Determining the minimum required uranium carbide content for HTGR UCO fuel kernels

International Nuclear Information System (INIS)

McMurray, Jacob W.; Lindemer, Terrence B.; Brown, Nicholas R.; Reif, Tyler J.; Morris, Robert N.; Hunn, John D.

2017-01-01

Highlights: • The minimum required uranium carbide content for HTGR UCO fuel kernels is calculated. • More nuclear and chemical factors have been included for more useful predictions. • The effect of transmutation products, like Pu and Np, on the oxygen distribution is included for the first time. - Abstract: Three important failure mechanisms that must be controlled in high-temperature gas-cooled reactor (HTGR) fuel for certain higher burnup applications are SiC layer rupture, SiC corrosion by CO, and coating compromise from kernel migration. All are related to high CO pressures stemming from O release when uranium present as UO 2 fissions and the O is not subsequently bound by other elements. In the HTGR kernel design, CO buildup from excess O is controlled by the inclusion of additional uranium apart from UO 2 in the form of a carbide, UC x and this fuel form is designated UCO. Here general oxygen balance formulas were developed for calculating the minimum UC x content to ensure negligible CO formation for 15.5% enriched UCO taken to 16.1% actinide burnup. Required input data were obtained from CALPHAD (CALculation of PHAse Diagrams) chemical thermodynamic models and the Serpent 2 reactor physics and depletion analysis tool. The results are intended to be more accurate than previous estimates by including more nuclear and chemical factors, in particular the effect of transmuted Pu and Np oxides on the oxygen distribution as the fuel kernel composition evolves with burnup.

Simultaneous contrast: evidence from licking microstructure and cross-solution comparisons.

Science.gov (United States)

Dwyer, Dominic M; Lydall, Emma S; Hayward, Andrew J

2011-04-01

The microstructure of rats' licking responses was analyzed to investigate both "classic" simultaneous contrast (e.g., Flaherty & Largen, 1975) and a novel discrete-trial contrast procedure where access to an 8% test solution of sucrose was preceded by a sample of either 2%, 8%, or 32% sucrose (Experiments 1 and 2, respectively). Consumption of a given concentration of sucrose was higher when consumed alongside a low rather than high concentration comparison solution (positive contrast) and consumption of a given concentration of sucrose was lower when consumed alongside a high rather than a low concentration comparison solution (negative contrast). Furthermore, positive contrast increased the size of lick clusters while negative contrast decreased the size of lick clusters. Lick cluster size has a positive monotonic relationship with the concentration of palatable solutions and so positive and negative contrasts produced changes in lick cluster size that were analogous to raising or lowering the concentration of the test solution respectively. Experiment 3 utilized the discrete-trial procedure and compared contrast between two solutions of the same type (sucrose-sucrose or maltodextrin-maltodextrin) or contrast across solutions (sucrose-maltodextrin or maltodextrin-sucrose). Contrast effects on consumption were present, but reduced in size, in the cross-solution conditions. Moreover, lick cluster sizes were not affected at all by cross-solution contrasts as they were by same-solution contrasts. These results are consistent with the idea that simultaneous contrast effects depend, at least partially, on sensory mechanisms.

Novel superconducting state in ferromagnetic superconductor UCoGe. Microscopic coexistence of ferromagnetism and superconductivity probed by 59Co-NQR measurements

International Nuclear Information System (INIS)

Ishida, Kenji; Hattori, Taisuke; Ihara, Yoshihiko; Nakai, Yusuke; Sato, Noriaki K.; Deguchi, Kazuhiko; Tamura, Nobuyuki; Satoh, Isamu

2010-01-01

We have investigated the relationship between ferromagnetism and superconductivity in ferromagnetic superconductor UCoGe from 59 Co nuclear quadrupole resonance (NQR) measurements. Our experimental results indicate the microscopic coexistence of ferromagnetism and superconductivity in UCoGe, and suggest a 'self-induced vortex state' in its superconducting state. We also review NQR experiments, which play an important role in this study. (author)

Magnetic stripes in the UCoGe superconductor

Energy Technology Data Exchange (ETDEWEB)

Mora, Pablo de la [Departemento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-542, 04510 Mexico DF, Mexico and Institute de Investigacion en Materiales, Universidad Nacional Autonoma de Mexico, Campus Morelia (Mexico); Navarro, O, E-mail: delamora@unam.m [Instituto de Investigacion en Materiales, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-360, 04510 Mexico DF (Mexico)

2009-05-01

The magnetic superconductor UCoGe is analyzed with an electronic structure package, spin-orbit coupling and intra-atomic repulsion (via Hubbard U{sub H}) were included. The possibility of an antiferromagnetic configuration is studied, but it is found to be unstable, also the non-collinear magnetization seems to be ruled out. The magnetization is given mainly by the Co-atoms with M = 0.6 mu{sub B}/f.u. The U-atoms have two magnetic moments; M = 0.07 and 0.32 mu{sub B}/f.u. arranged in an alternated planes along the b-direction forming magnetic stripes.

THE LICK/SDSS LIBRARY. I. SYNTHETIC INDEX DEFINITION AND CALIBRATION

International Nuclear Information System (INIS)

Franchini, M.; Morossi, C.; Di Marcantonio, P.; Malagnini, M. L.; Chavez, M.

2010-01-01

A new synthetic library of spectral feature indices, Lick/Sloan Digital Sky Survey (SDSS), for stellar population studies is presented. Lick/SDSS is computed from synthetic spectra with resolving power R = 1800 to fully exploit the content of the spectroscopic SDSS-DR7 stellar database. The Lick/SDSS system is based on the Lick/IDS one complemented with a UV index in the wavelength region of Ca II H and K lines. The system is well suited to study α-element abundances in F, G, and K stars. The reliability of synthetic indices in reproducing the behaviors of observational ones with effective temperature, surface gravity, overall metallicity, and α-element abundances is tested by using empirical stellar libraries (ELODIE, INDO-U.S., and MILES) and the SDSS-DR7 spectroscopic database. The importance of using the same temperature scale in comparing theoretical and observational indices is discussed. The full consistency between Lick/SDSS and observational indices derived from the above mentioned stellar libraries is assessed. The comparison with indices computed from SDSS-DR7 spectra evidences good consistency for 'dwarf' stars and significant disagreement for 'giant' stars due to systematic overestimation of the stellar T eff by the SEGUE Stellar Parameter Pipeline.

Ferromagnetism in 5f-band metamagnet UCoAl induced by Os doping

Czech Academy of Sciences Publication Activity Database

Andreev, Alexander V.; Shirasaki, K.; Šebek, Josef; Vejpravová, Jana; Gorbunov, Denis; Havela, L.; Daniš, S.; Yamamura, T.

2016-01-01

Roč. 681, Oct (2016), 275-282 ISSN 0925-8388 R&D Projects: GA ČR GA16-03593S Institutional support: RVO:68378271 Keywords : uranium intermetallics * UCoAl * itinerant metamagnetism Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 3.133, year: 2016

HIV-negative male couples' attitudes about pre-exposure prophylaxis (PrEP) and using PrEP with a sexual agreement.

Science.gov (United States)

Mitchell, Jason W; Lee, Ji-Young; Woodyatt, Cory; Bauermeister, José; Sullivan, Patrick; Stephenson, Rob

2016-08-01

One efficacious strategy to help prevent HIV is oral pre-exposure prophylaxis (PrEP), a daily regimen of antiretroviral treatment taken by HIV-negative individuals. Two of the recommendations of Centers for Disease Control and Prevention (CDC) guidelines for PrEP pertain to being in a relationship (i.e., male couples). Despite the recognition of how primary partners in male couples' relationships shape HIV risk and CDC's PrEP guidelines, there is a paucity of data that examine HIV-negative male couples' attitudes toward PrEP use and using PrEP with a sexual agreement. A sexual agreement is an explicit agreement made between two individuals about what sex and other related behaviors may occur within and outside of their relationship. In this qualitative study, we examine HIV-negative male couples' attitudes toward PrEP use and whether they thought PrEP could be integrated into a sexual agreement. Data for this study are drawn from couple-level interviews conducted in 2014 with 29 HIV-negative male couples who had a sexual agreement and were from Atlanta or Detroit. Both passive (e.g., flyers) and active (e.g., targeted Facebook advertisements) recruitment methods were used; the sample was stratified by agreement type. Thematic analysis was applied to identify the following themes regarding HIV-negative male couples' attitudes toward PrEP use: (1) PrEP and condom use; (2) concerns about PrEP (e.g., effectiveness, side effects, and promoting sexually risky behavior); and (3) accessibility of PrEP. Some thought PrEP could be a part of couples' agreement because it could help reduce sexual anxiety and sexual risk, and would help keep the couple safe. Others described PrEP use with an agreement as something for "others". Some were also concerned that incorporating PrEP could usurp the need for a sexual agreement in a couples' relationship. These themes highlight the need to improve informational messaging and promotion efforts about PrEP among HIV-negative male couples

Pressure-induced itinerant electron metamagnetism in UCo0.995Os0.005Al ferromagnet

Science.gov (United States)

Mushnikov, N. V.; Andreev, A. V.; Arnold, Z.

2018-05-01

The effect of external hydrostatic pressure on magnetic properties is studied for the UCo0.995Os0.005Al single crystal. At ambient pressure, the ground state is ferromagnetic. Even lowest applied pressure 0.11 GPa is sufficient to suppress ferromagnetism. A sharp metamagnetic transition is observed only in magnetic fields along the c axis of the crystal, similar to previously studied itinerant electron metamagnet UCoAl. Temperature dependence of the susceptibility for various pressures shows a broad maximum at Tmax 20 K. The experimental data are analyzed with the theory of itinerant electron metamagnetism, which considers anisotropic thermal fluctuations of the uranium magnetic moment. The observed pressure dependence of the susceptibility at Tmax and the temperature for the disappearance of the first-order metamagnetic transition are explained with the theory.

PrEP Whores and HIV Prevention: The Queer Communication of HIV Pre-Exposure Prophylaxis (PrEP).

Science.gov (United States)

Spieldenner, Andrew

2016-12-01

HIV pre-exposure prophylaxis (PrEP) has been introduced as another biomedical tool in HIV prevention. Whereas other such tools-including post-exposure prophylaxis (PEP) and interruption of perinatal transmission-have been embraced by those impacted by HIV, PrEP has been met with more conflict, especially within the gay community and HIV organizations. The "PrEP whore" has come to designate the social value and personal practices of those taking PrEP. This study examines the "PrEP whore" discourse by using queer theory and quare theory. Within these theoretical vantage points, the study explicates four discursive areas: slut shaming, dirty/clean binaries, mourning the loss of condoms, and reclaiming the inner whore. The study illuminates possible discursive strategies that lie outside of the domains of public health and within the individual and community.

Life cycle assessment (LCA) and exergetic life cycle assessment (ELCA) of the production of biodiesel from used cooking oil (UCO)

International Nuclear Information System (INIS)

Talens Peiro, L.; Lombardi, L.; Villalba Mendez, G.; Gabarrell i Durany, X.

2010-01-01

The paper assesses the life cycle of biodiesel from used cooking oil (UCO). Such life cycle involves 4 stages: 1) collection, 2) pre-treatment, 3) delivery and 4) transesterification of UCO. Generally, UCO is collected from restaurants, food industries and recycling centres by authorised companies. Then, UCO is pre-treated to remove solid particles and water to increase its quality. After that, it is charged in cistern trucks and delivered to the biodiesel facility to be then transesterified with methanol to biodiesel. The production of 1 ton of biodiesel is evaluated by a Life Cycle Assessment (LCA) to assess the environmental impact and by an Exergetic Life Cycle Assessment (ELCA) to account for the exergy input to the system. A detailed list of material and energy inputs is done using data from local companies and completed using Ecoinvent 1.2 database. The results show that the transesterification stage causes 68% of the total environmental impact. The major exergy inputs are uranium and natural gas. If targets set by the Spanish Renewable Energy Plan are achieved, the exergy input for producing biodiesel would be reduced by 8% in the present system and consequently environmental impacts and exergy input reduced up to 36% in 2010.

Operant licking for intragastric sugar infusions: differential reinforcing actions of glucose, sucrose and fructose in mice

Science.gov (United States)

Sclafani, Anthony; Ackroff, Karen

2015-01-01

Intragastric (IG) flavor conditioning studies in rodents indicate that isocaloric sugar infusions differ in their reinforcing actions, with glucose and sucrose more potent than fructose. Here we determined if the sugars also differ in their ability to maintain operant self-administration by licking an empty spout for IG infusions. Food-restricted C57BL/6J mice were trained 1 h/day to lick a food-baited spout, which triggered IG infusions of 16% sucrose. In testing, the mice licked an empty spout, which triggered IG infusions of different sugars. Mice shifted from sucrose to 16% glucose increased dry licking, whereas mice shifted to 16% fructose rapidly reduced licking to low levels. Other mice shifted from sucrose to IG water reduced licking more slowly but reached the same low levels. Thus IG fructose, like water, is not reinforcing to hungry mice. The more rapid decline in licking induced by fructose may be due to the sugar's satiating effects. Further tests revealed that the Glucose mice increased their dry licking when shifted from 16% to 8% glucose, and reduced their dry licking when shifted to 32% glucose. This may reflect caloric regulation and/or differences in satiation. The Glucose mice did not maintain caloric intake when tested with different sugars. They self-infused less sugar when shifted from 16% glucose to 16% sucrose, and even more so when shifted to 16% fructose. Reduced sucrose self-administration may occur because the fructose component of the disaccharide reduces its reinforcing potency. FVB mice also reduced operant licking when tested with 16% fructose, yet learned to prefer a flavor paired with IG fructose. These data indicate that sugars differ substantially in their ability to support IG self-administration and flavor preference learning. The same post-oral reinforcement process appears to mediate operant licking and flavor learning, although flavor learning provides a more sensitive measure of sugar reinforcement. PMID:26485294

An open source device for operant licking in rats.

Science.gov (United States)

Longley, Matthew; Willis, Ethan L; Tay, Cindy X; Chen, Hao

2017-01-01

We created an easy-to-use device for operant licking experiments and another device that records environmental variables. Both devices use the Raspberry Pi computer to obtain data from multiple input devices (e.g., radio frequency identification tag readers, touch and motion sensors, environmental sensors) and activate output devices (e.g., LED lights, syringe pumps) as needed. Data gathered from these devices are stored locally on the computer but can be automatically transferred to a remote server via a wireless network. We tested the operant device by training rats to obtain either sucrose or water under the control of a fixed ratio, a variable ratio, or a progressive ratio reinforcement schedule. The lick data demonstrated that the device has sufficient precision and time resolution to record the fast licking behavior of rats. Data from the environment monitoring device also showed reliable measurements. By providing the source code and 3D design under an open source license, we believe these examples will stimulate innovation in behavioral studies. The source code can be found at http://github.com/chen42/openbehavior.

Pressure-induced quantum phase transition in the itinerant ferromagnet UCoGa

Czech Academy of Sciences Publication Activity Database

Míšek, Martin; Prokleška, J.; Opletal, P.; Proschek, P.; Kaštil, Jiří; Kamarád, Jiří; Sechovský, V.

2017-01-01

Roč. 7, č. 5 (2017), s. 1-4, č. článku 055712. ISSN 2158-3226 R&D Projects: GA ČR GA16-06422S Institutional support: RVO:68378271 Keywords : quantum phase transition * high pressure * itinerant ferromagnet * UCoGa Subject RIV: BM - Solid Matter Physics ; Magnetism OBOR OECD: Condensed matter physics (including formerly solid state physics, supercond.) Impact factor: 1.568, year: 2016 http://aip.scitation.org/doi/10.1063/1.4976300

Project Final Report: Ubiquitous Computing and Monitoring System (UCoMS) for Discovery and Management of Energy Resources

Energy Technology Data Exchange (ETDEWEB)

Tzeng, Nian-Feng; White, Christopher D.; Moreman, Douglas

2012-07-14

The UCoMS research cluster has spearheaded three research areas since August 2004, including wireless and sensor networks, Grid computing, and petroleum applications. The primary goals of UCoMS research are three-fold: (1) creating new knowledge to push forward the technology forefronts on pertinent research on the computing and monitoring aspects of energy resource management, (2) developing and disseminating software codes and toolkits for the research community and the public, and (3) establishing system prototypes and testbeds for evaluating innovative techniques and methods. Substantial progress and diverse accomplishment have been made by research investigators in their respective areas of expertise cooperatively on such topics as sensors and sensor networks, wireless communication and systems, computational Grids, particularly relevant to petroleum applications.

Anomalous spin distribution in the superconducting ferromagnet UCoGe studied by polarized neutron diffraction

NARCIS (Netherlands)

Prokeš, K.; de Visser, A.; Huang, Y.K.; Fåk, B.; Ressouche, E.

2010-01-01

We report a polarized neutron-diffraction study conducted to reveal the nature of the weak ferromagnetic moment in the superconducting ferromagnet UCoGe. We find that the ordered moment in the normal phase in low magnetic fields (B∥c) is predominantly located at the U atom and has a magnitude of

Family planning providers' role in offering PrEP to women.

Science.gov (United States)

Seidman, Dominika; Weber, Shannon; Carlson, Kimberly; Witt, Jacki

2018-03-09

Pre-exposure prophylaxis (PrEP) provides a radically different HIV prevention option for women. Not only is PrEP the first discrete, woman-controlled method that is taken in advance of exposure, but it is both safe and highly effective, offering over 90% protection if taken daily. While multiple modalities of PrEP are in development ranging from vaginal rings to injectables and implants, only PrEP with oral tenofovir/emtricitabine is currently FDA-approved. Family planning clinics provide key access points for many women to learn about and obtain PrEP. By incorporating PrEP services into family planning care, family planning providers have the opportunity to meet women's expectations, ensure women are aware of and offered comprehensive HIV prevention options, and reverse emerging disparities in PrEP access. Despite real and perceived barriers to integrating PrEP into family planning care, providing PrEP services, ranging from education to onsite provision, is not only possible but an important component of providing high-quality sexual and reproductive healthcare to women. Lessons learned from early adopters will help guide those in family planning settings initiating or enhancing PrEP services. Copyright © 2018. Published by Elsevier Inc.

Effects of harmane and other β-carbolines on apomorphine-induced licking behavior in rat.

Science.gov (United States)

Farzin, Davood; Haghparast, Abbas; Motaman, Shirine; Baryar, Faegheh; Mansouri, Nazanin

2011-04-01

Harmane, harmine and norharmane are β-carboline compounds which have been referred to as inverse agonists of benzodiazepine receptors. The effect of these compounds on apomorphine-induced licking behavior was studied in rats. Subcutaneous (s.c.) injection of apomorphine (0.5 mg/kg) induced licking. The licking behavior was counted with a hand counter and recorded for a period of 75 min by direct observation. Intraperitoneal (i.p.) injections of harmane (1.25-5 mg/kg), harmine (2.5-10 mg/kg) and norharmane (1.25-5 mg/kg) significantly reduced the licking behavior. In rats pretreated with reserpine (5 mg/kg, i.p., 18 h before the test), the effects of harmane (4 mg/kg, i.p.), harmine (7.8 mg/kg, i.p.) and norharmane (2.5 mg/kg, i.p.) were unchanged. When flumazenil (2 mg/kg, i.p.) was administered 20 min before apomorphine, it was able to antagonize the effects of harmane, harmine and norharmane. It was concluded that the β-carbolines harmane, harmine and norharmane reduce the licking behavior via an inverse agonistic mechanism located in the benzodiazepine receptors. Copyright © 2011 Elsevier Inc. All rights reserved.

Ensembles of gustatory cortical neurons anticipate and discriminate between tastants in a single lick

Directory of Open Access Journals (Sweden)

Jennifer R Stapleton

2007-10-01

Full Text Available The gustatory cortex (GC processes chemosensory and somatosensory information and is involved in learning and anticipation. Previously we found that a subpopulation of GC neurons responded to tastants in a single lick (Stapleton et al., 2006. Here we extend this investigation to determine if small ensembles of GC neurons, obtained while rats received blocks of tastants on a fixed ratio schedule (FR5, can discriminate between tastants and their concentrations after a single 50 µL delivery. In the FR5 schedule subjects received tastants every fifth (reinforced lick and the intervening licks were unreinforced. The ensemble firing patterns were analyzed with a Bayesian generalized linear model whose parameters included the firing rates and temporal patterns of the spike trains. We found that when both the temporal and rate parameters were included, 12 of 13 ensembles correctly identified single tastant deliveries. We also found that the activity during the unreinforced licks contained signals regarding the identity of the upcoming tastant, which suggests that GC neurons contain anticipatory information about the next tastant delivery. To support this finding we performed experiments in which tastant delivery was randomized within each block and found that the neural activity following the unreinforced licks did not predict the upcoming tastant. Collectively, these results suggest that after a single lick ensembles of GC neurons can discriminate between tastants, that they may utilize both temporal and rate information, and when the tastant delivery is repetitive ensembles contain information about the identity of the upcoming tastant delivery.

[College Discovery: America's First PREP Program].

Science.gov (United States)

Smith, James J., Jr.

The Predischarge Education Program (PREP) is a federally funded program, approved in 1970, to help educationally disadvantaged servicemen continue their education. Many junior colleges are running or planning PREP projects in cooperation with military installations and the Veterans Administration. This paper describes the first year of one PREP…

Tech Prep Compendium of Models. [Revised].

Science.gov (United States)

Delaware Technical and Community Coll., Dover.

This publication discusses four models for technical preparation (tech prep): program organization; student progress; tech prep data collection and evaluation model; and school/community. The program organization model is divided into four sections. Section I, the business industry, and labor section, shows the flow from craft committee and…

Potential reduced exposure products (PREPs) in industry trial testimony.

Science.gov (United States)

Wayne, Geoffrey Ferris

2006-12-01

To identify patterns in trial testimony that may reflect on the intentions or expectations of tobacco manufacturers with regard to the introduction of potential reduced exposure products (PREPs). Research was conducted using the Deposition and Trial Testimony Archive (DATTA) collection of trial testimony and depositions housed online at Tobacco Documents Online (www.tobaccodocuments.org). Relevant testimony was identified through full-text searches of terms indicating PREPs or harm reduction strategies. The role and function of PREPs in testimony were classified according to common and contrasting themes. These were analysed in the context of broader trial arguments and against changes in time period and the market. Analysis of testimony suggests that the failure of PREPs in the market tempered initial industry enthusiasm and made protection of the conventional cigarette market its major priority. The "breakthrough" character of PREPs has been de-emphasised, with trial arguments instead positioning PREPs as simply another choice for consumers. This framework legitimises the sale of conventional brands, and shifts the responsibility for adoption of safer products from the manufacturer to the consumer. Likewise, testimony has abandoned earlier dramatic health claims made with regard to PREPs, which had undermined industry arguments regarding efforts to reduce harm in conventional products. More recent testimony advocates the broad acceptance of independent guidelines that would validate use of health claims and enable the industry to market PREPs to consumers. Trial testimony reflects the changing role and positioning of PREPs by the tobacco industry. The findings are of particular importance with regard to future evaluation and potential regulation of reduced harm products.

Regulation of hepatic lipogenesis by the transcription complex Prep1-Pbx1

OpenAIRE

Cabaro, Serena

2011-01-01

Prep1 is an homeodomain transcription factor belonging to the TALE proteins, including also Pbx1, which plays an essential role in hematopoiesis, organogenesis and development. Prep1 forms transcriptionally active complexes with Pbx1 and regulates the activity of several genes. The Prep1 null mutation leads to embryonic death at a very early stage. Therefore, Prep1 hypomorphic (Prep1i/i) mice have been generated. Prep1 heterozygous (Prep1i/+) mice, which express only 55-57% of protein, have a...

SAT math prep course

CERN Document Server

Kolby, Jeff

2011-01-01

Comprehensive Prep for SAT Math Every year, students pay 1,000 and more to test prep companies to prepare for the math section of the new SAT. Now you can get the same preparation in a book. Features: * Comprehensive Review: Twenty-three chapters provide complete review of SAT math. * Practice: Includes 164 examples and more than 500 exercises! Arranged from easy to medium to hard to very hard. * Diagnostic Test: The diagnostic test measures your strengths and weaknesses and directs you to areas you need to study more. * Performance: If your target is a 700+ score, this is the book!

PrEP implementation research in Africa: what is new?

Science.gov (United States)

Cowan, Frances M; Delany-Moretlwe, Sinead; Sanders, Eduard J; Mugo, Nelly R; Guedou, Fernand A; Alary, Michel; Behanzin, Luc; Mugurungi, Owen; Bekker, Linda-Gail

2016-01-01

Of the two million new HIV infections in adults in 2014, 70% occurred in sub-Saharan Africa. Several African countries have already approved guidelines for pre-exposure prophylaxis (PrEP) for individuals at substantial risk of HIV as part of combination HIV prevention but key questions remain about how to identify and deliver PrEP to those at greatest need. Throughout the continent, individuals in sero-discordant relationships, and members of key populations (sex workers, men who have sex with men (MSM), transgender women and injection drug users) are likely to benefit from the availability of PrEP. In addition, adolescent girls and young women (AGYW) are at substantial risk in some parts of the continent. It has been estimated that at least three million individuals in Africa are likely to be eligible for PrEP according to WHO's criteria. Tens of demonstration projects are planned or underway across the continent among a range of countries, populations and delivery settings. In each of the target populations, there are overarching issues related to (i) creating demand for PrEP, (ii) addressing supply-side issues and (iii) providing appropriate and tailored adherence support. Critical for creating demand for PrEP is the normalization of HIV prevention. Community-level interventions which engage opinion leaders as well as empowerment interventions for those at highest risk will be key. Critical to supply of PrEP is that services are accessible for all, including for stigmatized populations. Establishing accessible integrated services provides the opportunity to address other public health priorities including the unmet need for HIV testing, contraception and sexually transmitted infections treatment. National policies need to include minimum standards for training and quality assurance for PrEP implementation and to address supply chain issues. Adherence support needs to recognize that social and structural factors are likely to have an important influence

PrEP implementation in the Asia-Pacific region: opportunities, implementation and barriers

Science.gov (United States)

Zablotska, Iryna; Grulich, Andrew E; Phanuphak, Nittaya; Anand, Tarandeep; Janyam, Surang; Poonkasetwattana, Midnight; Baggaley, Rachel; van Griensven, Frits; Lo, Ying-Ru

2016-01-01

Introduction HIV epidemics in the Asia-Pacific region are concentrated among men who have sex with men (MSM) and other key populations. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention and could be a potential game changer in the region. We discuss the progress towards PrEP implementation in the Asia-Pacific region, including opportunities and barriers. Discussion Awareness about PrEP in the Asia-Pacific is still low and so are its levels of use. A high proportion of MSM who are aware of PrEP are willing to use it. Key PrEP implementation barriers include poor knowledge about PrEP, limited access to PrEP, weak or non-existent HIV prevention programmes for MSM and other key populations, high cost of PrEP, stigma and discrimination against key populations and restrictive laws in some countries. Only several clinical trials, demonstration projects and a few larger-scale implementation studies have been implemented so far in Thailand and Australia. However, novel approaches to PrEP implementation have emerged: researcher-, facility- and community-led models of care, with PrEP services for fee and for free. The WHO consolidated guidelines on HIV testing, treatment and prevention call for an expanded access to PrEP worldwide and have provided guidance on PrEP implementation in the region. Some countries like Australia have released national PrEP guidelines. There are growing community leadership and consultation processes to initiate PrEP implementation in Asia and the Pacific. Conclusions Countries of the Asia-Pacific region will benefit from adding PrEP to their HIV prevention packages, but for many this is a critical step that requires resourcing. Having an impact on the HIV epidemic requires investment. The next years should see the region transitioning from limited PrEP implementation projects to growing access to PrEP and expansion of HIV prevention programmes. PMID:27760688

Home-based pre-exposure prophylaxis (PrEP services for gay and bisexual men: An opportunity to address barriers to PrEP uptake and persistence.

Directory of Open Access Journals (Sweden)

Steven A John

Full Text Available Gay, bisexual, and other men who have sex with men (GBM are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906 would prefer to get PrEP-related care from a primary care provider (PCP compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP, defined to participants as conducting HIV/STI self-testing from home with PrEP prescription mailing after an initial in-person clinic visit. We examined the associations of demographics, sexual HIV transmission risk, concern about frequent medical checkups associated with PrEP, health care access, and PrEP intentions with preferences for healthcare provider type and HB-PrEP. Concern about frequent medical checkups were associated with preferring a PCP for PrEP-related care, but men who perceived a barrier to bringing up the topic of PrEP with a doctor preferred a specialist clinic or provider more than a PCP. HB-PrEP was more appealing for younger men and those engaged in sexual HIV transmission risk, suggesting HB-PrEP could help reach GBM most vulnerable to HIV and in need of PrEP. HB-PrEP expansion has potential to increase PrEP uptake and persistence among GBM, particularly for men with barriers to clinic-based care and higher intentions to initiate PrEP. Clinical guidelines regarding HB-PrEP are needed to expand its use.

Tech Prep Marketing Guide. The Complete Book of Strategies and Practical Experiences.

Science.gov (United States)

Williamson, Patty

This guide explains the concept of marketing tech prep and provides marketing principles and strategies to promote tech prep programs. The guide covers the following topics: (1) why it is necessary to market tech prep; (2) what a comprehensive tech prep marketing plan should include; (3) targeting the benefits message; (4) marketing tech prep to…

Best Practices: A Cure for the New Prep Headache?

Science.gov (United States)

Burns, Alan T.; Steinbach, Theresa A.

2010-01-01

The teaching of a new course is colloquially known among faculty as a "new prep." New preps are often time-consuming and laborious for instructors. They can be particularly frustrating when this effort does not yield results in the classroom. This research explores how a best practice approach can make the transfer of new preps across…

Bone mineral response to ammonium sulphate offered as a lick supplement in beef calves

Directory of Open Access Journals (Sweden)

L.E. Motsei

2006-06-01

Full Text Available Sixteen Bonsmara calves (4 males, 12 females between 10 and 18 months of age were blocked according to age and sex and randomly assigned to 2 groups. They were offered licks containing bone meal and salt (50:50 ratio (control and bone meal and ammonium sulphate (NH4SO4 at 1.25, 2.5, 5, 10, 15, and 18 % (treatment to evaluate the effects of dietary anions on bone phosphate (P concentration. Bone P concentration was significantly (P<0.05 higher in the NH4SO4 group compared with the control group, indicating that NH4SO4 was able to increase the P content of bone at each of the 6 concentrations used in the lick relative to the control animals, thereby improving the P status of the animals. Ammonium sulphate at 15% and 18% in the lick also significantly (P <0.05 increased bone P compared with the lower concentrations of NH4SO4. Bone calcium (Ca fluctuated as a result of the acidogenic lick. There was absorption of Ca when P was being resorbed and resorption of Ca when P was being absorbed into and out of bone. Bone Ca:P ratio ranged from 3.2 to 6.4 among the control group and 1.6 to 4.3 among the treatment group. Animals receiving the acidogenic lick had a higher percentage ash compared to the control group for most of the experimental period. Bone magnesium (Mg fluctuated in response to the acidogenic lick, and it was difficult to show a relationship between bone Mg and Ca or P. The overall mean cortical bone thickness was significantly (P < 0.05 greater in treatment (1.60 mm compared with control (1.43 mm calves and this was also true at sampling periods 2, 4, 5 and 6. Bone thickness followed bone P and not bone Ca. Results from this research indicate that the addition of ammonium sulphate to a lick had a beneficial effect in improving the P status by increasing bone P and improving the mineral status of bone by increasing the thickness of cortical bone and percentage ash.

Inserciones laborales tempranas: Los jóvenes trabajadores agrícolas en el Valle de Uco, Mendoza, Argentina Early labor markets incorporations: Agricultural young workers in the Uco Valley, Mendoza, Argentina

Directory of Open Access Journals (Sweden)

Gabriel I Bober

2011-06-01

Full Text Available Este artículo presenta las diferentes formas de inserción laboral de trabajadores jóvenes en el Valle de Uco, en la provincia de Mendoza. Durante las últimas décadas, el Valle de Uco basó su patrón de desarrollo agrícola en un modelo intensivo y empresarial de sus tres principales cultivos: los viñedos, los frutales y las hortalizas. En la actualidad, atraviesa un proceso de profunda reconversión productiva, orientada mayoritariamente hacia el mercado externo, que entre otras consecuencias pasó a modificar el funcionamiento del mercado de trabajo local. En este artículo, se contemplan las diferentes situaciones que llevan al ingreso laboral de los jóvenes en este contexto, según el momento etáreo que atraviesen. Se analiza la relación que este proceso guarda con el tamaño y la estructura de las familias y la situación socio-económica del hogar al que pertenecen. También, se examina el vínculo entre las características de los hogares y la forma de inserción de los jóvenes en el mercado de trabajo, de acuerdo al tipo de ocupación en la que se desempeñan y al destino que le dan a sus ingresos. A partir de la realización de entrevistas en profundidad a trabajadores jóvenes y a informantes clave se pudo dar cuenta de las preferencias de los jóvenes con respecto a distintos tipos de trabajos, con particular énfasis en ciertos trabajos agrícolas y, también en relación a su futuro laboral.This article deals with the different ways that young workers in the Uco Valley, at the province of Mendoza, enter to the agrarian local labour market. During the last decadas, the Uco Valley based its pattern of agricultural development in an intensive business model of its three main crops: vineyards, orchards, and vegetables. Currently, it is undergoing a process of profound restructuring of production, mainly oriented towards foreign markets, which among different consequences has modified the functioning of local labour markets. In

Head rubbing and licking reinforce social bonds in a group of captive African lions, Panthera leo.

Science.gov (United States)

Matoba, Tomoyuki; Kutsukake, Nobuyuki; Hasegawa, Toshikazu

2013-01-01

Many social animals have a species-specific repertoire of affiliative behaviours that characterise individualised relationships within a group. To date, however, quantitative studies on intragroup affiliative behaviours in social carnivores have been limited. Here, we investigated the social functions of the two most commonly observed affiliative behaviours in captive African lions (Panthera leo): head rubbing and licking. We conducted behavioural observations on a captive group of lions composed of 7 males and 14 females, and tested hypotheses regarding three social functions: tension reduction, social bonding, and social status expression. Disproportionately frequent male-male and female-to-male head rubbing was observed, while more than 95% of all licking interactions occurred in female-female dyads. In accordance with the social bond hypothesis, and in disagreement with the social status expression hypothesis, both head rubbing and licking interactions were reciprocal. After controlling for spatial association, the dyadic frequency of head rubbing was negatively correlated with age difference while licking was positively correlated with relatedness. Group reunion after daily separation did not affect the frequencies of the affiliative behaviours, which was in disagreement with the predictions from the tension reduction hypothesis. These results support the social bond hypothesis for the functions of head rubbing and licking. Different patterns of affiliative behaviour between the sexes may reflect differences in the relationship quality in each sex or the differential predisposition to licking due to its original function in offspring care.

Head rubbing and licking reinforce social bonds in a group of captive African lions, Panthera leo.

Directory of Open Access Journals (Sweden)

Tomoyuki Matoba

Full Text Available Many social animals have a species-specific repertoire of affiliative behaviours that characterise individualised relationships within a group. To date, however, quantitative studies on intragroup affiliative behaviours in social carnivores have been limited. Here, we investigated the social functions of the two most commonly observed affiliative behaviours in captive African lions (Panthera leo: head rubbing and licking. We conducted behavioural observations on a captive group of lions composed of 7 males and 14 females, and tested hypotheses regarding three social functions: tension reduction, social bonding, and social status expression. Disproportionately frequent male-male and female-to-male head rubbing was observed, while more than 95% of all licking interactions occurred in female-female dyads. In accordance with the social bond hypothesis, and in disagreement with the social status expression hypothesis, both head rubbing and licking interactions were reciprocal. After controlling for spatial association, the dyadic frequency of head rubbing was negatively correlated with age difference while licking was positively correlated with relatedness. Group reunion after daily separation did not affect the frequencies of the affiliative behaviours, which was in disagreement with the predictions from the tension reduction hypothesis. These results support the social bond hypothesis for the functions of head rubbing and licking. Different patterns of affiliative behaviour between the sexes may reflect differences in the relationship quality in each sex or the differential predisposition to licking due to its original function in offspring care.

Interactions between superconductivity and quantum criticality in CeCoIn5, URhGe and UCoGe

International Nuclear Information System (INIS)

Howald, L.

2011-01-01

The subject of this thesis is the analyze of the superconducting upper critical field (Hc2) and the interaction between superconductivity and quantum critical points (QCP), for the compounds CeCoIn 5 , URhGe and UCoGe. In CeCoIn 5 , study by mean of resistivity of the Fermi liquid domain allows us to localize precisely the QCP at ambient pressure. This analyze rule out the previously suggested pinning of Hc2(0) at the QCP. In a second part, the evolution of Hc2 under pressure is analyzed. The superconducting dome is unconventional in this compound with two characteristic pressures: at 1.6 GPa, the superconducting transition temperature is maximum but it is at 0.4 GPa that physical properties (maximum of Hc2(0), maximum of the initial slope dHc2/dT, maximum of the specific heat jump DC/C,... ) suggest a QCP. We explain this antagonism with pair-breaking effects in the proximity of the QCP. With these two experiments, we suggest a new phase diagram for CeCoIn 5 . In a third part, measurements of thermal conductivity on URhGe and UCoGe are presented. We obtained the bulk superconducting phase transition and confirmed the unusual curvature of the slope dHc2/dT observed by resistivity. The temperatures and fields dependence of thermal conductivity allow us to identify a non-electronic contribution for heat transport down to the lowest temperature (50 mK) and probably associated with magnon or longitudinal fluctuations. We also identified two different domains in the superconducting region, These domains are compatible with a two bands model for superconductivity. Thermopower measurements on UCoGe reveal a strong anisotropy to current direction and several anomaly under field applied in the b direction. We suggest a Lifshitz transition to explain our observations in these two compounds. (author) [fr

Shrieking, Biting, and Licking

Directory of Open Access Journals (Sweden)

Sarah Stang

2018-01-01

Full Text Available This article examines examples of the monstrous-feminine in the form of abject female monsters in a selection of critically acclaimed and commercially successful video games. Various female monsters from CD Projekt RED’s The Witcher series (2007-2015, and Santa Monica Studio’s God of War series (2005-2013 are considered as examples of the abject monstrous-feminine which fall into a long tradition in horror media of making the female body and body movements into something horrific and repulsive. These female monsters use shrieking, biting, licking, and spreading disease as weapons against the male protagonist, who must slay them to restore symbolic order and progress in the games.

Characterizing ingestive behavior through licking microstructure: Underlying neurobiology and its use in the study of obesity in animal models.

Science.gov (United States)

Johnson, Alexander W

2018-02-01

Ingestive behavior is controlled by multiple distinct peripheral and central physiological mechanisms that ultimately determine whether a particular food should be accepted or avoided. As rodents consume a fluid they display stereotyped rhythmic tongue movements, and by analyzing the temporal distribution of pauses of licking, it is possible through analyses of licking microstructure to uncover dissociable evaluative and motivational variables that contribute to ingestive behavior. The mean number of licks occurring within each burst of licking (burst and cluster size) reflects the palatability of the consumed solution, whereas the frequency of initiating novel bouts of licking behavior (burst and cluster number) is dependent upon the degree of gastrointestinal inhibition that accrues through continued fluid ingestion. This review describes the analysis of these measures within a context of the behavioral variables that come to influence the acceptance or avoidance of a fluid, and the neurobiological mechanisms that underlie alterations in the temporal distribution of pauses of licks. The application of these studies to models of obesity in animals is also described. Copyright © 2017 ISDN. Published by Elsevier Ltd. All rights reserved.

The Fine Temporal Structure of the Rat Licking Pattern: What Causes the Variabiliy in the Interlick Intervals and How is it Affected by the Drinking Solution?

Science.gov (United States)

2013-01-01

Licking is a repetitive behavior controlled by a central pattern generator. Even though interlick intervals (ILIs) within bursts of licks are considered fairly regular, the conditions that affect their variability are unknown. We analyzed the licking pattern in rats that licked water, 10% sucrose solution, or 10% ethanol solution, in 90-min recording sessions after 4h of water deprivation. The histograms of ILIs indicate that licking typically occurred at a preferred ILI of about 130−140ms with evidence of bimodal or multimodal distributions due to occasional licking failures. We found that the longer the pause between bursts of licks, the shorter was the first ILI of the burst. When bursts of licks were preceded by a pause >4 s, the ILI was the shortest (~110ms) at the beginning of the burst, and then it increased rapidly in the first few licks and slowly in subsequent licks. Interestingly, the first ILI of a burst of licks was not significantly different when licking any of the 3 solutions, but subsequent licks exhibited a temporal pattern characteristic of each solution. The rapid deceleration in intraburst licking rate was due to an increase from ~27ms to ~56ms in the tongue-spout contact duration while the intercontact interval was only slightly changed (80−90ms). Therefore, the contact duration seems to be the major factor that increases the variability in the ILIs and could be another means for the rat to adjust the amount of fluid ingested in each individual lick. PMID:23902635

A Closer Look at Racism and Heterosexism in Medical Students' Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education.

Science.gov (United States)

Calabrese, Sarah K; Earnshaw, Valerie A; Krakower, Douglas S; Underhill, Kristen; Vincent, Wilson; Magnus, Manya; Hansen, Nathan B; Kershaw, Trace S; Mayer, Kenneth H; Betancourt, Joseph R; Dovidio, John F

2018-04-01

Social biases among healthcare providers could limit PrEP access. In this survey study of 115 US medical students, we examined associations between biases (racism and heterosexism) and PrEP clinical decision-making and explored prior PrEP education as a potential buffer. After viewing a vignette about a PrEP-seeking MSM patient, participants reported anticipated patient behavior (condomless sex, extra-relational sex, and adherence), intention to prescribe PrEP to the patient, biases, and background characteristics. Minimal evidence for racism affecting clinical decision-making emerged. In unadjusted analyses, heterosexism indirectly affected prescribing intention via all anticipated behaviors, tested as parallel mediators. Participants expressing greater heterosexism more strongly anticipated increased risk behavior and adherence problems, which were associated with lower prescribing intention. The indirect effect via condomless sex remained significant adjusting for background characteristics. Prior PrEP education did not buffer any indirect effects. Heterosexism may compromise PrEP provision to MSM and should be addressed in PrEP-related medical education.

Competition of ground states in URu2Si2 and UCoGe

International Nuclear Information System (INIS)

Hassinger, E.

2010-10-01

In this thesis, two uranium based heavy fermion compounds are studied under pressure. URu2Si2 has a mysterious ground state below T0 = 17.5 K at ambient pressure. The order parameter has not been identified yet which led to the name 'hidden order' (HO). In addition, below 1.5 K the system becomes superconducting. With pressure, the ground state switches from the HO phase to an antiferromagnetic (AF) phase at a critical pressure and superconductivity is concomitantly suppressed. Shubnikov-de Haas measurements under pressure show that the Fermi surface doesn't change between the two phases. The folding of the Fermi surface which occurs in the high pressure AF phase therefore already happens in the HO phase, indicating a unit cell doubling. Our measurements of the complete angular dependence of the oscillation frequencies test the electronic structure and support new theoretical band structure calculations with rather itinerant 5f electrons. The second part of my research focuses on another uranium compound, UCoGe. It is one of the few known materials where superconductivity (Tsc = 0.6 K) coexists with ferromagnetism (T Curie = 2.8 K). Precise studies of the pressure phase diagram by resistivity, ac calorimetry and ac susceptibility show that the ferromagnetic phase is suppressed at a pressure of about 1 GPa and the superconducting phase extends into the paramagnetic phase induced by pressure. When ferromagnetism is suppressed to the superconducting transition no further distinct ferromagnetic anomalies are observed. Thus, the pressure phase diagram of UCoGe is unique in the class of ferromagnetic superconductors. (author)

Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men.

Science.gov (United States)

Greene, George J; Swann, Greg; Fought, Angela J; Carballo-Diéguez, Alex; Hope, Thomas J; Kiser, Patrick F; Mustanski, Brian; D'Aquila, Richard T

2017-05-01

HIV prevention method preferences were evaluated among 512 U.S. men who have sex with men (MSM; median age: 22 years). Approximately 90 % consistently preferred one option across pairwise comparisons of condoms, daily oral pre-exposure prophylaxis (PrEP), and long-acting PrEP delivered via either an injectable or one of two types of PrEP implants differing in visibility. Condoms were most frequently preferred (33.8 %), followed by non-visible implants (21.5 %), and oral PrEP (17.0 %); HIV risk was reported by more choosing implants. In a follow-up question comparing the four PrEP options only, daily oral pills and non-visible implants were most frequently preferred (35.5 and 34.3 %, respectively), followed by injections (25.2 %) and visible implants (4.3 %). An inductive, open-coding approach determined that convenience, duration of protection, and privacy were the most commonly cited reasons for a PrEP method choice, and associated with self-report of HIV risk. Tailoring PrEP product development to privacy and other concerns important to those at highest HIV risk may improve HIV prevention.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study.

Science.gov (United States)

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities.

Who Will Use Pre-Exposure Prophylaxis (PrEP and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study.

Directory of Open Access Journals (Sweden)

Jamie Frankis

Full Text Available Recent clinical trials suggest that pre-exposure prophylaxis (PrEP may reduce HIV transmission by up to 86% for men who have sex with men (MSM, whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK, using a mixed methods design.Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically.Under one third (29.7% of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8% were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use.These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity, as well as to responding to the diverse informational and sexual health needs of all MSM communities.

Ferromagnetic quantum critical fluctuations and anomalous coexistence of ferromagnetism and superconductivity in UCoGe revealed by Co-NMR and NQR studies

International Nuclear Information System (INIS)

Ohta, Tetsuya; Nakai, Yusuke; Ihara, Yoshihiko; Ishida, Kenji; Deguchi, Kazuhiko; Sato, Noriaki K.; Satoh, Isamu

2008-01-01

Co nuclear magnetic resonance (NMR) and nuclear quadrupole resonance (NQR) studies were carried out for the recently discovered UCoGe, in which the ferromagnetic and superconducting (SC) transitions are reported to occur at T Curie - 3 K and T S - 0.8 K, in order to investigate the coexistence of ferromagnetism and superconductivity as well as the normal-state and SC properties from a microscopic point of view. From the nuclear spin-lattice relaxation rate 1/T 1 and Knight-shift measurements, we confirm that ferromagnetic fluctuations that possess a quantum critical character are present above T Curie and also the occurrence of a ferromagnetic transition at 2.5 K in our polycrystalline sample. The magnetic fluctuations in the normal state show that UCoGe is an itinerant ferromagnet similar to ZrZn 2 and YCo 2 . The onset SC transition is identified at T S - 0.7 K, below which 1/T 1 arising from 30% of the volume fraction starts to decrease due to the opening of the SC gap. This component of 1/T 1 , which follows a T 3 dependence in the temperature range 0.3-0.1 K, coexists with the magnetic components of 1/T 1 showing a √T dependence below T S . From the NQR measurements in the SC state, we suggest that the self-induced vortex state is realized in UCoGe. (author)

Process to Obtain Quick Counts from PREP

Directory of Open Access Journals (Sweden)

Martínez–Cruz M.Á.

