User- and Message-Level Correlates of Endorsement and Engagement for HIV-Related Messages on Twitter: Cross-sectional Study

BackgroundYouth and young adults continue to experience high rates of HIV and are also frequent users of social media. Social media platforms such as Twitter can bolster efforts to promote HIV prevention for these individuals, and while HIV-related messages exist on Twitter, little is known about the impact or reach of these messages for this population.ObjectiveThis study aims to address this gap in the literature by identifying user and message characteristics that are associated with tweet endorsement (favorited) and engagement (retweeted) among youth and young men (aged 13-24 years).MethodsIn a secondary analysis of data from a study of HIV-related messages posted by young men on Twitter, we used model selection techniques to examine user and tweet-level factors associated with tweet endorsement and engagement.ResultsTweets from personal user accounts garnered greater endorsement and engagement than tweets from institutional users (aOR 3.27, 95% CI 2.75-3.89; P<.001). High follower count was associated with increased endorsement and engagement (aOR 1.05, 95% CI 1.04-1.06; P<.001); tweets that discussed STIs garnered lower endorsement and engagement (aOR 0.59, 95% CI 0.47-1.74; P<.001).ConclusionsFindings suggest practitioners should partner with youth to design and disseminate HIV prevention messages on social media, incorporate content that resonates with youth audiences, and work to challenge stigma and foster social norms conducive to open conversation about sex, sexuality, and health.     

Heart Failure after Laboratory Confirmed Influenza Infection (FLU-HF)

Background:Influenza has been shown to exacerbate heart failure (HF). Importantly, no study to date has examined the relationship between HF hospitalizations (HFH) with laboratory confirmed influenza infections. This study evaluated the association between laboratory confirmed influenza infection and HFH in the two largest hospitals in Saskatchewan, Canada.Methods:We used a retrospective self-controlled case series design to evaluate the association between laboratory-confirmed influenza infection and HFH. We compared the incidence ratio for HFH during the influenza risk interval with the control interval. We defined the influenza risk interval as the seven days after a laboratory confirmed influenza result and the control interval as one year before and after the risk interval.Results:We identified 114 HFH that occurred within one year before and after a positive test result for influenza between April 1, 2010, and April 30, 2018. Of these, 28 (28 admissions per week) occurred during the risk interval and 86 (0.853 admissions per week) occurred during the control interval. The incidence ratio of a HFH during the risk interval as compared with the control interval was 33.53 (95% confidence interval [CI], 21.89 to 51.36). A decline in incidence was observed after day seven; between days 8 to 14 and 14 to 28 incidence ratios was 0.91 (95% CI, 0.13 to 6.52) and 0.91 (95% CI, 0.22 to 3.68) respectively.Conclusion:We have observed a significant association between acute influenza infection and HFH. However, further research with a larger sample size and involving a multicenter setting is warranted.Highlights

• Influenza may contribute and exacerbate heart failure events especially during annual influenza season.
• Early identification of influenza among patients with heart failure, could lead to earlier treatment with antiviral medication, reduce unnecessary antibiotic use, and tail off the morbidity and mortality.
• In this study, despite our efficient study design, our sample size was limited to only the two largest hospitals in the province, possibly excluding a significant population in remote areas.

     

Insights on Skin Quality and Clinical Practice Trends in Asia Pacific and a Practical Guide to Good Skin Quality from the Inside Out

ObjectiveWe sought to examine the current skin quality trends and gaps in clinical practice in the Asia Pacific region and develop a practical guide to improve skin quality.MethodsMedical practitioners from 11 countries in the Asia Pacific region completed an online survey on current trends in skin quality treatment. A panel of 12 leading experts convened for a virtual meeting to develop a practical guide for skin quality improvement.ResultsA total of 153 practitioners completed the survey. The four most common skin quality issues were uneven skin tone, skin surface unevenness, skin laxity, and sebaceous gland hyperactivity and enlarged pores. Most practitioners reported using a combination of treatment modalities for each skin quality issue. It was also observed that each treatment modality could be used to treat several skin quality issues. A multimodal approach targeting different interrelated issues across the tissue planes was recommended for balanced results. The panel developed a practical guide for the appropriate combinations and sequence of treatments, and created treatment protocols for specific skin quality outcome goals. The guide employed an “inside-out” approach, treating the deeper tissue planes prior to the superficial layers to achieve harmonious results.LimitationsFuture studies are needed to support the recommended treatment protocols for skin quality improvement.ConclusionThese findings provide valuable insights on current skin quality trends and gaps in clinical practice. The practical guide provides a framework for practitioners to customize their treatment plan according to each patient’s needs.     

Influenza A Virus Hemagglutinin and Other Pathogen Glycoprotein Interactions with NK Cell Natural Cytotoxicity Receptors NKp46, NKp44, and NKp30

Natural killer (NK) cells are part of the innate immunity repertoire, and function in the recognition and destruction of tumorigenic and pathogen-infected cells. Engagement of NK cell activating receptors can lead to functional activation of NK cells, resulting in lysis of target cells. NK cell activating receptors specific for non-major histocompatibility complex ligands are NKp46, NKp44, NKp30, NKG2D, and CD16 (also known as FcγRIII). The natural cytotoxicity receptors (NCRs), NKp46, NKp44, and NKp30, have been implicated in functional activation of NK cells following influenza virus infection via binding with influenza virus hemagglutinin (HA). In this review we describe NK cell and influenza A virus biology, and the interactions of influenza A virus HA and other pathogen lectins with NK cell natural cytotoxicity receptors (NCRs). We review concepts which intersect viral immunology, traditional virology and glycobiology to provide insights into the interactions between influenza virus HA and the NCRs. Furthermore, we provide expert opinion on future directions that would provide insights into currently unanswered questions.     

Body surface area and medication dosing in patients with heart failure with reduced ejection fraction

Multiple medications are proven to reduce morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), but data regarding personalized approaches to optimize medication dosing remain limited. Current treatment guidelines recommend up-titration to target or maximally tolerated doses of these medications, yet use and dosing remain suboptimal in clinical practice. Body surface area (BSA) is a readily available clinical metric, used for dosing many medications, closely associated with blood pressure, renal function, and vascular congestion, and may influence efficacy, safety, and tolerability of HFrEF medications. In this review, we examine the rationale, strengths/weaknesses, and potential utility of BSA as a means of optimizing HFrEF medication use and dosing.     

New and emerging treatments for inflammatory itch

ObjectiveTo summarize recent therapeutic developments for chronic pruritus with a focus on allergic and type 2 inflammatory pathways.Data SourcesLiterature search of PubMed, industry websites, and review of the ClinicalTrials.gov database.Study SelectionsPeer-reviewed publications and public disclosures by industry relating to chronic pruritus pathophysiology and therapeutics.ResultsHistamine and immunoglobulin E remain primary targets for the treatment of itch in the setting of chronic urticaria. More recently, blockade of type 2 immune cell–associated cytokines, including interleukin (IL) 4, IL-13, and IL-31, and the epithelial cell–derived cytokines, specifically IL-33 and thymic stromal lymphopoietin, has and is revolutionizing the treatment of chronic pruritic dermatoses, such as atopic dermatitis and prurigo nodularis. Other novel targets include histamine receptor 4, Janus kinases, κ-opioid receptor, neurokinin 1 receptor, and phosphodiesterase 4.ConclusionAdvances in our understanding of the neuroimmunology of chronic pruritus have led to the identification of new therapeutic targets and the rapid development of cutting-edge clinical trials. Although incredible advances have already been made, chronic itch continues to be an area of great unmet need.