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Photosynthesis is generally assumed to be initiated by a single photon 1 – 3 from the Sun, which, as a weak light source, delivers at most a few tens of photons per nanometre squared per second within a chlorophyll absorption band 1 . Yet much experimental and theoretical work over the past 40 years has explored the events during photosynthesis subsequent to absorption of light from intense, ultrashort laser pulses 2 – 15 . Here, we use single photons to excite under ambient conditions the light-harvesting 2 (LH2) complex of the purple bacterium Rhodobacter sphaeroides , comprising B800 and B850 rings that contain 9 and 18 bacteriochlorophyll molecules, respectively. Excitation of the B800 ring leads to electronic energy transfer to the B850 ring in approximately 0.7 ps, followed by rapid B850-to-B850 energy transfer on an approximately 100-fs timescale and light emission at 850–875 nm (refs. 16 – 19 ). Using a heralded single-photon source 20 , 21 along with coincidence counting, we establish time correlation functions for B800 excitation and B850 fluorescence emission and demonstrate that both events involve single photons. We also find that the probability distribution of the number of heralds per detected fluorescence photon supports the view that a single photon can upon absorption drive the subsequent energy transfer and fluorescence emission and hence, by extension, the primary charge separation of photosynthesis. An analytical stochastic model and a Monte Carlo numerical model capture the data, further confirming that absorption of single photons is correlated with emission of single photons in a natural light-harvesting complex. Using a heralded single-photon source along with coincidence counting, we establish time correlation functions for B800 excitation and B850 fluorescence emission and demonstrate that both events involve single photons.

Though bonds with pets can be health-promoting for people with HIV (PWH), recent studies indicate that owning pets may complicate healthcare access, especially for those with fewer economic resources, poorer social support, and a strong human-animal bond. In this study, we make a case for considering pets to be an important element of the social environment that can influence healthcare access and utilization among PWH. Pet-owning PWH ( n = 204) were recruited at healthcare and community sites throughout Florida as part of a larger survey study (the “Florida Cohort”). We developed a 12-item index of pet-related barriers to healthcare, which was designed to assess whether the participants experienced or anticipated any barriers to accessing and/or utilizing timely healthcare or health-related services due to pet caregiving or concerns about pet welfare. We estimated a series of regression models (negative binomial, logistic regression) to assess the effects of comfort from companion animals, human social support, healthcare needs, and sociodemographic characteristics on 1) the total number of pet-related healthcare barriers endorsed, 2) previously experienced pet-related healthcare barriers, and 3) anticipated pet-related healthcare barriers. Thirty-six percent of the sample reported at least one experienced or anticipated pet-related barrier to their healthcare; 17% reported previous healthcare barriers and 31% anticipated future healthcare barriers. Greater comfort from companion animals, greater healthcare needs, and poorer social support were associated with a greater probability of experiencing or anticipating any pet-related healthcare barriers. Those who identified racially as Black were less likely to anticipate future healthcare barriers than those who were White. Income was associated with pet-related healthcare barriers in all models. Given the importance of health maintenance for PWH and previous research suggesting pets may be an important emotional support for this population, social safety net programs and community partnerships that support multispecies families are strongly recommended.

Background Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP) prevents HIV transmission but has low uptake among women. Identifying women who could benefit from PrEP remains a challenge. This study developed a women-specific model to predict HIV risk within a year using electronic health record (EHR) data and social determinants of health (SDoH). Methods We conducted a case-cohort study using EHR and claims data from a centralized patient repository in the Southeastern United States (OneFlorida+). The dataset was split into 60% training, 30% testing, and 10% calibration. Five-fold cross-validation was applied for hyperparameter tuning. Contextual-level SDoH were linked to EHR/claim data. Various machine learning (ML) methods were tested, and Shapley Additive Explanations (SHAP) values were used to interpret the model. Results Our sample included 1,458 women newly diagnosed with HIV and 33,155 controls who had never been diagnosed. The XGBoost model outperformed other ML methods, achieving an area under the curve (AUC) of 89.3%. Sensitivity and specificity ranged from 83% to 82% at the optimal Youden’s index cutoff, identifying 20% as high risk, to 42% and 97% at the optimal F1 score cutoff, identifying 5% as high risk. Of the 20 features with the highest SHAP values, 11 were related to SDoH. Conclusion The final model, incorporating demographics, clinical features, and SDoH, can predict HIV risk in the next year for women. Several SDoH factors were found to be important predictors. Future work could involve stakeholders in implementing the model into HIV PrEP decision support and exploring causal pathways to guide risk-reduction interventions.

[This corrects the article DOI: 10.1371/journal.pone.0292658.].

