Biological Assessment of Coral Reefs in Southern Puerto Rico: A Technical Approach for Coral Reef Protection Under the U.S. Clean Water Act.

Coast Manage. 2019;47(5):429-452

Authors: Fisher WS, Vivian DN, Campbell J, Lobue C, Hemmer RL, Wilkinson S, Harris P, Santavy DL, Parsons M, Bradley P, Humphrey A, Oliver LM, Harwell L

Abstract
States and other jurisdictions may protect coral reefs using biological water quality standards outlined by the United States Clean Water Act (CWA). Such protection will require long-term, regional monitoring of the resource using biological indicators and a probability-based sampling design. A 60-station survey targeting nearshore linear coral reef was conducted across southern Puerto Rico in December 2011 to document the status of reef inhabitants using a probabilistic, regional sampling design. The quantity, type and condition of stony corals, fish, gorgonians and sponges were documented from each station, providing a robust representation of linear reef status and composition across the region. Fish represented 106 unique taxa and stony corals 32 unique taxa. Benthic organisms (stony corals, sponges and gorgonians) averaged nearly 12 colonies per square meter, more than half of which were gorgonians. Assessment results can be used as a baseline to compare with future regional surveys to quantify change in reef condition over time (trend). Both temporal and spatial changes can be expected after large-scale disturbances like hurricanes Maria and Irma in 2017. The indicators and probabilistic sampling design support the long-term regional monitoring envisioned by the Environmental Protection Agency to implement CWA protections in Puerto Rico and elsewhere.

PMID: 31595103 [PubMed]

The insect apocalypse, and why it matters.

Curr Biol. 2019 Oct 07;29(19):R967-R971

Authors: Goulson D

Abstract
The majority of conservation efforts and public attention are focused on large, charismatic mammals and birds such as tigers, pandas and penguins, yet the bulk of animal life, whether measured by biomass, numerical abundance or numbers of species, consists of invertebrates such as insects. Arguably, these innumerable little creatures are far more important for the functioning of ecosystems than their furry or feathered brethren, but until recently we had few long-term data on their population trends. Recent studies from Germany and Puerto Rico suggest that insects may be in a state of catastrophic population collapse: the German data describe a 76% decline in biomass over 26 years, while the Puerto Rican study estimates a decline of between 75% and 98% over 35 years. Corroborative evidence, for example from butterflies in Europe and California (which both show slightly less dramatic reductions in abundance), suggest that these declines are not isolated. The causes are much debated, but almost certainly include habitat loss, chronic exposure to pesticides, and climate change. The consequences are clear; insects are integral to every terrestrial food web, being food for numerous birds, bats, reptiles, amphibians and fish, and performing vital roles such as pollination, pest control and nutrient recycling. Terrestrial and freshwater ecosystems will collapse without insects. These studies are a warning that we may have failed to appreciate the full scale and pace of environmental degradation caused by human activities in the Anthropocene.

PMID: 31593678 [PubMed - in process]

The association between serum lipids and risk of premature mortality in Latin America: a systematic review of population-based prospective cohort studies.

PeerJ. 2019;7:e7856

Authors: Carrillo-Larco RM, Albitres-Flores L, Barengo NC, Bernabe-Ortiz A

Abstract
Objective: To synthetize the scientific evidence on the association between serum lipids and premature mortality in Latin America (LA).
Methods: Five data bases were searched from inception without language restrictions: Embase, Medline, Global Health, Scopus and LILACS. Population-based studies following random sampling methods were identified. The exposure variable was lipid biomarkers (e.g., total, LDL- or HDL- cholesterol). The outcome was all-cause and cause-specific mortality. The risk of bias was assessed following the Newcastle-Ottawa criteria. Results were summarized qualitatively.
Results: The initial search resulted in 264 abstracts, five (N = 27,903) were included for the synthesis. Three papers reported on the same study from Puerto Rico (baseline in 1965), one was from Brazil (1996) and one from Peru (2007). All reports analysed different exposure variables and used different risk estimates (relative risks, hazard ratios or odds ratios). None of the reviewed reports showed strong association between individual lipid biomarkers and all-cause or cardiovascular mortality.
Conclusion: The available evidence is outdated, inconsistently reported on several lipid biomarker definitions and used different methods to study the long-term mortality risk. These findings strongly support the need to better ascertain the mortality risk associated with lipid biomarkers in LA.

PMID: 31592360 [PubMed]

HIV/AIDS stigma manifestations during clinical interactions with MSM in Puerto Rico.

