing care. We discuss each of these domains with the aim of inspiring further work to advance the ethical conduct of HIV remission research. For example, experiences of confusion and uncertainty regarding illness and diagnosis during acute HIV infection may complicate informed consent procedures in studies that seek to recruit directly after diagnosis. To address this, it may be appropriate to use staged re-consent procedures or comprehension assessment. Responsible conduct of research requires a broad understanding of acute HIV infection that encompasses its biomedical, psychological, social, and behavioral dimensions. We argue that the lived experience of acute HIV infection may introduce ethical concerns that researchers and reviewers should address during study design and ethical approval

Editorial: Syphilis infection: clinical, epidemiology, basic science, and behavioral research

Syphilis is an ancient sexually transmitted disease caused by the spirochete Treponema pallidum subspecies pallidum (T. pallidum). Over the past decade, syphilis incidence has increased in many countries. Untreated syphilis can lead to serious health problems, including blindness, neurocognitive disorders, cardiovascular injury, and adverse pregnancy outcomes. Syphilis research is urgently needed to decrease morbidity and mortality. This Frontiers Research Topic focuses on diverse aspects of syphilis infection. Its purpose was to expand our knowledge of syphilis epidemiology, clinical management, public health control measures, vaccine development, and basic science

Increasing Men's Engagement in HIV Testing and Treatment Programs through Crowdsourcing: A Mixed-Methods Analysis in Eswatini

Background Sub-Saharan African HIV programs have had limited success in engaging men. Crowdsourcing contests may be a useful method to spur men's engagement in HIV services. We evaluated contributions and social media response to a crowdsourcing contest focused on increasing men's engagement in Eswatini HIV services. Methods We conducted a crowdsourcing contest to gain insight from the public on how HIV campaigns can more effectively engage young (20-40 years old) men in HIV services. Eligible submissions included images, songs, videos, and Internet memes. We used standard qualitative methods to examine textual themes from submissions. We examined social media response using Facebook analytics, comparing the number of people reached through crowdsourced HIV messages and the number of people reached through conventional HIV messages. Results We received 144 submissions from 83 participants. They represented 55 towns and all 4 regions of Eswatini. The contest page gained 461 followers on Facebook. Emergent themes included appealing to men's roles as protectors by suggesting that they need to take care of their own health to continue safeguarding their families. Crowdsourced messages reached a mean of 88 individuals across 4 posts; conventional messages reached a mean of 75 individuals across 4 posts. Conclusions Crowdsourcing contest submissions provided insight on how to encourage men to engage in Eswatini HIV services. Crowdsourcing contests can be effective in collecting messages from men to create more locally relevant communication materials for HIV programs

Cuantificación de la Variabilidad de la Amplitud de la Onda T Mediante Técnicas de Re-parametrización Temporal

Los cambios de amplitud de onda T reflejan la dispersión de la repolarización y, por lo tanto, el riesgo arrítmico, pero pueden confundirse con diferencias en el dominio temporal. Nuestro objetivo es encontrar un marcador de variabilidad de amplitud de onda T, independiente de la variabilidad en el dominio temporal. Primero, comparamos la capacidad de dos algoritmos de re-parametrización para eliminar la variabilidad temporal, uno utiliza las ondas T originales y otro usa una transformada basada en la derivada (SRSF). Después, comparamos la robustez frente al ruido de dos marcadores de variabilidad de marcador de variabilidad de amplitud, , como la calculan en el dominio SRSF y utilizando las ondas T originales, respectivamente. Finalmente, usamos el marcador más robusto para medir la variabilidad de amplitud producto de una prueba de “Tilt”. El algoritmo de re-parametrización preferido fue el las ondas T. Además, demostró ser más robusto que . El SRSF porque no está afectado por diferencias en la amplitud de análisis de registros de electrocardiograma mostró que era supina (-5.5% vs. 6.5%, p<0.01). En conclusión, cuantifica significativamente menor durante el “Tilt” que en posición de forma robusta las variaciones fisiológicas de la amplitud de la onda T, demostrando su potencial para ser usado como predictor de riesgo arrítmico en la práctica clínica

Evaluating and volunteering for crowdsourced interventions: Cross-sectional data on COVID-19 safety from a University Survey