2011-10-01

Full Text Available Considering the Preliminary Electoral Results Program (PERP as a database of the federal elections for president of the Mexican Republic, a methodology was developed in order to find representative samples of ballot boxes installed in the election’s day (quick count in different hours, due to its characteristics of gathering of information, the PREP in the first hours forms a non-representative sample of data. In a particular way, in the election of July 2, 2006, after 3 hours of opening the PREP, it was observed that the accuracy of the process of the quick counts was better than the one obtained by the IFE. Among other things, this allows to lower the cost, to increase the confidentiality of the ballot boxes used in the sampling and to distinguish in a precise moment the winning candidate long before PREP finishes.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK – A Mixed Methods Study

Science.gov (United States)

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Background Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Methods Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Results Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18–25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. Conclusion These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health

PMP exam prep

CERN Document Server

Mulcahy, Rita

2013-01-01

This book has been FULLY updated to reflect PMI's changes to the PMP exam, and should be used to prepare for all PMP exams delivered on or after July 30th of 2013. Can you imagine valuing a book so much that you send the author a Thank You letter? Hundreds of thousands of project managers know and understand why PMP Exam Prep is a worldwide best-seller. Years of PMP exam preparation experience, endless hours of ongoing research, interviews with project managers who failed the exam to identify gaps in their knowledge, and a razor-sharp focus on making sure project managers don't waste a single minute of their time studying are THE reasons this book is the best-selling PMP exam preparation guide in the world. PMP Exam Prep, Eighth Edition contains hundreds of updates and improvements from previous editions--including new exercises and sample questions never before in print. Offering hundreds of sample questions, critical time-saving tips plus games and activities available nowhere else, this book will help y...

Preparing for the Rollout of Pre-Exposure Prophylaxis (PrEP: A Vignette Survey to Identify Intended Sexual Behaviors among Women in Kenya and South Africa if Using PrEP.

Directory of Open Access Journals (Sweden)

Amy Corneli

Full Text Available Several clinical trials have demonstrated the efficacy of pre-exposure prophylaxis (PrEP in reducing HIV risk. One concern with introducing PrEP is whether users will engage in riskier sexual behaviors.We assessed the effect that PrEP may have on sexual risk behaviors by administering a survey to 799 women in Bondo, Kenya, and Pretoria, South Africa. Participants were asked about their sexual behavior intentions twice--once as if they were taking PrEP and once as if they were not taking PrEP--within four risk situations (vignettes. They responded using a 5-point ordinal scale. We used a series of linear mixed effects models with an unstructured residual covariance matrix to estimate the between- and within-subject differences in the mean likelihood of engaging in risky sexual behavior across the PrEP and non-PrEP contexts. We also calculated the total percentage of participants who reported a greater likelihood of engaging in risky sexual behavior if taking PrEP than if not taking PrEP, by vignette.We found statistically significant differences in the mean likelihood of engaging in risky sexual behavior with the between-subject comparison (-0.17, p < 0.01 and with the within-subject comparison (-0.31, p < 0.001. Depending on the vignette, 27% to 40% of participants reported a greater likelihood of engaging in risky sexual behavior if taking PrEP than if not taking PrEP.Our findings indicate that modest increases in risky sexual behavior could occur with PrEP. Although responses from the majority of participants suggest they would not be more likely to engage in risky sexual behavior if they took PrEP, a substantial proportion might. Programs rolling out PrEP should be prepared to assist similar women in making informed choices about reducing their risk of HIV and about their sexual health beyond HIV prevention.

Measurement of kernel swelling and buffer densification in irradiated UCO-TRISO particles

Energy Technology Data Exchange (ETDEWEB)

Bower, Gordon R., E-mail: bowegr@inl.gov [Idaho National Laboratory, P.O. Box 1625, Idaho Falls, ID, 83415-6188 (United States); Ploger, Scott A.; Demkowicz, Paul A. [Idaho National Laboratory, P.O. Box 1625, Idaho Falls, ID, 83415-6188 (United States); Hunn, John D. [Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, TN, 37830-6093 (United States)

2017-04-01

Radiation-induced volume changes in the fuel kernels and buffer layers of UCO-TRISO particles irradiated to an average burnup of 16.1% FIMA have been determined. Measurements of particle dimensions were made on polished cross-sections of 56 irradiated particles at several different polish planes. The data were then analyzed to compute the equivalent spherical diameters of the kernels and the various coating layers, and these were compared to the average as-fabricated values to determine changes due to irradiation. The kernel volume was found to have increased by an average of 26 ± 6%. Buffer volume decreased by an average of 39 ± 2% due to densification.

PrEP implementation: moving from trials to policy and practice.

Science.gov (United States)

Cáceres, Carlos F; O'Reilly, Kevin R; Mayer, Kenneth H; Baggaley, Rachel

2015-01-01

It is increasingly clear that the HIV response will not be sustainable if the number of infections is not significantly reduced. For two decades, research has been ongoing to identify new behavioural and biomedical strategies to prevent HIV infection. In the past few years, the efficacy of several new strategies has been demonstrated, including oral pre-exposure prophylaxis (PrEP; i.e. daily use of tenofovir/emtricitabine). Because several social, political and logistic barriers remain, however, optimal PrEP implementation will require a better dissemination of new evidence in a number of areas and additional implementation research from various disciplinary perspectives (i.e. social science, policy and ethics; health systems; and economics, including cost-effectiveness studies). Discussion of new evidence on those topics, as well as case studies of potential PrEP implementation in diverse environments, can improve the understanding of the role that PrEP may play in addressing the global HIV/AIDS epidemic.In light of these needs, the Network for Multidisciplinary Studies in ARV-based HIV Prevention (NEMUS) and the World Health Organization (WHO) were honoured to co-organize a special issue of JIAS aimed at contributing to a scholarly discussion of current conditions surrounding PrEP implementation, potential impact and efficiency, social science concerns and the study of PrEP implementation in specific country cases. The papers included in this monograph identify and cover many of the main aspects of the complex yet promising discussions around PrEP implementation today. This is a collection of timely contributions from global leaders in HIV research and policy that addresses geographic diversity, uses a trans-disciplinary approach and covers a variety of the complex issues raised by PrEP. As this publication will become accessible to all, we hope that it will remain a valuable resource for policy makers, programme managers, researchers and activists around the

From modeling to morals: imagining the future of HIV PREP in Lesotho.

Science.gov (United States)

Kenworthy, Nora J; Bulled, Nicola

2013-08-01

Amidst growing global endorsements of new biomedical HIV prevention strategies, ARV-based pre-exposure prophylaxis (ARV PrEP) has garnered considerable attention as a potentially promising prevention strategy. Though it may offer more effective protection for certain at-risk groups than conventional prevention strategies (such as sexual partner reduction, condom use, and prevention of mother-to-child transmission), PrEP is more costly. PrEP requires more ongoing contact between individuals and providers, and a level of surveillance from the health system that is not necessary with other preventive measures. In this sense, it represents a new bio-technology for HIV prevention that poses particular challenges for worldwide implementation, given developing countries' struggling health systems and incomplete HIV treatment programs. Since the emergence of PrEP has stimulated ethical discussions premised on incomplete knowledge of efficacy and implementation, this paper explores the ethical parameters of a likely scenario for PrEP usage in a single, resource-poor country. We first develop a plausible model for PrEP deployment and utilization based on current PrEP research, while carefully considering the reigning institutional values of feasibility and effectiveness in global health approaches. Drawing on ethnographic research of HIV treatment and prevention approaches in Lesotho, we address ethical questions arising from this scenario of PrEP delivery. Lesotho presents a compelling and emblematic case study of PrEP's potential successes and pitfalls in a developing country, given the country's high HIV prevalence, struggles to achieve universal access to HIV treatment regimes, continued existence of stigma around the epidemic, and difficulties in addressing persistent social inequalities that fuel infections. © 2013 John Wiley & Sons Ltd.

PrEP in Europe - expectations, opportunities and barriers.

Science.gov (United States)

McCormack, Sheena Mary; Noseda, Veronica; Molina, Jean-Michel

2016-01-01

In contrast to the global trend showing a decline in new HIV infections, the number reported in the World Health Organization (WHO) region of Europe is increasing. Health systems are disparate, but even countries with free access to screening and treatment observe continuing high rates of new infections in key populations, notably men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is only available in France. This commentary describes the European epidemics and healthcare settings where PrEP could be delivered, how need might be estimated for MSM and the residual barriers to access. Health systems and government commitment to HIV prevention and care, both financial and political, differ considerably between the countries that make up Europe. A common feature is that funds for prevention are a small fraction of funds for care. Although care is generally good, access is limited in the middle-income countries of Eastern Europe and central Asia, and only 19% of people living with HIV received antiretroviral therapy in 2014. It is challenging to motivate governments or civil society to implement PrEP in the context of this unmet treatment need, which is driven by limited national health budgets and diminishing assistance from foreign aid. The high-income countries of Western Europe have hesitated to embrace PrEP for different reasons, initially due to key gaps in the evidence. Now that PrEP has been shown to be highly effective in European MSM in two randomized controlled trials, it is clear that the major barrier is the cost of the drug which is still on patent, although inadequate health systems and diminishing investment in civil society are also key challenges to overcome. The momentum to implement PrEP in European countries is increasing and provides a welcome opportunity to expand and improve clinical services and civil society support focused on HIV and related infections including other sexually transmitted and blood-borne infections.

The future of pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection.

Science.gov (United States)

Özdener, Ayşe Elif; Park, Tae Eun; Kalabalik, Julie; Gupta, Rachna

2017-05-01

People at high risk for HIV acquisition should be offered pre-exposure prophylaxis (PrEP). Tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) is currently the only medication recommended for pre-exposure prophylaxis (PrEP) by the Centers for Disease Control and Prevention (CDC) in people at high risk for HIV acquisition. This article will review medications currently under investigation and the future landscape of PrEP therapy. Areas covered: This article will review clinical trials that have investigated nontraditional regimens of TDF/FTC, antiretroviral agents from different drug classes such as integrase strand transfer inhibitors (INSTI), nucleoside reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) as potential PrEP therapies. Expert commentary: Currently, there are several investigational drugs in the pipeline for PrEP against HIV infection. Increased utilization of PrEP therapy depends on provider identification of people at high risk for HIV transmission. Advances in PrEP development will expand options and access for people and reduce the risk of HIV acquisition.

Cytomorphology of cervicovaginal melanoma: ThinPrep versus conventional Papanicolaou tests.

Science.gov (United States)

Setia, Namrata; Goulart, Robert A; Leiman, Gladywn; Otis, Christopher N; Modem, Rukmini; Pantanowtiz, Liron

2010-12-31

Primary cervicovaginal melanoma is a rare malignancy associated with a high risk of recurrence. Prior studies discussing the cytomorphology of cervicovaginal melanoma have been based primarily on review of conventional Papanicolaou (Pap) smears. The aim of this study was to evaluate cervicovaginal melanomas identified in liquid-based Pap tests, in comparison with features seen on conventional Pap smear preparation. Cases of cervicovaginal melanoma identified on Pap tests with concurrent or subsequent histopathologic confirmation were collected from the Baystate Medical Center cytopathology files and personal archives of the authors over a total period of 34 years. All cytopathology (n = 6) and the available histology slides (n = 5) were reviewed. Cases were analyzed regarding clinical, histopathologic and cytomorphological findings. A total of six cases with invasive cervicovaginal melanoma diagnosed on Pap tests were identified. Most patients were postmenopausal with contact bleeding, correlating with surface ulceration (identified in biopsy/excision material in 5/5 cases). Most cases had deeply invasive tumors (5/5: modified Breslow's thickness > 5 mm and Chung's level of invasion IV/V). Pap tests included four ThinPrep and two conventional smears. Overall, ThinPrep Pap tests exhibited a higher ratio of tumor cells to background squamous cells. While all Pap tests were bloodstained, tumor diathesis was prominent only within conventional smears. Melanoma cells were present both as clusters and scattered single cells in each Pap test type. Both the preparations contained epithelioid tumor cells, whereas spindled tumor cells were seen in only two ThinPrep cases. Prominent nucleoli and binucleation of tumor cells were seen in both the preparations. Melanin pigment was identified in only ThinPrep (3/4) cases and nuclear pseudo-inclusions in one conventional Pap smear. Cell blocks were made in three ThinPrep cases and immunocytochemistry (S-100, HMB45, Melan

Mineral licks: motivational factors for visitation and accompanying disease risk at communal use sites of elk and deer.

Science.gov (United States)

Lavelle, Michael J; Phillips, Gregory E; Fischer, Justin W; Burke, Patrick W; Seward, Nathan W; Stahl, Randal S; Nichols, Tracy A; Wunder, Bruce A; VerCauteren, Kurt C

2014-12-01

Free-ranging cervids acquire most of their essential minerals through forage consumption, though occasionally seek other sources to account for seasonal mineral deficiencies. Mineral sources occur as natural geological deposits (i.e., licks) or as anthropogenic mineral supplements. In both scenarios, these sources commonly serve as focal sites for visitation. We monitored 11 licks in Rocky Mountain National Park, north-central Colorado, using trail cameras to quantify daily visitation indices (DVI) and soil consumption indices (SCI) for Rocky Mountain elk (Cervus elaphus) and mule deer (Odocoileus hemionus) during summer 2006 and documented elk, mule deer, and moose (Alces alces) visiting licks. Additionally, soil samples were collected, and mineral concentrations were compared to discern levels that explain rates of visitation. Relationships between response variables; DVI and SCI, and explanatory variables; elevation class, moisture class, period of study, and concentrations of minerals were examined. We found that DVI and SCI were greatest at two wet, low-elevation licks exhibiting relatively high concentrations of manganese and sodium. Because cervids are known to seek Na from soils, we suggest our observed association of Mn with DVI and SCI was a likely consequence of deer and elk seeking supplemental dietary Na. Additionally, highly utilized licks such as these provide an area of concentrated cervid occupation and interaction, thus increasing risk for environmental transmission of infectious pathogens such as chronic wasting disease, which has been shown to be shed in the saliva, urine, and feces of infected cervids.

Prolyl Endopeptidase (PREP) is Associated With Male Reproductive Functions and Gamete Physiology in Mice.

Science.gov (United States)

Dotolo, Raffaele; Kim, Jung Dae; Pariante, Paolo; Minucci, Sergio; Diano, Sabrina

2016-03-01

Prolyl endopeptidase (PREP) is a serine protease which has been implicated in many biological processes, such as the maturation and degradation of peptide hormones and neuropeptides, learning and memory, cell proliferation and differentiation, and glucose metabolism. A small number of reports have also suggested PREP participation in both male and female reproduction-associated processes. In the present work, we examined PREP distribution in male germ cells and studied the effects of its knockdown (Prep(gt/gt)) on testis and sperm in adult mice. The protein is expressed and localized in elongating spermatids and luminal spermatozoa of wild type (wt) mice, as well as Sertoli, Leydig, and peritubular cells. PREP is also expressed in the head and midpiece of epididymal spermatozoa, whereas the remaining tail region shows a weaker signal. Furthermore, testis weight, histology of seminiferous tubules, and epididymal sperm parameters were assessed in wt and Prep(gt/gt) mice: wild type testes have larger average tubule and lumen diameter; in addition, lumenal composition of seminiferous tubules is dissimilar between wt and Prep(gt/gt), as the percentage of spermiated tubules is much higher in wt. Finally, total sperm count, sperm motility, and normal morphology are also higher in wt than in Prep(gt/gt). These results show for the first time that the expression of PREP could be necessary for a correct reproductive function, and suggest that the enzyme may play a role in mouse spermatogenesis and sperm physiology. © 2015 Wiley Periodicals, Inc.

Lick My Legacy: Are Women-Identified Spaces Still Needed to Nurture Women-Identified DJs?

Directory of Open Access Journals (Sweden)

Maren Hancock

2017-11-01

Full Text Available This article documents Lick Club; a Vancouver, BC lesbian bar that operated from 2003 until 2011, employing predominantly female (as well as trans and non-binary DJs. Specifically, this study examines the effects of Lick’s physical space on the careers of those DJs in the region, focusing on the queer DJ network that evolved from the club. The author bases her findings on qualitative data generated from interviews with key players in Lick’s localized DJ network. The interviewees describe how their participation in Lick provided them with access to mentors, DJ equipment and performance opportunities that proved to be integral to their development as professional DJs. This research corroborates other studies of female DJs in the USA (Farrugia 2004, 2012 and Europe (Gavanas and Reitsamer 2013, 2016 that demonstrate how mentors are of acute importance in fostering the careers of female and non-binary DJs. This study concludes that, although female and non-binary DJs are becoming more common in Canadian nightclubs and festivals, networks such as the one fostered by Lick are still significant to the careers of DJs whose identities do not afford them access to the “boys’ club(s”.

Biochemistry of the tale transcription factors PREP, MEIS, and PBX in vertebrates.

Science.gov (United States)

Longobardi, E; Penkov, D; Mateos, D; De Florian, G; Torres, M; Blasi, Francesco

2014-01-01

TALE (three amino acids loop extension) homeodomain transcription factors are required in various steps of embryo development, in many adult physiological functions, and are involved in important pathologies. This review focuses on the PREP, MEIS, and PBX sub-families of TALE factors and aims at giving information on their biochemical properties, i.e., structure, interactors, and interaction surfaces. Members of the three sets of protein form dimers in which the common partner is PBX but they can also directly interact with other proteins forming higher-order complexes, in particular HOX. Finally, recent advances in determining the genome-wide DNA-binding sites of PREP1, MEIS1, and PBX1, and their partial correspondence with the binding sites of some HOX proteins, are reviewed. These studies have generated a few general rules that can be applied to all members of the three gene families. PREP and MEIS recognize slightly different consensus sequences: PREP prefers to bind to promoters and to have PBX as a DNA-binding partner; MEIS prefers HOX as partner, and both PREP and MEIS drive PBX to their own binding sites. This outlines the clear individuality of the PREP and MEIS proteins, the former mostly devoted to basic cellular functions, the latter more to developmental functions. Copyright © 2013 Wiley Periodicals, Inc.

PREP advertisement features affect smokers’ beliefs regarding potential harm

Science.gov (United States)

Strasser, Andrew A; Tang, Kathy Z; Tuller, Michael D; Cappella, Joseph N

2014-01-01

Background The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. Objective To determine the effect of altering advertisement features on smokers’ beliefs of the harm exposure from a PREP. Methods A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a “red” condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a “no text” condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using “incorrect,” “unsure” and “correct” as outcomes, and advertisement type and covariates as predictors, was used for analyses. Results Participants randomised to the “no text” advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, healthier and make smoking safer. Conclusions Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising. PMID:18768457

PREP advertisement features affect smokers' beliefs regarding potential harm.

Science.gov (United States)

Strasser, A A; Tang, K Z; Tuller, M D; Cappella, J N

2008-09-01

The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. To determine the effect of altering advertisement features on smokers' beliefs of the harm exposure from a PREP. A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a "red" condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a "no text" condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using "incorrect," "unsure" and "correct" as outcomes, and advertisement type and covariates as predictors, was used for analyses. Participants randomised to the "no text" advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer. Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

Structural and magnetic properties of UCo1/3T2/3Al solid solutions (T = Ru, Pt, Rh)

International Nuclear Information System (INIS)

Andreev, A. V.; Bordallo, H. N.; Chang, S.; Nakotte, H.; Schultz, A. J.; Sechovsky, V.; Torikachvili, M. S.

1999-01-01

We report on neutron diffraction studies of UCo 1/3 T 2/3 Al (T = Ru, Pt, Rh). All three solid solutions form in the hexagonal ZrNiAl structure. The Ru-containing compound is found to be chemically ordered, while the Pt-containing compound is nearly disordered and the Rh-containing compound is purely disordered. All three compounds exhibit long-range magnetic order with rather small U moments

Spectroscopic Classifications of PSN J20372558+6607115 with Lick 3-m Reflector

Science.gov (United States)

Foley, R. J.; Zheng, W.; Filippenko, A. V.; van Dyk, S. D.

2015-03-01

We report the classifications of PSN J20372558+6607115 (discovered by K. Shima and announced on the CBAT TOCP) from a spectrum obtained with the Kast dual-beam spectrograph on the Lick 3-m Shane telescope on 2015 March 26 UT.

Element-specific observation of the ferromagnetic ordering process in UCoAl via soft x-ray magnetic circular dichroism

Science.gov (United States)

Takeda, Yukiharu; Saitoh, Yuji; Okane, Tetsuo; Yamagami, Hiroshi; Matsuda, Tatsuma D.; Yamamoto, Etsuji; Haga, Yoshinori; Ōnuki, Yoshichika

2018-05-01

We have performed soft x-ray magnetic circular dichroism (XMCD) experiments on the itinerant-electron metamagnet UCoAl at the U 4 d -5 f (N4 ,5) and Co 2 p -3 d (L2 ,3) absorption edges in order to investigate the magnetic properties of the U 5 f and Co 3 d electrons separately. From the line shape of the XMCD spectrum, it is deduced that the orbital magnetic moment of the Co 3 d electrons is unusually large. Through the systematic temperature (T )- and magnetic field (H )-dependent XMCD measurements, we have obtained two types of the magnetization curve as a function of H and T (M-H curve and M-T curve, respectively). The metamagnetic transition from a paramagnetic state to a field-induced ferromagnetic state was clearly observed under 15 K at HM. The value of the HM and its T dependence agree well between the U and Co sites, and the bulk magnetization. Whereas, we have discovered the remarkable differences in the M-H and M-T curves between the U and Co sites. The present findings clearly show that the role of the Co 3 d electrons should be considered more carefully in order to understand the origin of the magnetic ordering in UCoAl.

Get on Board the Cost Effective Way: A Tech Prep Replication Process.

Science.gov (United States)

Moore, Wayne A.; Szul, Linda F.; Rivosecchi, Karen

1997-01-01

The Northwestern Pennsylvania Tech Prep Consortium model for replicating tech prep programs includes these steps: fact finding, local industry analysis, curriculum development, detailed description, marketing strategies, implementation, and program evaluation. (SK)

The palatability of corn oil and linoleic acid to mice as measured by short-term two-bottle choice and licking tests.

Science.gov (United States)

Yoneda, Takeshi; Saitou, Katsuyoshi; Mizushige, Takafumi; Matsumura, Shigenobu; Manabe, Yasuko; Tsuzuki, Satoshi; Inoue, Kazuo; Fushiki, Tohru

2007-06-08

Free fatty acids (FFAs) were reported to be recognized in the oral cavity and possibly involved in fatty foods recognition. To understand the importance of oil recognition in the oral cavity, we investigated the effect of various concentrations of a fatty acid or corn oil on fluid intake as well as mice's preferences in a two-bottle choice test and a licking test. Linoleic acid (LA), which is a main component of corn oil, was used as a representative FFA. In the two-bottle choice test between a pair of different concentrations of corn oil, the mice consistently adopted the higher concentration of corn oil. In the licking test for corn oil, the licking rates for the serial concentration of corn oils (0, 1, 5, 10 and 100%) were increased in a concentration-dependent manner. On the other hand, in the two-bottle test for a pair of different concentrations of LA (0, 0.125, 0.25 and 1%), 0.25% and 1% LA were preferred to mineral oil, but 0.25% and 1% LA were preferred equally in mice. In the licking test for LA, the mice showed the largest number of initial lickings for the 1% LA, while the licking rates for the high concentration of LA decreased. These results suggest that mice could discriminate the concentration of corn oil and LA in the oral cavity. We also suggest that pure corn oil is a highly preferable solution, while an optimal concentration of LA according to the preferences of mice is a low-range concentration (0.25-1%).

Gynecological applications of helical CT using SmartPrep

Energy Technology Data Exchange (ETDEWEB)

Sakurada, Akira; Kakizaki, Dai; Abe, Kimihiko [Tokyo Medical Coll. (Japan)

1999-11-01

SmartPrep is software program for scanning a given region of interest (ROI) at optimal contrast density. An operator can arbitrarily define ROI and preset the CT value at which scanning should be started. After the injection of a contrast medium, system conducts continuous monitoring of the ROI and the operator starts helical scanning of the planned region when the present CT value has been reached. In comparison with conventional helical CT that requires a period of time from the beginning of contrast medium injection to the beginning of scanning, SmartPrep minimizes personal error and better depicts the artery-predominant phase under optimal conditions. In this study we examine the usefulness of contrast-enhanced helical CT using SmartPrep in the evaluation of gynecological disease. When the contrast medium was injected into the dorsal vein of the hand at a rate of 3 ml/sec, strong staining of pelvic arteries was observed in the CT images started at 17 to 23 sec after injection. The early-phase helical CT obtained under these conditions provided good depiction of lesions in cases of placenta accreta and invasive mole, as well as clear demonstration of tumor angiogenesis and evaluation of laterality in cases of cervical cancer. Comparison of the early and delayed phase also facilitated easier evaluation of lymph nodes than conventional comparison of simple and contrast-enhanced CT. The results thus suggest the usefulness of contrast-enhanced helical CT using SmartPrep in gynecology. (author)

Review of HIV Pre exposure prophylaxis (PrEP) and example of HIV PrEP Toolkit

Science.gov (United States)

2017-08-28

at Initiation of Sexual Activity Correct & Consistent Condom Use Prevention of mother-to- child transmission July 16, 2012: FDA approves...Okulicz JF, Medicine 2016 PrEP Utilization in a Managed Care System (Kaiser Permanente) 1200 ~ 1045 1000 . 800 600 . 400 200 0 835 657 0

Evaluating the impact of prioritization of antiretroviral pre-exposure prophylaxis (PrEP) in New York City

Science.gov (United States)

Kessler, Jason; Myers, Julie E.; Nucifora, Kimberly A.; Mensah, Nana; Toohey, Christopher; Khademi, Amin; Cutler, Blayne; Braithwaite, R. Scott

2015-01-01

Objective To compare the value and effectiveness of different prioritization strategies of pre-exposure prophylaxis (PrEP) in New York City (NYC). Design Mathematical modeling utilized as clinical trial is not feasible. Methods Using a model accounting for both sexual and parenteral transmission of HIV we compare different prioritization strategies (PPS) for PrEP to two scenarios—no PrEP and PrEP for all susceptible at-risk individuals. The PPS included PrEP for all MSM, only high-risk MSM, high-risk heterosexuals, and injection drug users, and all combinations of these four strategies. Outcomes included HIV infections averted, and incremental cost effectiveness (per-infection averted) ratios. Initial assumptions regarding PrEP included a 44% reduction in HIV transmission, 50% uptake in the prioritized population and an annual cost per person of $9,762. Sensitivity analyses on key parameters were conducted. Results Prioritization to all MSM results in a 19% reduction in new HIV infections. Compared to PrEP for all persons at-risk this PPS retains 79% of the preventative effect at 15% of the total cost. PrEP prioritized to only high-risk MSM results in a reduction in new HIV infections of 15%. This PPS retains 60% of the preventative effect at 6% of the total cost. There are diminishing returns when PrEP utilization is expanded beyond this group. Conclusions PrEP implementation is relatively cost-inefficient under our initial assumptions. Our results suggest that PrEP should first be promoted among MSM who are at particularly high-risk of HIV acquisition. Further expansion beyond this group may be cost-effective, but is unlikely to be cost-saving. PMID:25493594

SWATMOD-PREP: Graphical user interface for preparing coupled SWAT-modflow simulations

Science.gov (United States)

This paper presents SWATMOD-Prep, a graphical user interface that couples a SWAT watershed model with a MODFLOW groundwater flow model. The interface is based on a recently published SWAT-MODFLOW code that couples the models via mapping schemes. The spatial layout of SWATMOD-Prep guides the user t...

PrEP as a feature in the optimal landscape of combination HIV prevention in sub-Saharan Africa.

Science.gov (United States)

McGillen, Jessica B; Anderson, Sarah-Jane; Hallett, Timothy B

2016-01-01

The new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape. We use a model that was previously developed to capture subnational HIV transmission in sub-Saharan Africa. With this model, we can consider how prevention funds could be distributed across and within countries throughout sub-Saharan Africa to enable optimal HIV prevention (that is, avert the greatest number of infections for the lowest cost). Here, we focus on PrEP to elucidate where, and to whom, it would optimally be offered in portfolios of interventions (alongside voluntary medical male circumcision, treatment as prevention, and behaviour change communication). Over a range of continental expenditure levels, we use our model to explore prevention patterns that incorporate PrEP, exclude PrEP, or implement PrEP according to a fixed incidence threshold. At low-to-moderate levels of total prevention expenditure, we find that the optimal intervention portfolios would include PrEP in only a few regions and primarily for female sex workers (FSW). Prioritisation of PrEP would expand with increasing total expenditure, such that the optimal prevention portfolios would offer PrEP in more subnational regions and increasingly for men who have sex with men (MSM) and the lower incidence general population. The marginal benefit of including PrEP among the available interventions increases with overall expenditure by up to 14% (relative to excluding PrEP). The minimum baseline incidence for the optimal offer of PrEP declines for all population groups as expenditure increases. We find that using

Pre-Exposure Prophylaxis: A Narrative Review of Provider Behavior and Interventions to Increase PrEP Implementation in Primary Care.

Science.gov (United States)

Silapaswan, Andrew; Krakower, Douglas; Mayer, Kenneth H

2017-02-01

Since FDA approval of HIV pre-exposure prophylaxis (PrEP) for HIV prevention, attention has been focused on PrEP implementation. The CDC estimates that 1.2 million U.S. adults might benefit from PrEP, but only a minority are using PrEP, so there is a significant unmet need to increase access for those at risk for HIV. Given the large numbers of individuals who have indications for PrEP, there are not enough practicing specialists to meet the growing need for providers trained in providing PrEP. Moreover, since PrEP is a preventive intervention for otherwise healthy individuals, primary care providers (PCPs) should be primary prescribers of PrEP. There are important clinical considerations that providers should take into account when planning to prescribe PrEP, which are highlighted in the clinical case discussed. A growing body of research also suggests that some providers may be cautious about prescribing PrEP because of concerns regarding its "real-world" effectiveness, anticipated unintended consequences associated with its use, and ambiguity as to who should prescribe it. This review summarizes findings from studies that have assessed prescriber behavior regarding provision of PrEP, and offers recommendations on how to optimize PrEP implementation in primary care settings. Development and dissemination of educational interventions for PCPs and potential PrEP users are needed, including improved methods to assist clinicians in identifying appropriate PrEP candidates, and programs to promote medication adherence and access to social and behavioral health services. PCPs are well-positioned to prescribe PrEP and coordinate health-related services to improve the sexual health of their patients, but tailored educational programs are needed.

Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York City.

Science.gov (United States)

Rael, Christine Tagliaferri; Martinez, Michelle; Giguere, Rebecca; Bockting, Walter; MacCrate, Caitlin; Mellman, Will; Valente, Pablo; Greene, George J; Sherman, Susan; Footer, Katherine H A; D'Aquila, Richard T; Carballo-Diéguez, Alex

2018-03-27

Transgender women may face a disparate risk for HIV/AIDS compared to other groups. In 2012, Truvada was approved for daily use as HIV pre-exposure prophylaxis (PrEP). However, there is a dearth of research about barriers and facilitators to PrEP in transgender women. This paper will shed light on transgender women living in New York City's perceived and actual challenges to using PrEP and potential strategies to overcome them. After completing an initial screening process, four 90-min focus groups were completed with n = 18 transgender women. Participants were asked what they like and dislike about PrEP. Participants identified the following barriers: uncomfortable side effects, difficulty taking pills, stigma, exclusion of transgender women in advertising, and lack of research on transgender women and PrEP. Facilitators included: reducing pill size, increasing the types of available HIV prevention products, and conducting scientific studies to evaluate PrEP in transgender women.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK ? A Mixed Methods Study

OpenAIRE

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Background:\\ud Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design.\\ud Methods:\\ud Quantitative surveys of n = 690 MSM recruited online via social a...

Implications of HIV PrEP Trials Results

Science.gov (United States)

Anton, Peter; Fletcher, Courtney V.; DeGruttola, Victor; McGowan, Ian; Becker, Stephen; Zwerski, Sheryl; Burns, David

2011-01-01

Abstract Six randomized clinical trials have been implemented to examine the efficacy of tenofovir disoproxil fumarate (TDF) and/or TDF/emtricitabine (TDF/FTC) as preexposure prophylaxis for HIV-1 infection (PrEP). Although largely complementary, the six trials have many similar features. As the earliest results become available, an urgent question may arise regarding whether changes should be made in the conduct of the other trials. To consider this in advance, a Consultation on the Implications of HIV Pre-Exposure Prophylaxis (PrEP) Trials Results sponsored by the Division of AIDS (DAIDS) of the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), and the Bill and Melinda Gates Foundation (BMGF) was held on January 29, 2010, at the Natcher Conference Center, NIH, Bethesda, MD. Participants included basic scientists, clinical researchers (including investigators performing the current PrEP trials), and representatives from the U.S. Food and Drug Administration (FDA) and the agencies sponsoring the trials: the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Agency for International Development (USAID), the BMGF, and the U.S. NIH. We report here a summary of the presentations and highlights of salient discussion topics from this workshop. PMID:20969483

The Pre-Exposure Prophylaxis-Stigma Paradox: Learning from Canada's First Wave of PrEP Users.

Science.gov (United States)

Grace, Daniel; Jollimore, Jody; MacPherson, Paul; Strang, Matthew J P; Tan, Darrell H S

2018-01-01

With the emergence of daily oral tenofovir disoproxil fumarate and emtricitabine-based pre-exposure prophylaxis (PrEP) use in Canada, questions have emerged concerning the impacts of this HIV prevention tool on gay men's social and sexual lives. We conducted small focus groups and individual qualitative interviews with 16 gay men in Toronto who were part of the 'first wave' of Canadian PrEP users. Participants were on PrEP for at least one year as part of a demonstration project (November 2014-June 2016). These participants accessed PrEP before regulatory approval by Health Canada in February 2016. The mean age of participants was 37.6 years (SD 11.02); 94% completed secondary education, and 69% were white. Sex-stigma emerged as a complex theme in men's accounts of PrEP use across three overlapping domains: (1) PrEP-related stigma, including discussions of concealment and stigma from friends, family, and sexual partners, (2) PrEP as a perceived tool for combating HIV-related stigma, where some men said that they no longer discussed HIV status with sexual partners, and (3) PrEP as illuminating structural stigma, where it was attributed to unmasking stigma related to sex and sexuality. For some participants, PrEP has allowed for liberating sex and a self-described return to normalcy-normal, exciting, pleasurable sex that was no longer reliant on condom use. Paradoxically, some men said that PrEP use both led them to experience stigmatizing reactions within their social and sexual networks, while also helping to remove stigma, shame, and fear related to HIV, sexuality, and sex with gay men living with HIV.

Automated SmartPrep tracker positioning in liver MRI scans

International Nuclear Information System (INIS)

Goto, Takao; Kabasawa, Hiroyuki

2013-01-01

This paper presents a new method for automated SmartPrep tracker positioning in liver MRI scans. SmartPrep is used to monitor the contrast bolus signal in order to detect the arrival time of the bolus. Accurately placing the tracker in the aorta while viewing three planar scout images is a difficult task for the operator and is an important problem from the workflow standpoint. The development of an automated SmartPrep tracker would therefore help to improve workflow in liver MRI scans. In our proposed method, the aorta is detected using AdaBoost (which is a machine learning technique) by searching around the cerebral spinal fluid (CSF) in the spinal cord. Analysis of scout scan images showed that our detection method functioned properly for a variety of axial MR images without intensity correction. A total of 234 images reconstructed from the datasets of 64 volunteers were analyzed, and the results showed that the detection error for the aorta was approximately 3 mm. (author)

elPrep: High-Performance Preparation of Sequence Alignment/Map Files for Variant Calling.

Directory of Open Access Journals (Sweden)

Charlotte Herzeel

Full Text Available elPrep is a high-performance tool for preparing sequence alignment/map files for variant calling in sequencing pipelines. It can be used as a replacement for SAMtools and Picard for preparation steps such as filtering, sorting, marking duplicates, reordering contigs, and so on, while producing identical results. What sets elPrep apart is its software architecture that allows executing preparation pipelines by making only a single pass through the data, no matter how many preparation steps are used in the pipeline. elPrep is designed as a multithreaded application that runs entirely in memory, avoids repeated file I/O, and merges the computation of several preparation steps to significantly speed up the execution time. For example, for a preparation pipeline of five steps on a whole-exome BAM file (NA12878, we reduce the execution time from about 1:40 hours, when using a combination of SAMtools and Picard, to about 15 minutes when using elPrep, while utilising the same server resources, here 48 threads and 23GB of RAM. For the same pipeline on whole-genome data (NA12878, elPrep reduces the runtime from 24 hours to less than 5 hours. As a typical clinical study may contain sequencing data for hundreds of patients, elPrep can remove several hundreds of hours of computing time, and thus substantially reduce analysis time and cost.

Gendered differences in the perceived risks and benefits of oral PrEP among HIV-serodiscordant couples in Kenya.

Science.gov (United States)

Carroll, Jennifer J; Ngure, Kenneth; Heffron, Renee; Curran, Kathryn; Mugo, Nelly R; Baeten, Jared M

2016-08-01

Pre-exposure prophylaxis (PrEP) is effective for preventing HIV among HIV-serodiscordant heterosexual couples. Gender roles may influence perceived personal and social risks related to HIV-prevention behaviors and may affect use of PrEP. In this study, interviews and focus groups were conducted with 68 individuals from 34 mutually disclosed serodiscordant heterosexual partnerships in Thika, Kenya. Sociocultural factors that affect adherence to PrEP were explored using grounded analysis. Three factors were identified, which shape perceptions of PrEP: gendered power dynamics and control over decision-making in the household; conflicts between risk-reduction strategies and male sexual desire; culture-bound definitions of women's work. Adherence to PrEP in the Partners PrEP Study was high; however, participants articulated conflicting interests related to PrEP in connection with traditional gender roles. The successful delivery of PrEP will require understanding of key social factors, particularly related to gender and dyadic dynamics around HIV serostatus.

Ferromagnetic quantum criticality in the uranium-based ternary compounds URhSi, URhAl, and UCoAl

International Nuclear Information System (INIS)

Combier, Tristan

2014-01-01

In this thesis we explore the ferromagnetic quantum criticality in three uranium-based ternary compounds, by means of thermodynamical and transport measurements on single crystal samples, at low temperature and high pressure. URhSi and URhAl are itinerant ferromagnets, while UCoAl is a paramagnet being close to a ferromagnetic instability. All of them have Ising-type magnetic ordering. In the orthorhombic compound URhSi, we show that the Curie temperature decreases upon applying a magnetic field perpendicular to the easy magnetization axis, and a quantum phase transition is expected around 40 T. In the hexagonal system URhAl, we establish the pressure-temperature phase diagram for the first time, indicating a quantum phase transition around 5 GPa. In the isostructural compound UCoAl, we investigate the metamagnetic transition with measurements of magnetization, Hall effect, resistivity and X-ray magnetic circular dichroism. Some intriguing magnetic relaxation phenomena are observed, with step-like features. Hall effect and resistivity have been measured at dilution temperatures, under hydrostatic pressure up to 2.2 GPa and magnetic field up to 16 T. The metamagnetic transition terminates under pressure and magnetic field at a quantum critical endpoint. In this region, a strong effective mass enhancement occurs, and an intriguing difference between up and down field sweeps appears in transverse resistivity. This may be the signature of a new phase, supposedly linked to the relaxation phenomena observed in magnetic measurements, arising from frustration on the quasi-Kagome lattice of uranium atoms in this crystal structure. (author) [fr

PrEP adopted by the brazilian national health system: What is the size of the demand?

Science.gov (United States)

Luz, Paula M; Benzaken, Adele; Alencar, Tatianna M de; Pimenta, Cristina; Veloso, Valdilea G; Grinsztejn, Beatriz

2018-05-01

Brazil's response to the HIV epidemic now includes free access to preexposure prophylaxis (PrEP) to populations at substantial risk for HIV infection including men who have sex with men (MSM). We used nationally representative demographic, epidemiologic, and surveillance data to offer estimates for the number of MSM at substantial risk for HIV infection who might be eligible and willing to use PrEP in Brazil. Starting from the age/sex-stratified population, we calculated the number of men aged 15 to 64 years, in 5-year age groups, and the proportion of those who report sex with other men during their lifetime. We focused on 11 cities (representing all regions) that are responsible for a significant fraction of the HIV burden of the country and used city-specific HIV prevalence estimates to infer the fraction of MSM who are HIV-negative. We then derived the proportion of HIV-negative MSM under substantial risk for HIV infection defined as having unprotected receptive anal intercourse in the 6 months before study participation. Finally, PrEP uptake among the eligible was inferred from the PrEP Brazil study. Our results show that PrEP demand in these 11 cities is of 66,120 men aged 15 to 64 years. When we consider the lower and upper bounds for the available parameters, we find that PrEP demand in these 11 cities might vary from 33,378 to 97,962 men. If PrEP is restricted to those aged 15 to 49 years, demand drops by 20%. PrEP demand varies considerably by city, mostly because of the differences in population size and city-specific HIV prevalence. We have shed light on the probable size of PrEP demand in Brazil certain that the incorporation of PrEP as part of Brazil's combination prevention for populations at substantial risk for HIV infection is a necessary challenge. PrEP will not only prevent HIV infections, it will also expand testing among the most vulnerable with the added benefit of offering combination prevention for the uninfected and immediate treatment for

Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America.

Science.gov (United States)

Ravasi, Giovanni; Grinsztejn, Beatriz; Baruch, Ricardo; Guanira, Juan Vicente; Luque, Ricardo; Cáceres, Carlos F; Ghidinelli, Massimo

2016-01-01

Despite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP) is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool. We discuss the barriers and solutions for a fair consideration of PrEP as part of combination HIV prevention strategies in Latin America. Although demonstration projects are ongoing or being planned in a number of countries, to date no Latin American country has implemented a public PrEP programme. The knowledge of policymakers about PrEP implementation needs to be strengthened, and programmatic guidance and cost estimate tools need to be developed to support adequate planning. Despite high levels of awareness among health providers, especially if engaged in HIV or key population care, willingness to prescribe PrEP is still low due to the lack of national policies and guidelines. Key populations, especially men who have sex with men, transgender women and sex workers, have been engaged in demonstration projects, and qualitative research shows high awareness and willingness to use PrEP, especially if accessible in the public sector for free or at affordable price. Concerns of safety, adherence, effectiveness and risk compensation need to be addressed through targeted social communication strategies to improve PrEP knowledge and stimulate demand. Alliance among policymakers, civil society and representatives from key populations, healthcare providers and researchers will be critical for the design and successful implementation of PrEP demonstration projects of locally adapted delivery models. The use of mechanisms of joint negotiation and procurement of antiretrovirals

Prep1, A Homeodomain Transcription Factor Involved in Glucose and Lipid Metabolism

Directory of Open Access Journals (Sweden)

Francesco Oriente

2018-06-01

Full Text Available The three-amino acid loop extension (TALE homeodomain proteins are a family of transcription factor including the mammalian Pbx, MEIS and Prep proteins. TALE proteins can bind other transcription factors such as Pdx-1 and play an important role in the regulation of glucose metabolism. Experiments performed in mutant mice have shown that while the single Pbx1 or Pdx-1 knockout mice feature pancreatic islet malformations, impaired glucose tolerance and hypoinsulinemia, the trans-heterozygous Pbx1+/−Pdx1+/− mice develop age-dependent overt diabetes mellitus. In contrast, Prep1 plays a different role with respect to these proteins. Indeed, Prep1 hypomorphic mice, expressing low levels of protein, feature pancreatic islet hypoplasia accompanied by hypoinsulinemia similar to Pbx1 or Pdx1. Nevertheless, these animals show increased insulin sensitivity in skeletal muscle, liver and adipose tissue accompanied by protection from streptozotocin-induced diabetes. In addition, Prep1 hypomorphic mice feature reduced triglyceride synthesis and do not develop steatohepatitis after a methionine and coline deficient diet. In this review we have underlined how important metabolic functions are controlled by TALE proteins, in particular by Prep1, leading to hypothesis that its suppression might represent beneficial effect in the care of metabolic diseases.

Antinociceptive interaction between benfotiamine and resveratrol in capsaicin-induced licking.

Science.gov (United States)

Montiel-Ruiz, Rosa Mariana; Reyes-García, Gerardo; Flores-Murrieta, Francisco; Déciga-Campos, Myrna

2009-01-01

In an attempt to provide more direct evidence concerning the possible antinociceptive effect of resveratrol-benfotiamine combination on neurogenic pain, we investigated whether resveratrol and benfotiamine administered alone or in combination decrease capsaicin induced nociception in mice. Before testing, the animals were placed individually in transparent glass cylinders, 20 cm in diameter, serving as observation chambers. After the adaptation period, 20 microL of capsaicin (1.6 microg/paw) were injected under the skin of the dorsal of the right hind paw. Animals were observed individually for 5 min after capsaicin injection. The amount of time spent licking the injected paw was timed with a chronometer and was considered as indicative of nociception. Animals were pretreated with resveratrol (56.2-177 mg/kg, i.p.), benfotiamine (100-1000 mg/kg, p.o.) and their combinations (11:1, 22:2, 44:4; 88:8 mg/kg benfotiamine:resveratrol). It was observed that resveratrol (ED50 = 104 +/- 8.2 mg/kg) was able to produce more important decrement of capsaicin-induced licking than benfotiamine (ED50 = 529.4 +/- 85.2 mg/kg). In addition, a synergistic interaction was observed between benfotiamine and resveratrol, suggesting that this combination could be useful in neurogenic nociception.