J Gay Lesbian Soc Serv. 2019;31(2):141-152

Authors: Varas-Díaz N, Rivera-Segarra E, Neilands TB, Carminelli-Corretjer P, Rivera F, Varas-Rodríguez E, Ortiz N, Pedrogo Y, Díaz MR

Abstract
HIV/AIDS stigma can have detrimental effects on physician/patient interactions when manifested by health professionals. Unfortunately, HIV/AIDS stigma is usually manifested in an intersectional manner with other pre-existing stigmas, including stigma towards men who have sex with men (MSM). Therefore, our study aimed to examine the behavioral manifestations of HIV/AIDS stigma among physicians in training during simulated clinical interactions with MSM, and explore the interrelation between HIV/AIDS stigma attitudes and behaviors. We implemented an experimental design using Standardized Patient simulations with a sample of 100 physicians in training in Puerto Rico. Results show a significant difference in the two groups' means (p<.001), with a higher number of stigma behaviors in the HIV MSM patient condition (M=6.39) than the common cold control condition (M=5.20). Results evidence that stigma manifestations towards MSM with HIV may continue to be an obstacle for public health in Puerto Rico, and that medical training to prevent stigma is still needed.

PMID: 31588167 [PubMed]

A Proposed Grading Scale for Predicting Outcomes After Stereotactic Radiosurgery for Dural Arteriovenous Fistulas.

Neurosurgery. 2019 Oct 04;:

Authors: Mohammed N, Hung YC, Chen CJ, Xu Z, Schlesinger D, Kano H, Chiang V, Hess J, Lee J, Mathieu D, Kaufmann AM, Grills IS, Cifarelli CP, Vargo JA, Chytka T, Janouskova L, Feliciano CE, Mercado RR, Lunsford LD, Sheehan JP

Abstract
BACKGROUND: There are presently no grading scales that specifically address the outcomes of cranial dural arteriovenous fistula (dAVF) after stereotactic radiosurgery (SRS).
OBJECTIVE: To design a practical grading system that would predict outcomes after SRS for cranial dAVFs.
METHODS: From the International Radiosurgery Research Foundation (University of Pittsburgh [41 patients], University of Pennsylvania [6 patients], University of Sherbrooke [2 patients], University of Manitoba [1 patient], West Virginia University [2 patients], University of Puerto Rico [1 patient], Beaumont Health System 1 [patient], Na Homolce Hospital [13 patients], the University of Virginia [48 patients], and Yale University [6 patients]) centers, 120 patients with dAVF treated with SRS were included in the study. The factors predicting favorable outcome (obliteration without post-SRS hemorrhage) after SRS were assessed using logistic regression analysis. These factors were pooled with the factors that were found to be predictive of obliteration from 7 studies with 736 patients after a systematic review of literature. These were entered into stepwise multiple regression and the best-fit model was identified.
RESULTS: Based on the predictive model, 3 factors emerged to develop an SRS scoring system: cortical venous reflux (CVR), prior intracerebral hemorrhage (ICH), and noncavernous sinus location. Class I (score of 0-1 points) predicted the best favorable outcome of 80%. Class II patients (2 points score) had an intermediate favorable outcome of 57%, and class III (score 3 points) had the least favorable outcome at 37%. The ROC analysis showed better predictability to prevailing grading systems (AUC = 0.69; P = .04). Kaplan-Meier analysis showed statistically significant difference between the 3 subclasses of the proposed grading system for post-SRS dAVF obliteration (P = .001).
CONCLUSION: The proposed dAVF grading system incorporates angiographic, anatomic, and clinical parameters and improves the prediction of the outcomes following SRS for dAVF as compared to the existing scoring systems.

PMID: 31584074 [PubMed - as supplied by publisher]

Surveillance for Violent Deaths - National Violent Death Reporting System, 32 States, 2016.