Despite many innovative ideas generated in response to COVID-19, few studies have examined community preferences for these ideas. Our study aimed to determine university community members' preferences for three novel ideas identified through a crowdsourcing open call at the University of North Carolina (UNC) for making campus safer in the pandemic, as compared to existing (i.e. pre-COVID-19) resources. An online survey was conducted from March 30, 2021 -May 6, 2021. Survey participants included UNC students, staff, faculty, and others. The online survey was distributed using UNC's mass email listserv and research directory, departmental listservs, and student text groups. Collected data included participant demographics, COVID-19 prevention behaviors, preferences for finalist ideas vs. existing resources in three domains (graduate student supports, campus tours, and online learning), and interest in volunteering with finalist teams. In total 437 survey responses were received from 228 (52%) staff, 119 (27%) students, 78 (18%) faculty, and 12 (3%) others. Most participants were older than age 30 years (309; 71%), women (332, 78%), and white (363, 83.1%). Five participants (1%) were gender minorities, 66 (15%) identified as racial/ethnic minorities, and 46 (10%) had a disability. Most participants preferred the finalist idea for a virtual campus tour of UNC's lesser-known history compared to the existing campus tour (52.2% vs. 16.0%). For graduate student supports, 41.4% of participants indicated no preference between the finalist idea and existing supports; for online learning resources, the existing resource was preferred compared to the finalist idea (41.6% vs. 30.4%). Most participants agreed that finalists' ideas would have a positive impact on campus safety during COVID-19 (81.2%, 79.6%, and 79.2% for finalist ideas 1, 2 and 3 respectively). 61 (14.1%) participants indicated interest in volunteering with finalist teams. Together these findings contribute to the development and implementation of communityengaged crowdsourced campus safety interventions during COVID-19

HIV Linkage to Care and Retention in Care Rate Among MSM in Guangzhou, China

Quantifying HIV service provision along the HIV care continuum is increasingly important for monitoring and evaluating HIV interventions. We examined factors associated with linkage and retention in care longitudinally among MSM (n = 1974, 4933 person-years) diagnosed and living in Guangzhou, China, in 2008–2014. We measured longitudinal change of retention in care (≥2 CD4 tests per year) from linkage and antiretroviral therapy initiation (ART). We examined factors associated with linkage using logistic regression and with retention using generalized estimating equations. The rate of linkage to care was 89% in 2014. ART retention rate dropped from 71% (year 1) to 46% (year 2), suggesting that first-year retention measures likely overestimate retention over longer periods. Lower CD4 levels and older age predicted retention in ART care. These data can inform interventions to improve retention about some subgroups

Palaeoproterozoic magnesite: lithological and isotopic evidence for playa/sabkha environments

Magnesite forms a series of 1- to 15-m-thick beds within the approximate to2.0 Ga (Palaeoproterozoic) Tulomozerskaya Formation, NW Fennoscandian Shield, Russia. Drillcore material together with natural exposures reveal that the 680-m-thick formation is composed of a stromatolite-dolomite-'red bed' sequence formed in a complex combination of shallow-marine and non-marine, evaporitic environments. Dolomite-collapse breccia, stromatolitic and micritic dolostones and sparry allochemical dolostones are the principal rocks hosting the magnesite beds. All dolomite lithologies are marked by delta C-13 values from +7.1 parts per thousand to +11.6 parts per thousand (V-PDB) and delta O-18 ranging from 17.4 parts per thousand to 26.3 parts per thousand (V-SMOW). Magnesite occurs in different forms: finely laminated micritic; stromatolitic magnesite; and structureless micritic, crystalline and coarsely crystalline magnesite. All varieties exhibit anomalously high delta C-13 values ranging from +9.0 parts per thousand to +11.6 parts per thousand and delta O-18 values of 20.0-25.7 parts per thousand. Laminated and structureless micritic magnesite forms as a secondary phase replacing dolomite during early diagenesis, and replaced dolomite before the major phase of burial. Crystalline and coarsely crystalline magnesite replacing micritic magnesite formed late in the diagenetic/metamorphic history. Magnesite apparently precipitated from sea water-derived brine, diluted by meteoric fluids. Magnesitization was accomplished under evaporitic conditions (sabkha to playa lake environment) proposed to be similar to the Coorong or Lake Walyungup coastal playa magnesite. Magnesite and host dolostones formed in evaporative and partly restricted environments; consequently, extremely high delta C-13 values reflect a combined contribution from both global and local carbon reservoirs. A C- 13-rich global carbon reservoir (delta C-13 at around +5 parts per thousand) is related to the perturbation of the carbon cycle at 2.0 Ga, whereas the local enhancement in C-13 (up to +12 parts per thousand) is associated with evaporative and restricted environments with high bioproductivity