The lick-index calibration of the Gemini multi-object spectrographs

International Nuclear Information System (INIS)

Puzia, Thomas H.; Miller, Bryan W.; Trancho, Gelys; Basarab, Brett; Mirocha, Jordan T.; Butler, Karen

2013-01-01

We present the calibration of the spectroscopic Lick/IDS standard line-index system for measurements obtained with the Gemini Multi-Object Spectrographs known as GMOS-North and GMOS-South. We provide linear correction functions for each of the 25 standard Lick line indices for the B600 grism and two instrumental setups, one with 0.''5 slit width and 1 × 1 CCD pixel binning (corresponding to ∼2.5 Å spectral resolution) and the other with 0.''75 slit width and 2 × 2 binning (∼4 Å). We find small and well-defined correction terms for the set of Balmer indices Hβ, Hγ A , and Hδ A along with the metallicity sensitive indices Fe5015, Fe5270, Fe5335, Fe5406, Mg 2 , and Mgb that are widely used for stellar population diagnostics of distant stellar systems. We find other indices that sample molecular absorption bands, such as TiO 1 and TiO 2 , with very wide wavelength coverage or indices that sample very weak molecular and atomic absorption features, such as Mg 1 , as well as indices with particularly narrow passband definitions, such as Fe4384, Ca4455, Fe4531, Ca4227, and Fe5782, which are less robustly calibrated. These indices should be used with caution.

Knowledge, Practices, and Barriers to HIV Pre-Exposure Prophylaxis (PrEP) Prescribing Among Washington State Medical Providers.

Science.gov (United States)

Wood, Brian R; McMahan, Vanessa M; Naismith, Kelly; Stockton, Jonathan B; Delaney, Lori A; Stekler, Joanne D

2018-01-04

We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. Of 735 eligible providers, 64.8% had heard of PrEP. Younger providers and providers with a Doctor of Medicine (MD) degree were more likely to be aware of PrEP compared to older providers (p=0.0001) and providers of other training backgrounds (Advanced Registered Nurse Practitioner [ARNP], Doctor of Osteopathic Medicine [DO], or Physician Assistant [PA]) (p=0.04). Among providers aware of PrEP, most frequent reported concerns about prescribing were adherence (46.0%) and costs (42.9%). Providers felt very (20.1%) or somewhat (33.8%) comfortable discussing PrEP overall, but very (26.8%) or somewhat (44.7%) uncomfortable discussing cost and insurance issues. The 124 PrEP prescribers reported a median of 2 (range 1-175, total 1,142) patients prescribed PrEP. Prior authorizations and insurance denials had prevented prescriptions for 28.7% and 12.1% of prescribers, respectively. Interventions to improve PrEP access should include education to inform medical providers about PrEP, with particular attention to provider types less likely to be aware. Continued efforts to eliminate cost and insurance barriers and educate providers regarding financial resources would help improve PrEP access.

Effect of the dopamine D1-like receptor antagonist SCH 23390 on the microstructure of ingestive behaviour in water-deprived rats licking for water and NaCl solutions.

Science.gov (United States)

Galistu, Adriana; D'Aquila, Paolo S

2012-01-18

The analysis of licking microstructure provides measures, size and number of licking bouts, which might reveal, respectively, reward evaluation and behavioural activation. Based on the different effects of the dopamine D1-like and D2-like receptor antagonists SCH 23390 and raclopride on licking for sucrose, in particular the failure of the former to reduce bout size and the ability of the latter to induce a within-session decrement of bout number resembling either reward devaluation or neuroleptics on instrumental responding, we suggested that activation of reward-associated responses depends on dopamine D1-like receptor stimulation, and its level is updated on the basis of a dopamine D2-like receptor-mediated reward evaluation. Consistent results were obtained in a study examining the effect of dopamine D2-like receptor antagonism in rats licking for NaCl solutions and water. In this study, we examined the effects of the dopamine D1-like receptor antagonist SCH 23390 (0, 10, 20 and 40 μg/kg) on the microstructure of licking for water and sodium chloride solutions (0.075 M, 0.15 M, 0.3 M) in 12 h water deprived rats. Rats were exposed to each solution for 60 s either after the first lick or after 3 min that the animals were placed in the chambers. Bout size, but not bout number, was decreased at the highest NaCl concentration. SCH 23390 produced a decrease of bout number and of lick number mainly due to the decreased number of subjects engaging in licking behaviour, and failed to reduce bout size for Na Cl and water at a dose which increased the latency to the 1st lick but did not affect the intra-bout lick rate. In agreement with previous observations, these results suggest that dopamine D1-like receptors play an important role in the activation of reward-oriented responses. Copyright © 2011 Elsevier Inc. All rights reserved.

PRESTO-PREP: a data preprocessor for the PRESTO-II code

Energy Technology Data Exchange (ETDEWEB)

Bell, M.A.; Emerson, C.J.; Fields, D.E.

1984-07-01

PRESTO-II is a computer code developed to evaluate possible health effects from shallow land disposal of low level radioactive wastes. PRESTO-PREP is a data preprocessor that has been developed to expedite the formation of input data sets for PRESTO-II. PRESTO-PREP utilizes a library of nuclide and risk-specific data. Given an initial waste inventory, the code creates the radionuclide portion of the associated input data set for PRESTO-II. 2 references.

PRESTO-PREP: a data preprocessor for the PRESTO-II code

International Nuclear Information System (INIS)

Bell, M.A.; Emerson, C.J.; Fields, D.E.

1984-07-01

PRESTO-II is a computer code developed to evaluate possible health effects from shallow land disposal of low level radioactive wastes. PRESTO-PREP is a data preprocessor that has been developed to expedite the formation of input data sets for PRESTO-II. PRESTO-PREP utilizes a library of nuclide and risk-specific data. Given an initial waste inventory, the code creates the radionuclide portion of the associated input data set for PRESTO-II. 2 references

The DELTA PREP Initiative: Accelerating Coalition Capacity for Intimate Partner Violence Prevention

Science.gov (United States)

Zakocs, Ronda; Freire, Kimberley E.

2018-01-01

Background The DELTA PREP Project aimed to build the prevention capacity of 19 state domestic violence coalitions by offering eight supports designed to promote prevention integration over a 3-year period: modest grant awards, training events, technical assistance, action planning, coaching hubs, the Coalition Prevention Capacity Assessment, an online workstation, and the online documentation support system. Objectives Using quantitative and qualitative data, we sought to explain how coalitions integrated prevention within their structures and functions and document how DELTA PREP supports contributed to coalitions’ integration process. Results We found that coalitions followed a common pathway to integrate prevention. First, coalitions exhibited precursors of organizational readiness, especially having prevention champions. Second, coalitions engaged in five critical actions: engaging in dialogue, learning about prevention, forming teams, soliciting input from the coalition, and action planning. Last, by engaging in these critical actions, coalitions enhanced two key organizational readiness factors—developing a common understanding of prevention and an organizational commitment to prevention. We also found that DELTA PREP supports contributed to coalitions’ abilities to integrate prevention by supporting learning about prevention, fostering a prevention team, and engaging in action planning by leveraging existing opportunities. Two DELTA PREP supports—coaching hubs and the workstation—did not work as initially intended. From the DELTA PREP experience, we offer several lessons to consider when designing future prevention capacity-building initiatives. PMID:26245934

Adaptive optics and laser guide stars at Lick observatory

Energy Technology Data Exchange (ETDEWEB)

Brase, J.M. [Lawrence Livermore National Lab., CA (United States)

1994-11-15

For the past several years LLNL has been developing adaptive optics systems for correction of both atmospheric turbulence effects and thermal distortions in optics for high-power lasers. Our early work focused on adaptive optics for beam control in laser isotope separation and ground-based free electron lasers. We are currently developing innovative adaptive optics and laser systems for sodium laser guide star applications at the University of California`s Lick and Keck Observeratories. This talk will describe our adaptive optics technology and some of its applications in high-resolution imaging and beam control.

ThinPrep Pap-smear and cervical intraepithelial neoplasia in reproductive-aged Thai women.

Science.gov (United States)

Rugpao, S; Koonlertkit, S; Ruengkrist, T; Lamlertkittikul, S; Pinjaroen, S; Limtrakul, A; Werawatakul, Y; Sinchai, W

2009-06-01

To estimate the incidence of abnormal cervical cytology by ThinPrep Pap-tests and cervical intraepithelial neoplasia (CIN) in young adult reproductive-aged Thai women. A total of 1254 women distributed in all regions of Thailand were monitored from 2002 through 2004. Women were screened for abnormal cervical cytology using the ThinPrep method every 6 months. Interpretation of cervical cytology was based on the Bethesda system, version 2001. Women who had the ThinPrep Pap results as atypical squamous cells of undetermined significance or worse underwent colposcopic examination. The ThinPrep and all cervical tissue samples obtained from diagnostic or therapeutic procedures were analyzed and reviewed by Covance Central Laboratory Service, Inc., Indianapolis, USA. The cumulative incidence of abnormal ThinPrep Pap-tests was as follows: 15.3 per 100 woman years (WY) (95% confidence interval [CI] 12.3, 18.9) at 6 months; 12.3 per 100 WY (95% CI 10.3, 14.6) at 12 months; and 11.6 per 100 WY (95% CI 10.0, 13.5) at 18 months. Of 1448.6 woman years of follow up, the incidence of CIN1 was 4.1 per 100 WY (95% CI 3.2, 5.3); CIN2 0.8 per 100 WY (95% CI 0.4, 1.4); and CIN3 0.6 per 100 WY (95% CI 0.3, 1.2). The incidence of abnormal ThinPrep Pap-test and CIN in young adult Thai women had been reported. No comparable data is available.

'PrEP is not ready for our community, and our community is not ready for PrEP': pre-exposure prophylaxis for HIV for people who inject drugs and limits to the HIV prevention response.

Science.gov (United States)

Guise, Andy; Albers, Eliot Ross; Strathdee, Steffanie A

2017-04-01

Pre-exposure prophylaxis for HIV, or 'PrEP', is the use of antiretroviral medicines by people who are HIV-negative to protect themselves against acquiring HIV. PrEP has shown efficacy for preventing HIV acquisition. Despite the potential, many concerns have been voiced by people who inject drugs (PWID) and their organizations. There is a need to engage with these views and ensure their integration in to policy and strategy. This paper presents PWID views on PrEP to foster the uptake of these opinions into scientific and policy debate around PrEP METHODS: Critical analysis of a report of a community consultation led by the International Network of People who Use Drugs (INPUD). The INPUD report highlights enthusiasm from PWID for PrEP, but also three main concerns: the feasibility and ethics of PrEP, its potential use as a substitute for other harm reduction strategies and how a focus on PrEP heralds a re-medicalization of HIV. Each concern relates to evidenced gaps in essential services or opposition to harm reduction and PWID human rights. People who use drugs have fundamental concerns about the potential impacts of pre-exposure prophylaxis for HIV which reflect a 'fault line' in HIV prevention: a predominance of biomedical approaches over community perspectives. Greater community engagement in HIV prevention strategy is needed, or we risk continuing to ignore the need for action on the underlying structural drivers and social context of the HIV epidemic. © 2016 Society for the Study of Addiction.

Acceptability of Daily Use of Free Oral Pre-exposure Prophylaxis (PrEP) Among Transgender Women Sex Workers in Shenyang, China.

Science.gov (United States)

Wang, Zixin; Lau, Joseph T F; Yang, Xueying; Cai, Yong; Gross, Danielle L; Ma, Tiecheng; Liu, Yan

2017-12-01

This study investigated the acceptability of daily use of free oral pre-exposure prophylaxis (PrEP) and associated factors among transgender women sex workers in Shenyang, China, following a briefing on PrEP. A total of 183 HIV negative or sero-status unknown participants completed the cross-sectional survey. The prevalence of acceptability of daily use of free oral PrEP was 61.2%. Adjusting for education level and monthly income, variables on negative attitudes toward PrEP (i.e., having concerns about the side-effects of PrEP) [Adjusted odds ratios (AOR): 0.26], perceived subjective norms (i.e., perceiving support from male partners to take PrEP) (AOR: 2.08), and perceived behavioral control (e.g., perceiving complete control over using PrEP) (AOR: 2.10-16.72) were significantly associated with acceptability of daily use of free oral PrEP. In addition, experiencing violence during sex work, perceived risk of contracting HIV from clients and probable anxiety were also significant. Future PrEP promotion campaigns should consider these factors.

Electronics Technology. Tech Prep Competency Profile.

Science.gov (United States)

Lakeland Tech Prep Consortium, Kirtland, OH.

This tech prep competency profile covers the occupation of electronics technician. Section 1 provides the occupation definition. Section 2 lists development committee members. Section 3 provides the leveling codes--abbreviations for grade level, (by the end of grade 12, by the end of associate degree), academic codes (communications, math, or…

Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support.

Science.gov (United States)

Calabrese, Sarah K; Underhill, Kristen; Earnshaw, Valerie A; Hansen, Nathan B; Kershaw, Trace S; Magnus, Manya; Krakower, Douglas S; Mayer, Kenneth H; Betancourt, Joseph R; Dovidio, John F

2016-07-01

Strategic framing of public messages about HIV pre-exposure prophylaxis (PrEP) may influence public support for policies and programs affecting access. This survey study examined how public attitudes toward PrEP differed based on the social group PrEP was described as benefiting ("beneficiary") and the moderating effect of prejudice. Members of the general public (n = 154) recruited online were randomly assigned to three beneficiary conditions: general population, gay men, or Black gay men. All participants received identical PrEP background information before completing measures of PrEP attitudes (specifying beneficiary), racism, and heterosexism. Despite anticipating greater PrEP adherence among gay men and Black gay men and perceiving PrEP as especially beneficial to the latter, participants expressed lower support for policies/programs making PrEP affordable for these groups vs. the general population. This disparity in support was stronger among participants reporting greater prejudice. Inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts.

KEY RESULTS FROM IRRADIATION AND POST-IRRADIATION EXAMINATION OF AGR-1 UCO TRISO FUEL

Energy Technology Data Exchange (ETDEWEB)

Demkowicz, Paul A.; Hunn, John D.; Petti, David A.; Morris, Robert N.

2016-11-01

The AGR-1 irradiation experiment was performed as the first test of tristructural isotropic (TRISO) fuel in the US Advanced Gas Reactor Fuel Development and Qualification Program. The experiment consisted of 72 right cylinder fuel compacts containing approximately 3×105 coated fuel particles with uranium oxide/uranium carbide (UCO) fuel kernels. The fuel was irradiated in the Advanced Test Reactor for a total of 620 effective full power days. Fuel burnup ranged from 11.3 to 19.6% fissions per initial metal atom and time average, volume average irradiation temperatures of the individual compacts ranged from 955 to 1136°C. This paper focuses on key results from the irradiation and post-irradiation examination, which revealed a robust fuel with excellent performance characteristics under the conditions tested and have significantly improved the understanding of UCO coated particle fuel irradiation behavior within the US program. The fuel exhibited a very low incidence of TRISO coating failure during irradiation and post-irradiation safety testing at temperatures up to 1800°C. Advanced PIE methods have allowed particles with SiC coating failure to be isolated and meticulously examined, which has elucidated the specific causes of SiC failure in these specimens. The level of fission product release from the fuel during irradiation and post-irradiation safety testing has been studied in detail. Results indicated very low release of krypton and cesium through intact SiC and modest release of europium and strontium, while also confirming the potential for significant silver release through the coatings depending on irradiation conditions. Focused study of fission products within the coating layers of irradiated particles down to nanometer length scales has provided new insights into fission product transport through the coating layers and the role various fission products may have on coating integrity. The broader implications of these results and the application of

Threefold Increase in PrEP Uptake Over Time with High Adherence Among Young Men Who Have Sex With Men in Chicago.

Science.gov (United States)

Morgan, Ethan; Moran, Kevin; Ryan, Daniel T; Mustanski, Brian; Newcomb, Michael E

2018-05-04

The goal of this work is to better understand utilization and uptake of pre-exposure prophylaxis (PrEP) among young men who have sex with men (YMSM) and transgender women (TGW). We assessed trends and correlates of PrEP use and adherence across three time points of longitudinal data collection among 885 YMSM and TGW (aged 16-29) from the RADAR cohort in Chicago, 2015-2017. Past 6-month PrEP use increased across three visits: from 6.6 to 17.5%. In multivariable models, past 6-month PrEP use was significantly associated with participation in condomless sex, having more sexual partners, and older age. At least three-quarters of current PrEP users reported being ≥ 90% adherent to PrEP medication across all visits. Past 6-month PrEP use increased over time with those who participated in high-risk HIV behaviors also those most likely to have taken PrEP. As PrEP uptake continues to rise, more research will be needed to understand predictors of PrEP usage, as well as patterns of sexual behavior change following uptake.

The transcription factor Prep1 controls hepatic insulin sensitivity and gluconeogenesis by targeting nuclear localization of FOXO1

International Nuclear Information System (INIS)

Kulebyakin, Konstantin; Penkov, Dmitry; Blasi, Francesco; Akopyan, Zhanna; Tkachuk, Vsevolod

2016-01-01

Liver plays a key role in controlling body carbohydrate homeostasis by switching between accumulation and production of glucose and this way maintaining constant level of glucose in blood. Increased blood glucose level triggers release of insulin from pancreatic β-cells. Insulin represses hepatic glucose production and increases glucose accumulation. Insulin resistance is the main cause of type 2 diabetes and hyperglycemia. Currently thiazolidinediones (TZDs) targeting transcriptional factor PPARγ are used as insulin sensitizers for treating patients with type 2 diabetes. However, TZDs are reported to be associated with cardiovascular and liver problems and stimulate obesity. Thus, it is necessary to search new approaches to improve insulin sensitivity. A promising candidate is transcriptional factor Prep1, as it was shown earlier it could affect insulin sensitivity in variety of insulin-sensitive tissues. The aim of the present study was to evaluate a possible involvement of transcriptional factor Prep1 in control of hepatic glucose accumulation and production. We created mice with liver-specific Prep1 knockout and discovered that hepatocytes derived from these mice are much more sensitive to insulin, comparing to their WT littermates. Incubation of these cells with 100 nM insulin results in almost complete inhibition of gluconeogenesis, while in WT cells this repression is only partial. However, Prep1 doesn't affect gluconeogenesis in the absence of insulin. Also, we observed that nuclear content of gluconeogenic transcription factor FOXO1 was greatly reduced in Prep1 knockout hepatocytes. These findings suggest that Prep1 may control hepatic insulin sensitivity by targeting FOXO1 nuclear stability. - Highlights: • A novel model of liver-specific Prep1 knockout is established. • Ablation of Prep1 in hepatocytes increases insulin sensitivity. • Prep1 controls hepatic insulin sensitivity by regulating localization of FOXO1. • Prep1 regulates

Homosexual Fellatio: Erect Penis Licking between Male Bonin Flying Foxes Pteropus pselaphon.

Science.gov (United States)

Sugita, Norimasa

2016-01-01

A recent focus of interest has been on the functional significance of genital licking (fellatio and cunnilingus) in relation to sexual selection in Pteropodid bats. In the present paper, a form of fellatio in wild Bonin flying foxes, Pteropus pselaphon, performed between adult males has been reported. During the mating season, adult flying foxes roost in same-sex groups, forming ball-shaped clusters which provide warmth. The female clusters may also contain a few males. Unassociated with allogrooming, same-sex genital licking occurred among males in the all male clusters. As such, male-male fellatio can be considered as homosexual behavior, two functional explanations could account for this behavior; the social bonding and the social tension regulation hypotheses suggested in a previous review. Given that neither the simpler alternative that in all male groups such fellatio may represent misdirected sexual behavior, nor the two previously proposed functional hypotheses were supported by the data, I propose another functional hypothesis. Homosexual fellatio in this species could help males solve inconsistent situations in the roost when there are conflicts between cooperative behavior for social thermoregulation and competition for mating.

Homosexual Fellatio: Erect Penis Licking between Male Bonin Flying Foxes Pteropus pselaphon.

Directory of Open Access Journals (Sweden)

Norimasa Sugita

Full Text Available A recent focus of interest has been on the functional significance of genital licking (fellatio and cunnilingus in relation to sexual selection in Pteropodid bats. In the present paper, a form of fellatio in wild Bonin flying foxes, Pteropus pselaphon, performed between adult males has been reported. During the mating season, adult flying foxes roost in same-sex groups, forming ball-shaped clusters which provide warmth. The female clusters may also contain a few males. Unassociated with allogrooming, same-sex genital licking occurred among males in the all male clusters. As such, male-male fellatio can be considered as homosexual behavior, two functional explanations could account for this behavior; the social bonding and the social tension regulation hypotheses suggested in a previous review. Given that neither the simpler alternative that in all male groups such fellatio may represent misdirected sexual behavior, nor the two previously proposed functional hypotheses were supported by the data, I propose another functional hypothesis. Homosexual fellatio in this species could help males solve inconsistent situations in the roost when there are conflicts between cooperative behavior for social thermoregulation and competition for mating.

Commentary: the value of PrEP for people who inject drugs

OpenAIRE

Rosalind L Coleman; Susie McLean

2016-01-01

Introduction: The offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection. What ...

A tale of TALE, PREP1, PBX1, and MEIS1: Interconnections and competition in cancer.

Science.gov (United States)

Blasi, Francesco; Bruckmann, Chiara; Penkov, Dmitry; Dardaei, Leila

2017-05-01

We report the latest structural information on PREP1 tumor suppressor, the specific "oncogene" and "tumor suppressive" signatures of MEIS1 and PREP1, the molecular rules regulating PREP1 and MEIS1 binding to DNA, and how these can change depending on the interaction with PBX1, cell-type, neoplastic transformation, and intracellular concentration. As both PREP1 and MEIS1 interact with PBX1 they functionally compete with each other. PREP1, PBX1, and MEIS1 TALE-class homeodomain transcription factors act in an interdependent and integrated way in experimental tumorigenesis. We also pool together the plethora of data available in human cancer databanks and connect them with the available molecular information. The emerging picture suggests that a similarly basic approach might be used to better dissect and define other oncogenes and suppressors and better understand human cancer. © 2017 The Authors. BioEssays Published by WILEY Periodicals, Inc.

Provider perspectives on PrEP for adolescent girls and young women in Tanzania: The role of provider biases and quality of care.

Directory of Open Access Journals (Sweden)

Nanlesta Pilgrim

Full Text Available Oral pre-exposure prophylaxis (PrEP has the potential to reduce HIV acquisition among adolescent girls and young women (AGYW in sub-Saharan Africa. However, health care providers' (HCPs perspectives and interactions with potential clients can substantially influence effective provision of quality health services. We examine if HCPs' knowledge, attitude, and skills, as well as their perceptions of facility readiness to provide PrEP are associated with their willingness to provide PrEP to AGYW at high risk of HIV in Tanzania.A self-administered questionnaire was given to 316 HCPs from 74 clinics in two districts and 24 HCPs participated in follow-up in-depth interviews (IDIs. We conducted bivariate and multivariable Poisson regression to assess factors associated with willingness to provide PrEP to AGYW. Thematic content analysis was used to analyze the IDIs, which expanded upon the quantitative results.Few HCPs (3.5% had prior PrEP knowledge, but once informed, 61.1% were willing to prescribe PrEP to AGYW. Higher negative attitudes toward adolescent sexuality and greater concerns about behavioral disinhibition due to PrEP use were associated with lower willingness to prescribe PrEP. Qualitatively, HCPs acknowledged that biases, rooted in cultural norms, often result in stigmatizing and discriminatory care toward AGYW, a potential barrier for PrEP provision. However, better training to provide HIV services was associated with greater willingness to prescribe PrEP. Conversely, HCPs feared the potential negative impact of PrEP on the provision of existing HIV services (e.g., overburdened staff, and suggested the integration of PrEP into non-HIV services and the use of paramedical professionals to facilitate PrEP provision.Preparing for PrEP introduction requires more than solely training HCPs on the clinical aspects of providing PrEP. It requires a two-pronged strategy: addressing HCPs' biases regarding sexual health services to AGYW; and preparing

Poppers and PrEP: Use of Pre-exposure Prophylaxis Among Men Who Have Sex with Men Who Use Inhaled Nitrites.

Science.gov (United States)

Hambrick, H Rhodes; Park, Su Hyun; Schneider, John A; Mayer, Kenneth H; Carrico, Adam W; Sherman, Scott E; Duncan, Dustin T

2018-05-09

Men who have sex with men (MSM) commonly use inhaled nitrites, or poppers, though their use is a risk factor HIV seroconversion. Pre-exposure prophylaxis, or PrEP, is effective for HIV prevention, but is not widely used, and little is known regarding PrEP use and acceptability among MSM who use inhaled nitrites. We surveyed 580 MSM in Paris, France in 2016 about popper use, sexual behaviors including condomless anal intercourse (CAI), serosorting, and sexual positioning, PrEP use, PrEP candidacy, and interest in alternate PrEP delivery modalities. We included 444 HIV negative participants for the current study. 46.2% reported popper use in the prior 3 months. Using multivariate adjusted logistic regression, we found that popper users were more likely than non-users to consider themselves candidates for PrEP [adjusted relative risk ratio (aRRR) = 2.73; 95% CI 1.54-4.83], but they were not more likely to be current (aRRR = 1.54; 95% CI 0.71-3.33) or past (aRRR = 1.37; 95% CI 0.44-4.28) PrEP users. Mediation analyses indicated that increased CAI and serosorting partly explained the relationship between popper use and PrEP candidacy. There was considerable interest in alternate proposed PrEP delivery modalities, particularly long-acting injectable PrEP [adjusted risk ratio (aRR) = 1.43; 95% CI 1.15-1.79].

Lessons learned from the experiences of informal PrEP users in France: results from the ANRS-PrEPage study.

Science.gov (United States)

Rivierez, I; Quatremere, G; Spire, B; Ghosn, J; Rojas Castro, D

2018-05-30

Before January 2016, Pre-Exposure Prophylaxis (PrEP), a new biomedical HIV-prevention tool, was only available in France via ANRS-Ipergay clinical study but informal use was reported outside this setting. PrEPage qualitative study reports profiles and experiences of participants who used PrEP outside of a biomedical trial before this prevention method was authorized. Between March 2015 and February 2016, a cross-section of twenty-four informal PrEP users, mostly MSM, was recruited to complete in-depth semi-structured interviews. While ANRS-Ipergay was still ongoing (2012-2016), participants described their initiation to PrEP, the way they used it and the difficulties they faced to acquire antiretroviral drugs in an environment where PrEP was still not widely known and often criticized . Through the testimonies, different user profiles and motivation toward informal PrEP use emerged: (a) participants who have increasing difficulties using condoms, (b) "opportunists" who tried PrEP without the intention of using it regularly and (c) participants with a risk aversion who sought additional protection against HIV. Participants chose to use PrEP and/or their usual prevention strategies depending on available supplies, type of partners and individual attitudes toward risk. The feeling of living a safer sex life helped participants to outweigh the fear of possible toxicity and drug resistance. Participants' needs and expectations about PrEP implementation in France were also presented.

The impact of pre-exposure prophylaxis (PrEP) on HIV epidemics in Africa and India: A simulation study

NARCIS (Netherlands)

D.C.J. Vissers (Debby); H.A.C.M. Voeten (Hélène); N.J.D. Nagelkerke (Nico); J.D.F. Habbema (Dik); S.J. de Vlas (Sake)

2008-01-01

textabstractBackground: Pre-exposure prophylaxis (PrEP) is a promising new HIV prevention method, especially for women. An urgent demand for implementation of PrEP is expected at the moment efficacy has been demonstrated in clinical trials. We explored the long-term impact of PrEP on HIV

What Primary Care Providers Need to Know about Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: Narrative Review

Science.gov (United States)

Krakower, Douglas; Mayer, Kenneth H.

2013-01-01

As HIV prevalence climbs globally, including more than 50,000 new infections per year in the United States, we need effective HIV prevention strategies. The use of antiretrovirals for pre-exposure prophylaxis (known as “PrEP”) among high-risk HIV-uninfected persons is emerging as one such strategy. Randomized controlled trials have demonstrated that once daily oral PrEP decreased HIV incidence among at-risk MSM and African heterosexuals, including HIV serodiscordant couples. An additional randomized control trial of a pericoital topical application of antiretroviral microbicide gel reduced HIV incidence among at-risk heterosexual South African women. Two other studies in African women did not demonstrate the efficacy of oral or topical PrEP, raising concerns about adherence patterns and efficacy in this population. The FDA Antiretroviral Advisory Panel reviewed these studies and additional data in May 2012 and recommended the approval of oral tenofovir-emtricitabine for PrEP in high-risk populations. Patients may seek PrEP from their primary care providers and those on PrEP require monitoring. Thus, primary care providers should become familiar with PrEP. This review outlines the current state of knowledge about PrEP as it pertains to primary care including identification of individuals likely to benefit from PrEP, counseling to maximize adherence and minimize potential increases in risky behavior, and monitoring for potential drug toxicities, HIV acquisition, and antiretroviral drug resistance. Issues related to cost and insurance coverage are also discussed. Recent data suggest that PrEP, in conjunction with other prevention strategies, holds promise in helping to curtail the HIV epidemic. PMID:22821365

Role of the pharmacist in pre-exposure chemoprophylaxis (PrEP therapy for HIV prevention

Directory of Open Access Journals (Sweden)

Clauson KA

2009-03-01

Full Text Available With a global estimate of 2.5 million new infections of HIV occurring yearly, discovering novel methods to help stem the spread of the virus is critical. The use of antiretroviral chemoprophylaxis for preventing HIV after accidental or occupational exposure and in maternal to fetal transmission has become a widely accepted method to combat HIV. Based on this success, pre-exposure chemoprophylaxis (PrEP is being explored in at-risk patient populations such as injecting drug users, female sex workers and men who have sex with men. This off-label and unmonitored use has created a need for education and intervention by pharmacists and other healthcare professionals. Pharmacists should educate themselves on PrEP and be prepared to counsel patients about their means of obtaining it (e.g. borrowing or sharing medications and ordering from disreputable Internet pharmacies. They should also be proactive about medication therapy management in these patients due to clinically important drug interactions with PrEP medications. Only one trial exploring the safety and efficacy of tenofovir as PrEP has been completed thus far. However, five ongoing trials are in various stages and two additional studies are scheduled for the near future. Unfortunately, studies in this arena have met with many challenges that have threatened to derail progress. Ethical controversy surrounding post-trial care of participants who seroconvert during studies, as well as concerns over emerging viral resistance and logistical site problems, have already halted several PrEP trials. Information about these early trials has already filtered down to affected individuals who are experimenting with this unproven therapy as an “evening before pill”. The potential for PrEP is promising; however, more extensive trials are necessary to establish its safety and efficacy. Pharmacists are well-positioned to play a key role in helping patients make choices about PrEP, managing their therapy

Knowledge of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men in Denver, Colorado

Science.gov (United States)

Al-Tayyib, Alia A.; Thrun, Mark W.; Haukoos, Jason S.; Walls, N. Eugene

2014-01-01

As part of the National HIV Behavioral Surveillance System among men who have sex with men (MSM) in Denver, Colorado, we assessed knowledge of pre-exposure prophylaxis (PrEP); willingness to use PrEP; and potential changes in risk behaviors among HIV-negative participants reporting sexual activity with a male partner in the preceding 12 months. We examined knowledge of PrEP before (2008) and after (2011) results of the iPrEx trial were available. Of the 425 participants in the 2008 sample, 91 (21 %) were aware of PrEP compared to 131 (28 %) of the 461 participants in the 2011 sample (adjusted prevalence ratio: 1.43, 95 % confidence interval: 1.18, 1.72). Despite the increase in 2011, few MSM in Denver were aware of PrEP. Educating high-risk MSM about the potential utility of PrEP as an adjunct to other effective prevention methods is needed when considering the addition of PrEP to the HIV prevention arsenal. PMID:23824227

Knowledge, Attitudes, and Experiences of HIV Pre-Exposure Prophylaxis (PrEP) Trial Participants in Botswana.

Science.gov (United States)

Toledo, Lauren; McLellan-Lemal, Eleanor; Henderson, Faith L; Kebaabetswe, Poloko M

2015-03-01

Recent clinical trials have shown that a daily dose of oral TDF/FTC pre-exposure prophylaxis (PrEP) is effective in reducing human immunodeficiency (HIV) risk. Understanding trial participants' perspectives about retention and PrEP adherence is critical to inform future PrEP trials and the scale-up and implementation of PrEP programs. We analyzed 53 in-depth interviews conducted in April 2010 with participants in the TDF2 study, a Phase 3, randomized, double-blind, placebo-controlled clinical trial of daily oral TDF/FTC with heterosexual men and women in Francistown and Gaborone, Botswana. We examined participants' knowledge, attitudes, and experiences of the trial, identified facilitators and barriers to enrollment and retention, and compared participant responses by study site, sex, and study drug adherence. Our findings point to several factors to consider for participant retention and adherence in PrEP trials and programs, including conducting pre-enrollment education and myth reduction counseling, providing accurate estimates of participant obligations and side effect symptoms, ensuring participant understanding of the effects of non-adherence, gauging personal commitment and interest in study outcomes, and developing a strong external social support network for participants.

What Is the Tech Prep/Associate Degree Program?

Science.gov (United States)

Parnell, Dale

1993-01-01

Discusses the nature, importance, and future of the Tech Prep/Associate Degree program. Suggests that these programs must move beyond simple articulation and become aggressive in jointly examining, developing, and sustaining high quality educational programs. (JOW)

Arsenic in groundwater of Licking County, Ohio, 2012—Occurrence and relation to hydrogeology

Science.gov (United States)

Thomas, Mary Ann

2016-02-23

Arsenic concentrations were measured in samples from 168 domestic wells in Licking County, Ohio, to document arsenic concentrations in a wide variety of wells and to identify hydrogeologic factors associated with arsenic concentrations in groundwater. Elevated concentrations of arsenic (greater than 10.0 micrograms per liter [µg/L]) were detected in 12 percent of the wells (about 1 in 8). The maximum arsenic concentration of about 44 µg/L was detected in two wells in the same township.A subset of 102 wells was also sampled for iron, sulfate, manganese, and nitrate, which were used to estimate redox conditions of the groundwater. Elevated arsenic concentrations were detected only in strongly reducing groundwater. Almost 20 percent of the samples with iron concentrations high enough to produce iron staining (greater than 300 µg/L) also had elevated concentrations of arsenic.In groundwater, arsenic primarily occurs as two inorganic species—arsenite and arsenate. Arsenic speciation was determined for a subset of nine samples, and arsenite was the predominant species. Of the two species, arsenite is more difficult to remove from water, and is generally considered to be more toxic to humans.Aquifer and well-construction characteristics were compiled from 99 well logs. Elevated concentrations of arsenic (and iron) were detected in glacial and bedrock aquifers but were more prevalent in glacial aquifers. The reason may be that the glacial deposits typically contain more organic carbon than the Paleozoic bedrock. Organic carbon plays a role in the redox reactions that cause arsenic (and iron) to be released from the aquifer matrix. Arsenic concentrations were not significantly different for different types of bedrock (sandstone, shale, sandstone/shale, or other). However, arsenic concentrations in bedrock wells were correlated with two well-construction characteristics; higher arsenic concentrations in bedrock wells were associated with (1) shorter open intervals and

Cost-effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV-1 infections in rural Zambia: a modeling study

NARCIS (Netherlands)

Nichols, B.E.; Boucher, C.A.B.; van Dijk, J.H.; Thuma, P.E.; Nouwen, J.L.; Baltussen, R.; van de Wijgert, J.; Sloot, P.M.A.; van de Vijver, D.A.M.C.

2013-01-01

Background: Pre-exposure prophylaxis (PrEP) with tenofovir and emtricitabine effectively prevents new HIV infections. The optimal scenario for implementing PrEP where most infections are averted at the lowest cost is unknown. We determined the impact of different PrEP strategies on averting new

The Role of Social Relationships in PrEP Uptake and Use Among Transgender Women and Men Who Have Sex with Men.

Science.gov (United States)

Mehrotra, Megha L; Rivet Amico, K; McMahan, Vanessa; Glidden, David V; Defechereux, Patricia; Guanira, Juan V; Grant, Robert M

2018-05-12

Qualitative studies suggest that social relationships play an important role in HIV pre-exposure prophylaxis (PrEP) use, but there have been few quantitative assessments of the role of social relationships in PrEP uptake or adherence. We examined the association between disclosure of study participation or LGBT identity and PrEP use in the 1603 HIV-negative participants enrolled in the iPrEx OLE study. We also evaluated the association between LGBT social group involvement and PrEP use. Study participation disclosure to parents and LGBT identity disclosure to anyone in a participant's social network were associated with greater PrEP uptake. Study participation disclosure to partners was associated with higher probability of having protective PrEP drug concentrations compared [risk difference 0.15 95% CI (0.01, 0.30)]. For each additional type of LGBT organization a participant was involved in, the probability of PrEP uptake and having protective drug concentrations increased by 0.04 [95% CI (0.03, 0.06)] and 0.04 (95% CI (0.02, 0.07)] respectively. Overall, social context was associated with PrEP use in iPrEx OLE, and should be taken into consideration when designing future PrEP implementation programs.

Commentary: the value of PrEP for people who inject drugs.

Science.gov (United States)

Coleman, Rosalind L; McLean, Susie

2016-01-01

The offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection. What does this recommendation mean in terms of the diverse range of HIV prevention needs of key populations, some of whom are so discriminated against that they exist essentially outside formal systems such as national public health services, and for whom a substantial risk of HIV is part of a larger adverse and hostile situation? We discuss this question with reference to people who inject drugs, informed by concerns and comments that emerged from a series of consultations. HIV prevention is part of a spectrum of injecting drug users' priorities, and their access and uptake of HIV prevention services is contingent on their wider "risk environment." The need to address structural barriers to services and human rights violations, and to improve access to comprehensive harm reduction programmes are of prime importance and would have higher value than a mono-focus on HIV prevention. Where existing harm reduction activities are inadequate, fragile or dependent on external donors, shifts in funding priorities, including, for example, towards PrEP, could threaten investment in the broader programmes. For these reasons, it cannot be assumed that PrEP promotion will always be supported by people who inject drugs.The sexual partners of people who inject drugs, non-opioid users who also inject and for whom there is no established substitution treatment, as well as drug users who are unable to negotiate safe sex may value PrEP. As for all key populations, the involvement of people who inject drugs in

Are Thai MSM willing to take PrEP for HIV prevention? An analysis of attitudes, preferences and acceptance.

Directory of Open Access Journals (Sweden)

Ana Wheelock

Full Text Available We aimed to understand the attitudes, preferences and acceptance of oral and parenteral PrEP among men who have sex with men (MSM in Thailand.Pre-exposure prophylaxis (PrEP, the use of antiretrovirals to prevent HIV acquisition, has shown promising results in recent trials. To assess the potential impact of this new HIV prevention method, in addition to efficacy data, we need to understand which psychosocial factors are likely to determine its uptake among members of potential user groups.Surveys of willingness to use PrEP products were administered to MSM. Spearman's rank tests were used to uncover associations between questionnaire items. Mann-Whitney tests were performed to ascertain differences between groups. Conjoint analysis was used to examine the attitudes and preferences of MSM towards PrEP attributes. Most participants were willing to consider taking PrEP (39.2% "yes, definitely" and 49.2% "yes, probably" and perceived PrEP as giving them new possibilities in their lives (38.5% "a lot of hope" and 55.8% "some hope", even after being instructed of potential side effects and costs. HIV testing was considered the most important attribute and a daily pill and longer lasting injection in the arm were the preferred routes of administration.Despite its multiple challenges, MSM in Thailand would be willing to take PrEP, even if they had to experience inconvenience and expense. If PrEP were to be implemented in Thailand, our findings show that its uptake could be considerable.

76 FR 51037 - Determination That Halflytely and Bisacodyl Tablets Bowel Prep Kit (Containing Two Bisacodyl...

Science.gov (United States)

2011-08-17

... determined that Halflytely and Bisacodyl Tablets Bowel Prep Kit (polyethylene glycol (PEG) 3350, sodium... kits containing PEG-3350, sodium chloride, sodium bicarbonate, and potassium chloride for oral solution... that the Agency determine whether Halflytely and Bisacodyl Tablets Bowel Prep Kit (PEG- 3350, sodium...

Complex and Conflicting Social Norms: Implications for Implementation of Future HIV Pre-Exposure Prophylaxis (PrEP Interventions in Vancouver, Canada.

Directory of Open Access Journals (Sweden)

Rod Knight

Full Text Available HIV Pre-Exposure Prophylaxis (PrEP has been found to be efficacious in preventing HIV acquisition among seronegative individuals in a variety of risk groups, including men who have sex with men and people who inject drugs. To date, however, it remains unclear how socio-cultural norms (e.g., attitudes towards HIV; social understandings regarding HIV risk practices may influence the scalability of future PrEP interventions. The objective of this study is to assess how socio-cultural norms may influence the implementation and scalability of future HIV PrEP interventions in Vancouver, Canada.We conducted 50 interviews with young men (ages 18-24 with a variety of HIV risk behavioural profiles (e.g., young men who inject drugs; MSM. Interviews focused on participants' experiences and perceptions with various HIV interventions and policies, including PrEP.While awareness of PrEP was generally low, perceptions about the potential personal and public health gains associated with PrEP were interconnected with expressions of complex and sometimes conflicting social norms. Some accounts characterized PrEP as a convenient form of reliable protection against HIV, likening it to the female birth control pill. Other accounts cast PrEP as a means to facilitate 'socially unacceptable' behaviour (e.g., promiscuity. Stigmatizing rhetoric was used to position PrEP as a tool that could promote some groups' proclivities to take 'risks'.Stigma regarding 'risky' behaviour and PrEP should not be underestimated as a serious implementation challenge. Pre-implementation strategies that concomitantly aim to improve knowledge about PrEP, while addressing associated social prejudices, may be key to effective implementation and scale-up.

HIV providers' likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: a short report.

Science.gov (United States)

Adams, Leah M; Balderson, Benjamin H

2016-09-01

Pre-exposure prophylaxis (PrEP), the antiretroviral treatment regimen for HIV-negative people at high risk of acquiring HIV, has demonstrated efficacy across clinical trials in several patient populations. The Centers for Disease Control (CDC) have released detailed guidelines to aid providers in prescribing PrEP for their high-risk patients, including men who have sex with men (MSM), high-risk heterosexuals, and injection drug users (IDUs). Given that much attention in PrEP has focused on MSM patients, the present study used an online survey to assess factors involved in HIV care providers' (n = 363) decisions about prescribing PrEP, along with their willingness to prescribe PrEP to patients from various risk populations (e.g., MSM, heterosexuals, IDUs). The efficacy of PrEP was an important factor in providers' decisions about prescribing PrEP, as were considerations about patients' adherence to the regimen, regular follow-up for care, and medication costs. This survey's findings also suggest that providers' willingness to prescribe PrEP varies by patient group, with providers most willing to initiate the regimen with MSM who have an HIV-positive partner, and least willing to prescribe to high-risk heterosexuals or IDUs. In the context of the current CDC recommendations for PrEP that include MSM, heterosexuals, and IDUs, examining providers' rationales for and barriers against supporting this HIV prevention strategy across patient groups merits further attention.

Genetic control of oromotor phenotypes: A survey of licking and ingestive behaviors in highly diverse strains of mice.

Science.gov (United States)

St John, Steven J; Lu, Lu; Williams, Robert W; Saputra, Jennifer; Boughter, John D

2017-08-01

In order to examine genetic influences on fluid ingestion, 20-min intake of either water or 0.1M sucrose was measured in a lickometer in 18 isogenic strains of mice, including 15 inbred strains and 3 F 1 hybrid crosses. Intake and licking data were examined at a number of levels, including lick rate as defined by mean or median interlick interval, as well as several microstructural parameters (i.e. burst-pause structure). In general, strain variation for ingestive phenotypes were correlated across water and sucrose in all strains, indicating fundamental, rather than stimulus-specific, mechanisms of intake. Strain variation was substantial and robust, with heritabilities for phenotypes ranging from 0.22 to 0.73. For mean interlick interval (MPI; a measure of lick rate) strains varied continuously from 94.3 to 127.0ms, a range consistent with previous studies. Furthermore, variation among strains for microstructural traits such as burst size and number suggested that strains possess different overall ingestive strategies, with some favoring more short bursts, and others favoring fewer, long bursts. Strains also varied in cumulative intake functions, exhibiting both linear and decelerated rates of intake across the session. Copyright © 2017 Elsevier Inc. All rights reserved.

Gender, culture, and astrophysical fieldwork: Elizabeth Campbell and the Lick Observatory-Crocker eclipse expeditions.

Science.gov (United States)

Pang, A. S.-K.

The article is organized as follows. It begins with an overview of women in nineteenth-century American science. It then describes the culture of mountaintop observatories and life on Mount Hamilton. Elizabeth Campbell's unique role in the Crocker-Lick expeditions drew upon her equally unique role in the observatory, and also on the meaning given to women's work in general on the mountain. The bulk of the article focuses on the Campbells and their expeditions to India in 1898, Spain in 1905, and the South Pacific in 1908. The third section compares the Lick Observatory expeditions to those conducted by David Todd of Amherst College. Todd's wife, Mabel Loomis Todd, went into the field several times with her husband, but her place in the field was radically different from Elizabeth Campbell's, a difference that can be ascribed to a combination of local culture and personality. Finally, it compares American expeditions to British expeditions of the period, to see what the absence of British women on expeditions can tell us about the way national scientific styles and cultures affected gender roles in science.

Uptake of PrEP and condom and sexual risk behavior among MSM during the ANRS IPERGAY trial.