MMWR Surveill Summ. 2019 Oct 04;68(9):1-36

Authors: Ertl A, Sheats KJ, Petrosky E, Betz CJ, Yuan K, Fowler KA

Abstract
PROBLEM/CONDITION: In 2016, approximately 65,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 32 U.S. states for 2016. Results are reported by sex, age group, race/ethnicity, type of location where injured, method of injury, circumstances of injury, and other selected characteristics.
PERIOD COVERED: 2016.
DESCRIPTION OF SYSTEM: NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, Supplementary Homicide Reports, hospital data, and crime laboratory data). This report includes data collected from 32 states for 2016 (Alaska, Arizona, Colorado, Connecticut, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Utah, Vermont, Virginia, Washington, and Wisconsin). NVDRS collates information for each death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident.
RESULTS: For 2016, NVDRS captured 40,374 fatal incidents involving 41,466 deaths in the 32 states included in this report. The majority (62.3%) of deaths were suicides, followed by homicides (24.9%), deaths of undetermined intent (10.8%), legal intervention deaths (1.2%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm deaths (<1.0%). (The term legal intervention is a classification incorporated into the International Classification of Diseases, Tenth Revision [ICD-10] and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.) Demographic patterns varied by manner of death. Suicide rates were highest among males, non-Hispanic American Indians/Alaska Natives, non-Hispanic whites, adults aged 45-64 years, and men aged ≥75 years. The most common method of injury was a firearm among males and poisoning among females. Suicides were most often preceded by a mental health, intimate partner, substance abuse, or physical health problem or a recent or impending crisis during the previous or upcoming 2 weeks. Homicide rates were highest among males and persons aged <1 year and 15-44 years. Among males, non-Hispanic blacks accounted for most homicides and had the highest rate of any racial/ethnic group. The most common method of injury was a firearm. Homicides were most often precipitated by an argument or conflict, occurred in conjunction with another crime, or for females, were related to intimate partner violence. When the relationship between a homicide victim and a suspected perpetrator was known, the suspect was most frequently an acquaintance/friend among males and a current or former intimate partner among females. Legal intervention death rates were highest among men aged 20-44 years, and the rate among non-Hispanic black males was three times the rate among non-Hispanic white males. Precipitating circumstances for legal intervention deaths most frequently were an alleged criminal activity in progress, reported use of a weapon by the victim in the incident, a mental health or substance abuse problem (other than alcohol abuse), an argument or conflict, or a recent or impending crisis. Unintentional firearm deaths were more frequent among males, non-Hispanic whites, and persons aged 15-24 years. These deaths most often occurred while the shooter was playing with a firearm and most often were precipitated by a person unintentionally pulling the trigger or mistakenly thinking the firearm was unloaded. Rates of deaths of undetermined intent were highest among males, particularly non-Hispanic black and American Indian/Alaska Native males, and adults aged 25-64 years. Substance abuse, mental health problems, physical health problems, and a recent or impending crisis were the most common circumstances preceding deaths of undetermined intent. In 2016, a total of 3,655 youths aged 10-24 years died by suicide. The majority of these decedents were male, non-Hispanic white, and aged 18-24 years. Most decedents aged 10-17 years died by hanging/strangulation/suffocation (49.3%), followed by a firearm (40.4%), and suicides among this age group were most often precipitated by mental health, family relationship, and school problems. Most suicides among decedents aged 18-24 years were by a firearm (46.2%), followed by hanging/strangulation/suffocation (37.4%), and were precipitated by mental health, substance abuse, intimate partner, and family problems. A recent crisis, an argument or conflict, or both were common precipitating circumstances among all youth suicide decedents.
INTERPRETATION: This report provides a detailed summary of data from NVDRS for 2016. Suicides rates were highest among non-Hispanic American Indian/Alaska Native and white males, whereas homicide rates were highest among non-Hispanic black males. Mental health problems, intimate partner problems, interpersonal conflicts, and acute life stressors were primary precipitating events for multiple types of violent deaths, including suicides among youths aged 10-24 years.
PUBLIC HEALTH ACTION: NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths. For example, Utah VDRS data were used to help identify suicide risk factors among youths aged 10-17 years, Rhode Island VDRS suicide data were analyzed to identify precipitating circumstances of youth suicides over a 10-year period, and Kansas VDRS data were used by the Kansas Youth Suicide Prevention Task Force. In 2019, NVDRS expanded data collection to include all 50 states, Puerto Rico, and the District of Columbia. This expansion is essential to public health efforts to reduce violent deaths.

PMID: 31581165 [PubMed - in process]

"Money Helps": People who inject drugs and their perceptions of financial compensation and its ethical implications.

Ethics Behav. 2019;29(8):607-620

Authors: Abadie R, Brown B, Fisher CB

Abstract
This study documents how people who inject drugs (PWID) in rural Puerto Rico perceive payments for participating in HIV epidemiological studies. In-depth interviews were conducted among a subset (n = 40) of active PWID older than 18 years of age who had been previously enrolled in a much larger study (N = 360). Findings suggest that financial compensation was the main motivation for initially enrolling in the parent study. Then, as trust in the researchers developed, participants came to perceive compensation as part of a reciprocal exchange in which they assisted researchers by providing a trustful account of their experiences and researchers reciprocated with financial support.

