The association between raised blood pressure and increased risk of subsequent cognitive decline is well known. Left ventricular hypertrophy (LVH), as a marker of hypertensive target organ damage, ...may help identify those at risk of cognitive decline. We assessed whether LVH was associated with subsequent cognitive decline or dementia in hypertensive participants aged ≥80 years in the randomized, placebo-controlled Hypertension in the Very Elderly Trial. LVH was assessed using 12-lead electrocardiography (ECG) based on the Cornell Product (CP-LVH), Sokolow-Lyon (SL-LVH), and Cornell Voltage (CV-LVH) criteria. The Mini-Mental State Examination (MMSE) was used to assess cognitive function at baseline and annually. A fall in MMSE to <24 or an annual fall of >3 points were defined as cognitive decline and triggered dementia screening (Diagnostic Statistical Manual IV). Death was defined as a competing event. Fine-Gray regression models were used to examine the relationship between baseline LVH and cognitive outcomes. There were 2645 in the analytical sample, including 201 (7.6%) with CP-LVH, 225 (8.5%) SL-LVH and 251 (9.5%) CV-LVH. CP-LVH was associated with increased risk of cognitive decline, subdistribution hazard ratio (sHR)1.3 (95% confidence interval (CI) 1.01-1.67) in multivariate analyses. SL-LVH and CV-LVH were not associated with cognitive decline (sHR1.06 (95% CI 0.82-1.37) and sHR1.13 (95% CI 0.89-1.43), respectively). LVH was not associated with dementia. LVH may be related to subsequent cognitive decline, but evidence was inconsistent depending on ECG criterion and there were no associations with incident dementia. Additional work is needed to understand the relationships between blood pressure, LVH assessment and cognition.
Panguite (IMA 2010-057), (Ti4+,Sc,Al,Mg,Zr,Ca)1.8O3, is a new titania, occurring as fine-grained crystals with Ti-rich davisite in an ultra-refractory inclusion within an amoeboid olivine inclusion ...from the Allende CV3 carbonaceous chondrite. The phase was characterized by SEM, EBSD, synchrotron micro-diffraction, micro-Raman spectroscopy, and EPMA. The mean chemical composition of the type panguite is (wt%) TiO2 47.97, ZrO2 14.61, Sc2O3 10.67, Al2O3 7.58, MgO 5.54, Y2O3 5.38, CaO 3.34, SiO2 1.89, FeO 1.81, V2O3 0.95, Cr2O3 0.54, HfO2 0.28, sum 100.56 with a corresponding empirical formula calculated on the basis of 3 O atoms of (Ti0.79Zr0.16Si0.04)4+Σ0.99 (Sc0.20Al0.20Y0.06V0.02Cr0.01)3+Σ0.49 (Mg0.18Ca0.08Fe0.03)2+Σ0.29Σ1.77O3. Synchrotron micro-Laue diffraction (i.e., an energy scan by a high-flux X-ray monochromatic beam and white beam diffraction) on one type domain at sub-micrometer resolution revealed that panguite is an orthorhombic mineral in space group PBCA: The structure is a subgroup of the Ia3 bixbyite-type. The cell parameters are a=9.781(1), b=9.778(2), and c=9.815(1) Å, yielding V=938.7(1) Å3, Z=16, and a calculated density of 3.746 g/cm3. Panguite is not only a new mineral, but also a new titania material, likely formed by condensation. It is one of the oldest minerals in the solar system.
Voluntary medical male circumcision is an integral part of the South African government's response to the HIV and AIDS epidemic. Following circumcision, it is recommended that patients abstain from ...sexual activity for six weeks, as sex may increase the risk of female-to-male HIV transmission and prolong the healing period. This paper investigates the resumption of sexual activity during the healing period among a cohort of school-going males in the KwaZulu-Natal province of South Africa. The analysis for this paper compares two groups of sexually active school-going males: the first group reported having sex during the healing period (n = 40) and the second group (n = 98) reported no sex during the healing period (mean age: 17.7, SD: 1.7).The results show that 29% (n = 40) of young males (mean age: 17.9, SD: 1.8) who were previously sexually active, resumed sexual activity during the healing period, had on average two partners and used condoms inconsistently. In addition, those males that engage in sexual activity during the healing period were less inclined to practice safe sex in the future (AOR = 0.055, p = 0.002) than the group of males who reported no sex during the healing period. These findings suggest that a significant proportion of young males may currently and in the future, subject themselves to high levels of risk for contracting HIV post circumcision. Education, as part of a VMMC campaign, must emphasize the high risk of HIV transmission for both the males their partners during the healing period.
