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Abstract

Background
Black men who have sex with men (MSM) experience disproportionate rates of HIV infection in the USA, despite being no more likely to engage in sexual risk behaviors than other MSM racial/ethnic groups. HIV pre-exposure prophylaxis (PrEP) has been shown to reduce risk of HIV acquisition; however, rates of PrEP use among Black MSM remain low. Clinical, psychosocial, and structural factors have been shown to impact PrEP use and adherence among Black MSM. Care coordination of HIV prevention services has the potential to improve PrEP use and adherence for Black MSM, as it has been shown to improve HIV-related care outcomes among people living with HIV.

Methods
Client-centered care coordination (C4) is a multi-level intervention designed to address clinical, psychosocial, and structural barriers to HIV prevention services for Black MSM within HPTN 073, a PrEP demonstration project among Black MSM in three cities in the USA. The current study examined the implementation process of C4, specifically investigating the activities, cost, time, and outcomes associated with the C4 intervention.

Results
On average, participants engaged in five care coordination encounters. The vast majority of care coordination activities were conducted by counselors, averaging 30 min per encounter. The cost of care coordination was relatively low with a mean cost of $8.70 per client encounter.

Conclusion
Although client-centered care coordination was initially implemented in well-resourced communities with robust HIV research and service infrastructure, our findings suggest that C4 can be successfully implemented in resource constrained communities.

Endurance and resistance exercises, alone or in combination, induce metabolic changes that affect tryptophan (Trp) catabolism. The kynurenine pathway (KP) is the main route of Trp degradation, and it is modulated by the inflammatory and redox environments. Previous studies have shown that KP metabolites work as myokines that mediate the positive systemic effects related to exercise. However, it is poorly understood how different exercise modalities and intensities impact the KP. The aim of this study was to characterize the effect of two different exercise modalities, military diving and swimming, on the KP and the redox environment. A total of 34 healthy men from the Mexican Navy were included in the study, 20 divers and 14 swimmers, who started and stayed in military training consistently during the six months of the study; 12 Mexican men without fitness training were used as the control group. Physical fitness was determined at the beginning and after 6 months of training; criteria included body composition; serum levels of Trp, kynurenine (KYN), kynurenic acid (KYNA) and 3-hydroxykynurenine (3-HK); the glutathione ratio (GSH/GSSG); and malondialdehyde (MDA). Results showed a significant loss of body fat in both the diver and swimmer groups. Compared with the control group, divers showed a decrease in Trp and 3-HK levels, but no changes were observed in the KYN/Trp, KYNA/Trp or 3-HK/Trp ratios, while swimmers showed a decrease in KYN levels and an increase in the KYNA and 3-HK levels. Additionally, divers showed a decrease in the GSH/GSSG ratio and an increase in MDA levels, in contrast to the swimmers, who showed a decrease in MDA levels and an increase in GSH/GSSG levels. Our findings suggest a differential shift in the KP and redox environment induced by diving and swimming. Swimming promotes an antioxidant environment and a peripheral overactivation of the KP.

AbstractIntroductionImmune abnormalities have been described among youth with vertically acquired HIV (YWVH) despite antiretroviral treatment (ART). The CD4/CD8 ratio could be a useful prognostic marker. We assess immune activation and senescence in a cohort of YWVH in comparison to youth without vertically acquired HIV.MethodsYWVH under suppressive ART were included and compared to a group of HIV‐negative donors (HD) matched by age and sex, from September 2019 to September 2020. Subset distribution and expression of activation, maturation, senescence and exhaustion markers on T and NK cells were studied on peripheral blood mononuclear cells by multiparametric flow cytometry.ResultsThirty‐two YWVH (median age: 24.4 years (interquartile range: 22.5 to 28.3 years)) were included. Among YWVH, CD4‐ and CD8‐T cells showed high levels of activation (HLA‐DR/CD38), IL‐7 receptor expression (CD127) and exhaustion (TIM‐3). Regarding NK cells, YWVH showed increased levels of activation and exhaustion markers compared to HD. Strong inverted correlations were observed between T‐cell activation (HLA‐DR/CD38), senescence (CD57) and exhaustion (TIGIT, PD‐1) levels with the CD4/CD8 ratio among YWVH. HLA‐DR, CD69, NKG2D and NKG2A expression levels on NK cells also correlated with the CD4/CD8 ratio. Age at ART initiation was directly associated with higher frequency of CD16high NK‐cell subsets, exhaustion T‐cell levels (CD57, TIM3) and NK cells activation levels.ConclusionsImmunological changes associated with vertically acquired HIV, characterized by increased activation and exhaustion levels in innate and adaptive immune components, are only partially restored by ART. The CD4/CD8 ratio can be a useful marker of disease progression for routine clinical practice.