PMID: 31579222 [PubMed]

Estimates of Excess Deaths in Puerto Rico: Why Demography Matters.

Am J Public Health. 2019 Nov;109(11):e23-e24

Authors: Santos-Lozada AR, Howard JT

PMID: 31577501 [PubMed - in process]

Influenza Virus Polymerase Mutation Stabilizes a Foreign Gene Inserted into the Virus Genome by Enhancing the Transcription/Replication Efficiency of the Modified Segment.

MBio. 2019 Oct 01;10(5):

Authors: Furusawa Y, Yamada S, da Silva Lopes TJ, Dutta J, Khan Z, Kriti D, van Bakel H, Kawaoka Y

Abstract
We previously attempted to establish a reporter influenza virus by inserting the gene for the Venus fluorescent protein into the NS segment of influenza A/Puerto Rico/8/34 (PR8, H1N1) virus to yield WT-Venus-PR8. Although the inserted Venus gene was deleted during serial passages of WT-Venus-PR8, we discovered that the PB2-E712D mutation stabilizes the Venus gene. Here, we explored the mechanisms by which Venus gene deletion occurs and how the polymerase mutation stabilizes the Venus gene. Deep sequencing analysis revealed that PB2-E712D does not cause an appreciable change in the mutation rate, suggesting that the stability of the Venus gene is not affected by polymerase fidelity. We found by using quantitative real-time PCR that WT-Venus-PR8 induces high-level interferon beta (IFN-β) expression. The induction of IFN-β expression seemed to result from the reduced transcription/replication efficiency of the modified NS segment in WT-Venus-PR8. In contrast, the transcription/replication efficiency of the modified NS segment was enhanced by the PB2-E712D mutation. Loss of the Venus gene in WT-Venus-PR8 appeared to be caused by internal deletions in the NS segment. Moreover, to further our understanding of the Venus stabilization mechanisms, we identified additional amino acid mutations in the virus polymerase complex that stabilize the Venus gene. We found that some of these amino acids are located near the template exit or the product exit of the viral polymerase, suggesting that these amino acids contribute to the stability of the Venus gene by affecting the binding affinity between the polymerase complex and the RNA template and product.IMPORTANCE The reverse genetics method of influenza virus generation has enabled us to generate recombinant viruses bearing modified viral proteins. Recombinant influenza viruses expressing foreign genes have become useful tools in basic research, and such viruses can be utilized as efficient virus vectors or multivalent vaccines. However, the insertion of a foreign gene into the influenza virus genome often impairs virus replication, and the inserted genes are unstable. Elucidation of the mechanisms of foreign gene stabilization will help us to establish useful recombinant influenza viruses.

PMID: 31575766 [PubMed - in process]

A prospective analysis of red and processed meat consumption and risk of colorectal cancer in women.

Cancer Epidemiol Biomarkers Prev. 2019 Oct 01;:

Authors: Mehta SS, Arroyave WD, Lunn RM, Park YM, Boyd WA, Sandler DP

Abstract
BACKGROUND: Red and processed meats have been implicated as risk factors in the development of colorectal cancer (CRC) in U.S. women, but associations with cooking practices are less well established.
METHODS: Data are from the Sister Study, a cohort of women 35-74 years old from U.S. and Puerto Rico who have a sister diagnosed with breast cancer. Red and processed meat consumption, meat cooking practices, and intake of common meat products were collected at baseline using self-administered questionnaires (N=48,704). Multivariable hazard ratios (HRadj) and 95% confidence intervals (95%CIs) were estimated.
RESULTS: During a median 8.7 years follow-up (range <1-12.7 years), 216 CRC cases were diagnosed. In categorical analyses, an increased risk of CRC was seen in the highest quartile of processed meat consumption compared to the lowest [HRadj=1.52 (95%CI: 1.01-2.30); p-trend: 0.02], and for specific meat products, including breakfast sausages (HRadj=1.85 [95%CI: 1.30-2.64]) and bacon (HRadj=1.46 [95%CI: 1.01-2.11]). The adjusted HR for the highest quartile of red meat consumption was 1.04 (95%CI: 0.68-1.60), and little evidence of association was observed for cooking practices or doneness of red meat. We observed positive associations with specific red meat products when cooking methods were considered; e.g., grilled/ barbequed steaks (HRadj=2.23 [95%CI: 1.20-4.14]) and hamburgers (HRadj=1.98 [95%CI: 1.00-3.91]).
CONCLUSIONS: Higher reported daily intake of processed meats and consumption of barbecued/grilled red meat products were associated with increased risk of CRC in women.
IMPACT: Variability in CRC risk by meat type and cooking method should be considered when evaluating meat consumption.

