A Technology-Based Intervention Among Young Men Who Have Sex With Men and Nonbinary People (The Conectad@s Project): Protocol for A Vanguard Mixed Methods Study

Background In many parts of the world, including Brazil, uptake for biomedical interventions has been insufficient to reverse the HIV epidemic among key populations at high risk for HIV, including men who have sex with men. Young MSM (YMSM), particularly Black YMSM, have high HIV incidence, low viral suppression, and low preexposure prophylaxis (PrEP) uptake and adherence. Therefore, novel approaches to increase the HIV biomedical interventions uptake by YMSM are urgently needed. Objective We describe the Conectad@s Project, which aims to: (1) estimate the prevalence and incidence of HIV and other sexually transmitted infections, the onset of sexual risk behavior, and barriers to biomedical interventions among YMSM aged 18 to 24 years in Rio de Janeiro, Brazil; and (2) conduct a technology-based adherence intervention study to promote a rapid linkage of YMSM to HIV care or prevention, and support and sustain adherence. Methods A cross-sectional survey will be conducted with 400 YMSM recruited using respondent-driven sampling (RDS) adapted for social media-based sampling, preceded by a formative phase. HIV and sexually transmitted infections testing will be conducted, including early HIV infection biomarker detection. Behavioral, partnership, network, and structural measures will be collected through structured questionnaires. All individuals recruited for the survey will have access to HIV risk assessment, antiretroviral therapy (ART), PrEP, prevention counseling, and a technology-based adherence intervention. Those who accept the adherence intervention will receive weekly text messages via a social networking app (WhatsApp) for 24 weeks, with follow-up data collected over 48 weeks. Results The Conectad@s project has been approved by our local institutional review board (#CAAE 26086719.0.0000.4262) in accordance with all applicable regulations. Questionnaires for the RDS survey and intervention were developed and tested in 2020, formative interviews were conducted in January and February 2021 to guide the development of the RDS, and enrollment is planned to begin in early 2022. Conclusions The Conectad@s Project is a vanguard study that, for the first time, will apply digital RDS to sample and recruit YMSM in Brazil and rapidly connect them to ART, PrEP, or prevention counseling through a technology-based adherence intervention. RDS will allow us to estimate HIV prevalence among YMSM and measure HIV infection biomarkers in the context of the onset of risky behavior. The data will lay the groundwork to adapt and implement HIV prevention strategies, identify barriers to the earliest HIV infection diagnosis, immediate ART or PrEP initiation, and detect new clusters of HIV transmission. International Registered Report Identifier (IRRID) DERR1-10.2196/34885

Engineering immunomodulatory and osteoinductive implant surfaces via mussel adhesion-mediated ion coordination and molecular clicking

Immune response and new tissue formation are important aspects of tissue repair. However, only a single aspect is generally considered in previous biomedical interventions, and the synergistic effect is unclear. Here, a dual-effect coating with immobilized immunomodulatory metal ions (e.g., Zn2+) and osteoinductive growth factors (e.g., BMP-2 peptide) is designed via mussel adhesion-mediated ion coordination and molecular clicking strategy. Compared to the bare TiO2 group, Zn2+ can increase M2 macrophage recruitment by up to 92.5% in vivo and upregulate the expression of M2 cytokine IL-10 by 84.5%; while the dual-effect of Zn2+ and BMP-2 peptide can increase M2 macrophages recruitment by up to 124.7% in vivo and upregulate the expression of M2 cytokine IL-10 by 171%. These benefits eventually significantly enhance bone-implant mechanical fixation (203.3 N) and new bone ingrowth (82.1%) compared to the bare TiO2 (98.6 N and 45.1%, respectively). Taken together, the dual-effect coating can be utilized to synergistically modulate the osteoimmune microenvironment at the bone-implant interface, enhancing bone regeneration for successful implantation.

COVID-19 and Air Pollution: A Spatial Analysis of Particulate Matter Concentration and Pandemic-Associated Mortality in the US

In 2019, a novel coronavirus, SARS-CoV-2, was first reported in Wuhan, China. The virus causes the disease commonly known as COVID-19, and, since its emergence, it has infected over 252 million individuals globally and taken the lives of over 5 million in the same time span. Primary research on SARS-CoV-2 and COVID-19 focused on understanding the biomolecular composition of the virus. This research has led to the development of multiple vaccines with great efficacy and antiviral treatments for the disease. The development of biomedical interventions has been crucial to combating this pandemic; additionally, environmental confounding variables that could have exacerbated the pandemic need further assessment. In this research study, we conducted a spatial analysis of particulate matter (PM) concentration and its association with COVID-19 mortality in the United States. Results of this study demonstrate a significant positive correlation between PM concentration levels and COVID-19 mortality; however, this does not necessarily imply a causal relationship. These results are consistent with similar studies in Italy and China, where significant COVID-19 cases and corresponding deaths were exhibited. Furthermore, maps of the data demonstrate clustering of COVID-19 mortality which suggest further investigation into the social determinants of health impacting the pandemic.