The indiscriminate use of antibiotics in veterinary medicine and their negligent use among dog owners have contributed to the rise of antibiotic resistance in microorganisms found in pets. In addition, the search for medicinal plants with antibacterial properties has made the evaluation of aqueous extracts of Alpinia purpurata (Vieill.) K. Schum an important issue. Thus, the aim of this work was to determine the antibiotic resistance profile of gram-negative bacteria isolated from nasal swab samples of dogs and assess the antibacterial activity of the aqueous extracts of leaves and rhizomes of A. purpurata. The bacteria identified were tested using the agar disc diffusion assay for the evaluation of antibiotic resistance. A total of 16 isolates were obtained from the 19 samples collected, with a high prevalence of Escherichia coli (n=5). There was a high rate of resistance to ?-lactams, where the highest percentage was seen for amoxicillin (72.5%). Aqueous leaf extracts had high levels of total phenolic compounds (637.47 µg GAE mg-1), differing significantly (p < 0.05) from aqueous rhizome extracts (228.64 µg GAE mg-1). There was no significant difference in EC50 of DPPH values between the aqueous extracts; however, the antioxidant capacity of rhizome extracts had higher values than leaf extracts. The minimum inhibitory concentration (MIC) of leaves and rhizomes for the evaluated bacteria ranged from 9000 to 32,000 µg mL-1. For the minimum bactericidal concentration (MBC), most bacteria showed an MBC over 38,400 µg mL-1 for the rhizome. In conclusion, the bacteria isolated from dog nasal swabs showed a high resistance profile for the antibiotics of the penicillin class. Additionally, the results from the analysis of the aqueous extracts of rhizomes and leaves of A. purpurata showed an antimicrobial effect possibly associated with a high content of total phenolic compounds; these results can create a scope for using these extracts together with conventional antibiotics to control the emergence of antibiotic resistance among microbial species.

Myelodysplastic syndromes (MDS) are hematological disorders at high risk of progression to secondary acute myeloid leukemia (sAML). However, the mutational dynamics and clonal evolution underlying disease progression are poorly understood at present. To elucidate the mutational dynamics of pathways and genes occurring during the evolution to sAML, next generation sequencing was performed on 84 serially paired samples of MDS patients who developed sAML (discovery cohort) and 14 paired samples from MDS patients who did not progress to sAML during follow-up (control cohort). Results were validated in an independent series of 388 MDS patients (validation cohort). We used an integrative analysis to identify how mutations, alone or in combination, contribute to leukemic transformation. The study showed that MDS progression to sAML is characterized by greater genomic instability and the presence of several types of mutational dynamics, highlighting increasing (STAG2) and newly-acquired (NRAS and FLT3) mutations. Moreover, we observed cooperation between genes involved in the cohesin and Ras pathways in 15-20% of MDS patients who evolved to sAML, as well as a high proportion of newly acquired or increasing mutations in the chromatin-modifier genes in MDS patients receiving a disease-modifying therapy before their progression to sAML. ; This work was supported by grants from the Spanish Fondo de Investigaciones Sanitarias FIS PI18/01500, PI17/01741, Instituto de Salud Carlos III (ISCIII), Fondo de Investigación Sanitaria (Instituto de Salud Carlos III – Contratos Río Hortega (CM17/0017), European Regional Development Fund (ERDF), Una manera de hacer Europa, European Union Seventh Framework Programme [FP7/2007-2013] under Grant Agreement nº306242-NGS-PTL, SYNtherapy: Synthetic Lethality for Personalized Therapy-based Stratification in Acute Leukemia (ERAPERMED2018-275); ISCIII (AC18/00093), Proyectos de Investigación del SACYL, Gerencia Regional de Salud de Castilla y León: GRS1850/A18, GRS1653/A17, and Centro de Investigación Biomédica en Red de Cáncer (CIBERONC CB16/12/00233). MMI is supported by a predoctoral grant from the Junta de Castilla y León, and by the Fondo Social Europeo (JCYL-EDU/556/2019 PhD scholarship) and JMHS is supported by a research grant from Fundación Española de Hematología y Hemoterapia.