PMID: 31575555 [PubMed - as supplied by publisher]

The association of urinary organophosphate ester metabolites and self-reported personal care and household product use among pregnant women in Puerto Rico.

Environ Res. 2019 Sep 23;179(Pt A):108756

Authors: Ingle ME, Watkins D, Rosario Z, Vélez Vega CM, Huerta-Montanez G, Calafat AM, Ospina M, Cordero JF, Alshawabkeh A, Meeker JD

Abstract
BACKGROUND: Organophosphate esters (OPEs) are widely detected among U.S. pregnant women. OPEs, some of which are present in nail polish, have been associated with adverse reproductive health outcomes. More research is needed to investigate associations with OPEs and personal care products (PCP) use.
METHODS: Pregnant women (18-40 years) were recruited from two hospitals and five prenatal clinics in Northern Puerto Rico (n = 148 women) between 2011 and 2015. Concentrations of bis(2-chloroethyl) phosphate (BCEtP), bis(1-chloro-2-propyl) phosphate (BCPP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), di-n-butyl phosphate (DNBP), di-benzyl phosphate (DBzP), di-cresyl phosphate (DCP), DPHP, and 2,3,4,5-tetrabromobenzoic acid (TBBA) were measured twice during pregnancy. Participants completed questionnaires on PCP and household products (HP) use. Associations among products and metabolite concentrations (n = 296 observations) were assessed using linear mixed models.
RESULTS: BCEtP, BCPP, BDCPP and DPHP were detected frequently (≥77%). Correlations among metabolites (0.16 ≤ r ≤ 0.35) and Intraclass correlation coefficients (ICCs) (0.03 ≤ ICC≤0.34) were weak-to-moderate. Suntan lotion was associated with a 110% increase in BDCPP. DPHP increased with perfume (51%) and nail polish (49%) use. BCPP increased 46% with pesticide use in home.
CONCLUSION: Biomarkers of OPEs were often detected among pregnant women. Associations with PCP and HP use suggest OPEs may be used in such products, specifically in perfume and nail polish. Further investigation into these products is warranted.

PMID: 31574449 [PubMed - as supplied by publisher]

Genetic structure of Mexican lionfish populations in the southwest Gulf of Mexico and the Caribbean Sea.

PLoS One. 2019;14(10):e0222997

Authors: Labastida-Estrada E, Machkour-M'Rabet S, Carrillo L, Hénaut Y, Castelblanco-Martínez DN

Abstract
The recent expansion of the invasive lionfish throughout the Western Hemisphere is one of the most extensively studied aquatic invasions. Molecular studies have improved our understanding of larval dispersal, connectivity, and biogeographical barriers among lionfish populations, but none have included Mexican localities, an important area for the larval dispersal of Pterois volitans through the Western Caribbean and the Gulf of Mexico. Here, we present a genetic analysis of lionfishes collected along Mexican coasts, examining their connectivity with other Caribbean localities (Belize, Cuba, Puerto Rico) and the role of ocean currents on population structure. We collected 213 lionfish samples from seven locations comprising four countries. To evaluate genetic structure, mitochondrial control region and nuclear inter-simple sequence repeat markers were used. We found that lionfish collected along Mexican coasts show a similar haplotype composition (H02 followed by H01 and H04) to other Caribbean locations, and the H03 rare haplotype was not found. Haplotype composition in the southwest Gulf of Mexico suggests a discontinuity between the southern and northern areas of the Gulf of Mexico. The southern area clustered more strongly to the Caribbean region, and this is supported by the complexity of water circulation in the semi-enclosed region of the Gulf of Mexico. Mitochondrial genetic diversity parameters show small values, whereas nuclear markers produce medium to high values. Only nuclear markers highlighted significant genetic differentiation between the southwest Gulf of Mexico and Caribbean region, confirming a phylogeographic break between both regions. Separate analysis of Caribbean locations indicates restricted larval exchange between southern and northern regions of the Mesoamerican Barrier Reef System, potentially in response to regional oceanographic circulation.

PMID: 31574129 [PubMed - in process]

Implementing a Fast-Track Team Triage Approach in Response to Hurricane Maria.

