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Understanding the brain requires understanding neurons’ functional responses to the circuit architecture shaping them. Here we introduce the MICrONS functional connectomics dataset with dense calcium imaging of around 75,000 neurons in primary visual cortex (VISp) and higher visual areas (VISrl, VISal and VISlm) in an awake mouse that is viewing natural and synthetic stimuli. These data are co-registered with an electron microscopy reconstruction containing more than 200,000 cells and 0.5 billion synapses. Proofreading of a subset of neurons yielded reconstructions that include complete dendritic trees as well the local and inter-areal axonal projections that map up to thousands of cell-to-cell connections per neuron. Released as an open-access resource, this dataset includes the tools for data retrieval and analysis 1 , 2 . Accompanying studies describe its use for comprehensive characterization of cell types 3 , 4 , 5 – 6 , a synaptic level connectivity diagram of a cortical column 4 , and uncovering cell-type-specific inhibitory connectivity that can be linked to gene expression data 4 , 7 . Functionally, we identify new computational principles of how information is integrated across visual space 8 , characterize novel types of neuronal invariances 9 and bring structure and function together to uncover a general principle for connectivity between excitatory neurons within and across areas 10 , 11 . Dense calcium imaging combined with co-registered high-resolution electron microscopy reconstruction of the brain of the same mouse provide a functional connectomics map of tens of thousands of neurons of a region of the primary cortex and higher visual areas.

Background. Pre-exposure prophylaxis (PrEP) is an effective prevention tool for people at substantial risk of acquiring human immunodeficiency virus (HIV). To monitor the current state of PrEP use among men who have sex with men (MSM), we report on willingness to use PrEP and PrEP utilization. To assess whether the MSM subpopulations at highest risk for infection have indications for PrEP according to the 2014 clinical guidelines, we estimated indications for PrEP for MSM by demographics. Methods. We analyzed data from the 2014 cycle of the National HIV Behavioral Surveillance (NHBS) system among MSM who tested HIV negative in NHBS and were currently sexually active. Adjusted prevalence ratios and 95% confidence intervals were estimated from log-linked Poisson regression with generalized estimating equations to explore differences in willingness to take PrEP, PrEP use, and indications for PrEP. Results. Whereas over half of MSM said they were willing to take PrEP, only about 4% reported using PrEP. There was no difference in willingness to take PrEP between black and white MSM. PrEP use was higher among white compared with black MSM and among those with greater education and income levels. Young, black MSM were less likely to have indications for PrEP compared with young MSM of other races/ethnicities. Conclusions. Young, black MSM, despite being at high risk of HIV acquisition, may not have indications for PrEP under the current guidelines. Clinicians may need to consider other factors besides risk behaviors such as HIV incidence and prevalence in subgroups of their communities when considering prescribing PrEP.

Anthropogenic climate change calls for rapid and enormous cuts in emissions of CO₂ and other greenhouse gases to mitigate future impacts. Even with these, however, many changes will continue to occur over the next 20–30 years adding to those already observed. Adaptation is crucial and urgent, but identifying strategies is complex and requires dialogue and cooperation among stakeholders, especially for infrastructure that exhibits interdependent risks in that failure in one type may impact others. A serious game was codeveloped with infrastructure operators to communicate climate projections and climate hazards to them; identify potential interdependencies, cascading impacts, cumulative effects, and vulnerability hot spots; and engage them to improve cooperation and enable a shared understanding of cross-cutting climate risks and interdependencies. In the game, players provide present-day infrastructure services in the Inverclyde district, Scotland, as they experience a plausible decade of 2050s weather characterized by a sequence of hazard events. This sequence was extracted from climate model projections to ensure scientific plausibility. The infrastructure operators were responsible for drinking water and gas supplies, road and rail transport, wastewater treatment, and civil infrastructure. When playing the game the participating U.K. infrastructure providers felt that although there were challenges, they could cope with 2050s climate change. None of the projected hazard events were anticipated to cause catastrophic impact cascades on infrastructure. The game was positively received, and the study suggests it is a useful tool to both communicate climate hazards and explore potential interdependent risks by bringing together stakeholders’ individual expertise in an engaging way.

This article is a broad review focused on dragon trees—one of the most famous groups of trees in the world, well known from ancient times. These tertiary relicts are severely endangered in most of the area where they grow. The characteristic features of the dragon tree group are described and the species belonging to this group are listed. This review gathers together current knowledge regarding the taxonomy, evolution, anatomy and morphology, physiology, and ontogeny of arborescent dragon tree species. Attention is also paid to the composition, harvesting, medicinal, and ethnobotanical use of the resin (dragons’ blood). An evaluation of population structure, distribution, ecology, threats, and nature conservation forms the final part of the review. In the conclusions we recommend further avenues of research that will be needed to effectively protect all dragon tree species.