Controlling The Monster: Exploring Constructions Of Women And Their Bodies In Endometriosis Apps

<p>People globally increasingly use digital applications (apps) to manage their health and health conditions. In particular, women commonly use apps to understand and manage female reproductive issues. Some apps target women with endometriosis, a common but poorly understood condition primarily affecting women. The aim of the current research was to explore how endometriosis apps constructed endometriosis and people with endometriosis, how people with endometriosis were positioned, and the potential implications of this positioning for app users. Multimodal critical discourse analysis (MCDA) was used to systematically examine dominant meanings produced by visual and linguistic features (i.e. colour, imagery, text and interactive app functionality) of five endometriosis apps from the USA, New Zealand and Singapore. Results demonstrated that apps drew on biomedical and biological discourses to construct endometriosis as a complex and confusing disease of the female reproductive body. This positioned biomedical and natural health professionals as knowledgeable experts about endometriosis while minimising women’s experiential knowledge of their bodies. Apps drew on intersecting postfeminist, neoliberal and healthist discourses to construct women with endometriosis as responsible for self-tracking many physical, emotional and behavioural experiences. Self-tracking was constructed as generating data that was meaningfully interpreted by app algorithms and experts to help women understand and manage their endometriosis. Dominant management recommendations (i.e. biomedical interventions; lifestyle changes) aligned with hegemonic ideals of traditional and neoliberal femininity. These findings align with previous feminist research findings that mainstream endometriosis discourse reflects androcentric biases in medical knowledge and that health apps targeting women often reinforce neoliberal and postfeminist ideals. Therefore, dominant discourses about endometriosis and female biology that pathologise women’s bodies and behaviours limit the potential for apps to offer women empowered and agentic subject positions.</p>

Controlling The Monster: Exploring Constructions Of Women And Their Bodies In Endometriosis Apps

<p>People globally increasingly use digital applications (apps) to manage their health and health conditions. In particular, women commonly use apps to understand and manage female reproductive issues. Some apps target women with endometriosis, a common but poorly understood condition primarily affecting women. The aim of the current research was to explore how endometriosis apps constructed endometriosis and people with endometriosis, how people with endometriosis were positioned, and the potential implications of this positioning for app users. Multimodal critical discourse analysis (MCDA) was used to systematically examine dominant meanings produced by visual and linguistic features (i.e. colour, imagery, text and interactive app functionality) of five endometriosis apps from the USA, New Zealand and Singapore. Results demonstrated that apps drew on biomedical and biological discourses to construct endometriosis as a complex and confusing disease of the female reproductive body. This positioned biomedical and natural health professionals as knowledgeable experts about endometriosis while minimising women’s experiential knowledge of their bodies. Apps drew on intersecting postfeminist, neoliberal and healthist discourses to construct women with endometriosis as responsible for self-tracking many physical, emotional and behavioural experiences. Self-tracking was constructed as generating data that was meaningfully interpreted by app algorithms and experts to help women understand and manage their endometriosis. Dominant management recommendations (i.e. biomedical interventions; lifestyle changes) aligned with hegemonic ideals of traditional and neoliberal femininity. These findings align with previous feminist research findings that mainstream endometriosis discourse reflects androcentric biases in medical knowledge and that health apps targeting women often reinforce neoliberal and postfeminist ideals. Therefore, dominant discourses about endometriosis and female biology that pathologise women’s bodies and behaviours limit the potential for apps to offer women empowered and agentic subject positions.</p>

Semi-Supervised Pipeline for Autonomous Annotation of SARS-CoV-2 Genomes

SARS-CoV-2 genomic sequencing efforts have scaled dramatically to address the current global pandemic and aid public health. However, autonomous genome annotation of SARS-CoV-2 genes, proteins, and domains is not readily accomplished by existing methods and results in missing or incorrect sequences. To overcome this limitation, we developed a novel semi-supervised pipeline for automated gene, protein, and functional domain annotation of SARS-CoV-2 genomes that differentiates itself by not relying on the use of a single reference genome and by overcoming atypical genomic traits that challenge traditional bioinformatic methods. We analyzed an initial corpus of 66,000 SARS-CoV-2 genome sequences collected from labs across the world using our method and identified the comprehensive set of known proteins with 98.5% set membership accuracy and 99.1% accuracy in length prediction, compared to proteome references, including Replicase polyprotein 1ab (with its transcriptional slippage site). Compared to other published tools, such as Prokka (base) and VAPiD, we yielded a 6.4- and 1.8-fold increase in protein annotations. Our method generated 13,000,000 gene, protein, and domain sequences—some conserved across time and geography and others representing emerging variants. We observed 3362 non-redundant sequences per protein on average within this corpus and described key D614G and N501Y variants spatiotemporally in the initial genome corpus. For spike glycoprotein domains, we achieved greater than 97.9% sequence identity to references and characterized receptor binding domain variants. We further demonstrated the robustness and extensibility of our method on an additional 4000 variant diverse genomes containing all named variants of concern and interest as of August 2021. In this cohort, we successfully identified all keystone spike glycoprotein mutations in our predicted protein sequences with greater than 99% accuracy as well as demonstrating high accuracy of the protein and domain annotations. This work comprehensively presents the molecular targets to refine biomedical interventions for SARS-CoV-2 with a scalable, high-accuracy method to analyze newly sequenced infections as they arise.