Science.gov (United States)

Sagaon-Teyssier, Luis; Suzan-Monti, Marie; Demoulin, Baptiste; Capitant, Catherine; Lorente, Nicolas; Préau, Marie; Mora, Marion; Rojas Castro, Daniela; Chidiac, Christian; Chas, Julie; Meyer, Laurence; Molina, Jean-Michel; Spire, Bruno

2016-01-01

The double-blind phase of the randomized ANRS IPERGAY trial, evaluating sexual activity-based oral HIV pre-exposure prophylaxis (PrEP), was conducted among high-risk men who have sex with men (MSM). Results showed an 86% (95% CI: 40-98) relative reduction in HIV incidence among participants with tenofovir disoproxil fumarate-emtricitabine vs. placebo. The present pooled analysis aimed to analyze (i) participants' adherence to the prescribed treatment and/or condom use during sexual intercourse and (ii) sexual behavior during the double-blind phase of the study. Four hundred MSM were enrolled in the trial. Every 2 months they completed online questionnaires collecting sexual behavior and PrEP adherence data regarding their most recent sexual intercourse. A total of 2232 questionnaires (M0-M24) were analyzed. Changes over time were evaluated using a mixed model accounting for multiple measures. Irrespective of sexual partner and practice type, on average, 42.6% (min: 32.1-max: 45.8%) reported PrEP use only during their most recent episode of sexual intercourse; 29% (22.9-35.6%) reported both PrEP and condom use; 11.7% (7.2-18.9%) reported condom-use only, and 16.7% (10.8-29.6%) reported no PrEP or condom use with no significant change during the study. Scheduled (i.e., correct) PrEP use was reported on average by 59.0% (47.2-68.5%) of those reporting PrEP use during their most recent sexual intercourse. Overall, 70.3% (65.3-79.4%) and 69.3% (58.3-75.4%) of participants reported, respectively, condomless anal and condomless receptive anal intercourse during their most recent sexual encounter without significant change during follow-up. Overall, on average 83.3% (min: 70.4-max: 89.2%) of participants protected themselves by PrEP intake or condom use or both during the trial, and no increase in at-risk sexual practices was observed. None of these indicators showed significant trend during the follow-up, although we found a tendency toward decrease (p = .19) of the

Surveillance indicators for potential reduced exposure products (PREPs: developing survey items to measure awareness

Directory of Open Access Journals (Sweden)

McNeill Ann

2009-10-01

Full Text Available Abstract Background Over the past decade, tobacco companies have introduced cigarettes and smokeless tobacco products (known as Potential Reduced Exposure Products, PREPs with purportedly lower levels of some toxins than conventional cigarettes and smokeless products. It is essential that public health agencies monitor awareness, interest, use, and perceptions of these products so that their impact on population health can be detected at the earliest stages. Methods This paper reviews and critiques existing strategies for measuring awareness of PREPs from 16 published and unpublished studies. From these measures, we developed new surveillance items and subjected them to two rounds of cognitive testing, a common and accepted method for evaluating questionnaire wording. Results Our review suggests that high levels of awareness of PREPs reported in some studies are likely to be inaccurate. Two likely sources of inaccuracy in awareness measures were identified: 1 the tendency of respondents to misclassify "no additive" and "natural" cigarettes as PREPs and 2 the tendency of respondents to mistakenly report awareness as a result of confusion between PREPs brands and similarly named familiar products, for example, Eclipse chewing gum and Accord automobiles. Conclusion After evaluating new measures with cognitive interviews, we conclude that as of winter 2006, awareness of reduced exposure products among U.S. smokers was likely to be between 1% and 8%, with the higher estimates for some products occurring in test markets. Recommended measurement strategies for future surveys are presented.

Surveillance indicators for potential reduced exposure products (PREPs): developing survey items to measure awareness

Science.gov (United States)

Bogen, Karen; Biener, Lois; Garrett, Catherine A; Allen, Jane; Cummings, K Michael; Hartman, Anne; Marcus, Stephen; McNeill, Ann; O'Connor, Richard J; Parascandola, Mark; Pederson, Linda

2009-01-01

Background Over the past decade, tobacco companies have introduced cigarettes and smokeless tobacco products (known as Potential Reduced Exposure Products, PREPs) with purportedly lower levels of some toxins than conventional cigarettes and smokeless products. It is essential that public health agencies monitor awareness, interest, use, and perceptions of these products so that their impact on population health can be detected at the earliest stages. Methods This paper reviews and critiques existing strategies for measuring awareness of PREPs from 16 published and unpublished studies. From these measures, we developed new surveillance items and subjected them to two rounds of cognitive testing, a common and accepted method for evaluating questionnaire wording. Results Our review suggests that high levels of awareness of PREPs reported in some studies are likely to be inaccurate. Two likely sources of inaccuracy in awareness measures were identified: 1) the tendency of respondents to misclassify "no additive" and "natural" cigarettes as PREPs and 2) the tendency of respondents to mistakenly report awareness as a result of confusion between PREPs brands and similarly named familiar products, for example, Eclipse chewing gum and Accord automobiles. Conclusion After evaluating new measures with cognitive interviews, we conclude that as of winter 2006, awareness of reduced exposure products among U.S. smokers was likely to be between 1% and 8%, with the higher estimates for some products occurring in test markets. Recommended measurement strategies for future surveys are presented. PMID:19840394

Grade Repetition in Queensland State Prep Classes

Science.gov (United States)

Anderson, Robyn

2012-01-01

The current study considers grade repetition rates in the early years of schooling in Queensland state schools with specific focus on the pre-schooling year, Prep. In particular, it provides empirical evidence of grade repetition in Queensland state schools along with groups of students who are more often repeated. At the same time, much of the…

Awareness and Willingness to Use Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men and Transgender Women in Brazil.

Science.gov (United States)

Hoagland, Brenda; De Boni, Raquel B; Moreira, Ronaldo I; Madruga, José Valdez; Kallas, Esper G; Goulart, Silvia Pereira; Cerqueira, Natalia; Torres, Thiago S; Luz, Paula M; Fernandes, Nilo Martinez; Liu, Albert Y; Grinsztejn, Beatriz; Veloso, Valdilea G

2017-05-01

Antiretroviral pre-exposure prophylaxis (PrEP) is recommended to prevent HIV infection among high-risk men who have sex with men (MSM) though not available in Brazil where the HIV epidemic persists unabated in this group. This cross-sectional study describes PrEP awareness and willingness and associated factors among MSM and transvestite/transgender women (trans women) pre-screened for the PrEP Brasil study. Awareness was reported by 61.3 % of the participants and was associated with age, education, site, study period and prior HIV testing. Most participants (82.1 %) were willing to use PrEP, which was associated with site, study period, number of male condomless anal sexual partners and anal sex with HIV positive/unknown partners. PrEP information is need among young and less educated individuals. Willingness to use PrEP was high and future studies should be conducted to confirm PrEP acceptability and the characteristics of the population who chose to adopt this intervention.

75 FR 13292 - Determination That HalfLytely and Bisacodyl Tablets Bowel Prep Kit (Containing 4 Bisacodyl...

Science.gov (United States)

2010-03-19

... determined that HALFLYTELY AND BISACODYL TABLETS BOWEL PREP KIT (polyethylene glycol (PEG) 3350, sodium... kits containing PEG-3350, sodium chloride, sodium bicarbonate, and potassium chloride for oral solution... whether HALFLYTELY AND BISACODYL TABLETS BOWEL PREP KIT (PEG-3350, sodium chloride, sodium bicarbonate...

Effect of pH and dilution rate on specific production rate of extra cellular metabolites by Lactobacillus salivarius UCO_979C in continuous culture.

Science.gov (United States)

Valenzuela, Javier Ferrer; Pinuer, Luis; Cancino, Apolinaria García; Yáñez, Rodrigo Bórquez

2015-08-01

The effect of pH and dilution rate on the production of extracellular metabolites of Lactobacillus salivarius UCO_979 was studied. The experiments were carried out in continuous mode, with chemically defined culture medium at a temperature of 37 °C, 200 rpm agitation and synthetic air flow of 100 ml/min. Ethanol, acetic acid, formic acid, lactic acid and glucose were quantified through HPLC, while exopolysaccharide (EPS) was extracted with ethanol and quantified through the Dubois method. The results showed no linear trends for the specific production of lactic acid, EPS, acetic acid and ethanol, while the specific glucose consumption and ATP production rates showed linear trends. There was a metabolic change of the strain for dilution rates below 0.3 h(-1). The pH had a significant effect on the metabolism of the strain, which was evidenced by a higher specific glucose consumption and increased production of ATP at pH 6 compared with that obtained at pH 7. This work shows not only the metabolic capabilities of L. salivarius UCO_979C, but also shows that it is possible to quantify some molecules associated with its current use as gastrointestinal probiotic, especially regarding the production of organic acids and EPS.

Pre-Exposure Prophylaxis (PrEP) Use and Condomless Anal Sex: Evidence of Risk Compensation in a Cohort of Young Men Who Have Sex with Men.

Science.gov (United States)

Newcomb, Michael E; Moran, Kevin; Feinstein, Brian A; Forscher, Emily; Mustanski, Brian

2018-04-01

Young men who have sex with men (YMSM) are disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition. It remains unclear if PrEP use increases rates of condomless sex (ie, risk compensation), which may increase risk of infection if PrEP adherence is not optimal. This study aimed to examine whether PrEP use and PrEP adherence were associated with change in sexual risk behaviors in a large longitudinal cohort of YMSM reporting on multiple sexual partnerships over time. Data were obtained from the first 3 visits of an ongoing cohort study of YMSM in Chicago (analytic N = 953; 14.1% HIV-positive at baseline). Participants reported up to 4 sexual partnerships at each visit, including sexual behavior, PrEP use, and PrEP adherence within partnerships. YMSM reported higher rates of receptive condomless anal sex (CAS) in partnerships during which they were on PrEP compared with those when they were not on PrEP. This association was consistent across both HIV-negative and HIV-positive participants reporting on partnerships with both perceived HIV-negative/unknown and HIV-positive partners. The rate of receptive CAS was higher in PrEP nonadherent partnerships compared with non-PrEP partnerships. The rate of receptive CAS was also higher in PrEP nonadherent than adherent partnerships, but this was not statistically significant. These analyses provide compelling data suggesting that YMSM are engaging in risk compensation when on PrEP. If rates of receptive CAS are highest among YMSM who are PrEP nonadherent, PrEP as a prevention strategy could fail to curb HIV incidence among YMSM.

Exploring strategies for PrEP adherence and dosing preferences in the context of sexualized recreational drug use among MSM: a qualitative study.

Science.gov (United States)

Closson, Elizabeth F; Mitty, Jennifer A; Malone, Jowanna; Mayer, Kenneth H; Mimiaga, Matthew J

2018-02-01

The use of recreational drugs while having sex is associated with increased HIV incidence among men who have sex with men (MSM). Taking a daily antiretroviral pill, or pre-exposure prophylaxis (PrEP) is a biomedical intervention to prevent HIV. However, the efficacy of PrEP is closely tied with high levels of adherence. While PrEP has the potential to reduce HIV acquisition, the use of recreational drugs may impede adherence. We explored perceptions of PrEP utilization and regimen preferences among 40 HIV-negative, MSM who reported concurrent recreational drug use and condomless anal sex with a man. Semi-structured qualitative interviews were conducted and the data were analyzed using a qualitative descriptive approach. Participants perceived that it would be challenging to take PrEP while high on crystal meth, crack, powder cocaine, ecstasy and/or GHB. However, men identified strategies for using PrEP when they were not high on these drugs, including taking the pill when they started their day and integrating PrEP into an established routine, such as when taking other medications or preparing for sex. PrEP regimen preferences seemed to be shaped by the frequency in which participants used drugs and their ability to plan for sex. Taking PrEP everyday was appealing for those who regularly engaged in sexualized recreational drug use. Accounts depict these sexual interactions as frequent but unpredictable. A daily regimen would allow them to be prepared for sex without having to plan. An event-driven regimen was acceptable to men who occasionally used recreational drugs in the context of sex. For this group, sex usually occurred was generally prearranged. Patterns of sex and recreational drug use figured largely into participants' framings of how they would use PrEP. These behaviors will likely play a role in the uptake of and adherence to PrEP among this population.

Pre-exposure Prophylaxis (PrEP) Use, Seroadaptation, and Sexual Behavior Among Men Who Have Sex with Men, San Francisco, 2004-2014.

Science.gov (United States)

Chen, Yea-Hung; Snowden, Jonathan M; McFarland, Willi; Raymond, H Fisher

2016-12-01

The Food and Drug Administration approved pre-exposure prophylaxis (PrEP) to prevent HIV infection, and the Centers for Disease Control and Prevention has presented PrEP as a prevention option for groups at high risk such as men who have sex with men (MSM). Intervention data provide some information on how PrEP affects sexual behavior of MSM in trials, open label extensions, or clinics. However, it is unclear whether sexual risk and preventive behavioral patterns are changing in the population as a whole as PrEP becomes more widely available, whether due to PrEP use or other factors. We examined trends in PrEP use, numbers of condomless anal sex partners, consistent condom use, and seroadaptive strategies in San Francisco-a city which has actively promoted PrEP-using data from National HIV Behavioral Surveillance (NHBS). NHBS recruited 1211, 383, 373, and 268 HIV-negative MSM in 2004, 2008, 2011, and 2014, respectively. PrEP use increased from zero in 2004, 2008, and 2011 to 9.6 % in 2014. The proportion of men with no condomless anal sex partners dropped from 60.6 % in 2004, to 58.2 % in 2008, to 54.2 % in 2011, to 40.2 % in 2014. Consistent condom use decreased from 36.8 % in 2004, and 30.5 % in 2008 and 2011, to 18.3 % in 2014. PrEP's introduction and scale-up enters in a pre-existing trend of decreasing condom use and increasing sexually transmitted infections among MSM which may be accelerating in recent years. While PrEP use should be scaled up as a prevention option among those who would benefit most, we believe that public health officials need to be realistic about the possibility that condom use could very well continue to decline as PrEP use increases, and to an extent that may not be directly or indirectly offset by PrEP.

Oral Pre-Exposure Prophylaxis (PrEP) for Prevention of HIV in Serodiscordant Heterosexual Couples in the United States: Opportunities and Challenges

Science.gov (United States)

Myers, Julie E.; Kurth, Ann E.; Cohen, Stephanie E.; Mannheimer, Sharon B.; Simmons, Janie; Pouget, Enrique R.; Trabold, Nicole; Haberer, Jessica E.

2014-01-01

Abstract Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP—injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US. PMID:25045996

Licking as an out-of-hospital burns treatment-An isolated cultural phenomenon?

LENUS (Irish Health Repository)

Seoighe, Deirdre M

2012-02-01

Wound management in burns is a potentially complex issue. Salivary constituents have been shown experimentally to be of benefit in the treatment of thermal injuries. In our clinical experience we have encountered patients who have saliva directly applied to the burn wound prior to presenting to the national burns service. The practice is known as "Licking". We report two cases to illustrate the presentations we have encountered. We believe that these illustrate an isolated phenomenon unique to the Republic of Ireland.

A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP in clinical settings to prevent HIV infection.

Directory of Open Access Journals (Sweden)

Emily A Arnold

Full Text Available A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC can reduce HIV acquisition among men who have sex with men (MSM and transgender (TG women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States.Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time.Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations.While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor PrEP

A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP) in clinical settings to prevent HIV infection.

Science.gov (United States)

Arnold, Emily A; Hazelton, Patrick; Lane, Tim; Christopoulos, Katerina A; Galindo, Gabriel R; Steward, Wayne T; Morin, Stephen F

2012-01-01

A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC) can reduce HIV acquisition among men who have sex with men (MSM) and transgender (TG) women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States. Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time. Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations. While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor PrEP in their

Imaging the Formation of High-Energy Dispersion Anomalies in the Actinide UCoGa_{5}

Directory of Open Access Journals (Sweden)

Tanmoy Das

2012-11-01

Full Text Available We use angle-resolved photoemission spectroscopy to image the emergence of substantial dispersion and spectral-weight anomalies in the electronic renormalization of the actinide compound UCoGa_{5} that was presumed to belong to a conventional Fermi-liquid family. Kinks or abrupt breaks in the slope of the quasiparticle dispersion are detected both at low (approximately 130 meV and high (approximately 1 eV binding energies below the Fermi energy, ruling out any significant contribution of phonons. We perform numerical calculations to demonstrate that the anomalies are adequately described by coupling between itinerant fermions and spin fluctuations arising from the particle-hole continuum of the spin-orbit-split 5f states of uranium. These anomalies resemble the “waterfall” phenomenon of the high-temperature copper-oxide superconductors, suggesting that spin fluctuations are a generic route toward multiform electronic phases in correlated materials as different as high-temperature superconductors and actinides.

Acceptability of HIV Pre-Exposure Prophylaxis (PrEP) and Implementation Challenges Among Men Who Have Sex with Men in India: A Qualitative Investigation.

Science.gov (United States)

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Mengle, Shruta; Varghese, Jarvis; Nelson, Ruban; Bharat, Shalini

2015-10-01

This qualitative study explored the acceptability of HIV pre-exposure prophylaxis (PrEP) among MSM in India, and identified facilitators and barriers to future PrEP uptake. In 2014, we conducted 10 focus groups (n=61) among a purposive sample of diverse MSM recruited through community-based organizations in Chennai and Mumbai, and 10 key informant interviews with community leaders and health care providers. Participants' mean age was 26.1 years (SD 4.8); 62% completed secondary education, and 42% engaged in sex work. No focus group participants had heard of PrEP, but once explained, most reported they would likely use it. PrEP was alternately perceived as a 'back-up plan', a condom substitute, or a burden with concurrent condom use. Facilitators were potential for covert use, sex without condoms, and anxiety-less sex. Potential barriers emerged around stigma associated with PrEP use, fear of disclosures to one's family, wife, or male steady partner, and being labeled as HIV-positive or promiscuous by peers. Preferences emerged for intermittent rather than daily PrEP use, injectable PrEP, and free or subsidized access through community organizations or government hospitals. Key informants expressed additional concerns about risk compensation, non-adherence, and impact on ART availability for treatment. Demonstration projects are needed in India to support PrEP implementation tailored for at-risk MSM. Educational interventions for MSM should address concerns about PrEP effectiveness, side effects, and mitigate risk compensation. Community engagement may facilitate broad acceptability and challenge stigma around PrEP use. Importantly, provision of free or subsidized PrEP is necessary to making implementation feasible among low socioeconomic status MSM in India.

Learning to Trust. On the Treasure Coast, Tech Prep Proves a Trove for Educators Long Divided.

Science.gov (United States)

Winterburn, Patty

1995-01-01

Based on the "High Schools That Work" model, the Quad County Tech Prep Consortium in Florida has won several awards for its comprehensive tech prep program. The partnership enables technical students from four school districts to flow smoothly into an associate degree program at Indian River Community College. (JOW)

Sex, PrEP, and Stigma: Experiences with HIV Pre-exposure Prophylaxis Among New York City MSM Participating in the HPTN 067/ADAPT Study.

Science.gov (United States)

Franks, Julie; Hirsch-Moverman, Yael; Loquere, Avelino S; Amico, K Rivet; Grant, Robert M; Dye, Bonnie J; Rivera, Yan; Gamboa, Robert; Mannheimer, Sharon B

2018-04-01

The HPTN 067/Alternative Dosing to Augment Pre-Exposure Prophylaxis Pill Taking (ADAPT) study evaluated daily and non-daily dosing schedules for oral pre-exposure prophylaxis (PrEP) to prevent HIV. A qualitative sub-study including focus groups and in-depth interviews was conducted among men who have sex with men participating in New York City to understand their experience with PrEP and study dosing schedules. The 37 sub-study participants were 68% black, 11% white, and 8% Asian; 27% were of Hispanic/Latino ethnicity. Mean age was 34 years. Themes resulting from qualitative analysis include: PrEP is a significant advance for HIV prevention; non-daily dosing of PrEP is congruent with HIV risk; and pervasive stigma connected to HIV and risk behavior is a barrier to PrEP adherence, especially for non-daily dosing schedules. The findings underscore how PrEP intersects with other HIV prevention practices and highlight the need to understand and address multidimensional stigma related to PrEP use.

Preferences for Injectable PrEP Among Young U.S. Cisgender Men and Transgender Women and Men Who Have Sex with Men.

Science.gov (United States)

Biello, Katie B; Hosek, Sybil; Drucker, Morgan T; Belzer, Marvin; Mimiaga, Matthew J; Marrow, Elliot; Coffey-Esquivel, Julia; Brothers, Jennifer; Mayer, Kenneth H

2017-09-19

Young men who have sex with men account for approximately 20% of incident HIV infections in the U.S. Antiretroviral pre-exposure prophylaxis (PrEP) administered as a daily pill has been shown to decrease HIV acquisition in at-risk individuals. New modalities for PrEP are being developed and tested, including injectable PrEP; however, acceptability of these emerging modalities has not yet been examined in youth. We conducted six focus groups with 36 young men and transgender men and women who have sex with men in Boston, Chicago, and Los Angeles in 2016 to assess interest in and preference for different PrEP modalities. Youth were purposively recruited based on diversity of age, race/ethnicity, and prior PrEP experience. Data were coded using content coding based on key domains of the interview guide, in particular around the central themes of interest in and barriers and facilitators to injectable PrEP use. Participants were knowledgeable about oral PrEP but suggested barriers to broader uptake, including stigma, marginalization, and access to information. While participants were split on preference for injectable versus oral PrEP, they agreed quarterly injections may be more manageable and better for those who have adherence difficulties and for those who engage in sex more frequently. Concerns specific to injectable PrEP included: severity/duration of side effects, pain, level of protection prior to next injection, distrust of medical system and injections, and cost. Understanding barriers to and preferences for diverse prevention modalities will allow for more HIV prevention options, improved products, and better interventions, thus allowing individuals to make informed HIV prevention choices.

Comparing the impact of increasing condom use or HIV pre-exposure prophylaxis (PrEP use among female sex workers

Directory of Open Access Journals (Sweden)

Zindoga Mukandavire

2016-03-01

Full Text Available In many settings, interventions targeting female sex workers (FSWs could significantly reduce the overall transmission of HIV. To understand the role HIV pre-exposure prophylaxis (PrEP could play in controlling HIV transmission amongst FSWs, it is important to understand how its impact compares with scaling-up condom use—one of the proven HIV prevention strategies for FSWs. It is important to remember that condoms also have other benefits such as reducing the incidence of sexually transmitted infections and preventing pregnancy. A dynamic deterministic model of HIV transmission amongst FSWs, their clients and other male partners (termed ‘pimps’ was used to compare the protection provided by PrEP for HIV-negative FSWs with FSWs increasing their condom use with clients and/or pimps. For different HIV prevalence scenarios, levels of pimp interaction, and baseline condom use, we estimated the coverage of PrEP that gives the same reduction in endemic FSW HIV prevalence or HIV infections averted as different increases in condom use. To achieve the same impact on FSW HIV prevalence as increasing condom use by 1%, the coverage of PrEP has to increase by >2%. The relative impact of PrEP increases for scenarios where pimps contribute to HIV transmission, but not greatly, and decreases with higher baseline condom use. In terms of HIV infections averted over 10 years, the relative impact of PrEP compared to condoms was reduced, with a >3% increase in PrEP coverage achieving the same impact as a 1% increase in condom use. Condom promotion interventions should remain the mainstay HIV prevention strategy for FSWs, with PrEP only being implemented once condom interventions have been maximised or to fill prevention gaps where condoms cannot be used.

Perceived Advantages and Disadvantages of Using Pre-Exposure Prophylaxis (PrEP) among Sexually Active Black Women

Science.gov (United States)

Bond, Keosha T.; Gunn, Alana J.

2017-01-01

Knowledge of pre-exposure prophylaxis (PrEP) continues to remain scarce among Black women who are disproportionally affected by HIV in the United States. A thematic analysis of open-ended questions from a sample of Black women (n=119) who completed a mix-methods, online, e-health study was conducted to examine the perceived advantages and disadvantages of using PrEP. Being a female controlled method, empowerment, option for women with risky sex partners, and serodiscordant couples were advantages described. Disadvantages of PrEP were identified as the complexity of the choice, encouragement of sex with risky partners, increased burden, promotion of unprotected sex, and newness of the drug. PMID:28725660

Distinguishing hypothetical willingness from behavioral intentions to initiate HIV pre-exposure prophylaxis (PrEP): Findings from a large cohort of gay and bisexual men in the U.S.

Science.gov (United States)

Rendina, H Jonathon; Whitfield, Thomas H F; Grov, Christian; Starks, Tyrel J; Parsons, Jeffrey T

2017-01-01

Much of the data on the acceptability of HIV Pre-Exposure Prophylaxis (PrEP) is based on willingness to take PrEP (i.e., hypothetical receptivity) rather than actual intentions (i.e., planned behavioral action) to do so. We sought to examine differences between hypothetical willingness and behavioral intentions to begin PrEP in a national sample of gay and bisexual men (GBM) across the U.S. We utilized data collected in 2015 to examine differences between those Unwilling (42.6% n = 375), Willing but not intending (41.4%, n = 365), and willing and Intending to take PrEP (15.9%, n = 140) in a multivariable, multinomial logistic regression. Men with less education had higher odds of Intending to take PrEP. Compared to men unsure about PrEP's efficacy, those who believed PrEP was at least 90% efficacious had higher odds of Intending to take PrEP. Those who saw themselves as appropriate candidates for PrEP had higher odds of Intending to take PrEP while those who saw themselves as inappropriate candidates for PrEP had lower odds of Intending to take PrEP in comparison to men unsure if they were appropriate candidates. Increased motivation for condom non-use because of perceived sexual pressure by partners was associated with higher odds of Intending to take PrEP. The groups did not differ by risk behavior nor recent STI diagnosis. Overall, the distinction between willingness and intentions to take PrEP was meaningful and may help explain disparities between PrEP acceptability and uptake. While much of the literature has focused on hypothetical willingness to take PrEP, these results highlight the importance of simultaneously assessing willingness and intentions when examining correspondence with uptake and developing interventions to increase PrEP uptake. Copyright © 2016 Elsevier Ltd. All rights reserved.

[PrEP Forum: an on-line debate on pre-exposure prophylaxis in Brazil].

Science.gov (United States)

Queiroz, Artur Acelino Francisco Luz Nunes; Sousa, Alvaro Francisco Lopes de

2017-11-21

This study aimed to identify health-promoting contents focused on HIV/Aids prevention in messages posted in a Facebook group for debates on the use of pre-exposure prophylaxis (PrEP). This was a prospective observational study using systematic non-participant observation. From July 2015 to June 2016, all the posts in the group were catalogued and formed a corpus. Everything was processed in IRaMuTeQ and analyzed by descending hierarchical classification. The collected data were grouped in three classes: (1) HIV/Aids prevention: discussing prophylaxis, treatment, target public, and side effects; (2) universal access to PrEP in Brazil: discussing government responsibilities; (3) on-line purchase of truvada: exposing a situation of vulnerability. The findings call attention to a potential public health problem and provide backing for understanding facilitators and barriers to the use of PrEP in Brazil through the identification of health-promoting content linked to individual, social, and institutional markers.

How Much Do We Know about Drug Resistance Due to PrEP Use? Analysis of Experts' Opinion and Its Influence on the Projected Public Health Impact.

Directory of Open Access Journals (Sweden)

Dobromir T Dimitrov

Full Text Available Randomized controlled trials reported that pre-exposure prophylaxis (PrEP with tenofovir and emtricitabine rarely selects for drug resistance. However, drug resistance due to PrEP is not completely understood. In daily practice, PrEP will not be used under the well-controlled conditions available in the trials, suggesting that widespread use of PrEP can result in increased drug resistance.We surveyed expert virologists with questions about biological assumptions regarding drug resistance due to PrEP use. The influence of these assumptions on the prevalence of drug resistance and the fraction of HIV transmitted resistance was studied with a mathematical model. For comparability, 50% PrEP-coverage of and 90% per-act efficacy of PrEP in preventing HIV acquisition are assumed in all simulations.Virologists disagreed on the following: the time until resistance emergence (range: 20-180 days in infected PrEP users with breakthrough HIV infections; the efficacy of PrEP against drug-resistant HIV (25%-90%; and the likelihood of resistance acquisition upon transmission (10%-75%. These differences translate into projections of 0.6%- 1% and 3.5%-6% infected individuals with detectable resistance 10 years after introducing PrEP, assuming 100% and 50% adherence, respectively. The rate of resistance emergence following breakthrough HIV infection and the rate of resistance reversion after PrEP use is discontinued, were the factors identified as most influential on the expected resistance associated with PrEP. Importantly, 17-23% infected individuals could virologically fail treatment as a result of past PrEP use or transmitted resistance to PrEP with moderate adherence.There is no broad consensus on quantification of key biological processes that underpin the emergence of PrEP-associated drug resistance. Despite this, the contribution of PrEP use to the prevalence of the detectable drug resistance is expected to be small. However, individuals who become

Does Pre-exposure prophylaxis (PrEP) for HIV prevention in men who have sex with men (MSM) change risk behavior? A systematic review.

Science.gov (United States)

Freeborn, Kellie; Portillo, Carmen J

2017-08-03

Pre-exposure prophylaxis (PrEP) for HIV has been available since 2012. Even so, PrEP has not been widely accepted among healthcare providers and MSM some of whom are convinced that PrEP decreases condom use, and increases sexually transmitted infections (STIs). A systematic review of the state of the evidence regarding the association of PrEP with condom use, STI incidence and change in sexual risk behaviors in MSM. A structured search of databases resulted in 142 potential citations, but only ten publications met inclusion criteria and underwent data abstraction and critical appraisal. An adapted Cochrane Collaboration domain based assessment tool was used to critically appraise the methodological components of each quantitative study, and the Mixed Methods Appraisal Tool (MMAT) was used to critically appraise qualitative and mixed-methods studies. Condom use in MSM utilizing PrEP is influenced by multiple factors. Studies indicate rates of STIs in treatment and placebo groups were high. PrEP did not significantly change STI rates between baseline and follow-up. Reporting of sexual risk improved when questionnaires were completed in private by clients. Our review found that PrEP may provide an opportunity for MSM to access sexual health care, testing, treatment and counselling services. We did not find any conclusive evidence that PrEP users increase sexual risk behaviors. The perception among healthcare providers that PrEP leads to increased sexual risk behaviors has yet to be confirmed. In order to provide effective sexual health services, clinicians need to be knowledgeable about PrEP as an HIV prevention tool. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

'WTF is PrEP?': attitudes towards pre-exposure prophylaxis among men who have sex with men and transgender women in New York City.

Science.gov (United States)

Thomann, Matthew; Grosso, Ashley; Zapata, Richard; Chiasson, Mary Ann

2017-10-06

In the USA, gay and other men who have sex with men and transgender women are disproportionately affected by HIV. Uptake of pre-exposure prophylaxis (PrEP), anti-retroviral therapy to prevent HIV-negative individuals from seroconverting if exposed to HIV, by members of this population remains low, particularly among African-Americans. We conducted two focus groups to assess responses to an online social media campaign focusing on PrEP use in New York City. We designed, produced and disseminated the campaign to address knowledge of PrEP; its physical and psychological side effects; and psychosocial barriers related to PrEP adherence and sex shaming. Focus group participants demonstrated a relatively high knowledge of PrEP, although considerable concern remained about side effects, particularly among Black participants. Participants suggested that stigma against PrEP users was declining as PrEP use became more common, but stigma remained, particularly for those not using condoms. Many focus group participants reported distrust of medical providers and were critical of the commodification of HIV prevention by the pharmaceutical industry. Participants reported that those in romantic relationships confronted unique issues regarding PrEP, namely suspicions of infidelity. Finally, Black participants spoke of the need for more tailored and sensitive representations of Black gay men in future programmes and interventions.

Transitioning to HIV Pre-Exposure Prophylaxis (PrEP) from Non-Occupational Post-Exposure Prophylaxis (nPEP) in a Comprehensive HIV Prevention Clinic: A Prospective Cohort Study.

Science.gov (United States)

Siemieniuk, Reed A C; Sivachandran, Nirojini; Murphy, Pauline; Sharp, Andrea; Walach, Christine; Placido, Tania; Bogoch, Isaac I

2015-08-01

The uptake of pre-exposure prophylaxis (PrEP) for HIV prevention remains low. We hypothesized that a high proportion of patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP) would be candidates for PrEP based on current CDC guidelines. Outcomes from a comprehensive HIV Prevention Clinic are described. We evaluated all patients who attended the HIV Prevention Clinic for nPEP between January 1, 2013 and September 30, 2014. Each patient was evaluated for PrEP candidacy based on current CDC-guidelines and subjectively based on physician opinion. Patients were then evaluated for initiation of PrEP if they met guideline suggestions. Demographic, social, and behavioral factors were then analyzed with logistic regression for associations with PrEP candidacy and initiation. 99 individuals who attended the nPEP clinic were evaluated for PrEP. The average age was 32 years (range, 18-62), 83 (84%) were male, of whom 46 (55%) men who had have sex with men (MSM). 31 (31%) met CDC guidelines for PrEP initiation, which had very good agreement with physician recommendation (kappa=0.88, 0.78-0.98). Factors associated with PrEP candidacy included sexual exposure to HIV, prior nPEP use, and lack of drug insurance (p<0.05 for all comparisons). Combining nPEP and PrEP services in a dedicated clinic can lead to identification of PrEP candidates and may facilitate PrEP uptake. Strategies to ensure equitable access of PrEP should be explored such that those without drug coverage may also benefit from this effective HIV prevention modality.

PreP+07: improvements of a user friendly tool to preprocess and analyse microarray data

Directory of Open Access Journals (Sweden)

Claros M Gonzalo

2009-01-01

Full Text Available Abstract Background Nowadays, microarray gene expression analysis is a widely used technology that scientists handle but whose final interpretation usually requires the participation of a specialist. The need for this participation is due to the requirement of some background in statistics that most users lack or have a very vague notion of. Moreover, programming skills could also be essential to analyse these data. An interactive, easy to use application seems therefore necessary to help researchers to extract full information from data and analyse them in a simple, powerful and confident way. Results PreP+07 is a standalone Windows XP application that presents a friendly interface for spot filtration, inter- and intra-slide normalization, duplicate resolution, dye-swapping, error removal and statistical analyses. Additionally, it contains two unique implementation of the procedures – double scan and Supervised Lowess-, a complete set of graphical representations – MA plot, RG plot, QQ plot, PP plot, PN plot – and can deal with many data formats, such as tabulated text, GenePix GPR and ArrayPRO. PreP+07 performance has been compared with the equivalent functions in Bioconductor using a tomato chip with 13056 spots. The number of differentially expressed genes considering p-values coming from the PreP+07 and Bioconductor Limma packages were statistically identical when the data set was only normalized; however, a slight variability was appreciated when the data was both normalized and scaled. Conclusion PreP+07 implementation provides a high degree of freedom in selecting and organizing a small set of widely used data processing protocols, and can handle many data formats. Its reliability has been proven so that a laboratory researcher can afford a statistical pre-processing of his/her microarray results and obtain a list of differentially expressed genes using PreP+07 without any programming skills. All of this gives support to scientists

"I Did Not Want to Give Birth to a Child Who has HIV": Experiences Using PrEP During Pregnancy Among HIV-Uninfected Kenyan Women in HIV-Serodiscordant Couples.

Science.gov (United States)

Pintye, Jillian; Beima-Sofie, Kristin M; Kimemia, Grace; Ngure, Kenneth; Trinidad, Susan Brown; Heffron, Renee A; Baeten, Jared M; Odoyo, Josephine; Mugo, Nelly; Bukusi, Elizabeth A; Kelley, Maureen C; John-Stewart, Grace C

2017-11-01

The perceptions, motivations, and beliefs of HIV-uninfected women about pre-exposure prophylaxis (PrEP) use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy. Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant. Semistructured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy. Interviews were audio-recorded and transcribed into English. A qualitative descriptive analysis was performed, using a constant comparison approach to identify key themes related to PrEP use in pregnancy. Desire to remain HIV uninfected and have an HIV-free infant were strong motivators influencing continued use of PrEP during pregnancy. Supporting HIV-infected partners and childbearing within an HIV-serodiscordant relationship were also motivators. Women had challenges distinguishing normal pregnancy symptoms from PrEP side effects and were concerned that observed side effects could be signs of danger for the infant related to PrEP exposure. Health care providers were important conduits of knowledge about PrEP, and continuity of PrEP providers throughout pregnancy facilitated adherence. HIV-uninfected women in HIV-serodiscordant couples were motivated to use PrEP during pregnancy to remain HIV uninfected and to have an HIV-free child but had concerns about side effects. Health care providers will be important for PrEP messaging and adherence support in this unique population.

Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes.

Science.gov (United States)

Carlo Hojilla, J; Koester, Kimberly A; Cohen, Stephanie E; Buchbinder, Susan; Ladzekpo, Deawodi; Matheson, Tim; Liu, Albert Y

2016-07-01

Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP demonstration project to assess how men who have sex with men used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was 'seasonal' and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts.

Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships.

Science.gov (United States)

Gamarel, Kristi E; Golub, Sarit A

2015-04-01

In the USA, men who have sex with men (MSM) in primary partnerships are at elevated risk for human immunodeficiency virus (HIV) infection. Pre-exposure prophylaxis (PrEP), a new biomedical prevention strategy, has potential to reduce HIV transmission. This study examined predictors of PrEP adoption intentions among HIV-negative MSM in primary partnerships. The sample included HIV-negative MSM (n = 164) who participated in an ongoing cross-sectional study with an in-person interview examining PrEP adoption intentions. Higher HIV risk perception, intimacy motivations for condomless sex, recent condomless anal sex with outside partners, education, and age were each independently associated with PrEP adoption intentions. In a multivariate model, only age, education, and intimacy motivations for condomless sex were significantly associated with PrEP adoption intentions. Intimacy motivations may play a central role in PrEP adoption for MSM couples. Incorporating relationship dynamics into biomedical strategies is a promising avenue for research and intervention.

Perceptions of pre-exposure prophylaxis (PrEP) among HIV-negative and HIV-positive men who have sex with men.

OpenAIRE

Jaspal, Rusi; Daramilas, C.

2016-01-01

open access article Pre-exposure prophylaxis (PrEP) is a novel bio-medical HIV prevention op- tion for individuals at high risk of HIV exposure. This qualitative interview study ex- plores perceptions and understandings of PrEP among a sample of 20 HIV-negative and HIV-positive men who have sex with men (MSM) in the UK, where there is a debate about the feasibility of o ering PrEP on the NHS. Data were analysed using qualitative thematic analysis and social representations theory from soci...

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.

Science.gov (United States)

Koechlin, Florence M; Fonner, Virginia A; Dalglish, Sarah L; O'Reilly, Kevin R; Baggaley, Rachel; Grant, Robert M; Rodolph, Michelle; Hodges-Mameletzis, Ioannis; Kennedy, Caitlin E

2017-05-01

Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990-April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.

Science.gov (United States)

Walters, Suzan M; Reilly, Kathleen H; Neaigus, Alan; Braunstein, Sarah

2017-06-29

Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

No association between the PREP gene and lithium responsive bipolar disorder

Directory of Open Access Journals (Sweden)

Grof Paul

2007-02-01

Full Text Available Abstract Background Bipolar disorder (BD is a major psychiatric condition that commonly requires prophylactic and episodic treatment. Lithium (Li has been used for over 40 years now as an effective prophylactic agent. Response to Li treatment seems to be, at least in part, genetically determined. Although we ignore how Li specifically prevents mood episodes, it has previously been suggested that Li exerts an effect on the phosphoinositide pathway, and more recently, it has been proposed that Li may modulate prolyl endopeptidase (PREP. Methods In this study we carried out an association study looking at the PREP gene, located on ch 6q22. Five intronic single nucleotide polymorphisms (SNP, three coding SNPs and one SNP in the 5' UTR were investigated for their frequency in a BD sample of 180 excellent Li responders, 69 Li nonresponders and 126 controls. Genotyping was carried out using the SNaPshot reaction from Applied Biosystems, which is a modified fluorescent single base pair extension procedure. Results Following correction for multiple testing, no significant genotypic, allelic or estimated haplotypic differences were found between responders and nonresponders or between BD patients and controls. Conclusion PREP is an interesting candidate gene to investigate in genetic studies of BD, but our findings do not support the hypothesis that genetic variation in this gene plays a major role in the etiology of BD or Li response.

Effects on Student Achievement in General Chemistry Following Participation in an Online Preparatory Course. ChemPrep, a Voluntary, Self-Paced, Online Introduction to Chemistry

Science.gov (United States)

Botch, Beatrice; Day, Roberta; Vining, William; Stewart, Barbara; Rath, Kenneth; Peterfreund, Alan; Hart, David

2007-03-01

ChemPrep was developed to be a stand-alone preparatory short-course to help students succeed in general chemistry. It is Web-based and delivered using the OWL system. Students reported that the ChemPrep materials (short information pages, parameterized questions with detailed feedback, tutorials, and answers to questions through the OWL message system) permitted them to work independently without the need for textbook or lecture. On average, students who completed ChemPrep had higher grades in the subsequent GenChem, Nursing, and Honors chemistry courses, with a greater percentage achieving a grade of C- or higher. Participation in ChemPrep was voluntary, and more women than men responded. Students in the Honors course enrolled in ChemPrep in higher percentages than students in GenChem and Nursing. SAT and departmental math placement exam scores were used as proxy measures of prior achievement and ability. Based on these, Honors chemistry ChemPrep users were on par with their peers but performed better in the course than non-users. In GenChem and Nursing chemistry courses, ChemPrep helped students of high prior achievement and ability perform better than their achievement scores would predict. Weaker or less motivated students did not respond to the voluntary offerings of ChemPrep in the same numbers as stronger or more motivated students, and we are seeking alternate ways to reach this population.

The transcription factor Prep1 controls hepatic insulin sensitivity and gluconeogenesis by targeting nuclear localization of FOXO1.

Science.gov (United States)

Kulebyakin, Konstantin; Penkov, Dmitry; Blasi, Francesco; Akopyan, Zhanna; Tkachuk, Vsevolod

2016-12-02

Liver plays a key role in controlling body carbohydrate homeostasis by switching between accumulation and production of glucose and this way maintaining constant level of glucose in blood. Increased blood glucose level triggers release of insulin from pancreatic β-cells. Insulin represses hepatic glucose production and increases glucose accumulation. Insulin resistance is the main cause of type 2 diabetes and hyperglycemia. Currently thiazolidinediones (TZDs) targeting transcriptional factor PPARγ are used as insulin sensitizers for treating patients with type 2 diabetes. However, TZDs are reported to be associated with cardiovascular and liver problems and stimulate obesity. Thus, it is necessary to search new approaches to improve insulin sensitivity. A promising candidate is transcriptional factor Prep1, as it was shown earlier it could affect insulin sensitivity in variety of insulin-sensitive tissues. The aim of the present study was to evaluate a possible involvement of transcriptional factor Prep1 in control of hepatic glucose accumulation and production. We created mice with liver-specific Prep1 knockout and discovered that hepatocytes derived from these mice are much more sensitive to insulin, comparing to their WT littermates. Incubation of these cells with 100 nM insulin results in almost complete inhibition of gluconeogenesis, while in WT cells this repression is only partial. However, Prep1 doesn't affect gluconeogenesis in the absence of insulin. Also, we observed that nuclear content of gluconeogenic transcription factor FOXO1 was greatly reduced in Prep1 knockout hepatocytes. These findings suggest that Prep1 may control hepatic insulin sensitivity by targeting FOXO1 nuclear stability. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative Study.

Science.gov (United States)

Storholm, Erik D; Volk, Jonathan E; Marcus, Julia L; Silverberg, Michael J; Satre, Derek D

2017-08-01

The antiretroviral drug combination emtricitabine and tenofovir disoproxil fumarate (TDF/FTC) taken as pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, yet it also requires adherence and potentially decreases condom use. This study sought to examine these issues among a key population at risk of HIV infection, substance-using men who have sex with men (MSM). We conducted semi-structured interviews with an ethnically diverse sample of 30 young (aged 20-35) MSM prescribed PrEP within a large integrated healthcare system in San Francisco, who had reported recent drug use or hazardous drinking and one or more missed doses of PrEP. We explored participants' risk perception and sexual risk behavior, drug and alcohol use, and PrEP adherence in the context of substance use. Interviews were transcribed and coded using a directed content analysis approach to identify key categories and commonalities, and differences across participants. Salient subcategories included positive psychological effects of being on PrEP (e.g., decreased anxiety, feelings of empowerment), social effects (e.g., reduced HIV stigma), and reduction in overall perceptions of HIV risk. While overall reported use of condoms went down and many reported a brief period of increased condomless sex following PrEP initiation, others continued condom use with most of their sexual partners. Contextual factors influencing their decision to engage in condomless sex included how well they knew the partner and whether the partner was on PrEP or HIV antiretroviral treatment. Factors associated with poor adherence included disruptions in daily routine and use of alcohol and methamphetamine. PrEP-prescribing clinicians should support their patients in making informed decisions about condom use and identifying strategies to maximize adherence in the context of substance use.

Geographic and Individual Associations with PrEP Stigma: Results from the RADAR Cohort of Diverse Young Men Who have Sex with Men and Transgender Women.

Science.gov (United States)

Mustanski, Brian; Ryan, Daniel T; Hayford, Christina; Phillips, Gregory; Newcomb, Michael E; Smith, Justin D

2018-05-22

Increasing the uptake of pre-exposure prophylaxis (PrEP) to prevent HIV acquisition among at-risk populations, such as young men who have sex with men (YMSM), is of vital importance to slowing the HIV epidemic. Stigma and negative injunctive norms, such as the so called "Truvada Whore" phenomenon, hamper this effort. We examined the prevalence and types of PrEP stigma and injunctive norm beliefs among YMSM and transgender women and associated individual and geospatial factors. A newly created measure of PrEP Stigma and Positive Attitudes was administered to 620 participants in an ongoing longitudinal cohort study. Results indicated lower stigma among White, compared to Black and Latino participants, and among participants not identifying as male. Prior knowledge about PrEP was associated with lower stigma and higher positive attitudes. PrEP stigma had significant geospatial clustering and hotspots were identified in neighborhoods with high HIV incidence and concentration of racial minorities, whereas coldspots were identified in areas with high HIV incidence and low LGBT stigma. These results provide important information about PrEP attitudes and how PrEP stigma differs between individuals and across communities.

Perceived Advantages and Disadvantages of Using Pre-Exposure Prophylaxis (PrEP) among Sexually Active Black Women: An Exploratory Study.

Science.gov (United States)

Bond, Keosha T; Gunn, Alana J

2016-01-01

Knowledge of pre-exposure prophylaxis (PrEP) continues to remain scarce among Black women who are disproportionally affected by HIV in the United States. A thematic analysis of open-ended questions from a sample of Black women (n=119) who completed a mix-methods, online, e-health study was conducted to examine the perceived advantages and disadvantages of using PrEP. Being a female controlled method, empowerment, option for women with risky sex partners, and serodiscordant couples were advantages described. Disadvantages of PrEP were identified as the complexity of the choice, encouragement of sex with risky partners, increased burden, promotion of unprotected sex, and newness of the drug.

Fertility Intentions, Pregnancy, and Use of PrEP and ART for Safer Conception Among East African HIV Serodiscordant Couples.

Science.gov (United States)

Heffron, Renee; Thomson, Kerry; Celum, Connie; Haberer, Jessica; Ngure, Kenneth; Mugo, Nelly; Bukusi, Elizabeth; Katabira, Elly; Odoyo, Josephine; Bulya, Nulu; Asiimwe, Stephen; Tindimwebwa, Edna; Baeten, Jared M

2017-09-11

African HIV serodiscordant couples often desire pregnancy, despite sexual HIV transmission risk during pregnancy attempts. Pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) reduce HIV risk and can be leveraged for safer conception but how well these strategies are used for safer conception is not known. We conducted an open-label demonstration project of the integrated delivery of PrEP and ART among 1013 HIV serodiscordant couples from Kenya and Uganda followed quarterly for 2 years. We evaluated fertility intentions, pregnancy incidence, the use of PrEP and ART during peri-conception, and peri-conception HIV incidence. At enrollment, 80% of couples indicated a desire for more children. Pregnancy incidence rates were 18.5 and 18.7 per 100 person years among HIV-uninfected and HIV-infected women, and higher among women who recently reported fertility intention (adjusted odds ratio 3.43, 95% CI 2.38-4.93) in multivariable GEE models. During the 6 months preceding pregnancy, 82.9% of couples used PrEP or ART and there were no HIV seroconversions. In this cohort with high pregnancy rates, integrated PrEP and ART was readily used by HIV serodiscordant couples, including during peri-conception periods. Widespread scale-up of safer conception counseling and services is warranted to respond to strong desires for pregnancy among HIV-affected men and women.