Traditional approaches to practice guidelines frequently result in dissociation between strength of recommendation and quality of evidence. To construct a clinical guideline for pyogenic osteomyelitis management, with a new standard of evidence to resolve the gap between strength of recommendation and quality of evidence, through the use of a novel open access approach utilizing social media tools. This consensus statement and systematic review study used a novel approach from the WikiGuidelines Group, an open access collaborative research project, to construct clinical guidelines for pyogenic osteomyelitis. In June 2021 and February 2022, authors recruited via social media conducted multiple PubMed literature searches, including all years and languages, regarding osteomyelitis management; criteria for article quality and inclusion were specified in the group's charter. The GRADE system for evaluating evidence was not used based on previously published concerns regarding the potential dissociation between strength of recommendation and quality of evidence. Instead, the charter required that clear recommendations be made only when reproducible, prospective, controlled studies provided hypothesis-confirming evidence. In the absence of such data, clinical reviews were drafted to discuss pros and cons of care choices. Both clear recommendations and clinical reviews were planned with the intention to be regularly updated as new data become available. Sixty-three participants with diverse expertise from 8 countries developed the group's charter and its first guideline on pyogenic osteomyelitis. These participants included both nonacademic and academic physicians and pharmacists specializing in general internal medicine or hospital medicine, infectious diseases, orthopedic surgery, pharmacology, and medical microbiology. Of the 7 questions addressed in the guideline, 2 clear recommendations were offered for the use of oral antibiotic therapy and the duration of therapy. In addition, 5 clinical reviews were authored addressing diagnosis, approaches to osteomyelitis underlying a pressure ulcer, timing for the administration of empirical therapy, specific antimicrobial options (including empirical regimens, use of antimicrobials targeting resistant pathogens, the role of bone penetration, and the use of rifampin as adjunctive therapy), and the role of biomarkers and imaging to assess responses to therapy. The WikiGuidelines approach offers a novel methodology for clinical guideline development that precludes recommendations based on low-quality data or opinion. The primary limitation is the need for more rigorous clinical investigations, enabling additional clear recommendations for clinical questions currently unresolved by high-quality data.

Background. Over half of human immunodeficiency virus (HIV) infections in the United States occur among men who have sex with men (MSM). Among MSM, 16% of estimated new infections in 2010 occurred among black MSM <25 years old. Methodology. We analyzed National HIV Behavioral Surveillance data on MSM from 20 cities. Poisson models were used to test racial disparities, by age, in HIV prevalence, HIV awareness, and sex behaviors among MSM in 2014. Data from 2008, 2011, and 2014 were used to examine how racial/ethnic disparities changed across time. Results. While black MSM did not report greater sexual risk than other MSM, they were most likely to be infected with HIV and least likely to know it. Among black MSM aged 18–24 years tested in 2014, 26% were HIV positive. Among white MSM aged 18–24 years tested in 2014, 3% were HIV positive. The disparity in HIV prevalence between black and white MSM increased from 2008 to 2014, especially among young MSM. Conclusions. Disparities in HIV prevalence between black and white MSM continue to increase. Black MSM may be infected with HIV at younger ages than other MSM and may benefit from prevention efforts that address the needs of younger men.

Preexposure prophylaxis (PrEP) reduces the risk for sexual human immunodeficiency virus transmission by approximately 99%. In 2017, approximately one third of gay, bisexual, and other men who have sex with men (MSM) reported using PrEP. Although PrEP awareness was high for all racial/ethnic groups, a lower percentage of black and Hispanic MSM than white MSM had discussed PrEP with a health care provider or had used PrEP within the past year. To expand PrEP use, interventions to increase PrEP awareness, encourage health care providers to discuss PrEP, destigmatize PrEP use, and promote racial/ethnic equity in PrEP access are needed.

Evaluating routine HIV testing and treatment and use of services for people who inject drugs (PWID) is critical to curb the ongoing HIV epidemic. We analyzed data from the 2018 National HIV Behavioral Surveillance of PWID aged 18 years or older, recruited using respondent-driven sampling and offered anonymous HIV testing after survey. We performed bivariate and multivariable analyses with log-linked Poisson regression of the generalized linear models to examine the associations between demographics and PWID service use, past-year HIV testing, and current antiretroviral therapy (ART) use. Among 10,311 HIV-negative PWID, 56% reported past-year HIV testing, and of the 553 HIV-positive PWID, 69% reported current ART use. Of the HIV-negative PWID, 64% (2874/4482) in drug treatment and 62% (3386/5440) who used syringe service programs (SSPs) reported past-year HIV testing. Among HIV-positive PWID, 75% (187/248) in drug treatment and 67% (200/298) SSP participants were on ART. In the adjusted multivariable model, past-year HIV testing was associated with drug use treatment (aPR 1.26, 95% CI 1.23–1.31) and SSP participation (aPR 1.19, 95% CI 1.13–1.26) among HIV-negative PWID. Current ART use was associated with drug use treatment (aPR 1.13, 95% CI 1.00–1.28) but the link was not significant probably due to small sample size. Findings support the expansion and improvement of PWID-targeted services, into comprehensive programs, including drug use treatment, SSP, and HIV testing and treatment.

MSM bear a disproportionate burden of the HIV epidemic. Enacted stigma (overt negative actions) against sexual minorities may play an important role in increasing HIV risk among this population. Using data from the 2011 National HIV Behavioral Surveillance system, MSM cycle, we examined the independent associations between three measures of enacted stigma (verbal harassment, discrimination, physical assault) and engagement in each of four HIV-related risk behaviors as outcomes: condomless anal intercourse (CAI) at last sex with a male partner of HIV discordant or unknown status and, in the past 12 months, CAI with a male partner, ≥4 male sex partners, and exchange sex. Of 9819 MSM, 32% experienced verbal harassment in the past 12 months, 23% experienced discrimination, and 8% experienced physical assault. Discordant CAI at last sex with a male partner was associated with previous discrimination and physical assault. Past 12 month CAI with a male partner, ≥4 male sex partners, and exchange sex were each associated with verbal harassment, discrimination, and physical assault. These findings indicate that a sizable proportion of MSM report occurrences of past 12 month enacted stigma and suggest that these experiences may be associated with HIV-related risk behavior. Addressing stigma towards sexual minorities must involve an integrated, multi-faceted approach, including interventions at the individual, community, and societal level.