Alcohol misuse is highly prevalent in the United States and results in a huge financial and public health burden. Current alcohol reduction treatments are underused, and there is a critical need for innovation in the field. Transdermal alcohol biosensors measure alcohol use passively and continuously and may be helpful tools in alcohol interventions. To date, however, alcohol biosensors have not been widely used to directly intervene on alcohol use. There is a new wrist-worn biosensor that could be used to help people reduce their drinking, although it is unclear how best to incorporate such a device into an alcohol intervention. We aimed to identify desired features that would be acceptable and helpful in a wrist-worn biosensor-based alcohol intervention for adults who drink heavily. Participants were recruited through an alcohol contingency management study, a contact registry, and participant referral. To qualify, participants had to be aged at least 40 years, report drinking at least twice per week, and indicate interest in reducing their drinking. We conducted a semistructured interview with each participant via Zoom (Zoom Video Communications, Inc). The interview guide addressed general thoughts on the wrist-worn biosensor, how participants thought a wrist-worn biosensor could be used to help people quit or reduce drinking, types of information that participants would want to receive from the biosensor, how they would want to receive this information, and how they thought this information could be used to change their behavior. Interviews were transcribed verbatim and analyzed using thematic analysis. The sample comprised 20 adults (mean age 55.1, SD 6.1 years; 11/20, 55%, women; and 17/20, 85%, Black). Of the 20 participants, 9 (45%) had previous experience with the Secure Continuous Remote Alcohol Monitor continuous alcohol monitoring ankle biosensor from participating in an alcohol contingency management study. The desirable features could be grouped into 5 main themes: features that would influence willingness to use the biosensor (it should look attractive and be both comfortable to wear and accessible), personalized messaging (personalized biosensor-based prompts and feedback could be helpful), preference for time wearing the biosensor (for some, just wearing the biosensor could have an intervention effect), sharing data with others (this was appealing to many but not to all), and mental health support (many felt that mental health support could be incorporated into the biosensor). Five main themes that would maximize interest in using a wrist-worn biosensor for alcohol intervention were identified. Taken together, the identified themes could inform the development of a just-in-time adaptive intervention that uses a wrist-worn biosensor to help adults who drink heavily reduce their alcohol use.

The relationship between lifetime abuse (i.e., childhood abuse, intimate partner violence) and risky behaviors is well established. One proposed mechanism is poor emotion regulation and executive functioning, as a potential mechanism that may explain the relationship between lifetime abuse and risky behaviors. However, research on executive functioning and emotion regulation as mediators of this relationship has been limited. In the present study, we examined this association. We hypothesized that lifetime abuse would be significantly associated with executive function and emotion regulation which in turn would be associated with greater alcohol use and risky sex. This cross-sectional study included 150 women with a history of lifetime abuse who were assessed for hazardous alcohol use using the AUDIT Score; emotion regulation was measured using the Difficulties with Emotion Regulation Scale (DERS); risky sex was measured using the question: \"in the last 90 days, how many people did you have anal or vaginal sex without using a condom? Executive function was assessed using the NIH Toolbox. The mediation model followed the self-regulation theory, which proposes executive function as the higher-order cognitive process. Results showed that executive function deficit and poor emotion regulation significantly mediated the relationship between lifetime abuse and hazardous alcohol use (indirect effect = .097, SE .031, 95% CI = .035 to .158). Our findings suggest a higher-order cognitive process with executive function promoting emotion regulation as a potential mechanism for alcohol problems in women of color who experienced lifetime abuse.

Introduction Hazardous alcohol use is prevalent among people with HIV, with women disproportionately experiencing adverse alcohol-related outcomes in HIV care. This study aimed to qualitatively explore factors contributing to the onset, escalation, and continuation of hazardous drinking among women with HIV. Methods Women with HIV and hazardous drinking patterns were recruited from the WHAT-IF? Study, a randomized trial evaluating the efficacy of naltrexone for alcohol reduction. Participants completed 60-minute semi-structured interviews. Interview transcripts were analyzed using thematic analysis methods. Results Twenty women (mean age 49.3 years; 85% Black) participated. Common themes identified by the participants as influencing their drinking onset and escalation were early exposure and normalization, and the impact of use among family and friends. Emotion and coping were identified as essential motivators in drinking escalation, as well as drug use (using alcohol and drugs together or using alcohol instead of drugs). These factors also contributed to the persistence of hazardous drinking, alongside participants’ perceived health benefits of alcohol. While not common, some participants talked about a history of trying to reduce or stop drinking; they reported that their mental health and family and friends were instrumental in encouraging sobriety or continued alcohol use. Conclusion Women with HIV identified emotional and social factors as primary drivers of hazardous drinking across their lifespan. Interventions that address coping strategies and enhance social support may be beneficial in reducing alcohol use in this population.