Assessing the usefulness of mineral licks containing herbal extracts with anti-parasitic properties for the control of gastrointestinal helminths in grazing sheep – a field trial

Directory of Open Access Journals (Sweden)

Nosal P.

2016-06-01

Full Text Available One of the alternative methods of parasite control, of particular importance in sustainable farming, is the use of medicinal plants. The specific aim of the present field trial was to assess the anti-parasitic effects of herbal extracts contained in a commercially available lick formulation for sheep. At the outset of this study conducted during the grazing season, all animals were de-wormed and then randomly assigned to one of the two separately kept groups (treatment and control, each consisting of 25 animals (11 ewes and 14 lambs. The treatment group received mineral licks containing the extracts of the plants with anti-parasitic properties, while control animals received standard mineral licks ad libitum. Rectal fecal samples were collected monthly from all animals for the McMaster analyses. There were no significant differences in the prevalence and intensity of helminth infections between the treatment and control groups. Thus, we were not able to ascertain the efficacy of the commercial herbal de-wormer tested for the control of gastrointestinal helminths in grazing ewes and their lambs.

Geochemical study of acid mine drainage of the Big Lick Tunnel area, Williamstown, PA

International Nuclear Information System (INIS)

Tollin, S.

1993-01-01

Acid mine drainage in the anthracite region of Pennsylvania continues to be a significant environmental problem. This study examines the acid mine outflow from the Big Lick Tunnel, north of Williamstown, Dauphin County, Pennsylvania. The tunnel drains abandoned mines on the north side of the Big Lick Mountain. Mining ceased in the area circa 1940, and the tunnel has been in operation since that time. The water, soil and stream bed sediment geochemistry has been studied to determine their changes in chemistry over distance. The pH, TDS and metal concentrations were the primary focus. Metal concentrations were determined using an ICP unit. Data indicates the pH of the outflow to range between 6.7 and 7.3 Fe and Mn concentrations are as high as 9.7 ppb. Extensive metal precipitation (''yellow boy'') occurs within the tunnel and for several hundred meters from the mouth of the tunnel. The combination of near neutral pH and high metal concentration suggest that the drainage is in contact with highly alkaline materials prior to discharge from the tunnel. The geology of the area does not suggest bedrock as the possible source of alkaline material. One hypothesis is that the acidic water is reacting with the concrete tunnel and being neutralized. Data also suggests that the Fe precipitates much quicker than the Mn, resulting in a zonation between Fe-rich and Mn-rich sediments along the length of the drainage

Brief Report: Medication Sharing Is Rare Among African HIV-1 Serodiscordant Couples Enrolled in an Efficacy Trial of Oral Pre-exposure Prophylaxis (PrEP) for HIV-1 Prevention.

Science.gov (United States)

Thomson, Kerry A; Haberer, Jessica E; Marzinke, Mark A; Mujugira, Andrew; Hendrix, Craig W; Celum, Connie; Ndase, Patrick; Ronald, Allan; Bangsberg, David R; Baeten, Jared M

2017-06-01

Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at <0.01% of visits, and 0%-1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment.

Science.gov (United States)

Shrestha, Roman; Altice, Frederick L; Huedo-Medina, Tania B; Karki, Pramila; Copenhaver, Michael

2017-05-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the information-motivation-behavioral skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP.

Expanded HIV pre-exposure prophylaxis (PrEP) implementation in communities in New South Wales, Australia (EPIC-NSW): design of an open label, single arm implementation trial.

Science.gov (United States)

Zablotska, Iryna B; Selvey, Christine; Guy, Rebecca; Price, Karen; Holden, Jo; Schmidt, Heather-Marie; McNulty, Anna; Smith, David; Jin, Fengyi; Amin, Janaki; Cooper, David A; Grulich, Andrew E

2018-02-02

The New South Wales (NSW) HIV Strategy 2016-2020 aims for the virtual elimination of HIV transmission in NSW, Australia, by 2020. Despite high and increasing levels of HIV testing and treatment since 2012, the annual number of HIV diagnoses in NSW has remained generally unchanged. Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV infection among gay and bisexual men (GBM) when taken appropriately. However, there have been no population-level studies that evaluate the impact of rapid PrEP scale-up in high-risk GBM. Expanded PrEP Implementation in Communities in NSW (EPIC-NSW) is a population-level evaluation of the rapid, targeted roll-out of PrEP to high-risk individuals. EPIC-NSW, is an open-label, single-arm, multi-centre prospective observational study of PrEP implementation and impact. Over 20 public and private clinics across urban and regional areas in NSW have participated in the rapid roll-out of PrEP, supported by strong community mobilization and PrEP promotion. The study began on 1 March 2016, aiming to enroll at least 3700 HIV negative people at high risk of HIV. This estimate took into consideration criteria for PrEP prescription in people at high risk for acquiring HIV as defined in the NSW PrEP guidelines. Study participants receive once daily co-formulated tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) and are followed for up to 24 months. Follow-up includes: testing for HIV at 1 month, HIV and other sexually transmissible infections three-monthly, HCV annually and monitoring of renal function six-monthly. Optional online behavioural surveys are conducted quarterly. The co-primary endpoints are (i) HIV diagnoses and incidence in the cohort and (ii) HIV diagnoses in NSW. EPIC-NSW is a population-based PrEP implementation trial which targets the entire estimated population of GBM at high risk for HIV infection in NSW. It will provide a unique opportunity to evaluate the population impact of PrEP on a concentrated HIV

Role of oral pre-exposure prophylaxis (PrEP) in current and future HIV prevention strategies.

Science.gov (United States)

Burns, David N; Grossman, Cynthia; Turpin, Jim; Elharrar, Vanessa; Veronese, Fulvia

2014-12-01

Treatment as prevention is expected to have a major role in reducing HIV incidence, but other prevention interventions will also be required to bring the epidemic under control, particularly among key populations. One or more forms of pre-exposure prophylaxis (PrEP) will likely play a critical role. Oral PrEP with emtricitabine-tenofovir (Truvada®) is currently available in the US and some other countries, but uptake has been slow. We review the concerns that have contributed to this slow uptake and discuss current and future research in this critical area of HIV prevention research.

Optimization of the technology of fodder briquettes-licks with the use of a steam compression heat pump

Directory of Open Access Journals (Sweden)

L. I. Lytkina

2017-01-01

Full Text Available In conditions of industrial maintenance of animals, their health is noticeably weakening, in the majority of the body, profound metabolic disorders are noted, and productivity is reduced. In such conditions it is necessary to use feed additives in the form of briquettes-licks, able to compensate for the lack of micro and macro elements, vitamins and many other substances. Intensification of feed production through the use of new advanced technologies allows to improve the quality of products and reduce losses in its production. The technologies used for briquettes-licks and equipment for their production do not always allow to provide high quality products and achieve the necessary effect when fed. In addition, they are energy-intensive, do not imply the use of secondary energy carriers. Therefore, the creation of a functional product, combining a complex of substances necessary for animal feeding, and the development of an energy-efficient method for its production is topical. The proposed technology makes it possible to obtain feed briquettes with high homogeneity and a specified content of biologically active substances, to ensure a longer-term preservation of the products. The developed line provides for the maximum rapid cooling of the finished product and a reduction in the specific energy consumption for its production as a result of the heat of spent coolants. The high-quality licks produced were homogeneous in their composition, resistant to unfavorable conditions. They are characterized by a higher stability of structural and mechanical properties and stability of storage quality for a long time: after twelve months, the technological properties of the products have not changed, signs of damage associated with increased humidity of the environment have not been noted. On the surface of briquettes, signs of development of microflora were not observed. The values of microbiological quality indicators were within acceptable limits. The

Use of Pre-exposure Prophylaxis (PrEP) in Young Men Who Have Sex with Men is Associated with Race, Sexual Risk Behavior and Peer Network Size.

Science.gov (United States)

Kuhns, Lisa M; Hotton, Anna L; Schneider, John; Garofalo, Robert; Fujimoto, Kayo

2017-05-01

Pre-exposure prophylaxis (PrEP) is efficacious to prevent HIV infection, however, uptake among young men who have sex with men (YMSM) is relatively low. The purpose of this study was to describe PrEP use and related factors in a representative sample of YMSM in two cities, Chicago and Houston. YMSM, ages 16-29, were recruited via respondent-driven sampling (RDS) from 2014 to 2016. Correlates of PrEP uptake were assessed in weighted multivariable logistic regression models. A total of 12.2% of participants (of 394) reported ever taking PrEP; Black YMSM had the lowest rates of uptake (4.7%) and Whites the highest (29.5%). In a multivariable regression model, having an HIV positive sex partner, reporting recent group sex, peer network size, and city (Chicago) were significantly and positively associated with use of PrEP, while Black race was negatively associated with it. Given evidence of racial/ethnic disparities in PrEP uptake in this study, further research is needed to identify potential mechanisms of action and points of intervention.

Using data from a behavioural survey of men who have sex with men (MSM) to estimate the number likely to present for HIV pre-exposure prophylaxis (PrEP) in Ireland, 2017.

Science.gov (United States)

Nic Lochlainn, Laura; O'Donnell, Kate; Hurley, Caroline; Lyons, Fiona; Igoe, Derval

2017-11-01

In Ireland, men who have sex with men (MSM) have increased HIV risk. Pre-exposure prophylaxis (PrEP), combined with safe sex practices, can reduce HIV acquisition. We estimated MSM numbers likely to present for PrEP by applying French PrEP criteria to Irish MSM behavioural survey data. We adjusted for survey bias, calculated proportions accessing testing services and those likely to take PrEP. We estimated 1-3% of MSM in Ireland were likely to present for PrEP.

The Effect of PrEP on HIV Incidence Among Men Who Have Sex With Men in the Context of Condom Use, Treatment as Prevention, and Seroadaptive Practices.

Science.gov (United States)

LeVasseur, Michael T; Goldstein, Neal D; Tabb, Loni P; Olivieri-Mui, Brianne L; Welles, Seth L

2018-01-01

HIV preexposure prophylaxis (PrEP) is an effective tool in preventing HIV infection among high-risk men who have sex with men (MSM). It is unknown how effective PrEP is in the context of other implemented HIV prevention strategies, including condom use, seroadaption, and treatment as prevention (TasP). We evaluate the impact of increasing uptake of PrEP in conjunction with established prevention strategies on HIV incidence in a high-risk population of MSM through simulation. Agent-based simulation models representing the sexual behavior of high-risk, urban MSM in the United States over the period of 1 year were used to evaluate the effect of PrEP on HIV infection rates. Simulations included data for 10,000 MSM and compared increasing rates of PrEP uptake under 8 prevention paradigms: no additional strategies, TasP, condom use, seroadaptive behavior, and combinations thereof. We observed a mean of 103.2 infections per 10,000 MSM in the absence of any prevention method. PrEP uptake at 25% without any additional prevention strategies prevented 30.7% of infections. In the absence of PrEP, TasP, condom use, and seroadaptive behavior independently prevented 27.1%, 48.8%, and 37.7% of infections, respectively, and together prevented 72.2%. The addition of PrEP to the 3 aforementioned prevention methods, at 25% uptake, prevented an additional 5.0% of infections. To achieve a 25% reduction in HIV infections by 2020, HIV prevention efforts should focus on significantly scaling up access to PrEP in addition to HIV testing, access to antiretroviral therapy, and promoting condom use.

VizieR Online Data Catalog: Lick AGN monitoring 2011: light curves (Barth+, 2015)

Science.gov (United States)

Barth, A. J.; Bennert, V. N.; Canalizo, G.; Filippenko, A. V.; Gates, E. L.; Greene, J. E.; Li, W.; Malkan, M. A.; Pancoast, A.; Sand, D. J.; Stern, D.; Treu, T.; Woo, J.-H.; Assef, R. J.; Bae, H.-J.; Brewer, B. J.; Cenko, S. B.; Clubb, K. I.; Cooper, M. C.; Diamond-Stanic, A. M.; Hiner, K. D.; Honig, S. F.; Hsiao, E.; Kandrashoff, M. T.; Lazarova, M. S.; Nierenberg, A. M.; Rex, J.; Silverman, J. M.; Tollerud, E. J.; Walsh, J. L.

2015-05-01

This project was allocated 69 nights at the Lick 3m Shane telescope, distributed between 2011 March 27 and June 13. Observations were conducted using the Kast double spectrograph (3440-5515Å on the blue side and 5410-8200Å on the red side). In order to extend our light curves for two AGNs, we also requested additional observations from other observers using the Kast spectrograph: Mrk 50 from 2011 January through March, and Zw 229-015 in June and July. For Zw 229-015, three additional observations were taken 20-23 days after the end of our main campaign. See section 3. (2 data files).

Vulnerable infected populations and street markets for ARVs: Potential implications for PrEP rollout in the USA.

Science.gov (United States)

Kurtz, Steven P; Buttram, Mance E; Surratt, Hilary L

2014-04-01

Widespread diversion of antiretroviral (ARV) medications to illicit markets has recently been documented among indigent patients in South Florida. The recent approval of ARVs for pre-exposure prophylaxis (PrEP) has the potential to broaden these illicit markets, as high-risk individuals seek ARVs without a prescription or medical supervision. Nonadherence among diverters and unsupervised use of ARVs for treatment or PrEP increase risks of treatment failure, drug resistance, and disease transmission. We report the scope of ARV diversion among substance-using men who have sex with men in South Florida. Structured interviews (N = 515) queried demographics, HIV status, mental distress, substance dependence, and sexual risks. HIV-positive participants answered questions about medical care, treatment, and ARV adherence and diversion. Median age was 39. Of 46.4% who were HIV-positive, 79.1% were prescribed ARVs. Of these, 27% reported selling/trading ARVs. Reasons for diversion were sharing/trading with friends, sale/trade for money/drugs, and sale/trade of unused medications. ARV diverters, compared to nondiverters, were more likely to be substance dependent (74.5% vs. 58.7%, p = 0.046) and have traded sex for money/drugs (60.8% vs. 32.6%, p increased risks of treatment failure, disease transmission, and PrEP failure should be carefully considered in developing policy and behavioral supports to scaling up treatment as prevention and PrEP.

Barriers to uptake and use of pre-exposure prophylaxis (PrEP) among communities most affected by HIV in the UK: findings from a qualitative study in Scotland.

Science.gov (United States)

Young, Ingrid; Flowers, Paul; McDaid, Lisa M

2014-11-20

To explore the acceptability of pre-exposure prophylaxis (PrEP) among gay, bisexual and men who have sex with men (MSM) and migrant African communities in Scotland, UK. Consecutive mixed qualitative methods consisting of focus groups (FGs) and in-depth interviews (IDIs) explored PrEP acceptability. Data were digitally recorded, transcribed and analysed thematically to identify anticipated and emerging themes. Participants were recruited through community sexual health and outreach support services, and from non-sexual health settings across Scotland. Inclusion criteria included identification as either MSM and/or from migrant African communities; 18 years and older; living in Scotland at the time of participation. 7 FGs were conducted (n=33): 5 with MSM (n=22) and 2 mixed-sex groups with African participants (n=11, women=8), aged 18-75 years. 34 IDIs were conducted with MSM (n=20) and African participants (n=14, women=10), aged 19-60 years. The sample included participants who were HIV-positive and HIV-negative or untested (HIV-positive FG participants, n=22; HIV-positive IDI participants, n=17). Understandings of PrEP effectiveness and concerns about maintaining regular adherence were identified as barriers to potential PrEP uptake and use. Low perception of HIV risk due to existing risk management strategies meant few participants saw themselves as PrEP candidates. Participants identified risk of other sexually transmitted infections and pregnancy as a concern which PrEP did not address for either themselves or their sexual partners. PrEP emerged as a contentious issue because of the potentially negative implications it had for HIV prevention. Many participants viewed PrEP as problematic because they perceived that others would stop using condoms if PrEP was to become available. PrEP implementation needs to identify appropriate communication methods in the context of diverse HIV literacy; address risk-reduction concerns and; demonstrate how PrEP can be part of a

Significance of atypical squamous cells of undetermined significance on ThinPrep papanicolaou smears.

Science.gov (United States)

Eltabbakh, G H; Lipman, J N; Mount, S L; Morgan, A

2000-10-01

The aim of this study was to assess the prevalence and risk factors predictive of dysplasia among women seen in a gynecologic oncology service with the cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) on Papanicolaou smears obtained by the ThinPrep method. Patients with ASCUS ThinPrep Papanicolaou smears seen at the Division of Gynecologic Oncology, University of Vermont, between 1997 and 1999 were identified. The cytologic smears were reviewed and subtyped into reactive or suggestive of squamous intraepithelial lesion (SIL). The charts of these patients were reviewed and the following information was abstracted: age, gravidity, parity, menopausal status, use of hormonal replacement therapy, smoking, history of pelvic cancer, history of radiation therapy, history of abnormal Papanicolaou smear and its treatment, history of human papillomavirus (HPV) infection, and follow-up information including results of repeat Papanicolaou smears, colposcopy, and biopsies. The prevalence of dysplasia was calculated. The demographic features of women with ASCUS, reactive, were compared with those with ASCUS, SIL, using a two-sample t test, chi(2), and Fisher's exact test. Risk factors predictive of dysplasia were calculated using the odds ratio and the 95% confidence interval. P ASCUS on ThinPrep Papanicolaou smear were identified; 63 patients had ASCUS, reactive, and 63 patients had ASCUS, SIL. The demographic features of both groups were similar. The overall prevalence of dysplasia was 15.9% and was significantly higher among women with ASCUS, SIL, than among women with ASCUS, reactive (25.4% versus 6.4%, P = 0.003). The type of ASCUS cytology (reactive versus SIL), smoking, and history of HPV were significant risk factors for dysplasia (P = 0.003, 0.037, and 0. 042, respectively). The prevalence of dysplasia among women seen in a gynecologic oncology service with ASCUS cytology on ThinPrep Papanicolaou smears is 15.9%. Women with ASCUS favor

Single ferromagnetic fluctuations in UCoGe revealed by 73Ge- and 59Co-NMR studies

Science.gov (United States)

Manago, Masahiro; Ishida, Kenji; Aoki, Dai

2018-02-01

73Ge and 59Co nuclear magnetic resonance (NMR) and nuclear quadrupole resonance (NQR) measurements have been performed on a 73Ge-enriched single-crystalline sample of the ferromagnetic superconductor UCoGe in the paramagnetic state. The 73Ge NQR parameters deduced from NQR and NMR are close to those of another isostructural ferromagnetic superconductor URhGe. The Knight shifts of the Ge and Co sites are well scaled to each other when the magnetic field is parallel to the b or c axis. The hyperfine coupling constants of Ge are estimated to be close to those of Co. The large difference of spin susceptibilities between the a and b axes could lead to the different response of the superconductivity and ferromagnetism with the field parallel to these directions. The temperature dependence of the nuclear spin-lattice relaxation rates 1 /T1 at the two sites is similar to each other above 5 K. These results indicate that the itinerant U-5 f electrons are responsible for the ferromagnetism in this compound, consistent with previous studies. The similarities and differences in the three ferromagnetic superconductors are discussed.

Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study.

Science.gov (United States)

Bourne, Adam; Cassolato, Matteo; Thuan Wei, Clayton Koh; Wang, Bangyuan; Pang, Joselyn; Lim, Sin How; Azwa, Iskandar; Yee, Ilias; Mburu, Gitau

2017-08-02

Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake. As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis. Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to "at-risk" men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours. This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those

Prioritizing Risk in Preparation for a Demonstration Project: A Mixed Methods Feasibility Study of Oral Pre-Exposure Prophylaxis (PREP) among Female Sex Workers in South India.

Science.gov (United States)

Reza-Paul, Sushena; Lazarus, Lisa; Doshi, Monika; Hafeez Ur Rahman, Syed; Ramaiah, Manjula; Maiya, Raviprakash; Ms, Venugopal; Venukumar, K T; Sundararaman, Sundar; Becker, Marissa; Moses, Stephen; Lorway, Robert

2016-01-01

HIV prevalence among female sex workers (FSWs) in India remains well above the national average. Pre-exposure prophylaxis (PrEP), a new HIV prevention technology, may help to reduce HIV incidence, but there is a dearth of research that can inform the potential scale-up of PrEP in India. In partnership with Ashodaya Samithi, a local sex worker collective, we conducted a feasibility study to assess acceptance of a planned PrEP demonstration project, willingness to use PrEP, and recommendations for project roll-out among FSWs in southern Karnataka. From January-April 2015, 6 focus group discussions, 47 in-depth interviews, and 427 interviewer-administered questionnaires were completed by female sex workers. All participants were 18 years of age or older and practiced sex work. Qualitative data were coded for key themes and emergent categories. Univariate descriptive analysis was employed to summarise the quantitative data. Qualitative. PrEP was described as an exciting new prevention technology that places control in the hands of FSWs and provides a "double safety" in combination with condom use. Participants expressed agreement that women who may experience more HIV risk in their occupational environments should be prioritized for enrollment into a demonstration project. Quantitative. 406 participants (95%) expressed interest in PrEP. Participants prioritized the inclusion of FSWs under the age of 25 (79%), those who do not use condoms when clients offer more money (58%), who do not consistently use condoms with regular partners (57%), who drink alcohol regularly (49%), and who do not use condoms consistently with clients (48%). This feasibility study indicated strong interest in PrEP and a desire to move forward with the demonstration project. Participants expressed their responses in terms of public health discourses surrounding risk, pointing to the importance of situating PrEP scale up within the trusted spaces of community-based organizations as a means of

Prioritizing Risk in Preparation for a Demonstration Project: A Mixed Methods Feasibility Study of Oral Pre-Exposure Prophylaxis (PREP among Female Sex Workers in South India.

Directory of Open Access Journals (Sweden)

Sushena Reza-Paul

Full Text Available HIV prevalence among female sex workers (FSWs in India remains well above the national average. Pre-exposure prophylaxis (PrEP, a new HIV prevention technology, may help to reduce HIV incidence, but there is a dearth of research that can inform the potential scale-up of PrEP in India. In partnership with Ashodaya Samithi, a local sex worker collective, we conducted a feasibility study to assess acceptance of a planned PrEP demonstration project, willingness to use PrEP, and recommendations for project roll-out among FSWs in southern Karnataka.From January-April 2015, 6 focus group discussions, 47 in-depth interviews, and 427 interviewer-administered questionnaires were completed by female sex workers. All participants were 18 years of age or older and practiced sex work. Qualitative data were coded for key themes and emergent categories. Univariate descriptive analysis was employed to summarise the quantitative data.Qualitative. PrEP was described as an exciting new prevention technology that places control in the hands of FSWs and provides a "double safety" in combination with condom use. Participants expressed agreement that women who may experience more HIV risk in their occupational environments should be prioritized for enrollment into a demonstration project. Quantitative. 406 participants (95% expressed interest in PrEP. Participants prioritized the inclusion of FSWs under the age of 25 (79%, those who do not use condoms when clients offer more money (58%, who do not consistently use condoms with regular partners (57%, who drink alcohol regularly (49%, and who do not use condoms consistently with clients (48%.This feasibility study indicated strong interest in PrEP and a desire to move forward with the demonstration project. Participants expressed their responses in terms of public health discourses surrounding risk, pointing to the importance of situating PrEP scale up within the trusted spaces of community-based organizations as a means

The PREP Pipeline: Standardized preprocessing for large-scale EEG analysis

Directory of Open Access Journals (Sweden)

Nima eBigdelys Shamlo

2015-06-01

Full Text Available The technology to collect brain imaging and physiological measures has become portable and ubiquitous, opening the possibility of large-scale analysis of real-world human imaging. By its nature, such data is large and complex, making automated processing essential. This paper shows how lack of attention to the very early stages of an EEG preprocessing pipeline can reduce the signal-to-noise ratio and introduce unwanted artifacts into the data, particularly for computations done in single precision. We demonstrate that ordinary average referencing improves the signal-to-noise ratio, but that noisy channels can contaminate the results. We also show that identification of noisy channels depends on the reference and examine the complex interaction of filtering, noisy channel identification, and referencing. We introduce a multi-stage robust referencing scheme to deal with the noisy channel-reference interaction. We propose a standardized early-stage EEG processing pipeline (PREP and discuss the application of the pipeline to more than 600 EEG datasets. The pipeline includes an automatically generated report for each dataset processed. Users can download the PREP pipeline as a freely available MATLAB library from http://eegstudy.org/prepcode/.

The PREP pipeline: standardized preprocessing for large-scale EEG analysis.

Science.gov (United States)

Bigdely-Shamlo, Nima; Mullen, Tim; Kothe, Christian; Su, Kyung-Min; Robbins, Kay A

2015-01-01

The technology to collect brain imaging and physiological measures has become portable and ubiquitous, opening the possibility of large-scale analysis of real-world human imaging. By its nature, such data is large and complex, making automated processing essential. This paper shows how lack of attention to the very early stages of an EEG preprocessing pipeline can reduce the signal-to-noise ratio and introduce unwanted artifacts into the data, particularly for computations done in single precision. We demonstrate that ordinary average referencing improves the signal-to-noise ratio, but that noisy channels can contaminate the results. We also show that identification of noisy channels depends on the reference and examine the complex interaction of filtering, noisy channel identification, and referencing. We introduce a multi-stage robust referencing scheme to deal with the noisy channel-reference interaction. We propose a standardized early-stage EEG processing pipeline (PREP) and discuss the application of the pipeline to more than 600 EEG datasets. The pipeline includes an automatically generated report for each dataset processed. Users can download the PREP pipeline as a freely available MATLAB library from http://eegstudy.org/prepcode.

Estimating bighorn sheep (Ovis Canadensis) abundance using noninvasive sampling at a mineral lick within a national park wilderness area

Science.gov (United States)

Kathryn A. Schoenecker; Mary Kay Watry; Laura E. Ellison; Michael K. Schwartz; Gordon L. Luikart

2015-01-01

Conservation of species requires accurate population estimates. We used genetic markers from feces to determine bighorn sheep abundance for a herd that was hypothesized to be declining and in need of population status monitoring. We sampled from a small but accessible portion of the population’s range where animals naturally congregate at a natural mineral lick to test...

Evaluation of three-dimensional gadolinium-enhanced MR angiography using the timing monitoring function of contrast material (Smart Prep technique)

International Nuclear Information System (INIS)

Tsuchihashi, Toshio; Sasaki, Sadayuki; Yoshizawa, Satoshi; Maki, Toshio; Kitagawa, Matsuo; Suzuki, Takeshi

1998-01-01

The Smart Prep technique for gadolinium-enhanced three-dimensional MR angiography (3D-MRA) was evaluated in clinical practice. By monitoring signal intensity in the region of interest (tracking volume) in the target vessel, start timing after contrast injection can be optimized using the Smart Prep technique. Successful triggering was obtained in the chest, abdomen, and pelvic areas in about 80% of the cases in this study. Failures with this technique were mainly due to changes in tracking volume caused by patient motion and respiration. We noted that the scan started earlier than expected in the thoracic aorta when part of the heart or pulmonary artery was included in the tracking volume. Thus, care must be taken in defining the size and location of the tracking volume in gadolinium-enhanced 3D-MRA using the Smart Prep technique. (author)

A Multi-US City Assessment of Awareness and Uptake of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Black Men and Transgender Women Who Have Sex with Men.

Science.gov (United States)

Eaton, Lisa A; Matthews, Derrick D; Driffin, Daniel D; Bukowski, Leigh; Wilson, Patrick A; Stall, Ron D

2017-07-01

The HIV epidemic among Black men and transgender women who have sex with men (BMTW) demands an urgent public health response. HIV point prevalence among this population ranges from 25 to 43%-a rate far exceeding any other group. Pre-exposure prophylaxis (PrEP) for HIV prevention is a very promising prevention tool; however, its full potential to slow the epidemic has yet to be realized. For the current study, random time-location sampling at Black Gay Pride Events was used to collect data from N = 1274 BMTW, from five US cities, reporting HIV-negative/unknown status. In-field HIV testing was also provided to participants. Participants were assessed on awareness and use of PrEP, health care factors, HIV testing history, psychosocial variables, and sex behaviors. About one third of participants were aware of PrEP (39%), and a small percentage of participants were users of PrEP (4.6%). In multivariable analyses, being in a relationship, testing for HIV in the past 6 months, and others being aware of one's sexuality were positively associated with PrEP awareness. Higher levels of internalized homophobia and greater numbers of female sex partners were positively associated with PrEP use, while education and condom use were negatively associated. Based on study findings, messaging and uptake of PrEP needs greater expansion and requires novel approaches for scale-up. Improving linkage to HIV testing services is likely critical for engaging BMTW with PrEP. The potential for PrEP to slow the HIV epidemic is high; however, we must strengthen efforts to ensure universal availability and uptake.

A Culture of High Expectations: Teacher Leadership at Pritzker College Prep

Science.gov (United States)

Aspen Institute, 2014

2014-01-01

Relying on teachers as culture leaders is a solution embraced by many high-performing charter schools. This profile focuses on the design of the Grade Level Lead roles at Pritzker College Prep, a member of the Noble Network of Schools in Chicago. The successes of this school and network are well-documented: Of non-selective public high schools in…

A comparison of temporal Facebook networks of young men who have sex with men (MSM), differentiated by awareness and use of preexposure prophylaxis (PrEP)

Science.gov (United States)

Khanna, Aditya S.; Schumm, Phil; Schneider, John A.

2016-01-01

Young Black men who have sex with men (YBMSM) are the only population in the U.S. who have experienced rising HIV incidence over the past decade. Consistent preexposure prophylaxis (PrEP) use can substantially reduce the risk of HIV acquisition. What differentiates those who become aware of PrEP, and those who do not, remains largely unknown. The social networks of YBMSM can impact their awareness of PrEP; to examine this impact, we used two waves of Facebook data from the “uConnect” study – a longitudinal cohort study of YBMSM in Chicago (n=266). While PrEP awareness increased from 45% at baseline to 75% at follow-up, its use remained low (4% and 6%). There were 88 PrEP-unaware individuals at baseline who became aware (BA) by follow-up, and 56 who remained persistently unaware (PU). While the PUs had a higher median number of total Facebook friends, the BAs had a higher median numbers of friends who participated in uConnect, who were PrEP-aware, and who practiced behaviors previously found to be associated with individual-level awareness of PrEP at baseline. The BAs also had substantially more “influential” friends. These findings demonstrate the potential of social networks in raising PrEP awareness and use among YBMSM. PMID:28003117

Pre-exposure prophylaxis (PrEP) for men who have sex with men in Europe: review of evidence for a much needed prevention tool.

Science.gov (United States)

Reyniers, Thijs; Hoornenborg, Elske; Vuylsteke, Bea; Wouters, Kristien; Laga, Marie

2017-08-01

In many Western countries with good coverage of antiretroviral treatment (ART) programmes the annual number of HIV infections is still high and not (yet) declining among men who have sex with men (MSM). This might indicate that antiretroviral treatment roll-out alone will not turn around the course of the epidemic and that new, additional tools are needed. Antiretrovirals used as prevention tools for people not yet infected with HIV, such as pre-exposure prophylaxis (PrEP) could be such important additional tools. PrEP is a new type of biomedical prevention, which involves the use of antiretrovirals before, during and after (periods of) sexual exposure to HIV. In this review, we will focus on PrEP as a new prevention tool for MSM at high risk in Europe, including its evidence for effectiveness, challenges for implementation, ongoing European demonstration studies; as well as how PrEP relates to other existing prevention tools. In light of European Medicines Agency's recent recommendation for approval of PrEP we briefly review the potential implications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Could FDA approval of pre-exposure prophylaxis make a difference? A qualitative study of PrEP acceptability and FDA perceptions among men who have sex with men.

Science.gov (United States)

Underhill, Kristen; Morrow, Kathleen M; Operario, Don; Mayer, Kenneth H

2014-02-01

The FDA has approved tenofovir-emtricitabine for use as HIV pre-exposure prophylaxis, but it is unknown how approval may affect PrEP acceptability among US men who have sex with men. We conducted 8 focus groups among 38 Rhode Island MSM, including 3 groups among 16 male sex workers and 5 groups among 22 men in the general MSM community. Participants reported wide-ranging beliefs regarding consequences and meanings of FDA approval. Some participants would not use PrEP without approval, while others perceived approval as irrelevant or less significant than other sources of information. Our results suggest that FDA approval sends a signal that directly shapes PrEP acceptability among some MSM, while indirect influences of approval may affect uptake by others. Efforts to educate MSM about PrEP can increase acceptability by incorporating information about FDA approval, and outreach strategies should consider how this information may factor into personal decisions about PrEP use.

Alcohol based surgical prep solution and the risk of fire in the operating room: a case report

Directory of Open Access Journals (Sweden)

Gupta Rajiv

2008-04-01

Full Text Available Abstract A few cases of fire in the operating room are reported in the literature. The factors that may initiate these fires are many and include alcohol based surgical prep solutions, electrosurgical equipment, flammable drapes etc. We are reporting a case of fire in the operating room while operating on a patient with burst fracture C6 vertebra with quadriplegia. The cause of the fire was due to incomplete drying of the covering drapes with an alcohol based surgical prep solution. This paper discusses potential preventive measures to minimize the incidence of fire in the operating room.

PREP-PWR-1.0: a WIMS-D/4 pre-processor code for the generation of data for PWR fuel assemblies

International Nuclear Information System (INIS)

Ball, G.

1991-06-01

The PREP-PWR-1.0 computer code is a substantially modified version of the PREWIM code which formed part of the original MARIA System (Report J.E.N. 543). PREP-PWR-1.0 is a comprehensive pre-processor code which generates input data for the WIMS-D/4.1 code (Report PEL 294) for PWR fuel assemblies, with or without control and burnable poison rods. This data is generated at various base and off-base conditions. The overall cross section generation methodology is described, followed by a brief overview of the model. Aspects of the base/off-base calculational scheme are outlined. Additional features of the code are described while the input data format of PREP-PWR-1.0 is listed. The sample problems and suggestions for further improvements to the code are also described. 2 figs., 2 tabs., 12 refs

An Exploratory Investigation of the Promoting Responsibility through Education and Prevention (PREP) after School Program for African American At-Risk Elementary School Students

Science.gov (United States)

Sale, Elizabeth; Weil, Virginia; Kryah, Rachel

2012-01-01

The promoting responsibility through education and prevention (PREP) program is an after school substance abuse and violence prevention program for at-risk fourth and fifth grade youths in St. Louis, Missouri. Staffed by licensed clinical social workers and professional volunteers, PREP offers cultural cooking classes, yoga, and art as well as…

Wearing long sleeves while prepping a patient in the operating room decreases airborne contaminants.

Science.gov (United States)

Markel, Troy A; Gormley, Thomas; Greeley, Damon; Ostojic, John; Wagner, Jennifer

2018-04-01

The use of long sleeves by nonscrubbed personnel in the operating room has been called into question. We hypothesized that wearing long sleeves and gloves, compared with having bare arms without gloves, while applying the skin preparation solution would decrease particulate and microbial contamination. A mock patient skin prep was performed in 3 different operating rooms. A long-sleeved gown and gloves, or bare arms, were used to perform the procedure. Particle counters were used to assess airborne particulate contamination, and active and passive microbial assessment was achieved through air samplers and settle plate analysis. Data were compared with Student's t-test or Mann-Whitney U, and P airborne contamination while the skin prep is applied, which may lead to decreased surgical site infections. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

PrEP Chicago: A randomized controlled peer change agent intervention to promote the adoption of pre-exposure prophylaxis for HIV prevention among young Black men who have sex with men.

Science.gov (United States)

Young, Lindsay E; Schumm, Phil; Alon, Leigh; Bouris, Alida; Ferreira, Matthew; Hill, Brandon; Khanna, Aditya S; Valente, Thomas W; Schneider, John A

2018-02-01

Advances in biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) represent a new opportunity for reducing HIV incidence among young Black men who have sex with men, for whom the number of new HIV infections continues to rise. However, studies have documented low rates of PrEP uptake in this community. Research suggests that the peer networks of young Black men who have sex with men play important roles in their sexual health decisions. PrEP Chicago is a randomized controlled trial network intervention designed to increase PrEP uptake among young Black men who have sex with men living in Chicago. The aims of this study are twofold. Aim 1 is to estimate the effectiveness of a peer change agent intervention for (1) increasing the number of referrals made to a PrEP information line, (2) increasing the rate of PrEP adoption among non-participant peers, and (3) increasing PrEP knowledge, attitudes, and intentions among participants. Aim 2 is to determine the individual and network variables that explain peer change agent effectiveness. PrEP Chicago is a social network intervention that utilizes the influence of peer change agents to link young Black men who have sex with men in Chicago to PrEP. Young Black men who have sex with men were recruited using respondent-driven sampling. Once screened for eligibility, participants were randomly assigned to either one of two treatment sequences: (1) intervention treatment in Year 1 followed by a minimal contact attention control in Year 2 or (2) the minimal contact attention control in Year 1 followed by treatment in Year 2. The treatment consists of a PrEP/peer change agent training workshop followed by booster calls for 12 months. The attention control consists of a sex diary activity designed to help participants assess sexual risk. Psychosocial, sexual health, and network data are collected from all participants at baseline and at 12- and 24-month follow-ups. In total, 423 participants aged 18-35 have

Comparison of Plasmagel with LeucoPREP-Macrodex methods for separation of leukocytes for virus isolation.

Science.gov (United States)

Woods, G L; Proffitt, M R

1987-10-01

Plasmagel (Cellular Products, Inc., Buffalo, NY), which can separate both polymorphonuclear leukocytes (PMN) and mononuclear cells from other blood components, and LeucoPREP (Becton Dickinson Immunocytometry Systems, Mountain View, CA), which can separate mononuclear cells from other blood components, were used to harvest leukocytes from whole blood for the purpose of virus isolation. Macrodex was combined with the later, in a second step, for recovery of PMN. Of 90 peripheral blood specimens examined, cytomegalovirus was recovered from 10: in six by both methods, in three from Plasmagel prepared cells only, and in one from cells from the LeucoPREP-Macrodex preparation only. Total leukocyte counts, differential counts, and leukocyte viability did not differ significantly for the two methods. Plasmagel provided an efficient, inexpensive means of harvesting leukocytes from whole blood for virus isolation.

Partner Disclosure of PrEP Use and Undetectable Viral Load on Geosocial Networking Apps: Frequency of Disclosure and Decisions About Condomless Sex.

Science.gov (United States)

Newcomb, Michael E; Mongrella, Melissa C; Weis, Benjamin; McMillen, Samuel J; Mustanski, Brian

2016-02-01

Recent advances in biomedical prevention strategies, including pre-exposure prophylaxis (PrEP) and achieving an undetectable viral load (UVL) among HIV-infected persons, show promise in curbing the rising incidence of HIV among men who have sex with men (MSM) in the United States. This mixed-methods study aimed to investigate the frequency with which MSM encounter potential sex partners on geosocial networking apps who disclose biomedical prevention use, and how MSM make decisions about condom use after these disclosures. Participants were recruited through advertisements placed on a large geosocial networking app for MSM. A total of 668 and 727 participants, respectively, responded to questionnaires assessing partner disclosure of PrEP use and UVL. Each questionnaire included an open-ended item assessing reasons for condomless anal sex (CAS) with partners using biomedical prevention. Across both surveys, most respondents encountered potential sex partners who disclosed PrEP use or UVL, and the majority of those who met up with these partners engaged in CAS at least once. Qualitative analyses found that most participants who reported CAS did so after making a calculated risk about HIV transmission. We also describe a novel risk reduction strategy, "biomed-matching," or having CAS only when both individuals use PrEP or have UVL. We report serostatus differences in both quantitative and qualitative findings. Disclosure of PrEP use and UVL is not uncommon among MSM. Many MSM make accurate appraisals of the risks of CAS with biomedical prevention, and mobile apps may aid with disclosing biomedical prevention use.

NPT: the issues facing the Geneva PrepCom

International Nuclear Information System (INIS)

Hautecouverture, Benjamin

2013-04-01

The second session of the Preparatory Committee (PrepCom) for the 2015 Review Conference of the Parties to the Treaty on the Non- Proliferation of Nuclear Weapons (NPT) will meet from 22 April-3 May 2013 in Geneva, and will be chaired by Ambassador Cornel Feruta of Romania. Three years on from the adoption by consensus at the end of the 8. NPT Review Conference in New York of an Action Plan on non-proliferation, disarmament, and peaceful uses of nuclear energy - the three pillars of the NPT - as well as the Middle East, this session provides the opportunity both to take stock of the commitments undertaken in 2010 and to prepare the ground for the 2015 meeting. It is first worth noting that the beginning of the 9. five-year NPT review cycle in Vienna last year was marked by tangible optimism and revealed a constructive mindset on the part of the 110 delegations present. This was largely to be expected as a result of the success of the 2010 Review Conference. The two final PrepComs of 2010 cycle (Geneva in 2008 and New York in 2009) were also deemed a success by the delegations present, characterised by the rich and constructive nature of the discussion. Overall, the tension that marred the 2005 cycle has eased over the last few years. Yet, this positive development is sadly insufficient to ensure that the Treaty remains topical. Regarding the commitments undertaken in 2010 under the Action Plan, it is well known that it was impossible for the States concerned to come together in 2012 at a conference on establishment of a weapon-of-mass-destruction-free zone (WMDFZ) in the Middle East (chapter 4, 'The Middle East, particularly implementation of the 1995 Resolution on the Middle East'). Nevertheless, in accordance with the Action Plan, H.E. Mr Jaakko Laajava was appointed as the facilitator, Finland was named as the host country, and a rigorous consultative process is underway. Moreover, the EU has maintained its commitment to support this process by

High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project.

Science.gov (United States)

Hoagland, Brenda; Moreira, Ronaldo I; De Boni, Raquel B; Kallas, Esper G; Madruga, José Valdez; Vasconcelos, Ricardo; Goulart, Silvia; Torres, Thiago S; Marins, Luana M S; Anderson, Peter L; Luz, Paula M; Costa Leite, Iuri da; Liu, Albert Y; Veloso, Valdilea G; Grinsztejn, Beatriz

2017-04-06

The efficacy of pre-exposure prophylaxis (PrEP) in preventing sexual acquisition of human immunodeficiency virus (HIV) is well established. Little is known about the feasibility of PrEP implementation in middle-income settings with concentrated epidemics among men who have sex with men (MSM) and transgender women (TGW). PrEP Brasil is a prospective, multicentre, open-label demonstration project assessing PrEP delivery in the context of the Brazilian Public Health System. HIV-uninfected MSM and TGW in 3 referral centres in Rio de Janeiro and São Paulo were evaluated for eligibility and offered 48 weeks of daily emtricitabine/tenofovir for PrEP. Concentrations of tenofovir diphosphate in dried blood spot samples (DBS) at week 4 after enrolment (early adherence) were measured. Predictors of drug levels were assessed using ordinal logistic regression models considering the DBS drug level as a 3 level variable (<350 fmol/punch, ≥350-699 fmol/punch and ≥700 fmol/punch). 1,270 individuals were assessed for participation; n = 738 were potentially eligible and n = 450 were offered PrEP (PrEP uptake was 60.9%). Eligible but not enrolled individuals were younger, had lower HIV risk perception and had lower PrEP awareness. At week 4, 424 participants (of the 450 enrolled) had DBS TFV-DP concentrations, 94.1% in the protective range (≥350 fmol/punch, consistent with ≥2 pills per week), and 78% were in the highly protective range (≥700 fmol/punch, ≥4 pills per week). Participants with ≥12 years of schooling had 1.9 times the odds (95%CI 1.10-3.29) of a higher versus lower drug level than participants with <12 years of schooling. Condomless receptive anal intercourse in the prior 3 months was also associated with higher drug levels (adjusted OR = 1.78; 95% CI 1.08-2.94). The high uptake and early adherence indicate that PrEP for high-risk MSM and TGW can be successfully delivered in the context of the Brazilian Public Health System. Interventions to

Swords, Shields, and the Fight for Our Children: Lessons from Urban Prep

Science.gov (United States)

King, Tim

2011-01-01

The grim statistics are well known, but bear repeating: in Chicago, close to 60% of Black boys do not graduate from high school, and only one in forty receive a bachelor's degree by age 25. In the fall of 2006, Urban Prep Charter Academy for Young Men-Englewood Campus, the nation's first all-male charter public high school, was opened. In 2010 and…

PREP KITT, System Reliability by Fault Tree Analysis. PREP, Min Path Set and Min Cut Set for Fault Tree Analysis, Monte-Carlo Method. KITT, Component and System Reliability Information from Kinetic Fault Tree Theory

International Nuclear Information System (INIS)

Vesely, W.E.; Narum, R.E.

1997-01-01

1 - Description of problem or function: The PREP/KITT computer program package obtains system reliability information from a system fault tree. The PREP program finds the minimal cut sets and/or the minimal path sets of the system fault tree. (A minimal cut set is a smallest set of components such that if all the components are simultaneously failed the system is failed. A minimal path set is a smallest set of components such that if all of the components are simultaneously functioning the system is functioning.) The KITT programs determine reliability information for the components of each minimal cut or path set, for each minimal cut or path set, and for the system. Exact, time-dependent reliability information is determined for each component and for each minimal cut set or path set. For the system, reliability results are obtained by upper bound approximations or by a bracketing procedure in which various upper and lower bounds may be obtained as close to one another as desired. The KITT programs can handle independent components which are non-repairable or which have a constant repair time. Any assortment of non-repairable components and components having constant repair times can be considered. Any inhibit conditions having constant probabilities of occurrence can be handled. The failure intensity of each component is assumed to be constant with respect to time. The KITT2 program can also handle components which during different time intervals, called phases, may have different reliability properties. 2 - Method of solution: The PREP program obtains minimal cut sets by either direct deterministic testing or by an efficient Monte Carlo algorithm. The minimal path sets are obtained using the Monte Carlo algorithm. The reliability information is obtained by the KITT programs from numerical solution of the simple integral balance equations of kinetic tree theory. 3 - Restrictions on the complexity of the problem: The PREP program will obtain the minimal cut and

Twenty Years of Precise Radial Velocities at Keck and Lick Observatories

Science.gov (United States)

Wright, J. T.