African Studies Keyword: Malaria

From nearly any perspective and metric, the effects of malaria on the African continent have been persistent and deep. By focusing on the malady of malaria and the last century of biomedical interventions, Graboyes and Alidina raise critical historical, ethical, and scientific questions related to truth telling, African autonomy, and the obligations of foreign researchers. They provide a condensed history of malaria activities on the continent over the past 120 years, highlighting the overall history of failures to eliminate or control the disease. A case study of the risks of rebound malaria illustrates the practical and moral problems that abound when historical knowledge is ignored. In light of current calls for renewed global eradication efforts, Graboyes and Alidina provide evidence for why historical knowledge must be better integrated into global health epistemic realms.

Forms and Ethics of Baloch Midwifery

In Pakistan, the rise of unnecessary uterotonic injections to induce childbirth, sometimes also resulting in hysterectomies, has women returning to dhīnabogs (Baloch midwives) to heal the iatrogenic effects of biomedical interventions; and reinforcing local assumptions about the benefits of Balochi dhawā/medicine, dhīnabogiri or midwifery, and homebirths. Drawing on ethnographic research in Balochistan the chapter traces how dhīnabogs’ work, ethical stances, and critical outlook concerning the iatrogenic effects of biomedical interventions are non-oppositional forms of everyday resistance. The protective role of dhīnabogiri is embedded in the intimate aspects of childbirth that profoundly structure the ethical relationship between the labouring woman and her dhīnabog. This relationship is defined not only by dhīnabogs’ concern for the well-being of mother and child, but also by their character and ethics, which are inscribed in the vernacular and social authorized praxis of dhīnabogs , kawwās (expert midwives) and balluk (granny midwives).

Antiblackness within the assemblages of undetectability

This commentary is concerned with the role of anti-blackness for North American-based Black gender and sexual minorities in Brown's and Di Feliciantonio ‘Reconceptualising of PrEP, TasP and Undetectability’ . The commentary centers anti-blackness in order to address concerns within Feliciantonio and Brown's conceptualization of assemblages and subject formation within these spaces. In considering anti-blackness, the commentary points to the ways Black gender and sexual minorities are addressing barriers to accessing biomedical interventions through the promise of an AIDS-Free future that has not fully been realized within their communities. As such, this commentary argues that in addressing anti-blackness, Black communities are engaging in a queer futurity that expands the impact of biomedical interventions through the intersections of race, gender, and sexuality.

A Technology-Based Intervention Among Young Men Who Have Sex With Men and Nonbinary People (The Conectad@s Project): Protocol for A Vanguard Mixed Methods Study (Preprint)

BACKGROUND In many parts of the world, including Brazil, uptake for biomedical interventions has been insufficient to reverse the HIV epidemic among key populations at high risk for HIV, including men who have sex with men. Young MSM (YMSM), particularly Black YMSM, have high HIV incidence, low viral suppression, and low preexposure prophylaxis (PrEP) uptake and adherence. Therefore, novel approaches to increase the HIV biomedical interventions uptake by YMSM are urgently needed. OBJECTIVE We describe the Conectad@s Project, which aims to: (1) estimate the prevalence and incidence of HIV and other sexually transmitted infections, the onset of sexual risk behavior, and barriers to biomedical interventions among YMSM aged 18 to 24 years in Rio de Janeiro, Brazil; and (2) conduct a technology-based adherence intervention study to promote a rapid linkage of YMSM to HIV care or prevention, and support and sustain adherence. METHODS A cross-sectional survey will be conducted with 400 YMSM recruited using respondent-driven sampling (RDS) adapted for social media-based sampling, preceded by a formative phase. HIV and sexually transmitted infections testing will be conducted, including early HIV infection biomarker detection. Behavioral, partnership, network, and structural measures will be collected through structured questionnaires. All individuals recruited for the survey will have access to HIV risk assessment, antiretroviral therapy (ART), PrEP, prevention counseling, and a technology-based adherence intervention. Those who accept the adherence intervention will receive weekly text messages via a social networking app (WhatsApp) for 24 weeks, with follow-up data collected over 48 weeks. RESULTS The Conectad@s project has been approved by our local institutional review board (#CAAE 26086719.0.0000.4262) in accordance with all applicable regulations. Questionnaires for the RDS survey and intervention were developed and tested in 2020, formative interviews were conducted in January and February 2021 to guide the development of the RDS, and enrollment is planned to begin in early 2022. CONCLUSIONS The Conectad@s Project is a vanguard study that, for the first time, will apply digital RDS to sample and recruit YMSM in Brazil and rapidly connect them to ART, PrEP, or prevention counseling through a technology-based adherence intervention. RDS will allow us to estimate HIV prevalence among YMSM and measure HIV infection biomarkers in the context of the onset of risky behavior. The data will lay the groundwork to adapt and implement HIV prevention strategies, identify barriers to the earliest HIV infection diagnosis, immediate ART or PrEP initiation, and detect new clusters of HIV transmission. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/34885