This study examined factors associated with TB among persons living with HIV (PLWH) in Florida and the agreement between self-reported and medically documented history of tuberculosis (TB) in assessing the risk factors. Self-reported and medically documented data of 655 PLWH in Florida were analyzed. Data on sociodemographic factors such as age, race/ethnicity, place of birth, current marital status, education, employment, homelessness in the past year and 'ever been jailed' and behavioural factors such as excessive alcohol use, marijuana, injection drug use (IDU), substance and current cigarette use were obtained. Health status information such as health insurance status, adherence to HIV antiretroviral therapy (ART), most recent CD4 count, HIV viral load and comorbid conditions were also obtained. The associations between these selected factors with self-reported TB and medically documented TB diagnosis were compared using Chi-square and logistic regression analyses. Additionally, the agreement between self-reports and medical records was assessed. TB prevalence according to self-reports and medical records was 16.6% and 7.5% respectively. Being age ≥55 years, African American and homeless in the past 12 months were statistically significantly associated with self-reported TB, while being African American homeless in the past 12 months and not on antiretroviral therapy (ART) were statistically significantly associated with medically documented TB. African Americans compared to Whites had odds ratios of 3.04 and 4.89 for self-reported and medically documented TB, respectively. There was moderate agreement between self-reported and medically documented TB (Kappa = 0.41). TB prevalence was higher based on self-reports than medical records. There was moderate agreement between the two data sources, showing the importance of self-reports. Establishing the true prevalence of TB and associated risk factors in PLWH for developing policies may therefore require the use of self-reports and confirmation by screening tests, clinical signs and/or microbiologic data.

Background Racial/ethnic disparities in the HIV care continuum have been well documented in the US, with especially striking inequalities in viral suppression rates between White and Black persons with HIV (PWH). The South is considered an epicenter of the HIV epidemic in the US, with the largest population of PWH living in Florida. It is unclear whether any disparities in viral suppression or immune reconstitution—a clinical outcome highly correlated with overall prognosis—have changed over time or are homogenous geographically. In this analysis, we 1) investigate longitudinal trends in viral suppression and immune reconstitution among PWH in Florida, 2) examine the impact of socio-ecological factors on the association between race/ethnicity and clinical outcomes, 3) explore spatial and temporal variations in disparities in clinical outcomes. Methods Data were obtained from the Florida Department of Health for 42,369 PWH enrolled in the Ryan White program during 2008-2020. We linked the data to county-level socio-ecological variables available from County Health Rankings. GEE models were fit to assess the effect of race/ethnicity on immune reconstitution and viral suppression longitudinally. Poisson Bayesian hierarchical models were fit to analyze geographic variations in racial/ethnic disparities while adjusting for socio-ecological factors. Results Proportions of PWH who experienced viral suppression and immune reconstitution rose by 60% and 45%, respectively, from 2008-2020. Odds of immune reconstitution and viral suppression were significantly higher among White [odds ratio =2.34, 95% credible interval=2.14-2.56; 1.95 (1.85-2.05)], and Hispanic [1.70 (1.54-1.87); 2.18(2.07-2.31)] PWH, compared with Black PWH. These findings remained unchanged after accounting for socio-ecological factors. Rural and urban counties in north-central Florida saw the largest racial/ethnic disparities. Conclusions There is persistent, spatially heterogeneous, racial/ethnic disparity in HIV clinical outcomes in Florida. This disparity could not be explained by socio-ecological factors, suggesting that further research on modifiable factors that can improve HIV outcomes among Black and Hispanic PWH in Florida is needed.

Despite campaigns to increase safer sex practices, there are people living with HIV/AIDS (PLWH) who do not disclose their HIV status to sexual partners and engage in condomless sex. The purpose of this research was to: 1) describe factors associated with disclosure of HIV status to sexual partners; and 2) determine if disclosure and/or receipt of prevention counseling are independently associated with condomless sex. We used the Florida Medical Monitoring Project to analyze data from 376 HIV positive men with more than one sexual partner. Results indicated that 55% consistently disclosed their HIV status to sexual partners, 30% inconsistently disclosed, 15% did not disclose, and 48% reported any condomless sex. The odds of having condomless sex was 3.3 (CI = 1.5, 7.3) times greater in men who disclosed to all partners. Results suggest that men who disclose are also those who are more likely to have condomless sex. More research is needed to better understand the complex nature of disclosure and sexual risk behaviors and how disclosure impacts sexual risk.