2015-10-01

The precise radial velocity survey at Keck Observatory began over 20 years ago. Its survey of thousands of stars now has the time baseline to be sensitive to planets with decade-long orbits, including Jupiter analogs. I present several newly-finished orbital solutions for long-period giant planets. Although hot Jupiters are generally ``lonely'' (i.e. they are not part of multiplanet systems), those that are not appear to often have giant companions at 5 AU or beyond. I present two of the highest period-ratios among planets in a two-planet system, and some of the longest orbital periods ever measured for exoplanets. In many cases, combining Keck radial velocities from those from other long-term surveys at Lick Observatory, McDonald Observatory, HARPS, and, of course, OHP spectrographs, produces superior orbital fits, constraining both period and eccentricity better than could be possible with any single set alone. Stellar magnetic activity cycles can masquerade as long-period planets. In most cases this effect is very small, but a loud minority of stars, including, apparently, HD 154345, show very strong RV-activity correlations.

Moving beyond Test-Prep Pedagogy: Dialoguing with Multicultural Preservice Teachers for a Quality Education

Science.gov (United States)

Rodríguez, Louie F.

2013-01-01

In a "post-NCLB era," the schooling experiences of mostly low-income students of color continue to be consumed by a test-prep pedagogy--narrowed curriculum, low expectations, and ignored relationships. In this article the author describes a pedagogical approach using educational dialogues to engage preservice teachers to critically…

Including an Exam P/1 Prep Course in a Growing Actuarial Science Program

Science.gov (United States)

Wakefield, Thomas P.

2014-01-01

The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

Evaluation of a new preparative supercritical fluid chromatography system for compound library purification: the TharSFC SFC-MS Prep-100 system.

Science.gov (United States)

Ebinger, Katalin; Weller, Harold N; Kiplinger, Jeffrey; Lefebvre, Paul

2011-06-01

Preparative HPLC-MS is often the method of choice for purification of small amounts (libraries for drug discovery. The method is robust, well proven, and widely applicable. In contrast, preparative supercritical fluid chromatography coupled with mass spectrometry (SFC-MS) has seen only slow acceptance for the same application--despite some potential scientific and economic advantages. One of the reasons for slow adoption of SFC-MS is the lack of well-proven, robust, and commercially available instrumentation. In early 2009, TharSFC (a Waters Company, Pittsburgh, PA) introduced a new fully integrated system for preparative SFC-MS: The SFC-MS Prep-100. We report herein an objective evaluation of the SFC-MS Prep-100, including tests for pump and autosampler performance, sample recovery, sample carryover, fraction triggering, detector/fraction collector synchronization, and overall robustness. Our results suggest that the SFC-MS Prep-100 represents a significant advance over previous generation instrumentation. Copyright © 2011 Society for Laboratory Automation and Screening. Published by Elsevier Inc. All rights reserved.

The Use of Online Posts to Identify Barriers to and Facilitators of HIV Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men: A Comparison to a Systematic Review of the Peer-Reviewed Literature.

Science.gov (United States)

Hannaford, Alisse; Lipshie-Williams, Madeleine; Starrels, Joanna L; Arnsten, Julia H; Rizzuto, Jessica; Cohen, Phillip; Jacobs, Damon; Patel, Viraj V

2018-04-01

Pre-exposure prophylaxis (PrEP) remains an under-utilized HIV prevention tool among men who have sex with men (MSM). To more comprehensively elucidate barriers and facilitators to PrEP use among US MSM, we conducted a systematic review of peer-reviewed published articles and content analysis of online posts about PrEP. We searched peer-reviewed databases (Medline, Web of Science, Google Scholar) using MESH headings and keywords about PrEP and/or HIV prevention from 2005 to 2015. We included original studies among MSM in the US that reported on barriers, facilitators, or other factors related to PrEP use. We also searched online posts and associated comments (news articles, opinion pieces, blogs and other social media posts) in diverse venues (Facebook, Slate Outward, Huffington Post Gay Voices, Queerty, and My PrEP Experience blog) to identify posts about PrEP. We used content analysis to identify themes and compare potential differences between the peer-reviewed literature and online posts. We identified 25 peer-reviewed articles and 28 online posts meeting inclusion criteria. We identified 48 unique barriers and 46 facilitators to using PrEP. These 94 themes fit into six overarching categories: (1) access (n = 14), (2) attitudes/beliefs (n = 24), (3) attributes of PrEP (n = 13), (4) behaviors (n = 11), (5) sociodemographic characteristics (n = 8), and (6) social network (n = 6). In all categories, analysis of online posts resulted in identification of a greater number of unique themes. Thirty-eight themes were identified in the online posts that were not identified in the peer-reviewed literature. We identified barriers and facilitators to PrEP in online posts that were not identified in a systematic review of the peer-reviewed literature. By incorporating data both from a systematic review of peer-reviewed articles and from online posts, we have identified salient and novel information about barriers to and facilitators of PrEP use. Traditional

A small 'lick' will sink a great ship: fulminant septicaemia after dog saliva wound treatment in an asplenic patient.

Science.gov (United States)

Morandi, Evi M; Pauzenberger, Reinhard; Tasch, Christoph; Rieger, Ulrich M; Pierer, Gerhard; Djedovic, Gabriel

2017-12-01

Capnocytophaga canimorsus is a bacterium transmitted through the saliva of dogs. An infection can cause severe sepsis with acral necrosis and is potentially fatal. Here, we report the case of a 41-year-old man who was infected through a wound that was licked by his dog. He went into septic shock with disseminated intravascular coagulation and subsequently lost both lower legs, his nose and all the fingers on both hands. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

The Safety of Tenofovir-Emtricitabine for HIV Pre-Exposure Prophylaxis (PrEP) in Individuals With Active Hepatitis B.

Science.gov (United States)

Solomon, Marc M; Schechter, Mauro; Liu, Albert Y; McMahan, Vanessa M; Guanira, Juan V; Hance, Robert J; Chariyalertsak, Suwat; Mayer, Kenneth H; Grant, Robert M

2016-03-01

Pre-exposure prophylaxis (PrEP) with daily oral emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) prevents HIV infection. The safety and feasibility of HIV PrEP in the setting of hepatitis B virus (HBV) infection were evaluated. The Iniciativa Profilaxis Pre-Exposición study randomized 2499 HIV-negative men and transgender women who have sex with men to once-daily oral FTC/TDF versus placebo. Hepatitis serologies and transaminases were obtained at screening and at the time PrEP was discontinued. HBV DNA was assessed by polymerase chain reaction, and drug resistance was assessed by population sequencing. Vaccination was offered to individuals susceptible to HBV infection. Of the 2499 participants, 12 (0.5%; including 6 randomized to FTC/TDF) had chronic HBV infection. After stopping FTC/TDF, 5 of the 6 participants in the active arm had liver function tests performed at follow-up. Liver function tests remained within normal limits at post-stop visits except for a grade 1 elevation in 1 participant at post-stop week 12 (alanine aminotransferase = 90, aspartate aminotransferase = 61). There was no evidence of hepatic flares. Polymerase chain reaction of stored samples showed that 2 participants in the active arm had evidence of acute HBV infection at enrollment. Both had evidence of grade 4 transaminase elevations with subsequent resolution. Overall, there was no evidence of TDF or FTC resistance among tested genotypes. Of 1633 eligible for vaccination, 1587 (97.2%) received at least 1 vaccine; 1383 (84.7%) completed the series. PrEP can be safely provided to individuals with HBV infection if there is no evidence of cirrhosis or substantial transaminase elevation. HBV vaccination rates at screening were low globally, despite recommendations for its use, yet uptake and efficacy were high when offered.

The Safety of Tenofovir–Emtricitabine for HIV Pre-Exposure Prophylaxis (PrEP) in Individuals With Active Hepatitis B

Science.gov (United States)

Schechter, Mauro; Liu, Albert Y.; McManhan, Vanessa M.; Guanira, Juan V.; Hance, Robert J.; Chariyalertsak, Suwat; Mayer, Kenneth H.; Grant, Robert M.

2016-01-01

Background: Pre-exposure prophylaxis (PrEP) with daily oral emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) prevents HIV infection. The safety and feasibility of HIV PrEP in the setting of hepatitis B virus (HBV) infection were evaluated. Methods: The Iniciativa Profilaxis Pre-Exposición study randomized 2499 HIV-negative men and transgender women who have sex with men to once-daily oral FTC/TDF versus placebo. Hepatitis serologies and transaminases were obtained at screening and at the time PrEP was discontinued. HBV DNA was assessed by polymerase chain reaction, and drug resistance was assessed by population sequencing. Vaccination was offered to individuals susceptible to HBV infection. Results: Of the 2499 participants, 12 (0.5%; including 6 randomized to FTC/TDF) had chronic HBV infection. After stopping FTC/TDF, 5 of the 6 participants in the active arm had liver function tests performed at follow-up. Liver function tests remained within normal limits at post-stop visits except for a grade 1 elevation in 1 participant at post-stop week 12 (alanine aminotransferase = 90, aspartate aminotransferase = 61). There was no evidence of hepatic flares. Polymerase chain reaction of stored samples showed that 2 participants in the active arm had evidence of acute HBV infection at enrollment. Both had evidence of grade 4 transaminase elevations with subsequent resolution. Overall, there was no evidence of TDF or FTC resistance among tested genotypes. Of 1633 eligible for vaccination, 1587 (97.2%) received at least 1 vaccine; 1383 (84.7%) completed the series. Conclusions: PrEP can be safely provided to individuals with HBV infection if there is no evidence of cirrhosis or substantial transaminase elevation. HBV vaccination rates at screening were low globally, despite recommendations for its use, yet uptake and efficacy were high when offered. PMID:26413853

Correlates of Awareness of and Willingness to Use Pre-exposure Prophylaxis (PrEP) in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Geosocial-Networking Smartphone Applications in New York City.

Science.gov (United States)

Goedel, William C; Halkitis, Perry N; Greene, Richard E; Duncan, Dustin T

2016-07-01

Geosocial-networking smartphone applications are commonly used by gay, bisexual, and other men who have sex with men (MSM) to meet sexual partners. The purpose of the current study was to evaluate awareness of and willingness to use pre-exposure prophylaxis (PrEP) among MSM who use geosocial-networking smartphone applications residing in New York City. Recruitment utilizing broadcast advertisements on a popular smartphone application for MSM yielded a sample of 152 HIV-uninfected MSM. Multivariable models were used to assess demographic and behavioral correlates of awareness of and willingness to use PrEP. Most participants (85.5 %) had heard about PrEP but few (9.2 %) reported current use. Unwillingness to use PrEP was associated with concerns about side effects (PR = 0.303; 95 % CI 0.130, 0.708; p = 0.006). Given that more than half (57.6 %) of participants were willing to use PrEP, future research is needed to elucidate both individual and structural barriers to PrEP use among MSM.

Effect on incorporating urea molasses mineral block lick in the diet of crossbred calves on the protozoal production rate in the rumen

International Nuclear Information System (INIS)

Garg, M.R.; Gupta, B.N.; Singh, G.P.

1992-01-01

Sixteen male rumen fistulated calves (18-24 months of age; 180-200 kg body wt) were divided into four groups of four animals each. Animals in all groups were fed wheat straw ad lib as the sole roughage. However, animals in Gr I were fed concentrate mixture at maintenance level whereas, animals in Gr II, III and IV had free access to urea molasses mineral block (UMMB) lick existing modified 'A' and modified 'B', respectively without any concentrate mixture. Dry matter intake (kg/100 kg body wt) were similar in four groups. However, straw intake was significantly higher in UMMB supplemented groups. Protozoa production rate (gN/d) was significantly higher in Gr I (7.112 + 0.27) as compared to Gr II (4.302 + 0.51), Gr III (4.743 + 0.27) and Gr IV (4.501 + 0.25). Thus, these results indicated that protozoal production rate in the rumen is significantly lower when crossbred calves were fed on wheat straw based diet supplemented with different UMMB licks as compared to those fed concentrate mixture at maintenance level. (author). 12 refs., 4 tabs

Performance evaluation of the new Roche cobas AmpliPrep/cobas TaqMan HCV test, version 2.0, for detection and quantification of hepatitis C virus RNA

NARCIS (Netherlands)

S.D. Pas (Suzan); R. Molenkamp (Richard); J. Schinkel (Janke); S. Rebers; C. Copra (Cederick); S. Seven-Deniz; D. Thamke (Diana); R.J. de Knegt (Robert); B.L. Haagmans (Bart); M. Schutten (Martin)

2013-01-01

textabstractTo evaluate the analytical performance and explore the clinical applicability of the new Roche cobas AmpliPrep/cobas TaqMan HCV test, v2.0 (CAP/CTM v2.0), a platform comparison was performed on panels and diagnostic samples with the Roche cobas AmpliPrep/cobas TaqMan HCV test (CAP/CTM

Prep/Tech: Volume 1, No. 1, Youth on homelessness

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

PREP/TECH is a skill development, academic enrichment program of U. of Toledo in Toledo OH and The Engineers Foundation of Ohio; it addresses the mathematics, science, language, and intellectual needs of about 100 African-American and Hispanic-American 7th, 8th, and 9th graders in Toledo. This summer, after 3 weeks of classes, the 80 students returned for a second 3 week session and were divided into two groups, one studying the growing problem of homelessness in America. This group researched and published a pamphlet on homelessness. This report is divided into: myths, causes, descriptions, and solutions. Finally, a brief account is given of the homelessness project.

Can an inadequate cervical cytology sample in ThinPrep be converted to a satisfactory sample by processing it with a SurePath preparation?

Science.gov (United States)

Sørbye, Sveinung Wergeland; Pedersen, Mette Kristin; Ekeberg, Bente; Williams, Merete E Johansen; Sauer, Torill; Chen, Ying

2017-01-01

The Norwegian Cervical Cancer Screening Program recommends screening every 3 years for women between 25 and 69 years of age. There is a large difference in the percentage of unsatisfactory samples between laboratories that use different brands of liquid-based cytology. We wished to examine if inadequate ThinPrep samples could be satisfactory by processing them with the SurePath protocol. A total of 187 inadequate ThinPrep specimens from the Department of Clinical Pathology at University Hospital of North Norway were sent to Akershus University Hospital for conversion to SurePath medium. Ninety-one (48.7%) were processed through the automated "gynecologic" application for cervix cytology samples, and 96 (51.3%) were processed with the "nongynecological" automatic program. Out of 187 samples that had been unsatisfactory by ThinPrep, 93 (49.7%) were satisfactory after being converted to SurePath. The rate of satisfactory cytology was 36.6% and 62.5% for samples run through the "gynecology" program and "nongynecology" program, respectively. Of the 93 samples that became satisfactory after conversion from ThinPrep to SurePath, 80 (86.0%) were screened as normal while 13 samples (14.0%) were given an abnormal diagnosis, which included 5 atypical squamous cells of undetermined significance, 5 low-grade squamous intraepithelial lesion, 2 atypical glandular cells not otherwise specified, and 1 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion. A total of 2.1% (4/187) of the women got a diagnosis of cervical intraepithelial neoplasia 2 or higher at a later follow-up. Converting cytology samples from ThinPrep to SurePath processing can reduce the number of unsatisfactory samples. The samples should be run through the "nongynecology" program to ensure an adequate number of cells.

Autoshaping in the rat: conditioned licking response to a stimulus that signals sucrose reinforcement.

Science.gov (United States)

Reilly, Steve; Grutzmacher, Richard P.

2002-07-31

The present experiments were designed to determine if repeated presentations of an empty sipper tube (the conditioned stimulus or CS) with the response-independent delivery of a sucrose solution (the unconditioned stimulus or US) from a second spout results in the development of Pavlovian conditioned responding. In Experiment 1, rats in the experimental condition received paired CS-US presentations whereas subjects in the control condition were exposed to random presentations of CS and US. In Experiment 2, an additional control condition (CS alone) was included and, to encourage generalized responding between the US and CS, the CS tube was filled with water for all groups. The results of both experiments indicate that the CS-directed responding in the paired CS-US condition was Pavlovian in nature. Thus, the present procedure serves as an autoshaping task in which conditioned licking is generated.

Comparison of a prepCheck-supported self-assessment concept with conventional faculty supervision in a pre-clinical simulation environment.

Science.gov (United States)

Wolgin, M; Grabowski, S; Elhadad, S; Frank, W; Kielbassa, A M

2018-03-25

This study aimed to evaluate the educational outcome of a digitally based self-assessment concept (prepCheck; DentsplySirona, Wals, Austria) for pre-clinical undergraduates in the context of a regular phantom-laboratory course. A sample of 47 third-year dental students participated in the course. Students were randomly divided into a prepCheck-supervised (self-assessment) intervention group (IG; n = 24); conventionally supervised students constituted the control group (CG; n = 23). During the preparation of three-surface (MOD) class II amalgam cavities, each IG participant could analyse a superimposed 3D image of his/her preparation against the "master preparation" using the prepCheck software. In the CG, several course instructors performed the evaluations according to pre-defined assessment criteria. After completing the course, a mandatory (blinded) practical examination was taken by all course participants (both IG and CG students), and this assessment involved the preparation of a MOD amalgam cavity. Then, optical impressions by means of a CEREC-Omnicam were taken to digitalize all examination preparations, followed by surveying and assessing the latter using prepCheck. The statistical analysis of the digitalized samples (Mann-Whitney U test) revealed no significant differences between the cavity dimensions achieved in the IG and CG (P = .406). Additionally, the sum score of the degree of conformity with the "master preparation" (maximum permissible 10% of plus or minus deviation) was comparable in both groups (P = .259). The implemented interactive digitally based, self-assessment learning tool for undergraduates appears to be equivalent to the conventional form of supervision. Therefore, such digital learning tools could significantly address the ever-increasing student to faculty ratio. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The intention to use HIV-pre-exposure prophylaxis (PrEP) among men who have sex with men in Switzerland: testing an extended explanatory model drawing on the unified theory of acceptance and use of technology (UTAUT).

Science.gov (United States)

Nideröst, Sibylle; Gredig, Daniel; Hassler, Benedikt; Uggowitzer, Franziska; Weber, Patrick

2018-01-01

The aim of this study was to determine the intention to use pre-exposure prophylaxis (PrEP) when available and to identify predictors of the intention to use PrEP among men who have sex with men (MSM) living in Switzerland. The theoretical model drew on the Unified Theory of Acceptance and Use of Technology and considered additional variables related specifically to PrEP, HIV protection and the resources of MSM. For data collection, we used an anonymous, standardized self-administered online questionnaire. In 2015, we gathered a convenience sample of 556 HIV-negative MSM living in Switzerland. We analyzed the data using descriptive and bivariate statistics and used structural equation modeling to test the hypothesized model. Predictors of respondents' moderate intention to use PrEP were performance expectancy, effort expectancy, perceived social influence, concerns about using PrEP, attitudes toward condom use, negative experiences of condom use and age. These variables were predicted by HIV protection-related aspects and resources. The findings provide insights into the complex dynamic underlying the intention to use PrEP.

Appraisal of the PREP, KITT, and SAMPLE computer codes for the evaluation of the reliability characteristics of engineered systems

Energy Technology Data Exchange (ETDEWEB)

Shaw, P; White, R F

1976-01-01

For the probabilistic approach to reactor safety assessment by the use of event tree and fault tree techniques it is essential to be able to estimate the probabilities of failure of the various engineered safety features provided to mitigate the effects of postulated accident sequences. The PREP, KITT and SAMPLE computer codes, which incorporate Kinetic Tree Theory, perform these calculations and have been used extensively to evaluate the reliability characteristics of engineered safety features of American nuclear reactors. Working versions of these computer codes are now available in SRD, and this report explains the merits, capabilities and ease of application of the PREP, KITT, and SAMPLE programs for the solution of system reliability problems.

Explaining the Efficacy of Pre-exposure Prophylaxis (PrEP) for HIV Prevention: A Qualitative Study of Message Framing and Messaging Preferences Among US Men Who have Sex with Men.

Science.gov (United States)

Underhill, Kristen; Morrow, Kathleen M; Colleran, Christopher; Calabrese, Sarah K; Operario, Don; Salovey, Peter; Mayer, Kenneth H

2016-07-01

We investigated message comprehension and message framing preferences for communicating about PrEP efficacy with US MSM. We conducted eight focus groups (n = 38) and n = 56 individual interviews with MSM in Providence, RI. Facilitators probed comprehension, credibility, and acceptability of efficacy messages, including percentages, non-numerical paraphrases, efficacy ranges versus point estimates, and success- versus failure-framed messages. Our findings indicated a range of comprehension and operational understandings of efficacy messages. Participants tended to prefer percentage-based and success-framed messages, although preferences varied for communicating about efficacy using a single percentage versus a range. Participants reported uncertainty about how to interpret numerical estimates, and many questioned whether trial results would predict personal effectiveness. These results suggest that providers and researchers implementing PrEP may face challenges in communicating with users about efficacy. Efforts to educate MSM about PrEP should incorporate percentage-based information, and message framing decisions may influence message credibility and overall PrEP acceptability.

PREP inside and out: marriage education for inmates.

Science.gov (United States)

Einhorn, Lindsey; Williams, Tamara; Stanley, Scott; Wunderlin, Nicole; Markman, Howard; Eason, Joanne

2008-09-01

Although research has demonstrated that marriage education has positive effects on relationship quality, little is known about how such services impact relationships where one partner is incarcerated. The current study implemented an adapted version of the Prevention and Relationship Enhancement Program (PREP Inside and Out) for inmates in Oklahoma correctional facilities. Inmates, with or without their partners, participated in the 12-hour program. The impact of the program was investigated on a range of relationship variables including satisfaction with relationship, dedication, confidence, communication skills, friendship, and negative interactions as reported by the inmate partner. Participants reported substantial gains in all variables and in overall satisfaction with their relationship after completing the program, regardless of their gender and racial/ethnic background. Implications for future marriage education programs and research in prisons are discussed.

Risk perception and sex behaviour in pregnancy and breastfeeding in high HIV prevalence settings: Programmatic implications for PrEP delivery

Science.gov (United States)

Farley, Elise; Towriss, Catriona; Gomba, Yolanda; Bekker, Linda-Gail; Gorbach, Pamina; Shoptaw, Steven; Coates, Thomas; Myer, Landon

2018-01-01

HIV acquisition during pregnancy and breastfeeding significantly contributes toward paediatric HIV infection; however, little is known about risk behaviours in HIV-uninfected pregnant and postpartum women. We conducted twenty-six in-depth-interviews between July and December 2016 using a semi-structured interview guide among HIV-uninfected pregnant and recently postpartum women at-risk of HIV acquisition (defined as reporting ≥1 of the following: partner’s serostatus unknown or HIV-infected, recent condomless sex in pregnancy, and/or alcohol use during pregnancy) who attended primary healthcare services. Our study contextualizes factors related to risky sexual behaviours during pregnancy and postpartum periods and assesses knowledge and hypothetical acceptability of pre-exposure prophylaxis (PrEP) in pregnancy. Translated and transcribed data were coded and analysed by three researchers using a thematic analysis approach. In interviews with HIV-uninfected pregnant/postpartum women at-risk of HIV acquisition, we identified common themes associated with sexual risk behaviours during pregnancy, including: lack of control over decisions in sex and condom use in pregnancy, low perceived risk (e.g. beliefs that their partner has the same HIV-negative serostatus), and socio-cultural beliefs around condom use during pregnancy (e.g. contact with sperm is essential for baby’s development). PrEP knowledge was low among HIV-uninfected pregnant and breastfeeding women, and potential acceptability was good, though primary concerns were around the potential impact on the infant. While mothers presented a clear desire to protect themselves from HIV acquisition once pregnant, they also reported lack of control, and socio-cultural beliefs, like sex is good for the baby, that increased their risk of seroconversion. Mothers had limited PrEP awareness but reported hypothetical willingness to use PrEP because of concerns over HIV acquisition and onward mother to child transmission

Perspectives on HIV Pre- and Post-Exposure Prophylaxes (PrEP and PEP) Among Female and Male Sex Workers in Mombasa, Kenya: Implications for Integrating Biomedical Prevention into Sexual Health Services.

Science.gov (United States)

Restar, Arjee J; Tocco, Jack Ume; Mantell, Joanne E; Lafort, Yves; Gichangi, Peter; Masvawure, Tsitsi B; Chabeda, Sophie Vusha; Sandfort, Theo G M

2017-04-01

Pre- and post-exposure prophylaxes (PrEP and PEP) can reduce the risk of HIV acquisition, yet often are inaccessible to and underutilized by most-vulnerable populations, including sex workers in sub-Saharan Africa. Based on in-depth interviews with 21 female and 23 male HIV-negative sex workers in Mombasa, Kenya, we found that awareness and knowledge of PrEP and PEP were low, although willingness to use both was high. Participants felt PrEP would be empowering and give added protection against infection, although some expressed concerns about side effects. Despite PEP's availability, few knew about it and even fewer had used it, but most who had would use it again. Sex workers valued confidentiality, privacy, trustworthiness, and convenient location in health services and wanted thorough HIV/STI assessments. These findings suggest the importance of situating PrEP and PEP within sex worker-friendly health services and conducting outreach to promote these biomedical prevention methods for Kenyan sex workers.

THE LICK/SDSS LIBRARY. II. [Ca/Fe] AND [Mg/Fe] IN F, G, AND K STARS FROM SDSS-DR7

International Nuclear Information System (INIS)

Franchini, M.; Morossi, C.; Di Marcantonio, P.; Malagnini, M. L.; Chavez, M.

2011-01-01

We analyzed the spectra of 17,600 F, G, and K stars extracted from the seventh Sloan Digital Sky Survey Data Release (SDSS-DR7) database in order to derive ([α/Fe]), [Ca/Fe], and [Mg/Fe] ratios. Particular attention has been devoted to estimating homogeneous and self-consistent atmospheric parameter values, T eff , log g, and [Fe/H], by comparing synthetic and observational Lick/SDSS indices. We present results for the sub-sample of more than 4000 spectra whose overall quality allowed us to derive fairly accurate stellar atmospheric parameter values and, therefore, reliable abundance ratios. A Monte Carlo approach was adopted to evaluate both the errors in the observational Lick/SDSS indices and in the derived parameter estimates. The analysis of the trends of [Ca/Fe] and [Mg/Fe] versus [Fe/H] pointed out that (1) the [Ca/Fe] and [Mg/Fe] ratios increase with decreasing [Fe/H] with different slopes reaching maximum average levels of +0.25 and +0.40 dex at [Fe/H] ≅ -1.75, respectively; (2) our sample contains, at a given [Fe/H], stars characterized by significantly different amounts of α-enhancement, thus belonging to different Galactic populations; and (3) the analyzed sample shows a predominance of thick disk stars for [Fe/H] > - 0.5 and the presence of stars belonging to the h igh-αhalo population for -2.0 < [Fe/H] <-0.5.

Acceptability of Condoms, Circumcision and PrEP among Young Black Men Who Have Sex with Men: A Descriptive Study Based on Effectiveness and Cost

Directory of Open Access Journals (Sweden)

Richard A. Crosby

2014-02-01

Full Text Available The current study examined and compared the willingness of young Black men who have sex with men (YBMSM to accept pre-exposure prophylaxis (PrEP, adult male circumcision, and condoms for reducing their risk of HIV acquisition. The majority (67% reported unprotected receptive anal sex in the last six months. About three-quarters (71% would accept using PrEP if it was 100% effective. Cost influenced PrEP acceptance with 19% indicating acceptance at $100 per month co-pay. Of those not circumcised, 50% indicated willingness if circumcision was 100% effective. Acceptance of circumcision decreased markedly to 17% with co-pays of $100. About 73% of men were willing to use condoms if they were 100% effective and 50% indicated a willingness at the cost of $10 per month. The findings suggest that condom use promotion strategies should remain at the forefront of public health efforts to control HIV incidence among YBMSM.

Quantification of Parvovirus B19 DNA Using COBAS AmpliPrep Automated Sample Preparation and LightCycler Real-Time PCR

Science.gov (United States)

Schorling, Stefan; Schalasta, Gunnar; Enders, Gisela; Zauke, Michael

2004-01-01

The COBAS AmpliPrep instrument (Roche Diagnostics GmbH, D-68305 Mannheim, Germany) automates the entire sample preparation process of nucleic acid isolation from serum or plasma for polymerase chain reaction analysis. We report the analytical performance of the LightCycler Parvovirus B19 Quantification Kit (Roche Diagnostics) using nucleic acids isolated with the COBAS AmpliPrep instrument. Nucleic acids were extracted using the Total Nucleic Acid Isolation Kit (Roche Diagnostics) and amplified with the LightCycler Parvovirus B19 Quantification Kit. The kit combination processes 72 samples per 8-hour shift. The lower detection limit is 234 IU/ml at a 95% hit-rate, linear range approximately 104-1010 IU/ml, and overall precision 16 to 40%. Relative sensitivity and specificity in routine samples from pregnant women are 100% and 93%, respectively. Identification of a persistent parvovirus B19-infected individual by the polymerase chain reaction among 51 anti-parvovirus B19 IgM-negative samples underlines the importance of additional nucleic acid testing in pregnancy and its superiority to serology in identifying the risk of parvovirus B19 transmission via blood or blood products. Combination of the Total Nucleic Acid Isolation Kit on the COBAS AmpliPrep instrument with the LightCycler Parvovirus B19 Quantification Kit provides a reliable and time-saving tool for sensitive and accurate detection of parvovirus B19 DNA. PMID:14736825

Safety and adherence to intermittent pre-exposure prophylaxis (PrEP) for HIV-1 in African men who have sex with men and female sex workers.

Science.gov (United States)

Mutua, Gaudensia; Sanders, Eduard; Mugo, Peter; Anzala, Omu; Haberer, Jessica E; Bangsberg, David; Barin, Burc; Rooney, James F; Mark, David; Chetty, Paramesh; Fast, Patricia; Priddy, Frances H

2012-01-01

Little is known about safety of and adherence to intermittent HIV PrEP regimens, which may be more feasible than daily dosing in some settings. We present safety and adherence data from the first trial of an intermittent PrEP regimen among Kenyan men who have sex with men (MSM) and female sex workers (FSW). MSM and FSW were randomized to daily oral FTC/TDF or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day) oral FTC/TDF or placebo in a 2:1:2:1 ratio; volunteers were followed monthly for 4 months. Adherence was assessed with the medication event monitoring system (MEMS). Sexual activity data were collected via daily text message (SMS) queries and timeline followback interviews with a one-month recall period. Sixty-seven men and 5 women were randomized into the study. Safety was similar among all groups. Median MEMS adherence rates were 83% [IQR: 63-92] for daily dosing and 55% [IQR:28-78] for fixed intermittent dosing (p = 0.003), while adherence to any post-coital doses was 26% [IQR:14-50]. SMS response rates were low, which may have impaired measurement of post-coital dosing adherence. Acceptability of PrEP was high, regardless of dosing regimen. Adherence to intermittent dosing regimens, fixed doses, and in particular coitally-dependent doses, may be more difficult than adherence to daily dosing. However, intermittent dosing may still be appropriate for PrEP if intracellular drug levels, which correlate with prevention of HIV acquisition, can be attained with less than daily dosing and if barriers to adherence can be addressed. Additional drug level data, qualitative data on adherence barriers, and better methods to measure sexual activity are necessary to determine whether adherence to post-coital PrEP could be comparable to more standard regimens. ClinicalTrials.gov NCT00971230.

Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study

OpenAIRE

Adam Bourne; Matteo Cassolato; Clayton Koh Thuan Wei; Bangyuan Wang; Joselyn Pang; Sin How Lim; Iskandar Azwa; Ilias Yee; Gitau Mburu

2017-01-01

Abstract Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers t...

Views of policymakers, healthcare workers and NGOs on HIV pre-exposure prophylaxis (PrEP): a multinational qualitative study

NARCIS (Netherlands)

Wheelock, Ana; Eisingerich, Andreas B.; Gomez, Gabriela B.; Gray, Emily; Dybul, Mark R.; Piot, Peter

2012-01-01

To examine policymakers and providers' views on pre-exposure prophylaxis (PrEP) and their willingness to support its introduction, to inform policy and practice in this emerging field. Semistructured qualitative interview study. Peru, Ukraine, India, Kenya, Uganda, Botswana and South Africa. 35

PAIRS AND GROUPS OF GENETICALLY RELATED LONG-PERIOD COMETS AND PROPOSED IDENTITY OF THE MYSTERIOUS LICK OBJECT OF 1921

Energy Technology Data Exchange (ETDEWEB)

Sekanina, Zdenek [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Kracht, Rainer, E-mail: Zdenek.Sekanina@jpl.nasa.gov, E-mail: R.Kracht@t-online.de [Ostlandring 53, D-25335 Elmshorn, Schleswig-Holstein (Germany)

2016-05-20

We present the history of investigation of the dynamical properties of pairs and groups of genetically related long-period comets (other than the Kreutz sungrazing system). Members of a comet pair or group move in nearly identical orbits, and their origin as fragments of a common parent comet is unquestionable. The only variable is the time of perihelion passage, which differs considerably from member to member owing primarily to an orbital-momentum increment acquired during breakup. Meter-per-second separation velocities account for gaps of years or tens of years, thanks to the orbital periods of many millennia. The physical properties of individual members may not at all be alike, as illustrated by the trio of C/1988 A1, C/1996 Q1, and C/2015 F3. We exploit orbital similarity to examine whether the enigmatic and as-yet-unidentified object discovered from the Lick Observatory near the Sun at sunset on 1921 August 7 happened to be a member of such a pair and to track down the long-period comet to which it might be genetically related. Our search shows that the Lick object, which could not be a Kreutz sungrazer, was likely a companion to comet C/1847 C1 (Hind), whose perihelion distance was ∼9 R {sub ⊙} and true orbital period was approximately 8300 yr. The gap of 74.4 yr between their perihelion times is consistent with a separation velocity of ∼1 m s{sup −1} which sets the fragments apart following the parent's breakup in a general proximity of perihelion during the previous return to the Sun in the seventh millennium BCE.

Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis.

Science.gov (United States)

de Bekker-Grob, Esther W; de Kok, Inge M C M; Bulten, Johan; van Rosmalen, Joost; Vedder, Judith E M; Arbyn, Marc; Klinkhamer, Paul J J M; Siebers, Albertus G; van Ballegooijen, Marjolein

2012-08-01

Cervical cancer screening with liquid-based cytology (LBC) has been developed as an alternative to the conventional Papanicolaou (CP) smear. Cost-effectiveness is one of the issues when evaluating LBC. Based on the results of a Dutch randomised controlled trial, we conducted cost-effectiveness threshold analyses to investigate under what circumstances manually screened ThinPrep LBC is cost-effective for screening. The MISCAN-Cervix microsimulation model and data from the Dutch NETHCON trial (including 89,784 women) were used to estimate the costs and (quality-adjusted) life years ((QA)LYs) gained for EU screening schedules, varying cost-effectiveness threshold values. Screening strategies were primary cytological screening with LBC or CP, and triage with human papillomavirus (HPV) testing. Threshold analyses showed that screening with LBC as a primary test can be cost-effective if LBC is less than 3.2 more costly per test than CP, if the sensitivity of LBC is at least 3-5 % points higher than CP, if the quality of life for women in triage follow-up is only 0.39, or if the rate of inadequate CP smears is at least 16.2 %. Regarding test characteristics and costs of LBC and CP, only under certain conditions will a change from CP to manually screened ThinPrep LBC be cost-effective. If none of these conditions are met, implementation of manually screened ThinPrep LBC seems warranted only if there are advantages other than cost-effectiveness. Further research is needed to establish whether other LBC systems will be more favorable with regard to cost-effectiveness.

The cobas p 630 instrument: a dedicated pre-analytic solution to optimize COBAS® AmpliPrep/COBAS® TaqMan® system workflow and turn-around-time.

Science.gov (United States)

Vallefuoco, L; Sorrentino, R; Spalletti Cernia, D; Colucci, G; Portella, G

2012-12-01

The cobas p 630, a fully automated pre-analytical instrument for primary tube handling recently introduced to complete the Cobas(®) TaqMan systems portfolio, was evaluated in conjunction with: the COBAS(®) AmpliPrep/COBAS(®) TaqMan HBV Test, v2.0, COBAS(®) AmpliPrep/COBAS(®) TaqMan HCV Test, v1.0 and COBAS(®) AmpliPrep/COBAS(®) TaqMan HIV Test, v2.0. The instrument performance in transferring samples from primary to secondary tubes, its impact in improving COBAS(®) AmpliPrep/COBAS(®) TaqMan workflow and hands-on reduction and the risk of possible cross-contamination were assessed. Samples from 42 HBsAg positive, 42 HCV and 42 HIV antibody (Ab) positive patients as well as 21 healthy blood donors were processed with or without automated primary tubes. HIV, HCV and HBsAg positive samples showed a correlation index of 0.999, 0.987 and of 0.994, respectively. To assess for cross-contamination, high titer HBV DNA positive samples, HCV RNA and HIV RNA positive samples were distributed in the cobas p 630 in alternate tube positions, adjacent to negative control samples within the same rack. None of the healthy donor samples showed any reactivity. Based on these results, the cobas p 630 can improve workflow and sample tracing in laboratories performing molecular tests, and reduce turnaround time, errors, and risks. Copyright © 2012 Elsevier B.V. All rights reserved.

Safety, adherence and acceptability of intermittent tenofovir/emtricitabine as HIV pre-exposure prophylaxis (PrEP among HIV-uninfected Ugandan volunteers living in HIV-serodiscordant relationships: a randomized, clinical trial.

Directory of Open Access Journals (Sweden)

Freddie M Kibengo

Full Text Available BACKGROUND: Efficacy of oral pre-exposure prophylaxis (PrEP in prevention of HIV acquisition has been evaluated using a daily regimen. However, adherence to long term daily medication is rarely perfect. Intermittent regimen may be a feasible alternative. Preclinical studies have demonstrated effectiveness of intermittent PrEP in SHIV prevention among animals. However, little is known about intermittent PrEP regimens. DESIGN: Seventy two HIV-uninfected volunteers in HIV serodiscordant couple relationships in Uganda were randomly assigned to receive daily oral Tenofovir/Emtricitabine (TDF/FTC-Truvada or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day oral TDF/FTC or placebo in a 2:1:2:1 ratio. Volunteers and study staff were blinded to drug assignment, but not to regimen assignment. METHODS: Volunteers were followed for 4 months after randomization, with monthly clinical and laboratory safety assessments and comprehensive HIV risk reduction services. Adherence was monitored using medication event monitoring system (MEMS and self-report. Sexual activity data were collected via daily short text message (SMS and self-report. HIV-specific immune responses were assessed by IFN-γ ELISPOT. RESULTS: Both daily and intermittent oral TDF/FTC regimens were well tolerated. Median MEMS adherence rates were 98% (IQR: 93-100 for daily PrEP regimen, 91% (IQR: 73-97 for fixed intermittent dosing and 45% (IQR: 20-63 for post-coital dosing. SMS response rate was 74%, but increased to 80% after excluding server outages; results may have been affected by the novelty of this measure. The majority of volunteers expressed willingness with no particular preference for either regimen. CONCLUSIONS: Both daily and intermittent oral PrEP dosing regimens were safe. Adherence was high for daily and fixed intermittent dosing; post-coital dosing was associated with poor adherence. Fixed intermittent PrEP regimens may be

Safety and adherence to intermittent pre-exposure prophylaxis (PrEP for HIV-1 in African men who have sex with men and female sex workers.

Directory of Open Access Journals (Sweden)

Gaudensia Mutua

Full Text Available Little is known about safety of and adherence to intermittent HIV PrEP regimens, which may be more feasible than daily dosing in some settings. We present safety and adherence data from the first trial of an intermittent PrEP regimen among Kenyan men who have sex with men (MSM and female sex workers (FSW.MSM and FSW were randomized to daily oral FTC/TDF or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day oral FTC/TDF or placebo in a 2:1:2:1 ratio; volunteers were followed monthly for 4 months. Adherence was assessed with the medication event monitoring system (MEMS. Sexual activity data were collected via daily text message (SMS queries and timeline followback interviews with a one-month recall period. Sixty-seven men and 5 women were randomized into the study. Safety was similar among all groups. Median MEMS adherence rates were 83% [IQR: 63-92] for daily dosing and 55% [IQR:28-78] for fixed intermittent dosing (p = 0.003, while adherence to any post-coital doses was 26% [IQR:14-50]. SMS response rates were low, which may have impaired measurement of post-coital dosing adherence. Acceptability of PrEP was high, regardless of dosing regimen.Adherence to intermittent dosing regimens, fixed doses, and in particular coitally-dependent doses, may be more difficult than adherence to daily dosing. However, intermittent dosing may still be appropriate for PrEP if intracellular drug levels, which correlate with prevention of HIV acquisition, can be attained with less than daily dosing and if barriers to adherence can be addressed. Additional drug level data, qualitative data on adherence barriers, and better methods to measure sexual activity are necessary to determine whether adherence to post-coital PrEP could be comparable to more standard regimens.ClinicalTrials.gov NCT00971230.

A case study of chewed Truvada® for PrEP maintaining protective drug levels as measured by a novel urine tenofovir assay.

Science.gov (United States)

Lalley-Chareczko, Linden; Clark, Devon; Zuppa, Athena F; Moorthy, Ganesh; Conyngham, Caitlin; Mounzer, Karam; Koenig, Helen

2017-01-01

Emtricitabine/tenofovir disoproxil fumarate (FTC/TDF; Truvada ® ) given as pre-exposure prophylaxis (PrEP) successfully blocks HIV when taken once daily prior to potential HIV exposure. A 22-year-old male reported difficulty swallowing FTC/TDF for PrEP and subsequently began chewing the FTC/TDF tablets. Monthly urine samples assessed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) indicated tenofovir levels >1,000 ng/ml, indicative of protection from HIV acquisition, over a 48-week period. Data from observational studies of HIV-positive patients details the successful treatment of HIV using crushed FTC/TDF delivered via feeding and gastronomy tubes while small, randomized trials of healthy volunteers demonstrate bioequivalence between whole and crushed FTC/TDF.

Quaternary chronostratigraphy and stable isotope paleoecology of Big Bone Lick, Kentucky, USA

Science.gov (United States)

Tankersley, Kenneth Barnett; Murari, Madhav Krishna; Crowley, Brooke E.; Owen, Lewis A.; Storrs, Glenn W.; Mortensen, Litsa

2015-05-01

Big Bone Lick (BBL) in northern Kentucky, USA has been a critical geologic site in the historical development of North American Quaternary vertebrate paleontology since the 1700s. Sedimentology, geoarcheology, paleontology, accelerator mass spectrometry radiocarbon and optically stimulated luminescence dating, and stable carbon and nitrogen isotope analyses were undertaken to develop a chronostratigraphy and history of erosion and deposition for the site to provide a foundation for understanding taphonomy, and species extinction and adaptation to periods of climatic and environmental change. Three geomorphic surfaces are recognized at BBL representing significant periods of floodplain aggradation since the last glacial maximum (26.5-19 ka) dating to the Oldest Dryas (Tazewell, 25-19 ka), the Older Dryas (Cary, 14-12 ka), and late Holocene (5 ka to the present). Unconformities suggest significant periods of degradation during the transitions from cold and dry to warm and moist climates from the Oldest Dryas (Tazewell) to Bølling Oscillation, from the Older Dryas (Cary) to the Allerød, and from the Younger Dryas (Valders) to the Holocene Climatic Optimum. Increased anthropogenic activities since 5 ka may have increased soil upland erosion and floodplain aggradation. Stable isotopes demonstrate that the landscape has been dominated by C3 vegetation since the last glacial maximum.

Lecture to inquiry: The transformation of a tech prep biology teacher

Science.gov (United States)

Haskell, Deborah Harris

As teachers implement the National Science Education Standards (NRC, 1996) many have to reform the instructional methods they have used throughout their careers. This case study examines the transformation of Laurie, a 20-year teacher, during her first year of change from a "traditional" textbook/lecture style of teaching to a facilitator of an inquiry-based classroom. Implementing change requires not only pedagogical expertise, but also the belief that the modifications can be made and that the outcomes are significant. Using Bandura's social cognitive theory as a framework, changes in Laurie's self-efficacy, outcome expectancy, and motivation are followed throughout the transition. During her first year of change, Laurie used worksheets, small group activities, and guided inquiry activities, all strategies in which she had high self-efficacy and experienced positive student outcomes. She rarely used class forums, authentic assessment, and formative assessment. Factors that influenced her change were experiential professional development opportunities that allowed her to practice inquiry-based techniques, a change in her teaching environment from college prep chemistry to tech prep biology, autonomy regarding classroom decisions, and reflective decision making as she learned through experience. Using a standards-based biology textbook increased her self-efficacy toward using inquiry-based practices. The textbook format of embedding text in activities rather than adding activities to the text resulted in an increase of the number and frequency of activities done. Facilitating the textbook's Guided Inquiries and Extended Inquiries helped Laurie gain experience with inquiry-based methods. She also realized that when building from the students' concrete experiences, her students were able to attain higher-level thinking skills. The study revealed six factors contributing to Laurie's change process: (a) experiential professional development, (b) motivation for change

Houston Pre-Freshman Enrichment Program (Houston PREP). Final report, June 9, 1997--July 25, 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-10-01

The 1997 Houston Pre-Freshman Enrichment Program (PREP) was conducted at the campus of the University of Houston-Downtown from June 9 to July 25, 1997. Program participants were recruited from the Greater Houston Area. All participants were identified as high-achieving students with an interest in learning about the engineering and science professions. The goal of the program was to better prepare our pre-college youth prior to entering college as mathematics, science and engineering majors. The program participants were middle school and high school students from the Aldine, Alief, Channel View, Clear Creek, Cypress-Fairbanks, Fort Bend, Galena Park, Houston, Humble, Katy, Klein, North Forest, Pasadena, Private, and Spring Branch Independent School Districts. Of the 194 students starting the program, 165 students were from economically and socially disadvantage groups under-represented in the engineering and science professions, and 118 of the 194 were women. Our First Year group for 1997 composed of 96% minority and women students. Second and Third Year students combined were 96% minority or women. With financial support from the Center for Computational Sciences and Advanced Distributed Simulation, the Fourth Year Program was added to PREP this year. Twelve students completed the program (83% minority or women).

Could FDA approval of pre-exposure prophylaxis make a difference? A qualitative study of PrEP acceptability and FDA perceptions among men who have sex with men

OpenAIRE

Underhill, Kristen; Morrow, Kathleen M.; Operario, Don; Mayer, Kenneth H.