Kangite (IMA 2011-092), (Sc,Ti,Al,Zr,Mg,Ca,)2O3, is a new scandia mineral, occurring as micrometer-sized crystals with REE-rich perovskite and spinel in a davisite-dominant ultra-refractory inclusion ...from the Allende CV3 carbonaceous chondrite. The phase was characterized by SEM, EBSD, synchrotron micro-Laue diffraction, micro-Raman, and EPMA. The mean chemical composition of the type kangite is (wt%) TiO2 36.6, Sc2O3 26.4, ZrO2 11.3, Al2O3 7.0, Y2O3 5.4, CaO 3.9, MgO 3.14, Dy2O3 1.8, SiO2 1.7, V2O3 1.31, Er2O3 0.92, FeO 0.8, Gd2O3 0.60, Ho2O3 0.40, Tb2O3 0.18, Cr2O3 0.09, ThO2 0.04, O -0.3, sum 101.28, which leads to an empirical formula calculated on the basis of 3 O atoms of (Sc0.54 Al0.16 Y0.07 V0.03 Gd0.01 Dy0.01 Er0.01)3+Σ0.83(Ti0.66 Zr0.13)4+Σ0.79 (Mg0.11 Ca0.06 Fe0.02)2+Σ0.190.19Σ2.00O3. Synchrotron micro-Laue diffraction (i.e., an energy scan by a high-flux X-ray monochromatic beam) on one type domain at submicrometer resolution revealed that kangite has a cation-deficient Ia3 bixbyite-type cubic structure. The cell parameters are a=9.842(1) Å, V=953.3(1) Å3, Z=16, which leads to a calculated density of 3.879 g/cm3. Kangite is a new ultra-refractory mineral, likely originating through low-temperature oxidation of a Sc-,Ti3+-enriched high-temperature condensate oxide dating to the birth of the Solar System.
Short Message Service (SMS) offers an innovative method of promoting sexual health to key and vulnerable populations who are users of mobile phones and are at high risk of HIV infection. This cluster ...randomised control trial tests the effectiveness of a SMS intervention in reducing HIV risk behaviours and improving HIV testing behaviours among truck drivers, sex workers and community residents located near Roadside Wellness Clinics (RWCs) in three southern African countries. The SMS arm received 35 HIV risk reduction and HIV testing SMSs over a 6-month period. The SMS intervention had no significant impact on sexual risk behaviours. However, participants in the SMS arm were more likely to have tested for HIV in the previous 6 months (86.1% vs. 77.7%; AOR 1.71, 95% CI 1.11–2.66). The results indicate that the general SMS intervention, which provide health promoting information, improved HIV testing rates in key and vulnerable populations in southern Africa.
Purpose
This study sought to assess risk compensation following voluntary medical male circumcision of young school-going men. Risk compensation is defined as an inadvertent increase in sexual risk ...behaviors and a corresponding decrease in self-perceived risk for contracting HIV following the application of a risk reduction technology.
Methods
This study documented the sexual practices of circumcised (
n
= 485) and uncircumcised (
n
= 496) young men in 42 secondary schools at three time points (baseline and 6 and 12 months) in a sub-district of KwaZulu-Natal, South Africa. Study participants were aged from 16 to 24 years old.
Results
At the end of the study period, there was no significant difference between the two cohorts concerning learners’ perceptions of being at risk of contracting HIV (interaction effect:
b
= −0.12,
p
= 0.40). There was also no significant difference in the number of sexual partners in the previous month (interaction effect:
b
= −0.23,
p
= 0.15). The proportion of learners who have never used a condom decreased significantly over time (time effect:
b
= −0.27,
p
= 0.01), and there was no difference between the circumcised and uncircumcised learners (interaction effect:
b
= −0.09,
p
= 0.91).
Conclusions
Risk compensation, as evidenced in this study over a 1-year period, was not associated with undergoing voluntary medical male circumcision (VMMC) in our sample of young school-going men. However, it is of concern that at the end of this study, less than half of the sexually active sample in a high-HIV-prevalence community used condoms consistently in the previous month (39% for both study cohorts). The latter underscores the need to view VMMC as a potential entry point for planned HIV and sexuality education interventions targeting young men in this community.
Comprehensive sexuality education (CSE) is seen as a key instrument through which to affect behaviour and improve sexual and reproductive health (SRH) outcomes amongst adolescents. However, few ...studies have to date evaluated key SRH outcomes following exposure to CSE within a school setting. This study estimates the association between CSE and HIV testing and HIV testing self-efficacy amongst HIV positive adolescent girls. Data were collected from a cross-sectional survey administered in four high HIV prevalence districts . Independent variables included exposure to CSE, with outcome variables measuring uptake of HIV testing in the 12 months preceding the survey, and HIV testing self-efficacy. The sample comprised 505 HIV positive adolescent girls aged 12-19. . Attending CSE was associated with both; being more confident to get an HIV test (AOR: 2.44, 95% CI: 1.47-4.06,
< 0.001) and having ever tested for HIV (AOR: 2.15, 95% CI: 1.39-3.33,
< 0.001) while controlling for numerous variables. Results suggest CSE can play an important role in not only affecting HIV-related behaviours themselves, but also critical factors that affect HIV behaviours, including self-efficacy.