Am J Nurs. 2019 Oct;119(10):58-64

Authors: Parak BE, Hodge NS, Eccleston SD

Abstract
BACKGROUND: Hurricane Maria struck Puerto Rico on September 20, 2017, and caused widespread damage to the island, resulting in decreased access to health care. Sixteen days later, a mobile military hospital (MMH) was deployed to Humacao, Puerto Rico, to provide medical relief. Overcrowding in EDs is a problem in disaster relief responses, as was the case here. Initial triage practices resulted in long wait times and limited access to care, and many people left before being seen by a provider.
PURPOSE: This study describes the implementation of a combined fast-track and team triage process to quickly and effectively screen patients in the MMH.
METHODS: In addition to maintaining a formal triage, our ED staff combined two systems, fast track and team triage, to accommodate the influx of patients. This newly combined approach consisted of a health care provider (an MD, NP, or physician assistant) and an RN to facilitate the evaluation, treatment, and discharge of lower-acuity patients.
RESULTS: During peak operations (days 13 to 26 of the total 31 days of operation), 70% of MMH patients were evaluated, treated, and discharged from the combined fast-track and team triage, while only 28% of patients were sent to formal triage; patients with critical conditions (2% of the total) were sent directly to the ED. The mean number of patients seen daily in the first 10 days of operation (n = 84) increased by an average of 48% (n = 124) in the 14 days of peak operations.
CONCLUSION: The combined fast-track and team triage approach enabled us to quickly and effectively screen patients and greatly improved clinical outcomes and patient flow in a mobile facility.

PMID: 31567260 [PubMed - in process]

MDCK-B4GalNT2 cells disclose a α2,3-sialic acid requirement for the 2009 pandemic H1N1 A/California/04/2009 and NA aid entry of A/WSN/33.

Emerg Microbes Infect. 2019;8(1):1428-1437

Authors: Wong HH, Fung K, Nicholls JM

Abstract
Switching of receptor binding preference has been widely considered as one of the necessary mutations for avian influenza viruses, enabling efficient transmissions between human hosts. By stably overexpressing B4GalNT2 gene in MDCK cells, surface α2,3-siallylactose receptors were modified without affecting α2,6-receptor expression. The cell line MDCK-B4GalNT2 was used as a tool to screen for α2,3-receptor requirements in a panel of influenza viruses with previously characterized glycan array data. Infection of viruses with α2,3-receptor binding capability was inhibited in MDCK-B4GalNT2 cells, with the exception of A/WSN/33 (WSN). Infection with the 2009 pandemic H1N1 strains, A/California/04/2009 (Cal04) and A/Hong Kong/415742/2009 (HK09), despite showing α2,6-receptor binding, was also found to be inhibited. Further investigation showed that viral inhibition was due to a reduction in viral entry rate and viral attachment. Recombinant WSN virus with the neuraminidase (NA) gene swapped to A/Puerto Rico/8/1934 (PR8) and Cal04 resulted in a significant viral inhibition in MDCK-B4GalNT2 cells. With oseltamivir, the NA active site was found to be important for the replication results of WSN, but not Cal04.

PMID: 31560252 [PubMed - in process]

Native American admixture recapitulates population-specific migration and settlement of the continental United States.

PLoS Genet. 2019 Sep;15(9):e1008225

Authors: Jordan IK, Rishishwar L, Conley AB

Abstract
European and African descendants settled the continental US during the 17th-19th centuries, coming into contact with established Native American populations. The resulting admixture among these groups yielded a significant reservoir of Native American ancestry in the modern US population. We analyzed the patterns of Native American admixture seen for the three largest genetic ancestry groups in the US population: African descendants, Western European descendants, and Spanish descendants. The three groups show distinct Native American ancestry profiles, which are indicative of their historical patterns of migration and settlement across the country. Native American ancestry in the modern African descendant population does not coincide with local geography, instead forming a single group with origins in the southeastern US, consistent with the Great Migration of the early 20th century. Western European descendants show Native American ancestry that tracks their geographic origins across the US, indicative of ongoing contact during westward expansion, and Native American ancestry can resolve Spanish descendant individuals into distinct local groups formed by more recent migration from Mexico and Puerto Rico. We found an anomalous pattern of Native American ancestry from the US southwest, which most likely corresponds to the Nuevomexicano descendants of early Spanish settlers to the region. We addressed a number of controversies surrounding this population, including the extent of Sephardic Jewish ancestry. Nuevomexicanos are less admixed than nearby Mexican-American individuals, with more European and less Native American and African ancestry, and while they do show demonstrable Sephardic Jewish ancestry, the fraction is no greater than seen for other New World Spanish descendant populations.