2014-01-01

The FDA has approved tenofovir-emtricitabine for use as HIV pre-exposure prophylaxis, but it is unknown how approval may affect PrEP acceptability among US men who have sex with men. We conducted 8 focus groups among 38 Rhode Island MSM, including 3 groups among 16 male sex workers and 5 groups among 22 men in the general MSM community. Participants reported wide-ranging beliefs regarding consequences and meanings of FDA approval. Some participants would not use PrEP without approval, while o...

Pre-exposure prophylaxis (PrEP against HIV: efficacy, safety and uncertainties

Directory of Open Access Journals (Sweden)

Santiago Moreno Guillen

2017-09-01

Full Text Available Despite the global stabilization of the number of new HIV infections in recent years, there has been an increase in new infections among men who have sex with men. This fact indicates the lack of effectiveness of the measures and prevention campaigns established so far for this group. It is therefore necessary to implement alternative preventive measures for them. Pre-exposure pharmacological prophylaxis (PrEP is one of the best evaluated options and has had high protection rates in both clinical and real-life trials. The strategy has also shown an adequate profile in terms of safety, tolerance, adverse effects and cost-effectiveness in the studies carried out to assess this important topic.

Cervical cancer incidence after normal cytological sample in routine screening using SurePath, ThinPrep, and conventional cytology

DEFF Research Database (Denmark)

Rozemeijer, Kirsten; Naber, Steffie K; Penning, Corine

2017-01-01

of histo- and cytopathology in the Netherlands (PALGA), January 2000 to March 2013.Population Women with 5 924 474 normal screening samples (23 833 123 person years).Exposure Use of SurePath or ThinPrep versus conventional cytology as screening test.Main outcome measure 72 month cumulative incidence...

THE LICK AGN MONITORING PROJECT: PHOTOMETRIC LIGHT CURVES AND OPTICAL VARIABILITY CHARACTERISTICS

International Nuclear Information System (INIS)

Walsh, Jonelle L.; Bentz, Misty C.; Barth, Aaron J.; Minezaki, Takeo; Sakata, Yu; Yoshii, Yuzuru; Baliber, Nairn; Bennert, Vardha Nicola; Street, Rachel A.; Treu, Tommaso; Li Weidong; Filippenko, Alexei V.; Stern, Daniel; Brown, Timothy M.; Canalizo, Gabriela; Gates, Elinor L.; Greene, Jenny E.; Malkan, Matthew A.; Woo, Jong-Hak

2009-01-01

The Lick AGN Monitoring Project targeted 13 nearby Seyfert 1 galaxies with the intent of measuring the masses of their central black holes using reverberation mapping. The sample includes 12 galaxies selected to have black holes with masses roughly in the range 10 6 -10 7 M sun , as well as the well-studied active galactic nucleus (AGN) NGC 5548. In conjunction with a spectroscopic monitoring campaign, we obtained broadband B and V images on most nights from 2008 February through 2008 May. The imaging observations were carried out by four telescopes: the 0.76 m Katzman Automatic Imaging Telescope, the 2 m Multicolor Active Galactic Nuclei Monitoring telescope, the Palomar 60 inch (1.5 m) telescope, and the 0.80 m Tenagra II telescope. Having well-sampled light curves over the course of a few months is useful for obtaining the broad-line reverberation lag and black hole mass, and also allows us to examine the characteristics of the continuum variability. In this paper, we discuss the observational methods and the photometric measurements, and present the AGN continuum light curves. We measure various variability characteristics of each of the light curves. We do not detect any evidence for a time lag between the B- and V-band variations, and we do not find significant color variations for the AGNs in our sample.

Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts.

Science.gov (United States)

Cahill, Sean; Taylor, S Wade; Elsesser, Steven A; Mena, Leandro; Hickson, DeMarc; Mayer, Kenneth H

2017-11-01

Gay and bisexual men and other men who have sex with men (MSM) account for more than two thirds of new HIV infections in the U.S., with Black MSM experiencing the greatest burden. Antiretroviral pre-exposure prophylaxis (PrEP) can reduce MSM's vulnerability to HIV infection. Uptake of PrEP has been limited, particularly among racial and ethnic minority MSM. Four semi-structured focus groups with gay and bisexual men and other MSM at risk for HIV infection were convened in Boston and Jackson in late 2013. The analysis plan utilized a within-case, across-case approach to code and analyze emerging themes, and to compare results across the two cities. Participants recruited in Jackson were primarily Black gay men, while Boston participants were mostly non-Hispanic White gay men. Participants in both sites shared concerns about medication side effects and culturally insensitive health care for gay men. Jackson participants described stronger medical mistrust, and more frequently described experiences of anti-gay and HIV related stigma. Multiple addressable barriers to PrEP uptake were described. Information about side effects should be explicitly addressed in PrEP education campaigns. Providers and health departments should address medical mistrust, especially among Black gay and bisexual men and other MSM, in part by training providers in how to provide affirming, culturally competent care. Medicaid should be expanded in Mississippi to cover low-income young Black gay and bisexual men and other MSM.

Improved removal of blood contamination from ThinPrep cervical cytology samples for Raman spectroscopic analysis.

Science.gov (United States)

Traynor, Damien; Duraipandian, Shiyamala; Martin, Cara M; O'Leary, John J; Lyng, Fiona M

2018-05-01

There is an unmet need for methods to help in the early detection of cervical precancer. Optical spectroscopy-based techniques, such as Raman spectroscopy, have shown great potential for diagnosis of different cancers, including cervical cancer. However, relatively few studies have been carried out on liquid-based cytology (LBC) pap test specimens and confounding factors, such as blood contamination, have been identified. Previous work reported a method to remove blood contamination before Raman spectroscopy by pretreatment of the slides with hydrogen peroxide. The aim of the present study was to extend this work to excessively bloody samples to see if these could be rendered suitable for Raman spectroscopy. LBC ThinPrep specimens were treated by adding hydrogen peroxide directly to the vial before slide preparation. Good quality Raman spectra were recorded from negative and high grade (HG) cytology samples with no blood contamination and with heavy blood contamination. Good classification between negative and HG cytology could be achieved for samples with no blood contamination (sensitivity 92%, specificity 93%) and heavy blood contamination (sensitivity 89%, specificity 88%) with poorer classification when samples were combined (sensitivity 82%, specificity 87%). This study demonstrates for the first time the improved potential of Raman spectroscopy for analysis of ThinPrep specimens regardless of blood contamination. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

High acceptability of HIV pre-exposure prophylaxis but challenges in adherence and use: qualitative insights from a phase I trial of intermittent and daily PrEP in at-risk populations in Kenya.

Science.gov (United States)

Van der Elst, Elisabeth Maria; Mbogua, Judie; Operario, Don; Mutua, Gaudensia; Kuo, Caroline; Mugo, Peter; Kanungi, Jennifer; Singh, Sagri; Haberer, Jessica; Priddy, Frances; Sanders, Eduard Joachim

2013-07-01

This paper used qualitative methods to explore experiences of men who have sex with men and female sex workers in Nairobi and Mtwapa, Kenya, who used oral pre-exposure prophylaxis (PrEP) for HIV prevention as part of a four-month trial of safety, acceptability and adherence. Fifty-one of 72 volunteers who took part in a randomized, placebo-controlled, blinded trial that compared daily and intermittent dosage of PrEP underwent qualitative assessments after completing the trial. Analyses identified three themes: (i) acceptability of PrEP was high, i.e. side effects were experienced early in the study but diminished over time, however characteristics of pills could improve comfort and use; (ii) social impacts such as stigma, rumors, and relationship difficulties due to being perceived as HIV positive were prevalent; (iii) adherence was challenged by complexities of daily life, in particular post-coital dosing adherence suffered from alcohol use around time of sex, mobile populations, and transactional sex work. These themes resonated across dosing regimens and gender, and while most participants favored the intermittent dosing schedule, those in the intermittent group noted particular challenges in adhering to the post-coital dose. Culturally appropriate and consistent counseling addressing these issues may be critical for PrEP effectiveness.

Impact of the COBAS AmpliPrep/COBAS AMPLICOR HIV-1 MONITOR Test, Version 1.5, on Clinical Laboratory Operations▿

Science.gov (United States)

Germer, Jeffrey J.; Bendel, Jordan L.; Dolenc, Craig A.; Nelson, Sarah R.; Masters, Amanda L.; Gerads, Tara M.; Mandrekar, Jayawant N.; Mitchell, P. Shawn; Yao, Joseph D. C.

2007-01-01

The COBAS AmpliPrep/COBAS AMPLICOR HIV-1 MONITOR Test, version 1.5 (CAP/CA), and the COBAS AMPLICOR HIV-1 MONITOR Test, version 1.5, were compared. CAP/CA reduced and consolidated labor while modestly increasing assay throughput without increased failure rates or direct costs, regardless of batch size and assay format. PMID:17634308

Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence within State Domestic Violence Coalitions

Science.gov (United States)

Freire, Kimberley E.; Zakocs, Ronda; Le, Brenda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn

2015-01-01

Background: Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states.…

PREP: Production and Reprocessing management tool for CMS

International Nuclear Information System (INIS)

Cossutti, F; Lenzi, P; Naziridis, N; Samyn, D; Stöckli, F

2012-01-01

The production of simulated samples for physics analysis at LHC represents a noticeable organization challenge, because it requires the management of several thousands different workflows. The submission of a workflow to the grid based computing infrastructure starts with the definition of the general characteristics of a given set of coherent samples (called a ‘campaign'), up to the definition of the physics settings to be used for each sample corresponding to a specific process to be simulated, both at hard event generation and detector simulation level. In order to have an organized control of the of the definition of the large number of MC samples needed by CMS, a dedicated management tool, called PREP, has been built. Its basic component is a database storing all the relevant information about the sample and the actions implied by the workflow definition, approval and production. A web based interface allows the database to be used from experts involved in production to trigger all the different actions needed, as well as by normal physicists involved in analyses to retrieve the relevant information. The tool is integrated through a set of dedicated APIs with the production agent and information storage utilities of CMS.

"Get a Blue and You Will See Your Money Back Again": Staffing and Marketing the English Prep School, 1890-1912

Science.gov (United States)

Benson, John

2014-01-01

This article explores the ways in which English prep schools were staffed and marketed in the years before the First World War. Its aim more specifically is to employ a biographical approach to consider the emphasis that the schools placed upon sport, and in particular the extent to which they recruited Oxford and Cambridge Blues as teachers…

Strong relationship between oral dose and tenofovir hair levels in a randomized trial: hair as a potential adherence measure for pre-exposure prophylaxis (PrEP.

Directory of Open Access Journals (Sweden)

Albert Y Liu

Full Text Available Pre-exposure prophylaxis (PrEP trials using tenofovir-based regimens have demonstrated that high levels of adherence are required to evaluate efficacy; the incorporation of objective biomarkers of adherence in trial design has been essential to interpretation, given the inaccuracy of self-report. Antiretroviral measurements in scalp hair have been useful as a marker of long-term exposure in the HIV treatment setting, and hair samples are relatively easy and inexpensive to collect, transport, and store for analysis. To evaluate the relationship between dose and tenofovir concentrations in hair, we examined the dose proportionality of tenofovir in hair in healthy, HIV-uninfected adults.A phase I, crossover pharmacokinetic study was performed in 24 HIV-negative adults receiving directly-observed oral tenofovir tablets administered 2, 4, and 7 doses/week for 6 weeks, with a ≥3-week break between periods. Small samples of hair were collected after each six-week period and analyzed for tenofovir concentrations. Geometric-mean-ratios compared levels between each pair of dosing conditions. Intensive plasma pharmacokinetic studies were performed during the daily-dosing period to calculate areas-under-the-time-concentration curves (AUCs.Over 90% of doses were observed per protocol. Median tenofovir concentrations in hair increased monotonically with dose. A log-linear relationship was seen between dose and hair levels, with an estimated 76% (95% CI 60-93% increase in hair level per 2-fold dose increase. Tenofovir plasma AUCs modestly predicted drug concentrations in hair.This study found a strong linear relationship between frequency of dosing and tenofovir levels in scalp hair. The analysis of quantitative drug levels in hair has the potential to improve adherence measurement in the PrEP field and may be helpful in determining exposure thresholds for protection and explaining failures in PrEP trials. Hair measures for adherence monitoring may also

In the Absence of a Mechanical Bowel Prep, Does the Addition of Pre-Operative Oral Antibiotics to Parental Antibiotics Decrease the Incidence of Surgical Site Infection after Elective Segmental Colectomy?

Science.gov (United States)

Atkinson, Sarah J; Swenson, Brian R; Hanseman, Dennis J; Midura, Emily F; Davis, Bradley R; Rafferty, Janice F; Abbott, Daniel E; Shah, Shimul A; Paquette, Ian M

2015-12-01

Pre-operative oral antibiotics administered the day prior to elective colectomy have been shown to decrease the incidence of surgical site infections (SSI) if a mechanical bowel prep (MBP) is used. Recently, the role for mechanical bowel prep has been challenged as being unnecessary and potentially harmful. We hypothesize that if MBP is omitted, oral antibiotics do not alter the incidence of SSI following colectomy. We selected patients who underwent an elective segmental colectomy from the 2012 and 2013 National Surgical Quality Improvement Program colectomy procedure targeted database. Indications for surgery included colon cancer, diverticulitis, inflammatory bowel disease, or benign polyp. Patients who received mechanical bowel prep were excluded. The primary outcome measured was surgical site infection, defined as the presence of superficial, deep or, organ space infection within 30 d from surgery. A total of 6,399 patients underwent elective segmental colectomy without MBP. The incidence of SSI differed substantially between patients who received oral antibiotics, versus those who did not (9.7% vs. 13.7%, p=0.01). Multivariate analysis indicated that age, smoking status, operative time, perioperative transfusions, oral antibiotics, and surgical approach were associated with post-operative SSI. When controlling for confounding factors, the use of pre-operative oral antibiotics decreased the incidence of surgical site infection (odds ratio=0.66, 95% confidence interval=0.48-0.90, p=0.01). Even in the absence of mechanical bowel prep, pre-operative oral antibiotics appear to reduce the incidence of surgical site infection following elective colectomy.

Houston prefreshman enrichment program (Houston PREP). Final report, June 10, 1996--August 1, 1996

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-10-01

The 1996 Houston Pre-freshman Enrichment Program (PREP) was conducted on the campus of the University of Houston-Downtown from June 10 to August 1, 1996. Program Participants were recruited from the Greater Houston area. All participants were identified as high achieving students with an interest in learning about the engineering and science professions. The goal of the program was to better prepare our pre-college youth prior to entering college as mathematics, science and engineering majors. The program participants were middle school and high school students from the Aldine, Alief, Channel View, Crockett, Cypress-Fairbanks, Fort Bend, Galena Park, Houston, Humble, Katy, Klein, North Forest, Pasadena, Private, and Spring Branch Independent School Districts. Of the 197 students starting the program, 170 completed, 142 students were from economically and socially disadvantage groups underrepresented in the engineering and science professions, and 121 of the 197 were female. Our First Year group for 1996 composed of 96% minority and women students. Our Second and Third Year students were 100% and 93.75% minority or women respectively. This gave an overall minority and female population of 93.75%. This year, special efforts were again made to recruit students from minority groups, which caused a significant increase in qualified applicants. However, due to space limitations, 140 applicants were rejected. Investigative and discovery learning were key elements of PREP. The academic components of the program included Algebraic Structures, Engineering, Introduction to Computer Science, Introduction to Physics, Logic and Its Application to Mathematics, Probability and Statistics, Problem Solving Seminar using computers and PLATO software, SAT Preparatory Seminars, and Technical Writing.

Evaluating the effectiveness of PrepSTART for promoting oral language and emergent literacy skills in disadvantaged preparatory students.

Science.gov (United States)

Lennox, Maria; Westerveld, Marleen F; Trembath, David

2018-04-01

This study examined the effectiveness of a classroom-based intervention programme aimed at improving the oral language and emergent literacy skills of students from low socio-economic, culturally diverse backgrounds within their first formal year of schooling ("prep"). Data from 137 students were available for analysis. Participants were from three primary schools located in Queensland, Australia. Eight classes were allocated to intervention and two classes acted as a business as usual control. All students received literacy instruction as per the Australian Curriculum. However, the intervention group received 24 weeks of scripted, classroom-based, book-based intervention targeting code- and meaning-related emergent literacy skills. All students were assessed individually pre- and post-intervention on code-related measures (i.e. letter identification and phonological awareness) and meaning-related measures (i.e. vocabulary, oral narrative comprehension and retell). All students made significant improvement over time for all measures. Students in the intervention group showed significantly more progress than the business as usual group on all measures, except for letter identification and oral narrative comprehension. This classroom-based book-based intervention can improve the code- and meaning-related emergent literacy skills of prep students from low socio-economic backgrounds and provide these students with the building blocks for successful literacy acquisition.

FIVE PLANETS AND AN INDEPENDENT CONFIRMATION OF HD 196885Ab FROM LICK OBSERVATORY

International Nuclear Information System (INIS)

Fischer, Debra; Isaacson, Howard; Giguere, Matt; McCarthy, Chris; Driscoll, Peter; Marcy, Geoffrey W.; Howard, Andrew; Peek, Katherine; Valenti, Jeff; Wright, Jason T.; Henry, Gregory W.; Johnson, John Asher

2009-01-01

We present time series Doppler data from Lick Observatory that reveal the presence of long-period planetary companions orbiting nearby stars. The typical eccentricity of these massive planets are greater than the mean eccentricity of known exoplanets. HD 30562b has Msin i = 1.29 M Jup , with semimajor axis of 2.3 AU and eccentricity 0.76. The host star has a spectral type F8V and is metal rich. HD 86264b has Msin i = 7.0 M Jup , a rel = 2.86 AU, an eccentricity e = 0.7 and orbits a metal-rich, F7V star. HD 87883b has Msin i = 1.78 M Jup , a rel = 3.6 AU, e = 0.53 and orbits a metal-rich K0V star. HD 89307b has Msin i = 1.78 M Jup , a rel = 3.3 AU, e = 0.24 and orbits a G0V star with slightly subsolar metallicity. HD 148427b has Msin i = 0.96 M Jup , a rel = 0.93 AU, eccentricity of 0.16 and orbits a metal rich K0 subgiant. We also present velocities for a planet orbiting the F8V metal-rich binary star, HD 196885A. The planet has Msin i = 2.58 M Jup , a rel = 2.37 AU, and orbital eccentricity of 0.48, in agreement with the independent discovery by Correia et al.

PREP-45, Input Preparation for CITATION-2

International Nuclear Information System (INIS)

Ramalho Carlos, C.A.

1995-01-01

1 - Description of program or function: A Fortran program has been created, which saves much effort in preparing sections 004 (intervals in the coordinates) and 005 (zone numbers) of the input data file for the multigroup theory code CITATION (version CITATION-2, NESC0387/09), particularly when a thin complicated mesh is used. 2 - Method of solution: A domain is defined for CITATION calculations through specifying its sub-domains (e.g. graphite, lead, beryllium, water and fuel sub-domains) in a compact and simple way. An independent and previous geometrical specification is made of the various types of elements which are envisaged to constitute the contents of the reactor core grid positions. Then the load table for the configuration is input and scanned throughout, thus enabling the geometric mesh description to be produced (section 004). Also the zone placement (section 005) is achieved by means of element description subroutines for the different types of element (which may require appropriate but simple changes in the actual cases). The output of PREP45 is directly obtained in a format which is compatible with CITATION-2 input. 3 - Restrictions on the complexity of the problem: Only rectangular two-dimensional Cartesian coordinates are considered. A maximum of 12 sub-domains in the x direction (18 in the y direction) and up to 8 distinct element types are considered in this version. Other limitations exist which can nevertheless be overcome with simple changes in the source program

Cervical histology after routine ThinPrep or SurePath liquid-based cytology and computer-assisted reading in Denmark

DEFF Research Database (Denmark)

Rebolj, Matejka; Rask, Johanne; van Ballegooijen, Marjolein

2015-01-01

nationwide registers, technological phases were identified by slide preparation, reading technique, and triage of borderline cytology. Trends in the detection of cervical intraepithelial neoplasia (CIN) were an indicator of the technology's relative sensitivity, and trends in false-positive tests......BACKGROUND: We compared the sensitivity and specificity of liquid-based cytology (LBC) and computer-assisted reading for SurePath/FocalPoint and ThinPrep with those of manually read conventional cytology in routine cervical screening in four Danish laboratories. METHODS: Using data from five...

Exergy analysis of integrated waste management in the recovery and recycling of used cooking oils.

Science.gov (United States)

Talens Peiró, Laura; Villalba Méndez, Gara; Gabarrell i Durany, Xavier

2008-07-01

Used cooking oil (UCO) is a domestic waste generated daily by food industries, restaurants, and households. It is estimated that in Europe 5 kg of UCO are generated per inhabitant, totalling 2.5 million metric tons per year. Recovering UCO for the production of biodiesel offers a way of minimizing and avoiding this waste and related pollution. An exergy analysis of the integrated waste management (IWM) scheme for UCO is used to evaluate such a possibility by accounting for inputs and outputs in each stage, calculating the exergy loss and the resource input and quantifying the possible improvements. The IWM includes the collection, pretreatment, and delivery of UCO and the production of biodiesel. The results show that the greatest exergy loss occurs during the transport stages (57%). Such exergy loss can be minimized to 20% by exploiting the full capacity of collecting vans and using biodiesel in the transport stages. Further, the cumulative exergy consumption helps study how the exergy consumption of biodiesel can be further reduced by using methanol obtained from biogas in the transesterification stage. Finally, the paper discusses how increasing the collection of UCO helps minimize uncontrolled used oil disposal and consequently provides a sustainable process for biodiesel production.

THE LICK AGN MONITORING PROJECT 2011: SPECTROSCOPIC CAMPAIGN AND EMISSION-LINE LIGHT CURVES

Energy Technology Data Exchange (ETDEWEB)

Barth, Aaron J. [Department of Physics and Astronomy, 4129 Frederick Reines Hall, University of California, Irvine, CA, 92697-4575 (United States); Bennert, Vardha N. [Physics Department, California Polytechnic State University, San Luis Obispo, CA 93407 (United States); Canalizo, Gabriela [Department of Physics and Astronomy, University of California, Riverside, CA 92521 (United States); Filippenko, Alexei V.; Li, Weidong [Department of Astronomy, University of California, Berkeley, CA 94720-3411 (United States); Gates, Elinor L. [Lick Observatory, P.O. Box 85, Mount Hamilton, CA 95140 (United States); Greene, Jenny E. [Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544 (United States); Malkan, Matthew A.; Treu, Tommaso [Department of Physics and Astronomy, University of California, Los Angeles, CA 90095-1547 (United States); Pancoast, Anna [Department of Physics, University of California, Santa Barbara, CA 93106 (United States); Sand, David J. [Texas Tech University, Physics Department, Box 41051, Lubbock, TX 79409-1051 (United States); Stern, Daniel [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Boulevard, Pasadena, CA 91109 (United States); Woo, Jong-Hak [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of); Assef, Roberto J. [Núcleo de Astronomía de la Facultad de Ingeniería, Universidad Diego Portales, Av. Ejército Libertador 441, Santiago (Chile); Bae, Hyun-Jin [Department of Astronomy and Center for Galaxy Evolution Research, Yonsei University, Seoul 120-749 (Korea, Republic of); Brewer, Brendon J. [Department of Statistics, The University of Auckland, Private Bag 92019, Auckland 1142 (New Zealand); Cenko, S. Bradley [Astrophysics Science Division, NASA Goddard Space Flight Center, MC 661, Greenbelt, MD 20771 (United States); and others

2015-04-15

In the Spring of 2011 we carried out a 2.5 month reverberation mapping campaign using the 3 m Shane telescope at Lick Observatory, monitoring 15 low-redshift Seyfert 1 galaxies. This paper describes the observations, reductions and measurements, and data products from the spectroscopic campaign. The reduced spectra were fitted with a multicomponent model in order to isolate the contributions of various continuum and emission-line components. We present light curves of broad emission lines and the active galactic nucleus (AGN) continuum, and measurements of the broad Hβ line widths in mean and rms spectra. For the most highly variable AGNs we also measured broad Hβ line widths and velocity centroids from the nightly spectra. In four AGNs exhibiting the highest variability amplitudes, we detect anticorrelations between broad Hβ width and luminosity, demonstrating that the broad-line region “breathes” on short timescales of days to weeks in response to continuum variations. We also find that broad Hβ velocity centroids can undergo substantial changes in response to continuum variations; in NGC 4593, the broad Hβ velocity shifted by ∼250 km s{sup −1} over a 1 month period. This reverberation-induced velocity shift effect is likely to contribute a significant source of confusion noise to binary black hole searches that use multi-epoch quasar spectroscopy to detect binary orbital motion. We also present results from simulations that examine biases that can occur in measurement of broad-line widths from rms spectra due to the contributions of continuum variations and photon-counting noise.

A Fast Solution to NGS Library Prep with Low Nanogram DNA Input

Science.gov (United States)

Liu, Pingfang; Lohman, Gregory J.S.; Cantor, Eric; Langhorst, Bradley W.; Yigit, Erbay; Apone, Lynne M.; Munafo, Daniela B.; Stewart, Fiona J.; Evans, Thomas C.; Nichols, Nicole; Dimalanta, Eileen T.; Davis, Theodore B.; Sumner, Christine

2013-01-01

Next Generation Sequencing (NGS) has significantly impacted human genetics, enabling a comprehensive characterization of the human genome as well as a better understanding of many genomic abnormalities. By delivering massive DNA sequences at unprecedented speed and cost, NGS promises to make personalized medicine a reality in the foreseeable future. To date, library construction with clinical samples has been a challenge, primarily due to the limited quantities of sample DNA available. Our objective here was to overcome this challenge by developing NEBNext® Ultra DNA Library Prep Kit, a fast library preparation method. Specifically, we streamlined the workflow utilizing novel NEBNext reagents and adaptors, including a new DNA polymerase that has been optimized to minimize GC bias. As a result of this work, we have developed a simple method for library construction from an amount of DNA as low as 5 ng, which can be used for both intact and fragmented DNA. Moreover, the workflow is compatible with multiple NGS platforms.

VizieR Online Data Catalog: Lick Observatory Supernova Search (LOSS) revisited (Graur+, 2017)

Science.gov (United States)

Graur, O.; Bianco, F. B.; Huang, S.; Modjaz, M.; Shivvers, I.; Filippenko, A. V.; Li, W.; Eldridge, J. J.

2017-10-01

Most types of supernovae (SNe) have yet to be connected with their progenitor stellar systems. Here, we reanalyze the 10-year SN sample collected during 1998-2008 by the Lick Observatory Supernova Search (LOSS; see Leaman+, 2011, J/MNRAS/412/1419) in order to constrain the progenitors of SNe Ia and stripped-envelope SNe (SE SNe, i.e., SNe IIb, Ib, Ic, and broad-lined Ic). We matched the LOSS galaxy sample with spectroscopy from the Sloan Digital Sky Survey (SDSS) and measured SN rates as a function of galaxy stellar mass, specific star formation rate, and oxygen abundance (metallicity). We find significant correlations between the SN rates and all three galaxy properties. The SN Ia correlations are consistent with other measurements, as well as with our previous explanation of these measurements in the form of a combination of the SN Ia delay-time distribution and the correlation between galaxy mass and age. The ratio between the SE SN and SN II rates declines significantly in low-mass galaxies. This rules out single stars as SE SN progenitors, and is consistent with predictions from binary-system progenitor models. Using well-known galaxy scaling relations, any correlation between the rates and one of the galaxy properties examined here can be expressed as a correlation with the other two. These redundant correlations preclude us from establishing causality-that is, from ascertaining which of the galaxy properties (or their combination) is the physical driver for the difference between the SE SN and SN II rates. We outline several methods that have the potential to overcome this problem in future works. (7 data files).

Carbon black selection from simulated broth solution for ADU gel spheres

International Nuclear Information System (INIS)

Chai, Jeong Kyung; Ho, Eom Sung; Kim, Yeon Ku; Cho, Moon Seoung

2012-01-01

The VHTR (Very High Temperature Gas Reactor) is one of the reactor concepts in the Gen IV International Collaboration. The nuclear fuel of a VHTR in the US is based on microspheres containing a mixture of UO 2 and UC 2 coated with multi carbon layers and a SiC layer. This mixture is called a 'UCO (uranium oxi carbide)' kernel. The fabrication process of this kernel was based on the sol-gel method between an ADUN and HMTA and urea, a process referred to as internal gelation. UCO kernel microspheres were first prepared at ORNL in the late 1970s. CB(Carbon Black) as a carbon source in the final UCO kernel is added during the broth solution preparation, in the processing of UCO kernel fabrication. The preparation of a good quality UCO kernel is very difficult due to the homogeneous distribution of carbon in a UCO kernel. The key requirement to obtain a good quality kernel is a uniform distribution of carbon in the ADU gel sphere forming process before the thermal treatment, i.e., during the gel formation step. The internal gelation concept was adapted in ADU gel sphere fabrication in the ORNL process of the US. Generally, UO 2 kernel microspheres are prepared by an internal gelation method (USA, India) or external gelation method (Germany, China, Japan). The UCO kernel microspheres prepared only in the US, use an internal gelation method. A material flow chart on the preparation of the microsphere kernel is simply shown in Fig. 1. The broth solution preparation, the raw material, additives, and thermal steps such as calcining and sintering processes were different to compared with the external gelation and internal gelation methods. In this study, we first carried out the matching CB selection experiments among the various kinds of CBs in a broth solution, for UCO kernel preparation using an external gelation method.

Consensus builds on population policy as ICPD PrepCom meetings conclude. Vatican objections firm and vocal.

Science.gov (United States)

1994-04-29

In April, 1994, at UN headquarters in New York, delegates from almost 200 countries and nongovernmental organizations (NGOs) negotiated a Programme of Action to be ratified following more debate at the International Conference on Population and Development in Cairo in September. A sizable consensus emerged for this Preparatory Committee III (PrepCom) meeting. It has an expanded view of population policy that centers more on meeting individual needs and less on achieving strict demographic goals. Thus, it focuses on the unmet need for reproductive health services (family planning, basic women's health care, and services linked to sexually transmitted diseases). It considers women's status and female education as being important themselves as well as key determinants of fertility rates. Disagreement over access to abortion services and reproductive health services for adolescents remain. Unlike earlier world conferences, most of the world is working towards a consensus, while the Vatican and just a few small countries (Benin, Malta, Honduras, and Nicaragua) object to these services. Some topics that US National Conference of Catholic Bishops did not want in the Programme of Action were references to reducing the incidence of unsafe abortion, promoting condom use to prevent HIV/AIDS, and even safe motherhood. The US and Japan have committed sizable increases in population assistance. Some European countries are concerned about how their contributions would be allocated. US Undersecretary for Global Affairs and a mostly female 23-member US delegation attended PrepCom III. Most of the US delegates were from NGOs. Many country delegates were women. Many countries accepted recommendations of the women's caucus. The US's priorities are promotion of universal access to the full range of high quality family planning and reproductive health services; increasing women's status; child survival promotion; serving adolescent needs; augmenting the role and responsibility of men in

Single Nucleotide Polymorphism in Gene Encoding Transcription Factor Prep1 Is Associated with HIV-1-Associated Dementia

Science.gov (United States)

van Manen, Daniëlle; Bunnik, Evelien M.; van Sighem, Ard I.; Sieberer, Margit; Boeser-Nunnink, Brigitte; de Wolf, Frank; Schuitemaker, Hanneke; Portegies, Peter; Kootstra, Neeltje A.; van 't Wout, Angélique B.

2012-01-01

Background Infection with HIV-1 may result in severe cognitive and motor impairment, referred to as HIV-1-associated dementia (HAD). While its prevalence has dropped significantly in the era of combination antiretroviral therapy, milder neurocognitive disorders persist with a high prevalence. To identify additional therapeutic targets for treating HIV-associated neurocognitive disorders, several candidate gene polymorphisms have been evaluated, but few have been replicated across multiple studies. Methods We here tested 7 candidate gene polymorphisms for association with HAD in a case-control study consisting of 86 HAD cases and 246 non-HAD AIDS patients as controls. Since infected monocytes and macrophages are thought to play an important role in the infection of the brain, 5 recently identified single nucleotide polymorphisms (SNPs) affecting HIV-1 replication in macrophages in vitro were also tested. Results The CCR5 wt/Δ32 genotype was only associated with HAD in individuals who developed AIDS prior to 1991, in agreement with the observed fading effect of this genotype on viral load set point. A significant difference in genotype distribution among all cases and controls irrespective of year of AIDS diagnosis was found only for a SNP in candidate gene PREP1 (p = 1.2×10−5). Prep1 has recently been identified as a transcription factor preferentially binding the −2,518 G allele in the promoter of the gene encoding MCP-1, a protein with a well established role in the etiology of HAD. Conclusion These results support previous findings suggesting an important role for MCP-1 in the onset of HIV-1-associated neurocognitive disorders. PMID:22347417

Single nucleotide polymorphism in gene encoding transcription factor Prep1 is associated with HIV-1-associated dementia.

Directory of Open Access Journals (Sweden)

Sebastiaan M Bol

Full Text Available BACKGROUND: Infection with HIV-1 may result in severe cognitive and motor impairment, referred to as HIV-1-associated dementia (HAD. While its prevalence has dropped significantly in the era of combination antiretroviral therapy, milder neurocognitive disorders persist with a high prevalence. To identify additional therapeutic targets for treating HIV-associated neurocognitive disorders, several candidate gene polymorphisms have been evaluated, but few have been replicated across multiple studies. METHODS: We here tested 7 candidate gene polymorphisms for association with HAD in a case-control study consisting of 86 HAD cases and 246 non-HAD AIDS patients as controls. Since infected monocytes and macrophages are thought to play an important role in the infection of the brain, 5 recently identified single nucleotide polymorphisms (SNPs affecting HIV-1 replication in macrophages in vitro were also tested. RESULTS: The CCR5 wt/Δ32 genotype was only associated with HAD in individuals who developed AIDS prior to 1991, in agreement with the observed fading effect of this genotype on viral load set point. A significant difference in genotype distribution among all cases and controls irrespective of year of AIDS diagnosis was found only for a SNP in candidate gene PREP1 (p = 1.2 × 10(-5. Prep1 has recently been identified as a transcription factor preferentially binding the -2,518 G allele in the promoter of the gene encoding MCP-1, a protein with a well established role in the etiology of HAD. CONCLUSION: These results support previous findings suggesting an important role for MCP-1 in the onset of HIV-1-associated neurocognitive disorders.

Analysis of Advanced Fuel Kernel Technology

International Nuclear Information System (INIS)

Oh, Seung Chul; Jeong, Kyung Chai; Kim, Yeon Ku; Kim, Young Min; Kim, Woong Ki; Lee, Young Woo; Cho, Moon Sung

2010-03-01

The reference fuel for prismatic reactor concepts is based on use of an LEU UCO TRISO fissile particle. This fuel form was selected in the early 1980s for large high-temperature gas-cooled reactor (HTGR) concepts using LEU, and the selection was reconfirmed for modular designs in the mid-1980s. Limited existing irradiation data on LEU UCO TRISO fuel indicate the need for a substantial improvement in performance with regard to in-pile gaseous fission product release. Existing accident testing data on LEU UCO TRISO fuel are extremely limited, but it is generally expected that performance would be similar to that of LEU UO 2 TRISO fuel if performance under irradiation were successfully improved. Initial HTGR fuel technology was based on carbide fuel forms. In the early 1980s, as HTGR technology was transitioning from high-enriched uranium (HEU) fuel to LEU fuel. An initial effort focused on LEU prismatic design for large HTGRs resulted in the selection of UCO kernels for the fissile particles and thorium oxide (ThO 2 ) for the fertile particles. The primary reason for selection of the UCO kernel over UO 2 was reduced CO pressure, allowing higher burnup for equivalent coating thicknesses and reduced potential for kernel migration, an important failure mechanism in earlier fuels. A subsequent assessment in the mid-1980s considering modular HTGR concepts again reached agreement on UCO for the fissile particle for a prismatic design. In the early 1990s, plant cost-reduction studies led to a decision to change the fertile material from thorium to natural uranium, primarily because of a lower long-term decay heat level for the natural uranium fissile particles. Ongoing economic optimization in combination with anticipated capabilities of the UCO particles resulted in peak fissile particle burnup projection of 26% FIMA in steam cycle and gas turbine concepts

An Infrared Method for Discovering AGN: Lick Spectroscopy of New Seyfert I’s in the Kepler Fields

Science.gov (United States)

Tsan, Tran; Edelson, Rick; Smith, Krista Lynne; Malkan, Matthew Arnold

2016-06-01

Spectra of Active Galactic Nuclei (AGN) candidates in the Kepler fields were observed at Lick Observatory. We used the Shane 3.0-meter telescope with the Kast double spectrograph, covering from 0.35-0.8 μm. Using IRAF, we extracted 1D spectra from the original 2D long-slit images of the candidates. Our main goals are to determine the redshift of the candidates and identify any new AGN. The wavelength and flux calibration are fairly accurate, and most spectra have a good signal-to-noise ratio. Twenty- seven nights of data (consisting of 106 candidates) have been analyzed. For 89% of them, we have determined the redshifts to a precision of δz = 0.0005 in most cases. The rest give inconclusive results. 19 of the candidates turn out to be galactic stars. The most commonly identified emission lines are Hα+[NII], the [OIII] doublet, and Hβ. 44 of the candidates show a Broad Line Region, meaning that their wide permitted lines classify them as either Seyfert I’s or quasars. 6 of these have redshifts above 0.5, indicating that they are highly luminous quasars. One candidate appears to be a bl-lac object. We are now analyzing the Kepler light curves of these Seyfert galaxies.

76 FR 20392 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Science.gov (United States)

2011-04-12

..., SMH, SNDK, SPLS, SPXU, SPY, SSO, SYMC, TBT, T, TLT, TNA,TSM, TWM, TXN, TZA, UCO, USO, UWM, UYG, VALE..., S, SH, SLV, SPF, SPXU, SPY, SSO, TBT, TLT, TWM, TZA, UCO, USO, UWM, VXX, XLI, XLP. Transactions in...

THE LICK AGN MONITORING PROJECT: RECALIBRATING SINGLE-EPOCH VIRIAL BLACK HOLE MASS ESTIMATES

Energy Technology Data Exchange (ETDEWEB)

Park, Daeseong; Woo, Jong-Hak [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of); Treu, Tommaso; Bennert, Vardha N. [Department of Physics, University of California, Santa Barbara, CA 93106 (United States); Barth, Aaron J.; Walsh, Jonelle [Department of Physics and Astronomy, 4129 Frederick Reines Hall, University of California, Irvine, CA 92697-4575 (United States); Bentz, Misty C. [Department of Physics and Astronomy, Georgia State University Atlanta, GA 30303 (United States); Canalizo, Gabriela [Department of Physics and Astronomy, University of California, Riverside, 900 University Ave., Riverside, CA 92521 (United States); Filippenko, Alexei V. [Department of Astronomy, University of California, Berkeley, CA 94720-3411 (United States); Gates, Elinor [Lick Observatory, P.O. Box 85, Mount Hamilton, CA 95140 (United States); Greene, Jenny E. [Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544 (United States); Malkan, Matthew A., E-mail: woo@astro.snu.ac.kr [Department of Physics and Astronomy, University of California, Los Angeles, CA 90024 (United States)

2012-03-01

We investigate the calibration and uncertainties of black hole (BH) mass estimates based on the single-epoch (SE) method, using homogeneous and high-quality multi-epoch spectra obtained by the Lick Active Galactic Nucleus (AGN) Monitoring Project for nine local Seyfert 1 galaxies with BH masses <10{sup 8} M{sub Sun }. By decomposing the spectra into their AGNs and stellar components, we study the variability of the SE H{beta} line width (full width at half-maximum intensity, FWHM{sub H{beta}} or dispersion, {sigma}{sub H{beta}}) and of the AGN continuum luminosity at 5100 A (L{sub 5100}). From the distribution of the 'virial products' ({proportional_to} FWHM{sub H{beta}}{sup 2} L{sup 0.5}{sub 5100} or {sigma}{sub H{beta}}{sup 2} L{sup 0.5}{sub 5100}) measured from SE spectra, we estimate the uncertainty due to the combined variability as {approx}0.05 dex (12%). This is subdominant with respect to the total uncertainty in SE mass estimates, which is dominated by uncertainties in the size-luminosity relation and virial coefficient, and is estimated to be {approx}0.46 dex (factor of {approx}3). By comparing the H{beta} line profile of the SE, mean, and root-mean-square (rms) spectra, we find that the H{beta} line is broader in the mean (and SE) spectra than in the rms spectra by {approx}0.1 dex (25%) for our sample with FWHM{sub H{beta}} <3000 km s{sup -1}. This result is at variance with larger mass BHs where the difference is typically found to be much less than 0.1 dex. To correct for this systematic difference of the H{beta} line profile, we introduce a line-width dependent virial factor, resulting in a recalibration of SE BH mass estimators for low-mass AGNs.

Examination of hepatic contrast-enhanced CT monitored by Smart Prep

International Nuclear Information System (INIS)

Kakizaki, Dai; Saito, Kazuhiro; Sakurada, Toru; Abe, Kimihiko; Suzuki, Kenji

1999-01-01

The aim of the present study is to obtain the time density curves of the contrast-enhanced CT of hepatic portal vein, hepatic and splenic parenchyma, and to examine the relation with age, body weight, type of liver dysfunction. Subjects were 32 patients with liver tumors or liver diseases. For this purpose, the procedure of hepatic CT was monitored by Smart Prep and the images of whole liver was taken when the level of the contrast at the hepatic portal vein reached to the enhancement threshold. The contrast medium used was Iomeprol 300. The adverse reactions by Iomeprol 300 were mild and any treatment did not need. There was no correlation age and weight with enhancement threshold at the hepatic portal vein and peak time at the splenic parenchyma. The enhancement threshold at the hepatic portal vein was various in patients with chrrhosis and chronic hepatitis, and tended to be delayed in patients with chrrhosis. The peak time of the splenic parenchyma was up to 52 seconds in all patients with chronic hepatitis. The shortage of the enhancement threshold and the increase in blood flow at arterial early phase were observed in the patients with advanced acute hepatitis. This method should be examined more cases with various hepatic diseases. (K.H.)

Ultrasound-Guided Bipolar Umbilical Cord Occlusion in Complicated Monochorionic Pregnancies

DEFF Research Database (Denmark)

Schou, Katrine V; Jensen, Lisa N; Jørgensen, Connie

2017-01-01

INTRODUCTION: Ultrasound-guided bipolar umbilical cord occlusion (UCO) is used in complicated monochorionic multiple pregnancies in Denmark. The aim of this study was to assess a learning curve in the procedure of UCO. MATERIALS AND METHODS: One hundred and two monochorionic pregnancies treated...

The Effects of Advance Graphic Organizers Strategy Intervention on Academic Achievement, Self Efficacy, and Motivation to Learn Social Studies in Learning Disabled Second Year Prep Students

Science.gov (United States)

Eissa, Mourad Ali

2012-01-01

This study investigated the effect of using advance graphic organizers on academic achievement, self efficacy, and motivation to learn social studies in learning disabled second year prep students. A total of 60 students identified with LD were invited to participate. The sample was randomly divided into two groups; experimental (n = 30, 23 boys,…

Used Cooking Oils in the Biogas Chain: A Technical and Economic Assessment

Directory of Open Access Journals (Sweden)

Erika Carnevale

2017-02-01

Full Text Available The current concerns on global energy security, climate change, and environmental pollution represent some of the major elements of the growing interest on renewable energy. In this framework agro-food energy systems are at the center of a twofold debate: on the one hand they represent a key option for energy production while on the other their sustainability is threatened by the expansion of the bioenergy market that could lead to negative social and environmental consequences. The aim of this work is to evaluate—through a case study—the technical and economic feasibility of the replacement of energy crops (ECs with used cooking oil (UCO in an anaerobic digestion (AD full-scale plant. At this purpose, a full-scale plant performing AD was monitored for two years. Three scenarios were developed and compared to evaluate the impacts and the potential benefits in terms of land saving in case of a substitution of ECs with UCO. Results highlighted a reduction of land use of over 50% if UCO is introduced in co-digestion with ECs. The lack of an appropriate legislative framework limits the utilization of used cooking oils (UCOs in AD with a consequently missed opportunity for biogas owners that could find an important alternative in UCO.

Comparative life cycle assessment of alternative strategies for energy recovery from used cooking oil.

Science.gov (United States)

Lombardi, Lidia; Mendecka, Barbara; Carnevale, Ennio

2018-06-15

The separate collection of Used Cooking Oil (UCO) is gaining popularity through several countries in Europe. An appropriate management of UCO waste stream leads to substantial benefits. In this study, we analyse two different possibilities of UCO energy reuse: the direct feed to a reciprocating internal combustion engine (ICE) for cogeneration purpose, and the processing to generate biodiesel. Concerning biodiesel production, we analyse four among conventional and innovative technologies, characterised by different type and amount of used chemicals, heat and electricity consumptions and yields. We perform a systematic evaluation of environmental benefits and drawbacks by applying life cycle assessment (LCA) analysis to compare the alternatives. For the impact assessment, two methods are selected: the Global Warming Potential (GWP) and Cumulative Exergy Consumption (CExC). Results related only to the processing phases (i.e. not including yet the avoided effects) show that the recovery of UCO in cogeneration plant has in general lower values in terms of environmental impacts than its employment in biodiesel production. When products and co-products substitution are included, the savings obtained by the substitution of conventional diesel production, in the biodiesel cases, are significantly higher than the avoided effects for electricity and heat in the cogeneration case. In particular, by using the UCO in the biodiesel production processes, the savings vary from 41.6 to 54.6 GJ ex per tUCO, and from 2270 to 2860 kg CO 2eq per tUCO for CExC and GWP, respectively. A particular focus is put on sensitivity and uncertainty analyses. Overall, high uncertainty of final results for process impacts is observed, especially for the supercritical methanol process. Low uncertainty values are evaluated for the avoided effects. Including the uncertain character of the impacts, cogeneration scenario and NaOH catalysed process of biodiesel production result to be the most suitable

PENYEBAB KEMATIAN PENDUDUK KOTA PONTIANAK TAHUN 2007

Directory of Open Access Journals (Sweden)

Yuslely Usman

2012-11-01

Full Text Available Background: Mortality statistic was essential to provide basic information on the status of population health. Indonesiadoes not have a standard national role for recording and reporting cause of death for every case that occurs in hospital or at home. In 2005 NIHRD colaberations with WHO and University of Queensland to developed "Sertifikat MediaPenyebab Kematian" and verbal Aotopsi. This certificate was using in Pontianak city populations death to find the underlying cause of death since 2007. Methods: Training and socialization to medical doctors in every hospital in Pontianak city how to fill the certificate according t international standard in ICD-10. Training to medical doctor and paramedic of health center how to do autopsy verbal and resume the diagnosis on underlying cause of death. Results: A 1207 of total death the higher frequency of underlying cause of death (UCoD in Pontianak city in 2007 is stroke. The higher UCoD of infant death was intrauterine hypoxia and birth asphyxia that occur in neonatal period. The higher UCoD of BALITA (1-4 years is drowning. 13.26% of death occur in production age (15-44 years, although the heigher age group death is > 65 years old (34.12%. The most UCoD in male production age group is transport accident while in female is other direct obstetric death. Lung Tb is common UCoD in productive age group, third rank in male and seventh rank in female. Conclusions: Recording and reporting system on UCoD in Pontianak city is developed but not optimal, because the result was still underestimate of mortality rate. Need refreshing training to all medical doctors in hospital how to produce certificate of death, and refreshing training to medical doctor and paramedic in health center how to do autopsy verbal and resume of UCoD from autopsy verbal. Key words: Underlying Couse of Death, autopsy verbal, ICD-10.