Mit dem "Teilhabechancengesetz" wurden zum Jahresbeginn 2019 die Instrumente "Eingliederung von Langzeitarbeitslosen" (§16e SGB II) sowie "Teilhabe am Arbeitsmarkt" (§16i SGB II) eingeführt. Beide Instrumente richten sich gleichermaßen an langzeitarbeitslose Leistungsberechtigte, die auch bei guter Arbeitsmarktlage nur geringe Aussichten auf eine ungeförderte Beschäftigung und damit auf ein Leben jenseits staatlicher Transferzahlungen haben. Damit rückt eine Teilgruppe unter den erwerbsfähigen Leistungsberechtigten in den Fokus der arbeitsmarktpolitischen Förderung, die über Jahre hinweg faktisch von regelmäßiger Erwerbstätigkeit und den darüber vermittelten Teilhabemöglichkeiten ausgeschlossen ist. Entsprechend besteht das Kernanliegen beider Instrumente darin, den Geförderten die Beteiligung am Arbeitsleben zu eröffnen und dadurch zur Verbesserung ihrer Beschäftigungsfähigkeit, ihrer Arbeitsmarktchancen und ihrer gesellschaftlichen Teilhabemöglichkeiten beizutragen. Zusammen mit der Einführung beider Förderinstrumente hat der Gesetzgeber auch deren umfassende wissenschaftliche Evaluation beschlossen. Die Evaluation erfolgt im Rahmen der Wirkungsforschung nach §55 Abs. 1 SGB II und obliegt damit dem Institut für Arbeitsmarkt- und Berufsforschung (IAB). Im Fokus der Studie stehen insbesondere die Implementation der Maßnahmen auf Ebene der Jobcenter, ihr betrieblicher Einsatz sowie ihre Wirkungen auf die Beschäftigungsfähigkeit, die Arbeitsmarktchancen und die gesellschaftliche Teilhabe der Geförderten. Der vorliegende Bericht dokumentiert den aktuellen Arbeits- und Erkenntnisstand der wissenschaftlichen Evaluation. ; Despite the decline of unemployment in recent years, long-term unemployment remains one of the major challenges for the German labour market. For that reason another two active labour market programmes were introduced in 2019. Both measures address long-term unemployed people with very poor labour market prospects. While the key objective of the first measure is to improve participants' chances on the regular job market, the second one intends to strengthen participants' prospects of social inclusion. Both programmes are designed as a wage subsidy for employers. The evaluation aims at a comprehensive analysis of the institutional implementation, the operational use at the establishment level as well as the individual effects of both labour market programmes. This report documents the current status of the evaluation and provides first research results.

The additive sorbitan monolaurate consists of sorbitol (and its anhydrides) esterified with fatty acids derived from coconut oil. It is currently authorised in the European Union and it is intended to be used as a technological additive (functional group of emulsifiers), in feedingstuffs for all animal species, at a maximum concentration of 85 mg/kg complete feed. In 2019, the EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) issued an opinion on the safety and efficacy of sorbitan monolaurate. Owing the lack of data, the FEEDAP Panel could not conclude on the safety of the additive for the environment. The applicant submitted new data (fate and degradation as well as ecotoxicity data) that were evaluated in the present opinion. The absorption, distribution, metabolism and excretion of structurally related compounds (sorbitan monostearate and sorbitan trioleate) indicate that the additive is expected to be partially metabolised. In addition, sorbitan monolaurate and some related compounds are readily biodegradable. The limited available data on the effects of sorbitan monolaurate in marine crustaceans and in marine sediment indicate that the ecotoxicity of the additive is low, in consistency with the very low acute toxicity of sorbitan esters. Overall, the FEEDAP Panel concludes that a risk of sorbitan monolaurate to terrestrial and aquatic environment is unlikely. Therefore, no safety concerns for the environment are expected from the use of the additive under assessment according to the established conditions of use.

This study was conducted to characterize the epidemiology of bovine brucellosis in the state of Pernambuco, Brazil. The state was divided into three regions, and in each region, approximately 300 properties were randomly sampled. From these selected properties, a pre-established number of animals were randomly selected and blood serum samples were obtained. A total of 3,901 animals were selected from 900 properties. For each selected property, an epidemiological questionnaire was administered to assess the type of farming, the animal husbandry practices and the sanitary practices that could be associated with the presence of brucellosis infection. The testing protocol consisted of screening the samples with a buffered acidified plate antigen test and retesting the positive samples with a complement fixation test (CF). One positive animal was enough to define an infected herd. The prevalence rates of infected herds and animals in the state were 4.5% [3.2; 6.4%] and 1.4% [0.7; 2.7%], respectively. By region, the prevalence rates of infected herds and animals, respectively, were as follows: Zona da Mata, 3.3% [1.8; 6.1%] and 1.7% [0.5; 3.0%]; Agreste, 7.4% [4.9; 10.9%] and 1.9% [0.8; 3.0%]; and Sertão, 1.3% [0.5; 3.5%] and 0.7% [0.0; 1.6%]. Flooded pastures (OR = 2.86 [1.37; 6.42]) and the presence of 13 or more females in the herd (3rd quartile) (OR = 2.65 [1.19; 5.89]) were identified as risk factors. The existence of veterinary care emerged as a protective factor against bovine brucellosis in the state of Pernambuco (OR = 0.24 [0.10; 0.58]).

El libro contiene el desarrollo de preocupaciones estrechamente vinculadas, como son los conceptos de ciudadanía, democracia, derechos humanos e interculturaliad desde Latino-américa. El supuesto más importante que lo recorre, a pesar de los distintos enfoques que el lector podrá constatar, es el que sostiene la necesidad de ubicar los procesos propios del poder en nuestra región como condición para interpretar su relación con los pueblos originarios indígenas.