Ahrensite (IMA 2013-028), γ-Fe2SiO4, is the natural Fe-analog of the silicate-spinel ringwoodite (γ-Mg2SiO4). It occurs in the Tissint Martian meteorite, where it forms through the transformation of ...the fayalite-rich rims of olivine megacrysts or Fe-rich microphenocrysts in contact with shock melt pockets. The typical sequence of phase assemblages traversing across a Tissint melt pocket into olivine is: quenched melt or fayalite-pigeonite intergrowth⇒bridgmanite+wüstite⇒ahrensite and/or ringwoodite⇒highly-deformed olivine+nanocrystalline ringwoodite⇒deformed olivine. We report the first comprehensive set of crystallographic, spectroscopic, and quantitative chemical analysis of type ahrensite, and show that concentrations of ferric iron and inversion in the type material of this newly approved mineral are negligible. We also report the occurrence of nanocrystalline ringwoodite in strained olivine and establish correlations between grain size and distance from melt pockets. The ahrensite and ringwoodite crystals show no preferred orientation, consistent with random nucleation and incoherent growth within a highly strained matrix of olivine. Grain sizes of ahrensite immediately adjacent to melt pockets are consistent with growth during a shock of moderate duration (1–10ms).
Several studies have reported on the benefits of social support for health behaviour, including risky sex. Social support may thus be an important resource for promoting individual health and ...well-being, particularly in regions where HIV rates are high and healthcare resources are scarce. However, prior research on the implications of social support for the health behaviour of young women has yielded mixed and inconclusive findings. Using prospective data from young women in South Africa, this study examines the associations of social support with subsequent sexual practices, health behaviour, and health outcomes.
We used two rounds of longitudinal data from a sample of n = 1446 HIV-negative emerging adult women, aged 18 to 29 years, who participated in a population-based HIV study in KwaZulu-Natal, South Africa. Applying the analytic template for outcome-wide longitudinal designs, we estimated the associations between combinations of social support (i.e. tangible, educational, emotional) and ten HIV risk-related outcomes.
Combinations of tangible, educational, and emotional support, as well as tangible support by itself, were associated with lower risk for several outcomes, whereas educational and emotional support, by themselves or together, showed little evidence of association with the outcomes.
This study highlights the protective role of tangible support in an environment of widespread poverty, and the additional effect of combining tangible support with non-tangible support. The findings strengthen recent evidence on the benefits of combining support in the form of cash and food with psychosocial care in mitigating risk behaviours associated with HIV and negative health outcomes among young women.
Young women in sub-Saharan Africa remain at the epicentre of the HIV epidemic, with surveillance data indicating persistent high levels of HIV incidence. In South Africa, adolescent girls and young ...women (AGYW) account for a quarter of all new HIV infections. Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) is a strategy introduced by the United States President's Emergency Plan for AIDS Relief (PEPFAR) aimed at reducing HIV incidence among AGYW in 10 countries in sub-Saharan Africa by 25% in the programme's first year, and by 40% in the second year. This study will assess the change in HIV incidence and reduction in risk associated behaviours that can be attributed to the DREAMS initiative in South Africa, using a population-based cross-sectional survey.
Data will be collected from a household-based representative sample of AGYW (between the ages 12-24 years) in four high prevalence districts (more than 10% of the population have HIV in these districts) in South Africa in which DREAMS has been implemented. A stratified cluster-based sampling approach will be used to select eligible participants for a cross-sectional survey with 18,500, to be conducted over 2017/2018. A questionnaire will be administered containing questions on sexual risk behaviour, selected academic and developmental milestones, prevalence of gender based violence, whilst examining exposure to DREAMS programmes. Biological samples, including two micro-containers of blood and self-collected vulvovaginal swab samples, are collected in each survey to test for HIV infection, HIV incidence, sexually transmitted infections (STIs) and pregnancy. This study will measure trends in population level HIV incidence using the Limiting antigen (LAg) Avidity Enzyme Immuno-Assay (EIA) and monitor changes in HIV incidence.
Ending the HIV/AIDS pandemic by 2030 requires the continual monitoring and evaluation of prevention programmes, with the aim of optimising efforts and ensuring the achievement of epidemic control. This study will determine the impact DREAMS interventions have had on HIV incidence among AGYW in a 'real world, non-trial setting'.
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