PMID: 31545791 [PubMed - in process]

A Web-Based Study of HIV Prevention in the Era of Pre-Exposure Prophylaxis Among Vulnerable HIV-Negative Gay and Bisexual Men, Transmen, and Transwomen Who Have Sex With Men: Protocol for an Observational Cohort Study.

JMIR Res Protoc. 2019 Sep 17;8(9):e13715

Authors: Nash D, Stief M, MacCrate C, Mirzayi C, Patel VV, Hoover D, Pantalone DW, Golub S, Millett G, D'Angelo AB, Westmoreland DA, Grov C

Abstract
BACKGROUND: Gay, bisexual, and other men who have sex with men continue to bear a large burden of the HIV epidemic in the United States and are among the only populations with increasing incidence in recent years.
OBJECTIVE: The Together 5000 (T5K) Study aimed to enroll a US-based, racially diverse sample of HIV-negative men, transmen, and transwomen who are not on pre-exposure prophylaxis (PrEP) into an observational cohort to inform the design, implementation, scale-up, and evaluation of HIV prevention programs.
METHODS: We used internet-based strategies to enroll a large, racially diverse national sample of HIV-negative men, transmen, and transwomen aged 16 to 49 years at high risk of HIV acquisition via sexual networking apps. Study participants are contacted every 6 months (in between annual surveys) for a brief survey on HIV testing, HIV diagnosis, and PrEP use (ie, attempts to access, PrEP initiation, and PrEP discontinuation). Participants complete annual self-administered at-home HIV testing and Web-based surveys. Using baseline serologic data and self-reported HIV testing history, we reconstructed a cohort of persons who were HIV negative at 12 months before baseline to estimate HIV incidence leading up to cohort enrollment.
RESULTS: The study sample included 8777 participants from all 50 US states, Puerto Rico, and Guam; 50.91% (4468/8777) were persons of color and 25.30% (2221/8777) were young individuals aged 16 to 24 years. Per eligibility criteria, all T5K participants reported having sex with >2 male partners in the 90 days before enrollment, self-reported not having been diagnosed with HIV, and were not actively taking PrEP. In addition, 79.39% (6968/8777) reported >2 insertive condomless anal sex (CAS) acts, 61.02% (5356/8777) reported >1 receptive CAS acts in the past 90 days. Furthermore, most (7525/8777, 85.74%) reported never having taken PrEP. In total, 70.25% (6166/8777) were sent a self-administered at-home HIV test kit and 82.29% (5074/6166) of those sent a kit returned a sample for testing. The HIV incidence rate during the 12-month period leading up to enrollment was estimated to be 2.41 (95% CI 2.02-2.90) per 100 person-years.
CONCLUSIONS: A large, national, and racially diverse fully Web-based cohort of HIV-negative men, transmen, and transwomen at high risk for HIV seroconversion has successfully been recruited into longitudinal follow-up. This cohort is at high risk for HIV acquisition and can provide important insights related to the real-world uptake, impact, and equity of HIV prevention interventions in the United States. Participants can be invited to participate in trials aimed at testing strategies to improve the uptake of and engagement in these interventions.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/13715.

PMID: 31538945 [PubMed]

Rapid Screening of Aedes aegypti Mosquitoes for Susceptibility to Insecticides as Part of Zika Emergency Response, Puerto Rico.

Emerg Infect Dis. 2019 Oct;25(10):1959-1961

Authors: Hemme RR, Vizcaino L, Harris AF, Felix G, Kavanaugh M, Kenney JL, Nazario NM, Godsey MS, Barrera R, Miranda J, Lenhart A

Abstract
In response to the 2016 Zika outbreak, Aedes aegypti mosquitoes from 38 locations across Puerto Rico were screened using Centers for Disease Control and Prevention bottle bioassays for sensitivity to insecticides used for mosquito control. All populations were resistant to pyrethroids. Naled, an organophosphate, was the most effective insecticide, killing all mosquitoes tested.

PMID: 31538919 [PubMed - in process]

Nonmedical use of d-Amphetamines and Methylphenidate in Medical Students.

