Personal networks among people experiencing homelessness are vital but often overlooked. Drawing on a unique three-year dataset (2022-2024) from over 3,000 unhoused individuals in King County, Washington, this study analyzes the structure and change of four different personal networks: acquaintances, close friends, kinship (household), and peer referrals. Using this respondent-driven sample data set, we find that the mean size of the acquaintance networks ranged from 22 to 27 people, while the mean number of close friendships declined from 4.9 to 4.19. This drop, despite population growth, suggests a decrease in network density and potentially an increase in social isolation or a shift in composition (e.g., more people experiencing homelessness for the first time). However, we do see growth in the kinship networks, which grew slightly, indicating a greater prevalence of family cohomelessness or reliance on kin. These shifts highlight the need for policies that foster social connection and community stability.

In chronic diseases, accelerated muscle mass loss is associated with poor clinical outcomes. Computed tomography (CT) is considered a reference standard for assessing muscle mass, but it is limited for longitudinal assessment. Ultrasound (US) is more suitable for longitudinal measurements, but limited reliability data or reference values exist to inform clinical adoption. This pilot study evaluated the reliability of rectus femoris (RF) muscle US measurements [cross-sectional area (CSA) and shear-wave elastography (SWE) stiffness] and investigated their relationship with CT-derived truncal muscle mass. Forty healthy living liver donors undergoing abdominal CT were included. CT-derived skeletal muscle area and skeletal muscle index at T12 and L3 were quantified using deep learning. US B-mode and SWE RF images obtained with manual and automated measurements. Reliability was assessed using intraclass correlation (ICC). Agreement between manual and automated methods was evaluated using the Dice coefficient. US and CT measurements associations were evaluated using Pearson correlation and multiple linear regression. Inter-reader agreement for manual US CSA was excellent (ICC=0.95, 95% CI: 0.88-0.97). Test-retest reliability of SWE was good (ICC=0.78, 95% CI: 0.67-0.87). Automated and manual methods showed strong agreement (Dice coefficient 0.94) and good reliability (ICC=0.85, 95% CI: 0.75-0.91). RF CSA demonstrated weak but significant correlations with CT-derived skeletal muscle area at both T12 and L3 levels (r=0.37 to 0.40, P<0.05). US parameters showed moderate predictive value for CT-derived skeletal muscle index at L3 (adjusted R²=0.70). In conclusion, RF US measurements are reliable, and automated measurements are feasible but show a modest correlation with CT-derived muscle mass measurements.

Aquaculture is the fastest-growing seafood production system globally, offering economic and social opportunities for small-scale fishing communities. Yet, it is often introduced through top-down, technocratic approaches that ignore the social-ecological realities of these communities. Drawing on four case studies from Mexico and Honduras, this study uses a multistage, participatory mixed-methods approach to examine the integration of aquaculture into existing fisheries. We focus on governance, social organization, economic assets, and cultural traditions, key yet understudied dimensions of implementation. Findings reveal that projects overlooking these interactions risk deepening inequities, displacing traditional livelihoods, and weakening community cohesion. Success depends on early economic support, recognition of local traditions and social structures, and the creation of context-specific governance systems. Centering community needs and experiences can help design equitable, place-based aquaculture initiatives that strengthen, rather than disrupt, small-scale fishing livelihoods.

As persons with human immunodeficiency virus (PWH) live longer, interactions between human immunodeficiency virus (HIV), aging, and structural brain integrity become increasingly vital for understanding cognitive disorders. This study analyzed the effects of aging, HIV serostatus, and viral load on cognition and brain volumes in a large cohort of persons without HIV (PWOH), PWH with undetectable virus (PWHU) (HIV RNA ≤50 copies/mL), and PWH with detectable virus (PHWD) (HIV RNA >50 copies/mL). Cross-sectional and longitudinal data were included. Cognitive composites (NPZ4) and brain volumes were obtained from 259 PWOH, 264 PWHU, and 84 PWHD with a total of 841 sessions. A series of generalized additive mixed models explored group differences in the relationship between age and cognition, age and regional brain volumes, and interactions between age and brain volumes on cognition. PWOH and PWHU exhibited similar change in cognitive performance with age, while PWHD exhibited a steeper decline compared to both. While both PWH groups had significantly smaller regional brain volumes compared to PWOH, the slopes of volume loss with age were similar across all groups except in the lentiform regions. Smaller brain volumes and increased age interacted for greater cognitive decline in PWHD. PWH who achieve viral suppression do not exhibit accelerated decline in cognition or brain volumes compared to PWOH, while PWHD may be at an increased risk for accelerated cognitive decline. These findings highlight the clinical importance of managing viral load in aging PWH and suggest that once viral suppression is achieved, changes to brain integrity are not accelerated compared to PWOH.

Sequestration of Plasmodium falciparum-infected erythrocytes (IE) in the microvasculature is a major virulence determinant. While the sequestration of mature stage parasites (trophozoite and schizonts) to vascular endothelium is well established, the conditions that promote ring-stage IE sequestration are less understood. Here, we observed in ring-stage parasites that febrile exposure increased transcript levels of several exported parasite genes involved in the trafficking of the P. falciparum erythrocyte membrane protein 1 (PfEMP1) ligand responsible for adherence to the endothelium of blood vessels. Furthermore, it accelerated PfEMP1 surface display in ring-stage IEs, leading to a 2-fold increase in their binding in a perfusable 3D human brain microvessel model. Additionally, we observed that parasite exposure enhances the binding of uninfected erythrocytes in 3D brain microvessels. These findings suggest a complex interplay between fever and parasite biomass in the pathogenesis of cerebral malaria.

In response to large-scale health crises, emergency healthcare infrastructure projects (EHIPs) have been implemented to provide healthcare services rapidly. However, few studies have systematically explored the success of these projects. This study aims to assess the success of EHIPs throughout the whole life cycle using a cloud matter-element model (CMEM). Considering multiple performance indicators that measure the success of EHIPs, a hierarchy model of the project success index is proposed through eight rounds of Delphi surveys. This model comprises 10 key performance indicators (KPIs) that are most appropriate for measuring the success of EHIPs and 20 quantitative metrics aligned with these KPIs across the life cycle. Based on the hierarchy model, the CMEM is applied to evaluate the success of EHIPs, which effectively addresses the fuzziness and randomness inherent in the Delphi process. Two cases were then utilized for verifying the practicality of the proposed project success assessment model. The findings demonstrate that the CMEM-based assessment offers not only significant flexibility but also high accuracy, robustness, and scalability. The CMEM-based assessment seamlessly integrates numerous incompatible indexes and their characteristic values, without being limited by the number of evaluation indexes. Further, sensitivity analyses are conducted to test the robustness of the assessment model and its results. These analyses confirmed that the CMEM is a robust, reliable, and adaptable tool for assessing the success of EHIPs. Theoretically, this study should set an exemplar of aggregating the performance measurement with emergency management and healthcare systems, facilitating an efficient response to major crises. It also provides a novel approach to evaluating multiple-criteria decision-making problems. Practically, this study should enable project management teams to identify and improve weak areas, ensuring continuous success in the EHIP-related domain.