Cryptococcus neoformans is a pathogen that is common in immunosuppressed patients. It can be treated with amphotericin B and fluconazole, but the mortality rate remains 15 to 30%. Thus, novel and more effective anticryptococcal therapies are needed. The troponoids are based on natural products isolated from western red cedar, and have a broad range of antimicrobial activities. Extracts of western red cedar inhibit the growth of several fungal species, but neither western red cedar extracts nor troponoid derivatives have been tested against C. neoformans. We screened 56 troponoids for their ability to inhibit C. neoformans growth and to assess whether they may be attractive candidates for development into anticryptococcal drugs. We determined MICs at which the compounds inhibited 80% of cryptococcal growth relative to vehicle-treated controls and identified 12 compounds with MICs ranging from 0.2 to 15 M. We screened compounds with MICs of Յ20 M for cytotoxicity in liver hepatoma cells. Fifty percent cytotoxicity values (CC 50 s) ranged from 4 to Ͼ100 M. The therapeutic indexes (TI, CC 50 /MIC) for most of the troponoids were fairly low, with most being Ͻ8. However, two compounds had TI values that were Ͼ8, including a tropone with a TI of Ͼ300. These tropones are fungicidal and are not antagonistic when used in combination with fluconazole or amphotericin B. Inhibition by these two tropones remains unchanged under conditions favoring cryptococcal capsule formation. These data support the hypothesis that troponoids may be a productive scaffold for the development of novel anticryptococcal therapies.

We report on data we collected from a 2018 survey examining jails’ human papillomavirus virus vaccine delivery capacity and on a secondary analysis we conducted to describe factors similarly associated with delivery planning for the COVID-19 vaccine. We provide recommendations for delivering the COVID-19 vaccine in jails, based on evidence from Kansas, Iowa, Nebraska, and Missouri. Our key finding is that jails have limited staff to implement vaccination and will require collaboration between jail administrators, jail medical staff, and local health departments.

Criminal-legal involved women experience significant barriers to preventive cervical care, and consequently there is a higher incidence of cervical cancer in this population. The purpose of this study is to identify variables that may facilitate abnormal Pap follow-up among criminal-legal involved women living in community settings. The study included n = 510 women with criminal-legal histories, from three U.S. cities—Birmingham, AL; Kansas City, KS/MO; Oakland, CA. Participants completed a 288-item survey, with questions related to demographics, social advantages, provider communication, and reasons for missing follow-up care. There were n = 58 women who reported abnormal Pap testing, and n = 40 (69%) received follow-up care. Most women received either repeat Pap/HPV testing (n = 15, 38%), or colposcopy and/or biopsy (n = 14, 35%). Women who did not follow-up (n = 15, 26%) cited that they forgot (n = 8, 53%), were uninsured (n = 3, 20%), or were reincarcerated (n = 3, 20%). In a multivariate analysis, both having a primary care provider (OR 4.6, 95% CI 1.3–16.0) and receiving specific provider communication about follow-up (OR 3.8, 95% CI 1.1–13.2) were independent predictors for abnormal Pap follow-up. Interventions that offer linkages to providers in the community or ensure abnormal Pap care plans are communicated effectively may mitigate the disparate incidence of cervical cancer among criminal-legal involved women.

E very year, more than 3.2 million women come into contact with the criminal legal system in the United States. 1 Representing the fastest-growing incarcerated group, women with criminal legal histories are more likely to report chronic conditions, such as cancer, hypertension, heart disease, and diabetes. 2 Around 67% of females in jails reported ever having a chronic condition. 3 On top of these health issues, many women are affected by sexual trauma, poverty, drug addition, mental illness, and limited access to medical care. 4 The majority of incarcerated women are between the ages of 18 and 44. 1 Women with incarceration histories bear a greater burden of sexual and reproductive health problems such as abnormal Pap test histories, cervical cancer, unintended pregnancies, and sexually transmitted infections (STIs). 1,5,6 In addition, there is a growing number of women in jails and prisons who are 55 and older, a group of women who have lower rates of up-to-date mammograms compared with the general population. 7,8 When released from jail, women must face these and other health and social problems as they reorient themselves back into the community. 9,10 Community reentry presents an opportune moment for health intervention in that it gets women to think about changing circumstances at a high-risk time 11 and may provide women with resources to see those changes through. Researchers have found that women with past criminal legal histories are often savvy health care users, though woefully underinsured in some regions of the U.S. 12 Although most incarcerated women are knowledgeable about behavioral health issues to some extent, many have beliefs about women's health that are outdated, often affected by family, medical, or social beliefs about screening regimens, or in some cases their own trauma histories. 13 These

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