P R Health Sci J. 2019 Sep;38(3):185-188

Authors: Acosta DL, Fair CN, Gonzalez CM, Iglesias M, Maldonado N, Schenkman N, Valle SM, Velez JL, Mejia L

Abstract
OBJECTIVE: The purpose of this study was to determine the prevalence of medical and nonmedical use of prescription attention deficit hyperactive disorder (ADHD) stimulant medication among medical students.
MATERIALS AND METHODS: An IRB approved 19-question web survey was sent out to all students from a Puerto Rico (PR) medical school to assess use of ADHD medication. Out of the 250 stu-dents consulted there was a response of 152 surveys. Data was cross-referenced and compared with data from other studies.
RESULTS/DISCUSSION: From the results gathered, the study's sample had a higher prevalence of use than the 15% reported in previous studies, reaching 47.4%. Among students who had used these drugs, 89.4% indicated using it without a prescription. 86.8% of all respondents used some form of stimulant or substance in order to cope with the academic workload of medical school, includ-ing coffee, energy drinks, cigarettes, and alcohol. The majority of students (60.5%) considered study techniques workshops and exercise programs to succeed academically.
CONCLUSION: This study suggests a higher prevalence of ADHD medication use amongst the PR medical student sample compared to findings reported of US medical students, as well as a high prevalence related to nonmedical use as a means for medical students to cope with their training. The nonmedical use of stimulants in the medical school setting remains of utmost public health and clinical concern. The results of this study could help develop proper workshops and non-pharmacological techniques to help medical students cope with their workload.

PMID: 31536633 [PubMed - in process]

Improvement in Hispanics' CRC Knowledge and Awareness using the Inflatable Caribe Colon.

P R Health Sci J. 2019 Sep;38(3):176-180

Authors: Portilla-Skerrett GM, Díaz-Algorri Y, Soto-Salgado M, Cruz-Correa M

Abstract
OBJECTIVE: Colorectal cancer (CRC) is the most common cause of cancer death in Puerto Rico (PR). CRC screening rates among PR Hispanics aged ≥ 50 years (57.5%) are below the Healthy People 2020 recommendations (70.5%). Low screening rates can be attributed to lack of education, and beliefs and knowledge about CRC screening procedures. This study evaluated the effectiveness of the Caribe Colon inflatable colon model in two community events as an educational tool to increase CRC knowledge, awareness, and intention to undergo CRC screening.
METHODS: Participants (aged ≥ 40 years and with no previous CRC history) completed a pre- and post- questionnaire, and took the tour of the Caribe Colon.
RESULTS: After completing the tour, survey responses (n=154) revealed a significant increase in CRC knowledge and awareness (p<0.0001). Multivariable logistic regression models showed that fear of CRC screening procedures was the primary independent factor for not getting screened after adjusting for age, gender, education, regular visits to a primary care physician, insurance, and history of CRC screening (p=0.006).
CONCLUSION: Future studies should focus on understanding and reducing barriers to CRC screening including fear. Patients more knowledgeable about CRC screening procedures may have less fear for CRC screening. Furthermore, educational strategies need to be reinforced to reduce fear; this may lead to an increase in CRC screening rates among Hispanics.

PMID: 31536631 [PubMed - in process]

Comparison of Skin Biomechanics and Skin Color in Puerto Rican and Non-Puerto Rican Women.

P R Health Sci J. 2019 Sep;38(3):170-175

Authors: Regueira Y, Fargo JD, Tiller D, Brown K, Clements C, Beachman B, Brignone E, Sommers MS

Abstract
OBJECTIVE: Skin biomechanics are physical properties that protect the body from injury. Little is known about differences in skin biomechanics in racial/ethnic groups and the role of skin color in these differences. The purpose of this study was to determine the relationship between skin biomechanics (viscoelasticity, hydration) and skin color, when controlling for demographic and health-related variables in a sample of Puerto Rican and non-Puerto Rican women.
METHODS: We performed a secondary analysis of data from 545 women in a longitudinal, observational study of skin injury in Puerto Rico and the United States. Data included measures of skin viscoelasticity, skin hydration, skin color, demographic, and health related variables. Skin color was measured by spectrophotometry (L* - lightness/darkness, a*- redness/greenness, b* - yellowness/blueness). The sample was 12.5% Puerto Rican, 27.3% non-Puerto Rican Latina, 28.8% Black, 28.6% White, and 2.8% Other.
RESULTS: Regression analyses showed that: 1) higher levels of skin viscoelasticity were associated with lower age, higher BMI, and identifying as non-Puerto Rican Latina as compared to Puerto Rican; (all p < .001); and 2) higher levels of hydration were associated with lower L* values, higher health status, lower BMI, and identifying as non-Puerto Rican Latina, White, or Other as compared to Puerto Rican (all p < .05).
CONCLUSION: When adjusting for skin color, Puerto Rican women had lower viscoelasticity and hydration as compared to other groups. Puerto Rican women may be at long-term risk for skin alterations, including pressure injury, as they age or become chronically ill.

PMID: 31536630 [PubMed - in process]