Results of the Abbott RealTime HIV-1 assay for specimens yielding "target not detected" results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test.

Science.gov (United States)

Babady, N Esther; Germer, Jeffrey J; Yao, Joseph D C

2010-03-01

No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding "target not detected" results by CTM.

Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence Within State Domestic Violence Coalitions

Science.gov (United States)

Freire, Kimberley E.; Zakocs, Ronda; Le, Brenda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn

2018-01-01

Background Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states. Objective DELTA PREP’s summative evaluation addressed four major questions: (1) Did coalitions improve their prevention capacity during the project period? (2) Did coalitions serve as catalysts for prevention activities within their states during the project period? (3) Was initial prevention capacity associated with the number of prevention activity types initiated by coalitions by the end of the project? (4) Did coalitions sustain their prevention activities 6 months after the end of the project period? Results DELTA PREP achieved its capacity-building goal, with all 19 participant coalitions integrating prevention within their organizations and serving as catalysts for prevention activities in their states. At 6 months follow up, coalitions had sustained almost all prevention activities they initiated during the project. Baseline prevention capacity (Beginner vs. Intermediate) was not associated with the number of prevention activity types coalitions implemented by the end of the project. Conclusion Service and treatment organizations are increasingly asked to integrate a full spectrum of prevention strategies. Selecting organizations that have high levels of general capacity and readiness for an innovation like integrating a public health approach to IPV prevention will likely increase success in building an innovation-specific capacity, and in turn implementing an innovation. PMID:26245932

PREPS2 - a PC-based computer program for performing economic analysis of capital projects

International Nuclear Information System (INIS)

Blake, M.W.; Brand, D.O.; Chastain, E.T.; Johnson, E.D.

1990-01-01

In these times of increased spending to finance new capacity and to meet clean air act legislation, many electric utilities are giving a high priority to controlling capital expenditures at existing generating facilities. Determining the level of capital expenditures which are economically justified is very difficult; units which have higher capacity factors are worth more to the utility. Therefore, the utility can more readily justify higher capital expenditures to improve or maintain reliability and heat rate than on units with lower capacity factors. This paper describes a PC-based computer program (PREPS2) which performs an economic analysis of individual capital projects. The program incorporates tables which describe the worth to the system of making improvements in each unit. This computer program is currently being used by the six Southern Company operating companies to evaluate all production capital projects over $50,000. Approximately 500 projects representing about $300 million are being analyzed each year

Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study

Science.gov (United States)

d'Assuncao, Jefferson; Irwig, Les; Macaskill, Petra; Chan, Siew F; Richards, Adele; Farnsworth, Annabelle

2007-01-01

Objective To compare the accuracy of liquid based cytology using the computerised ThinPrep Imager with that of manually read conventional cytology. Design Prospective study. Setting Pathology laboratory in Sydney, Australia. Participants 55 164 split sample pairs (liquid based sample collected after conventional sample from one collection) from consecutive samples of women choosing both types of cytology and whose specimens were examined between August 2004 and June 2005. Main outcome measures Primary outcome was accuracy of slides for detecting squamous lesions. Secondary outcomes were rate of unsatisfactory slides, distribution of squamous cytological classifications, and accuracy of detecting glandular lesions. Results Fewer unsatisfactory slides were found for imager read cytology than for conventional cytology (1.8% v 3.1%; Pcytology (7.4% v 6.0% overall and 2.8% v 2.2% for cervical intraepithelial neoplasia of grade 1 or higher). Among 550 patients in whom imager read cytology was cervical intraepithelial neoplasia grade 1 or higher and conventional cytology was less severe than grade 1, 133 of 380 biopsy samples taken were high grade histology. Among 294 patients in whom imager read cytology was less severe than cervical intraepithelial neoplasia grade 1 and conventional cytology was grade 1 or higher, 62 of 210 biopsy samples taken were high grade histology. Imager read cytology therefore detected 71 more cases of high grade histology than did conventional cytology, resulting from 170 more biopsies. Similar results were found when one pathologist reread the slides, masked to cytology results. Conclusion The ThinPrep Imager detects 1.29 more cases of histological high grade squamous disease per 1000 women screened than conventional cytology, with cervical intraepithelial neoplasia grade 1 as the threshold for referral to colposcopy. More imager read slides than conventional slides were satisfactory for examination and more contained low grade cytological

A Consensual Qualitative Research Study of the Transformation from High School Dropout to Second Chance Alumni

Science.gov (United States)

Smith, Jayne E.

2013-01-01

This study focused on understanding the perceived process of change, outcomes and influencing factors experienced by high school graduates of Urban Corps of San Diego County (UCO) from a bioecological theory of human development standpoint. UCO is a second chance high school diploma-job training program that offers students free mental health…

Results of the Abbott RealTime HIV-1 Assay for Specimens Yielding “Target Not Detected” Results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test▿

OpenAIRE

Babady, N. Esther; Germer, Jeffrey J.; Yao, Joseph D. C.

2009-01-01

No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding “target not detected” results by CTM.

Preserving the Voices of Adult Educators

Science.gov (United States)

Bogner, Len A.; King, Brett P.

2017-01-01

The Adult Education Interview Series (AEIS) started at the University of Central Oklahoma (UCO) and was inspired by the use of TED talks and other similar videos in online and distance education courses. It is a collaboration between the Adult Education and Safety Science Department and the Center for eLearning and Connected Environments at UCO.…

Diffusion tensor imaging detects ventilation-induced brain injury in preterm lambs.

Directory of Open Access Journals (Sweden)

Dhafer M Alahmari

Full Text Available Injurious mechanical ventilation causes white matter (WM injury in preterm infants through inflammatory and haemodynamic pathways. The relative contribution of each of these pathways is not known. We hypothesised that in vivo magnetic resonance imaging (MRI can detect WM brain injury resulting from mechanical ventilation 24 h after preterm delivery. Further we hypothesised that the combination of inflammatory and haemodynamic pathways, induced by umbilical cord occlusion (UCO increases brain injury at 24 h.Fetuses at 124±2 days gestation were exposed, instrumented and either ventilated for 15 min using a high tidal-volume (VT injurious strategy with the umbilical cord intact (INJ; inflammatory pathway only, or occluded (INJ+UCO; inflammatory and haemodynamic pathway. The ventilation groups were compared to lambs that underwent surgery but were not ventilated (Sham, and lambs that did not undergo surgery (unoperated control; Cont. Fetuses were placed back in utero after the 15 min intervention and ewes recovered. Twenty-four hours later, lambs were delivered, placed on a protective ventilation strategy, and underwent MRI of the brain using structural, diffusion tensor imaging (DTI and magnetic resonance spectroscopy (MRS techniques.Absolute MRS concentrations of creatine and choline were significantly decreased in INJ+UCO compared to Cont lambs (P = 0.03, P = 0.009, respectively; no significant differences were detected between the INJ or Sham groups and the Cont group. Axial diffusivities in the internal capsule and frontal WM were lower in INJ and INJ+UCO compared to Cont lambs (P = 0.05, P = 0.04, respectively. Lambs in the INJ and INJ+UCO groups had lower mean diffusivities in the frontal WM compared to Cont group (P = 0.04. DTI colour mapping revealed lower diffusivity in specific WM regions in the Sham, INJ, and INJ+UCO groups compared to the Cont group, but the differences did not reach significance. INJ+UCO lambs more likely to exhibit

Combustion, emission and engine performance characteristics of used cooking oil biodiesel - A review

Energy Technology Data Exchange (ETDEWEB)

Enweremadu, C.C. [Department of Mechanical Engineering, Vaal University of Technology, Private Bag X021, Vanderbijlpark 1900 (South Africa); Rutto, H.L. [Department of Chemical Engineering, Vaal University of Technology, Private Bag X021, Vanderbijlpark 1900 (South Africa)

2010-12-15

As the environment degrades at an alarming rate, there have been steady calls by most governments following international energy policies for the use of biofuels. One of the biofuels whose use is rapidly expanding is biodiesel. One of the economical sources for biodiesel production which doubles in the reduction of liquid waste and the subsequent burden of sewage treatment is used cooking oil (UCO). However, the products formed during frying, such as free fatty acid and some polymerized triglycerides, can affect the transesterification reaction and the biodiesel properties. This paper attempts to collect and analyze published works mainly in scientific journals about the engine performance, combustion and emissions characteristics of UCO biodiesel on diesel engine. Overall, the engine performance of the UCO biodiesel and its blends was only marginally poorer compared to diesel. From the standpoint of emissions, NOx emissions were slightly higher while un-burnt hydrocarbon (UBHC) emissions were lower for UCO biodiesel when compares to diesel fuel. There were no noticeable differences between UCO biodiesel and fresh oil biodiesel as their engine performances, combustion and emissions characteristics bear a close resemblance. This is probably more closely related to the oxygenated nature of biodiesel which is almost constant for every biodiesel (biodiesel has some level of oxygen bound to its chemical structure) and also to its higher viscosity and lower calorific value, which have a major bearing on spray formation and initial combustion. (author)

Thermoeconomic Analysis of Biodiesel Production from Used Cooking Oils

Directory of Open Access Journals (Sweden)

Emilio Font de Mora

2015-05-01

Full Text Available Biodiesel from used cooking oil (UCO is one of the most sustainable solutions to replace conventional fossil fuels in the transport sector. It can achieve greenhouse gas savings up to 88% and at the same time reducing the disposal of a polluting waste. In addition, it does not provoke potential negative impacts that conventional biofuels may eventually cause linked to the use of arable land. For this reason, most policy frameworks favor its consumption. This is the case of the EU policy that double-counters the use of residue and waste use to achieve the renewable energy target in the transport sector. According to different sources, biodiesel produced from UCO could replace around 1.5%–1.8% of the EU-27 diesel consumption. This paper presents an in-depth thermoeconomic analysis of the UCO biodiesel life cycle to understand its cost formation process. It calculates the ExROI value (exergy return on investment and renewability factor, and it demonstrates that thermoeconomics is a useful tool to assess life cycles of renewable energy systems. It also shows that UCO life cycle biodiesel production is more sustainable than biodiesel produced from vegetable oils.

Elevated dopamine alters consummatory pattern generation and increases behavioral variability during learning

Directory of Open Access Journals (Sweden)

Mark A. Rossi

2015-05-01

Full Text Available The role of dopamine in controlling behavior remains poorly understood. In this study we examined licking behavior in an established hyperdopaminergic mouse model—dopamine transporter knockout (DAT KO mice. DAT KO mice showed higher rates of licking, which is due to increased perseveration of licking in a bout. By contrast, they showed increased individual lick durations, and reduced inter-lick-intervals. During extinction, both KO and control mice transiently increased variability in lick pattern generation while reducing licking rate, yet they showed very different behavioral patterns. Control mice gradually increased lick duration as well as variability. By contrast, DAT KO mice exhibited more immediate (within 10 licks adjustments—an immediate increase in lick duration variability, as well as more rapid extinction. These results suggest that the level of dopamine can modulate the persistence and pattern generation of a highly stereotyped consummatory behavior like licking, as well as new learning in response to changes in environmental feedback. Increased dopamine in DAT KO mice not only increased perseveration of bouts and individual lick duration, but also increased the behavioral variability in response to the extinction contingency and the rate of extinction.

Study guide for 1Z0-071 Oracle Database 12c SQL : Oracle Certification Prep

CERN Document Server

Morris, Matthew

2016-01-01

This Study Guide is targeted at IT professionals who are working towards becoming an Oracle Database 12c SQL Certified Associate. The book provides information covering all of the exam topics for the Oracle certification exam: "1Z0-071: Oracle Database 12c SQL". The books in the Oracle Certification Prep series are built in lockstep with the test topics provided by Oracle Education's certification program. Each book is intended to provide the information that will be tested in a clean and concise format. The guides introduce the subject you'll be tested on, follow that with the information you'll need to know for it, and then move on to the next topic. They contain no drills or unrealistic self-tests to bump the page count without adding value. The series is intended to provide a concentrated source of exam information that is compact enough to be read through multiple times. This series is ideal for experienced Oracle professionals that are familiar with the topic being tested, but want a means to rapidly re...

THE LICK AGN MONITORING PROJECT: REVERBERATION MAPPING OF OPTICAL HYDROGEN AND HELIUM RECOMBINATION LINES

International Nuclear Information System (INIS)

Bentz, Misty C.; Walsh, Jonelle L.; Barth, Aaron J.; Thornton, Carol E.; Yoshii, Yuzuru; Sakata, Yu; Minezaki, Takeo; Woo, Jong-Hak; Malkan, Matthew A.; Wang, Xiaofeng; Steele, Thea N.; Silverman, Jeffrey M.; Serduke, Frank J. D.; Li, Weidong; Lee, Nicholas; Treu, Tommaso; Street, Rachel A.; Hidas, Marton G.; Hiner, Kyle D.; Greene, Jenny E.

2010-01-01

We have recently completed a 64-night spectroscopic monitoring campaign at the Lick Observatory 3 m Shane telescope with the aim of measuring the masses of the black holes in 12 nearby (z 6 -10 7 M sun and also the well-studied nearby active galactic nucleus (AGN) NGC 5548. Nine of the objects in the sample (including NGC 5548) showed optical variability of sufficient strength during the monitoring campaign to allow for a time lag to be measured between the continuum fluctuations and the response to these fluctuations in the broad Hβ emission, which we have previously reported. We present here the light curves for the Hα, Hγ, He II λ4686, and He I λ5876 emission lines and the time lags for the emission-line responses relative to changes in the continuum flux. Combining each emission-line time lag with the measured width of the line in the variable part of the spectrum, we determine a virial mass of the central supermassive black hole from several independent emission lines. We find that the masses are generally consistent within the uncertainties. The time-lag response as a function of velocity across the Balmer line profiles is examined for six of the AGNs. We find similar responses across all three Balmer lines for Arp 151, which shows a strongly asymmetric profile, and for SBS 1116+583A and NGC 6814, which show a symmetric response about zero velocity. For the other three AGNs, the data quality is somewhat lower and the velocity-resolved time-lag response is less clear. Finally, we compare several trends seen in the data set against the predictions from photoionization calculations as presented by Korista and Goad. We confirm several of their predictions, including an increase in responsivity and a decrease in the mean time lag as the excitation and ionization level for the species increases. Specifically, we find the time lags of the optical recombination lines to have weighted mean ratios of τ(Hα):τ(Hβ):τ(Hγ):τ(He I):τ(He II) = 1

Effect of Thin Prep® imaging system on laboratory rate and relative sensitivity of atypical squamous cells, high-grade squamous intraepithelial lesion not excluded and high-grade squamous intraepithelial lesion interpretations

Directory of Open Access Journals (Sweden)

Brooke R Koltz

2013-01-01

Full Text Available Introduction: Automated screening of Thin Prep ® Papanicolaou Tests has become increasingly common in clinical practice. Increased productivity has initiated laboratory use of the Thin Prep ® Imaging System (TIS. Increased sensitivity is a potential additional benefit of TIS. Published studies have shown an increase in discovery of dysplastic cells. This study evaluates the effect of TIS on the incidence of atypical squamous cells high-grade squamous intraepithelial lesion not excluded (ASC-H and high-grade squamous intraepithelial lesion (HGSIL results on Thin Prep ® Pap Tests by comparing TIS-assisted and manual screening findings and the diagnoses on subsequent follow-up in a screening population over a 1-year time period. Materials and Methods: A compilation of all ASC-H and HGSIL cases was prepared by conducting a computerized search over a 1-year period (7/06-6/07. The accumulated cases include Thin Prep Pap tests that were both TIS and manually screened. Follow-up results of cytologic and histologic cervical specimens were obtained for a time period extending to 2010. Interpretation utilizing TIS was in place 10 months prior to the study′s initiation. Results: During the study period 70,522 Pap tests were performed in our laboratory. One third (33% of Pap tests were screened with assistance of TIS. Manual screening was performed on 47,380 Pap tests of which 153 (0.32% were interpreted as ASC-H and 164 (0.35% were interpreted as HGSIL. During the same time period automated screening (TIS was performed on 23,111 Pap tests. Interpretation of 62 (0.27% cases provided an ASC-H result, while 71 (0.31% were HGSIL. Follow-up cervical dysplasia by colposcopic biopsy and cone biopsy was distributed proportionally between TIS and manual screening for both ASC-H and HGSIL categories. Cervical intraepithelial neoplasia (CIN II/III was identified on follow-up biopsy of 41% TIS cases and 45% manually screened cases for ASC-H. In the HGSIL subset 71

The exploitation of "Exploitation" in the tenofovir prep trial in Cameroon: Lessons learned from media coverage of an HIV prevention trial.

Science.gov (United States)

Mack, Natasha; Robinson, Elizabeth T; MacQueen, Kathleen M; Moffett, Jill; Johnson, Laura M

2010-06-01

media coverage influences how clinical trials are perceived internationally and in communities where trials occur, affecting recruitment, retention, and political support for research. We conducted a discourse analysis of news coverage from 2004-2005 of a trial in Cameroon on oral PrEP for HIV prevention, to identify messages, communication techniques, and sources of messages that were amplified via media. We identified two parallel discourses: one on ethical concerns about the Cameroon trial, and a second, more general "science exploitation" discourse concerned with the potential for trials with vulnerable participant populations to be conducted unethically, benefiting only wealthy populations. Researchers should overtly address exploitation as an integral, ongoing component of research, particularly where historical or cultural conditions set the stage for controversy to emerge.

Experimental modelling of the consequences of brief late gestation asphyxia on newborn lamb behaviour and brain structure.

Directory of Open Access Journals (Sweden)

Margie Castillo-Melendez

Full Text Available Brief but severe asphyxia in late gestation or at the time of birth may lead to neonatal hypoxic ischemic encephalopathy and is associated with long-term neurodevelopmental impairment. We undertook this study to examine the consequences of transient in utero asphyxia in late gestation fetal sheep, on the newborn lamb after birth. Surgery was undertaken at 125 days gestation for implantation of fetal catheters and placement of a silastic cuff around the umbilical cord. At 132 days gestation (0.89 term, the cuff was inflated to induce umbilical cord occlusion (UCO, or sham (control. Fetal arterial blood samples were collected for assessment of fetal wellbeing and the pregnancy continued until birth. At birth, behavioral milestones for newborn lambs were recorded over 24 h, after which the lambs were euthanased for brain collection and histopathology assessments. After birth, UCO lambs displayed significant latencies to (i use all four legs, (ii attain a standing position, (iii find the udder, and (iv successfully suckle--compared to control lambs. Brains of UCO lambs showed widespread pathologies including cell death, white matter disruption, intra-parenchymal hemorrhage and inflammation, which were not observed in full term control brains. UCO resulted in some preterm births, but comparison with age-matched preterm non-UCO control lambs showed that prematurity per se was not responsible for the behavioral delays and brain structural abnormalities resulting from the in utero asphyxia. These results demonstrate that a single, brief fetal asphyxic episode in late gestation results in significant grey and white matter disruption in the developing brain, and causes significant behavioral delay in newborn lambs. These data are consistent with clinical observations that antenatal asphyxia is causal in the development of neonatal encephalopathy and provide an experimental model to advance our understanding of neuroprotective therapies.

THE LICK AGN MONITORING PROJECT: THE M BH-σ* RELATION FOR REVERBERATION-MAPPED ACTIVE GALAXIES

International Nuclear Information System (INIS)

Woo, Jong-Hak; Treu, Tommaso; Bennert, Vardha N.; Barth, Aaron J.; Walsh, Jonelle L.; Bentz, Misty C.; Wright, Shelley A.; Filippenko, Alexei V.; Li, Weidong; Martini, Paul; Canalizo, Gabriela; Gates, Elinor; Greene, Jenny; Malkan, Matthew A.; Stern, Daniel; Minezaki, Takeo

2010-01-01

To investigate the black hole mass versus stellar velocity dispersion (M BH -σ * ) relation of active galaxies, we measured the velocity dispersions of a sample of local Seyfert 1 galaxies, for which we have recently determined black hole masses using reverberation mapping. For most objects, stellar velocity dispersions were measured from high signal-to-noise ratio optical spectra centered on the Ca II triplet region (∼8500 A), obtained at the Keck, Palomar, and Lick Observatories. For two objects, in which the Ca II triplet region was contaminated by nuclear emission, the measurement was based on high-quality H-band spectra obtained with the OH-Suppressing Infrared Imaging Spectrograph at the Keck-II telescope. Combining our new measurements with data from the literature, we assemble a sample of 24 active galaxies with stellar velocity dispersions and reverberation-based black hole mass measurements in the range of black hole mass 10 6 BH /M sun 9 . We use this sample to obtain reverberation-mapping constraints on the slope and intrinsic scatter of the M BH -σ * relation of active galaxies. Assuming a constant virial coefficient f for the reverberation-mapping black hole masses, we find a slope β = 3.55 ± 0.60 and the intrinsic scatter σ int = 0.43 ± 0.08 dex in the relation log(M BH /M sun ) = α + β log(σ * /200 km s -1 ), which are consistent with those found for quiescent galaxies. We derive an updated value of the virial coefficient f by finding the value which places the reverberation masses in best agreement with the M BH -σ * relation of quiescent galaxies; using the quiescent M BH -σ * relation determined by Gueltekin et al., we find log f = 0.72 +0.09 -0.10 with an intrinsic scatter of 0.44 ± 0.07 dex. No strong correlations between f and parameters connected to the physics of accretion (such as the Eddington ratio or line-shape measurements) are found. The uncertainty of the virial coefficient remains one of the main sources of the

Comparison of the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 test v1.0 with v2.0 in HIV-1 viral load quantification

Directory of Open Access Journals (Sweden)

Yi-Ching Tung

2015-04-01

Full Text Available Roche modified the COBAS AmpliPrep/COBAS TaqMan human immunodeficiency virus type 1 (HIV-1 test version 1.0 (CAP/CTM v1.0, resulting in the COBAS AmpliPrep/COBAS TaqMan HIV-1 test version 2.0 (CAP/CTM v2.0. The aim of this study was to evaluate the performance of the CAP/CTM v2.0 and to compare this performance with that of the CAP/CTM v1.0. The study was conducted in a small local study group in Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. A total of 86 plasma samples from HIV-1-seropositive patients were tested using the two assays. The correlation and concordance of results between the two assays were calculated. The CAP/CTM v2.0 generated higher values than did the CAP/CTM v1.0, and five samples (5.8% yielded a difference of > 1 log10 copies/mL. In addition, our data show that CAP/CTM v1.0 and CAP/CTM v2.0 yielded relatively consistent values for 23 samples with low viral loads (< 200 copies/mL. Furthermore, when viral loads were in a medium range (2–5 log10 copies/mL, the results of the two assays were more compatible. This study shows a good correlation between CAP/CTM v1.0 and v2.0 in HIV-1 viral load measurement. Further attention must be paid to those cases in which measured viral loads present larger differences between the two assays.

Magnetic properties of uranium and plutonium laves phases with 3d transition elements

International Nuclear Information System (INIS)

Lam, D.J.; Aldred, A.T.

1974-01-01

The magnetization of UMn 2 , UFe 2 , UCo 2 , UNi 2 , PuMn 2 , PuFe 2 , PuCo 2 , and PuNi 2 from 4 to 300 0 K in fields up to 14 kOe were measured. The susceptibility of UMn 2 shows a small maximum near 240 0 K (which may indicate an antiferromagnetic transition) in agreement with previous results. The data for UFe 2 , UCo 2 , and UNi 2 are not in good agreement with earlier work; the ferromagnetic ordering temperature (158 0 K) of a single crystal sample of UFe 2 is lower than any reported value, UNi 2 orders ferromagnetically at 30 0 K, and UCo 2 may order below 5 0 K. In contrast, PuMn 2 , PuCo 2 , and PuNi 2 have small weakly-temperature-dependent susceptibilities. PuFe 2 is ferromagnetic at room temperature, in agreement with previous Moessbauer results, and has a saturation moment of approximately 2.6 μ/sub B//mole. (U.S.)

Geophagy in brown spider monkeys (Ateles hybridus) in a lowland tropical rainforest in Colombia.

Science.gov (United States)

Link, Andres; de Luna, Ana Gabriela; Arango, Ricardo; Diaz, Maria Clara

2011-01-01

Spider monkeys and howler monkeys are the only Neotropical primates that eat soil from mineral licks. Not all species within these genera visit mineral licks, and geophagy has been restricted to populations of Ateles belzebuth belzebuth,Ateles belzebuth chamek and Alouatta seniculus in western Amazonian rainforests. With the aid of a camera trap we studied the visitation patterns of a group of brown spider monkeys (Ateles hybridus) to a mineral lick at Serrania de Las Quinchas, in Colombia. Spider monkeys visited the lick frequently throughout the year, with a monthly average of 21.7 ± 7.2 visits per 100 days of camera trapping (n = 14 months). Spider monkeys visited the mineral lick almost always on days with no rain, or very little (<3 mm) rain, suggesting that proximate environmental variables might determine spider monkeys' decisions to come to the ground at the licks. This study expands the geographical occurrence of mineral lick use by spider monkeys providing additional data for future assessments on the biogeographical correlates of mineral lick use by platyrrhines. Copyright © 2011 S. Karger AG, Basel.

Chem-Prep PZT 95/5 for Neutron Generator Applications: Particle Size Distribution Comparison of Development and Production-Scale Powders

International Nuclear Information System (INIS)

SIPOLA, DIANA L.; VOIGT, JAMES A.; LOCKWOOD, STEVEN J.; RODMAN-GONZALES, EMILY D.

2002-01-01

The Materials Chemistry Department 1846 has developed a lab-scale chem-prep process for the synthesis of PNZT 95/5, a ferroelectric material that is used in neutron generator power supplies. This process (Sandia Process, or SP) has been successfully transferred to and scaled by Department 14192 (Ceramics and Glass Department), (Transferred Sandia Process, or TSP), to meet the future supply needs of Sandia for its neutron generator production responsibilities. In going from the development-size SP batch (1.6 kg/batch) to the production-scale TSP powder batch size (10 kg/batch), it was important that it be determined if the scaling process caused any ''performance-critical'' changes in the PNZT 95/5 being produced. One area where a difference was found was in the particle size distributions of the calcined PNZT powders. Documented in this SAND report are the results of an experimental study to determine the origin of the differences in the particle size distribution of the SP and TSP powders

SurePath Specimens Versus ThinPrep Specimen Types on the COBAS 4800 Platform: High-Risk HPV Status and Cytology Correlation in an Ethnically Diverse Bronx Population.

Science.gov (United States)

Naeem, R C; Goldstein, D Y; Einstein, Mark H; Ramos Rivera, G; Schlesinger, K; Khader, S N; Suhrland, M; Fox, A S

2017-08-01

To compare the cytologic preparations of 130 cervical specimens (from women of various ethnicities at high risk for human papillomavirus [HPV] infection) using the SurePath (SP) collection system with specimens gathered using the ThinPrep (TP) system, as processed on the Cobas 4800 analyzer, to determine which collection method more accurately identifies HPV infection. In our prospective study, specimens were collected from 130 women of various ethnicities residing in or near Bronx County, NY. The SP-collected specimen was first processed for cytologic findings; if clinical HPV testing was requested on that specimen, it was tested using Hybrid Capture II (HC2) methodology. We tested the remnant SP-collected cell concentrate using the Cobas analyzer. Then, the TP-collected and SP-collected specimens were tested in the same run on that analyzer, and the results were compared. We also compared the results with the concurrent cytologic findings. The results were concordant for overall HR-HPV status in 93.8% of cases. Also, a statistically significant lower cycle threshold value was observed with Cobas testing of specimen concentrates tested via the BD SurePath Pap Test (P = .001), suggesting higher sensitivity compared with specimens tested via the ThinPrep Pap Test. Cobas 4800 HPV testing of SP-collected specimen concentrates yields comparable results to TP-collected specimen concentrates. Based on the limited data that we derived, SP collection may be a more favorable methodology than TP collection for HPV testing of individuals at high risk in our ethnically diverse, urban patient population. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Fabrication of Uranium Oxycarbide Kernels for HTR Fuel

International Nuclear Information System (INIS)

Barnes, Charles; Richardson, Clay; Nagley, Scott; Hunn, John; Shaber, Eric

2010-01-01

Babcock and Wilcox (B and W) has been producing high quality uranium oxycarbide (UCO) kernels for Advanced Gas Reactor (AGR) fuel tests at the Idaho National Laboratory. In 2005, 350-(micro)m, 19.7% 235U-enriched UCO kernels were produced for the AGR-1 test fuel. Following coating of these kernels and forming the coated-particles into compacts, this fuel was irradiated in the Advanced Test Reactor (ATR) from December 2006 until November 2009. B and W produced 425-(micro)m, 14% enriched UCO kernels in 2008, and these kernels were used to produce fuel for the AGR-2 experiment that was inserted in ATR in 2010. B and W also produced 500-(micro)m, 9.6% enriched UO2 kernels for the AGR-2 experiments. Kernels of the same size and enrichment as AGR-1 were also produced for the AGR-3/4 experiment. In addition to fabricating enriched UCO and UO2 kernels, B and W has produced more than 100 kg of natural uranium UCO kernels which are being used in coating development tests. Successive lots of kernels have demonstrated consistent high quality and also allowed for fabrication process improvements. Improvements in kernel forming were made subsequent to AGR-1 kernel production. Following fabrication of AGR-2 kernels, incremental increases in sintering furnace charge size have been demonstrated. Recently small scale sintering tests using a small development furnace equipped with a residual gas analyzer (RGA) has increased understanding of how kernel sintering parameters affect sintered kernel properties. The steps taken to increase throughput and process knowledge have reduced kernel production costs. Studies have been performed of additional modifications toward the goal of increasing capacity of the current fabrication line to use for production of first core fuel for the Next Generation Nuclear Plant (NGNP) and providing a basis for the design of a full scale fuel fabrication facility.

AGR-2 irradiation test final as-run report, Rev. 1

International Nuclear Information System (INIS)

2014-01-01

This document presents the as-run analysis of the AGR-2 irradiation experiment. AGR-2 is the second of the planned irradiations for the Advanced Gas Reactor (AGR) Fuel Development and Qualification Program. Funding for this program is provided by the U.S. Department of Energy as part of the Very High Temperature Reactor (VHTR) Technical Development Office (TDO) program. The objectives of the AGR-2 experiment are to: (a) Irradiate UCO (uranium oxycarbide) and UO 2 (uranium dioxide) fuel produced in a large coater. Fuel attributes are based on results obtained from the AGR-1 test and other project activities; (b) Provide irradiated fuel samples for post-irradiation experiment (PIE) and safety testing; and, (c) Support the development of an understanding of the relationship between fuel fabrication processes, fuel product properties, and irradiation performance. The primary objective of the test was to irradiate both UCO and UO 2 TRISO (tri-structural isotropic) fuel produced from prototypic scale equipment to obtain normal operation and accident condition fuel performance data. The UCO compacts were subjected to a range of burnups and temperatures typical of anticipated prismatic reactor service conditions in three capsules. The test train also includes compacts containing UO 2 particles produced independently by the United States, South Africa, and France in three separate capsules. The range of burnups and temperatures in these capsules were typical of anticipated pebble bed reactor service conditions. The results discussed in this report pertain only to U.S. produced fuel. In order to achieve the test objectives, the AGR-2 experiment was irradiated in the B-12 position of the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL) for a total irradiation duration of 559.2 effective full power days (EFPD). Irradiation began on June 22, 2010, and ended on October 16, 2013, spanning 12 ATR power cycles and approximately three and a half calendar years. The

AGR-2 Irradiation Test Final As-Run Report, Rev 2

Energy Technology Data Exchange (ETDEWEB)

Collin, Blaise P. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2014-08-01

This document presents the as-run analysis of the AGR-2 irradiation experiment. AGR-2 is the second of the planned irradiations for the Advanced Gas Reactor (AGR) Fuel Development and Qualification Program. Funding for this program is provided by the U.S. Department of Energy as part of the Very High Temperature Reactor (VHTR) Technical Development Office (TDO) program. The objectives of the AGR-2 experiment are to: (a) Irradiate UCO (uranium oxycarbide) and UO₂ (uranium dioxide) fuel produced in a large coater. Fuel attributes are based on results obtained from the AGR-1 test and other project activities. (b) Provide irradiated fuel samples for post-irradiation experiment (PIE) and safety testing. (c) Support the development of an understanding of the relationship between fuel fabrication processes, fuel product properties, and irradiation performance. The primary objective of the test was to irradiate both UCO and UO₂ TRISO (tri-structural isotropic) fuel produced from prototypic scale equipment to obtain normal operation and accident condition fuel performance data. The UCO compacts were subjected to a range of burnups and temperatures typical of anticipated prismatic reactor service conditions in three capsules. The test train also includes compacts containing UO₂ particles produced independently by the United States, South Africa, and France in three separate capsules. The range of burnups and temperatures in these capsules were typical of anticipated pebble bed reactor service conditions. The results discussed in this report pertain only to U.S. produced fuel. In order to achieve the test objectives, the AGR-2 experiment was irradiated in the B-12 position of the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL) for a total irradiation duration of 559.2 effective full power days (EFPD). Irradiation began on June 22, 2010, and ended on October 16, 2013, spanning 12 ATR power cycles and approximately three and a

An inhibitory switch derepressed by pbx, hox, and Meis/Prep1 partners regulates DNA-binding by pbx1 and E2a-pbx1 and is dispensable for myeloid immortalization by E2a-pbx1.

Science.gov (United States)

Calvo, K R; Knoepfler, P; McGrath, S; Kamps, M P

1999-12-23

The Pbx/Exd family of homeodomain (HD) proteins contribute to the transcriptional and developmental roles of other Hox and Meis/Prep1/Hth HD proteins through heterodimer formation. E2a-Pbx1 is an oncogenic derrivative of Pbx1 produced by the t(1;19) translocation in pediatric pre-B cell acute lymphoblastic leukemia. E2a-Pbx1 heterodimerizes with Hox but not with Meis/Prep1 proteins, produces acute myeloid leukemia in mice, and blocks differentiation of cultured murine myeloid progenitors. Here, we characterize negative and positive regulatory sequences that flank the Pbx1 HD and determine their importance for myeloid immortalization by E2a-Pbx1. A 25 residue predicted alpha helix preceding the Pbx1 HD bound the HD and prevented both its binding to DNA and its ability to heterodimerize with Hox proteins. Addition of 39 residues N-terminal to this inhibitory helix exposed a Pbx dimerization interface that orchestrated cooperative DNA-binding of E2a-Pbx1 and all Pbx proteins as homodimers and heterdimers. Sequences inhibiting DNA-binding and mediating Pbx dimerization coincided with those reported to have nuclear export function. An additional 103 residues N-terminal to the Pbx dimerization interface restored heterodimerization with Hox and Meis1/Prep1 proteins. This negative switch domain - comprised of the inhibitory helix and N-terminal regions required for its partner-mediated derepression - was dispensable for myeloid immortalization by E2a-Pbx1. While stabilizing the heterodimer, the 310 helix C-terminal to the Pbx1 HD was also dispensable for the ability of E2a-Pbx1 to heterodimerize with Hox proteins and immortalize myeloblasts. Retention of myeloid immortalization by E2a-Pbx1 proteins lacking all Pbx1 sequences N- or C-terminal to the HD indicates that Hox proteins, or a yet undefined factor that binds the Pbx1 HD and derepresses DNA-binding by the HD, cooperate with E2a-Pbx1 in myeloid immortalization.

Utilization of eggshell waste as low-cost solid base catalyst for biodiesel production from used cooking oil

Science.gov (United States)

Asri, N. P.; Podjojono, B.; Fujiani, R.; Nuraini

2017-05-01

A solid CaO-based catalyst of waste eggshell was developed for biodiesel production from used cooking oil. The waste eggshell powder was calcined in air at 90° C for 4 h to convert calcium species in the eggshells into active CaO catalysts. The characterization of CaO catalyst was done by XRD and BET analysis. The CaO catalyst was then introduced for transesterification of used cooking oil (UCO) for testing of its catalytic activity. The experiment was conducted in batch type reactor that consists of three-neck glass equipped by reflux condenser and magnetic stirrer. Before tranesterification process, the UCO was treated by coconut coir powder in order to reduce the free fatty acid content. The result showed that the catalyst was potentially use for transesterification of used cooking oil into biodiesel with relatively high yield of 75.92% was achieved at reaction temperature, reaction time, molar ratio UCO to methanol and catalyst amount of 65° C, 7 h, 1:15 and 6%, respectively.

PREP-CHEM-SRC – 1.0: a preprocessor of trace gas and aerosol emission fields for regional and global atmospheric chemistry models

Directory of Open Access Journals (Sweden)

S. R. Freitas

2011-05-01

Full Text Available The preprocessor PREP-CHEM-SRC presented in the paper is a comprehensive tool aiming at preparing emission fields of trace gases and aerosols for use in atmospheric-chemistry transport models. The considered emissions are from the most recent databases of urban/industrial, biogenic, biomass burning, volcanic, biofuel use and burning from agricultural waste sources. For biomass burning, emissions can be also estimated directly from satellite fire detections using a fire emission model included in the tool. The preprocessor provides emission fields interpolated onto the transport model grid. Several map projections can be chosen. The inclusion of these emissions in transport models is also presented. The preprocessor is coded using Fortran90 and C and is driven by a namelist allowing the user to choose the type of emissions and the databases.

Morphological evaluation of the cerebral blood vessels in the late gestation fetal sheep following hypoxia in utero.

Science.gov (United States)

Baburamani, Ana A; Lo, Camden; Castillo-Melendez, Margie; Walker, David W

2013-01-01

Hypoxia can significantly contribute to the development of permanent brain injury in the term neonate; however the response of cerebral blood vessels is not well understood. This study aimed to quantitatively measure vascular density and morphology using laminin immunohistochemistry as a marker of blood vessels, and determine the effects of a single, severe bout of hypoxia (umbilical cord occlusion, UCO) late in gestation on the developing cerebrovasculature in fetal sheep. At 124-126 days gestation singleton fetal sheep underwent surgery for implantation of catheters and placement of an inflatable cuff around the umbilical cord. A 10 min UCO or sham UCO (n=5) occurred at 132 days gestation. Fetal brains were collected at 24 h (n=5) or 48 h (n=4) after UCO for vascular density and morphology analysis of laminin immunohistochemistry. 48 h following a single, brief bout of severe hypoxia late in gestation decreased vascular density was seen in the caudate nucleus and no changes in vascular morphology occurred. However closer analysis revealed a significant shift in the frequency of smaller (≤10 μm) to larger (≤100 μm) perimeter blood vessels in periventricular and subcortical white matter. Close examination of the frequency distribution of vascular perimeter highlights that alterations in vascular morphology persist in the near term fetal brain for up to 48 h following a brief (10 min) hypoxia in white but not gray matter. These findings suggest that the near term brain may still be vulnerable to white matter injury following in utero hypoxia. Copyright © 2012 Elsevier Inc. All rights reserved.

THE LICK AGN MONITORING PROJECT: BROAD-LINE REGION RADII AND BLACK HOLE MASSES FROM REVERBERATION MAPPING OF Hβ

International Nuclear Information System (INIS)

Bentz, Misty C.; Walsh, Jonelle L.; Barth, Aaron J.; Baliber, Nairn; Bennert, Vardha Nicola; Greene, Jenny E.; Hidas, Marton G.; Canalizo, Gabriela; Hiner, Kyle D.; Filippenko, Alexei V.; Ganeshalingam, Mohan; Lee, Nicholas; Li, Weidong; Serduke, Frank J. D.; Silverman, Jeffrey M.; Steele, Thea N.; Gates, Elinor L.; Malkan, Matthew A.; Minezaki, Takeo; Sakata, Yu

2009-01-01

We have recently completed a 64-night spectroscopic monitoring campaign at the Lick Observatory 3-m Shane telescope with the aim of measuring the masses of the black holes in 12 nearby (z 6 -10 7 M sun and also the well-studied nearby active galactic nucleus (AGN) NGC 5548. Nine of the objects in the sample (including NGC 5548) showed optical variability of sufficient strength during the monitoring campaign to allow for a time lag to be measured between the continuum fluctuations and the response to these fluctuations in the broad Hβ emission. We present here the light curves for all the objects in this sample and the subsequent Hβ time lags for the nine objects where these measurements were possible. The Hβ lag time is directly related to the size of the broad-line region (BLR) in AGNs, and by combining the Hβ lag time with the measured width of the Hβ emission line in the variable part of the spectrum, we determine the virial mass of the central supermassive black hole in these nine AGNs. The absolute calibration of the black hole masses is based on the normalization derived by Onken et al., which brings the masses determined by reverberation mapping into agreement with the local M BH -σ * relationship for quiescent galaxies. We also examine the time lag response as a function of velocity across the Hβ line profile for six of the AGNs. The analysis of four leads to rather ambiguous results with relatively flat time lags as a function of velocity. However, SBS 1116+583A exhibits a symmetric time lag response around the line center reminiscent of simple models for circularly orbiting BLR clouds, and Arp 151 shows an asymmetric profile that is most easily explained by a simple gravitational infall model. Further investigation will be necessary to fully understand the constraints placed on the physical models of the BLR by the velocity-resolved response in these objects.

Selection of LEU/Th reference fuel for the HTGR-SC/C lead plant

International Nuclear Information System (INIS)

Turner, R.F.; Neylan, A.J.; Baxter, A.M.; McEachern, D.W.; Stansfield, O.M.

1983-05-01

This paper describes the reference fuel materials for the high-temperature gas-cooled reactor (HTGR) plant for steam cycle/cogeneration (SC/C). A development and testing program carried out in 1978 through 1982 led to the selection of coated fuel particles of uranium-oxycarbide (UCO) for fissile materials and thorium oxide (ThO 2 ) for fertiel materials. Low-enriched uranium (LEU) is the enrichment basis for the HTGR-SC/C application. While UC 2 and UO 2 would also meet the essential criteria for fissile fuel, the UCO, alternative was selected on the basis of improved performance, economics, and process conditions

LOSS Revisited. I. Unraveling Correlations between Supernova Rates and Galaxy Properties, as Measured in a Reanalysis of the Lick Observatory Supernova Search

Energy Technology Data Exchange (ETDEWEB)

Graur, Or [Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Bianco, Federica B.; Huang, Shan; Modjaz, Maryam [CCPP, New York University, 4 Washington Place, New York, NY 10003 (United States); Shivvers, Isaac; Filippenko, Alexei V.; Li, Weidong [Department of Astronomy, University of California, Berkeley, CA 94720-3411 (United States); Eldridge, J. J., E-mail: or.graur@cfa.harvard.edu [Department of Physics, University of Auckland, Private Bag 92019, Auckland (New Zealand)

2017-03-10

Most types of supernovae (SNe) have yet to be connected with their progenitor stellar systems. Here, we reanalyze the 10-year SN sample collected during 1998–2008 by the Lick Observatory Supernova Search (LOSS) in order to constrain the progenitors of SNe Ia and stripped-envelope SNe (SE SNe, i.e., SNe IIb, Ib, Ic, and broad-lined Ic). We matched the LOSS galaxy sample with spectroscopy from the Sloan Digital Sky Survey and measured SN rates as a function of galaxy stellar mass, specific star formation rate, and oxygen abundance (metallicity). We find significant correlations between the SN rates and all three galaxy properties. The SN Ia correlations are consistent with other measurements, as well as with our previous explanation of these measurements in the form of a combination of the SN Ia delay-time distribution and the correlation between galaxy mass and age. The ratio between the SE SN and SN II rates declines significantly in low-mass galaxies. This rules out single stars as SE SN progenitors, and is consistent with predictions from binary-system progenitor models. Using well-known galaxy scaling relations, any correlation between the rates and one of the galaxy properties examined here can be expressed as a correlation with the other two. These redundant correlations preclude us from establishing causality—that is, from ascertaining which of the galaxy properties (or their combination) is the physical driver for the difference between the SE SN and SN II rates. We outline several methods that have the potential to overcome this problem in future works.

77 FR 76420 - Final Flood Elevation Determinations

Science.gov (United States)

2012-12-28

... Road. Salt Lick Branch (backwater effects At the Licking River +924 Unincorporated Areas from Licking... +3206 At the intersection of Slide Road and 58th Street......... +3256 * National Geodetic Vertical...). confluence. of Magoffin County. Approximately 355 feet +901 upstream of Clyde Holliday Cemetery Road. [[Page...

Fellatio by fruit bats prolongs copulation time.

Directory of Open Access Journals (Sweden)

Min Tan

Full Text Available Oral sex is widely used in human foreplay, but rarely documented in other animals. Fellatio has been recorded in bonobos Pan paniscus, but even then functions largely as play behaviour among juvenile males. The short-nosed fruit bat Cynopterus sphinx exhibits resource defence polygyny and one sexually active male often roosts with groups of females in tents made from leaves. Female bats often lick their mate's penis during dorsoventral copulation. The female lowers her head to lick the shaft or the base of the male's penis but does not lick the glans penis which has already penetrated the vagina. Males never withdrew their penis when it was licked by the mating partner. A positive relationship exists between the length of time that the female licked the male's penis during copulation and the duration of copulation. Furthermore, mating pairs spent significantly more time in copulation if the female licked her mate's penis than if fellatio was absent. Males also show postcopulatory genital grooming after intromission. At present, we do not know why genital licking occurs, and we present four non-mutually exclusive hypotheses that may explain the function of fellatio in C. sphinx.

Enhancing fermentative digestion of cereal straws by using urea-molasses multinutrient blocks

International Nuclear Information System (INIS)

El Fouly, H.A.; Leng, R.A.

1987-01-01

Research trials connected with the preparation of licks are described. In vivo experiments carried out on lambs indicated that the rate of consumption from the licks is governed by the degree of solidification of the block, the urea level, the supplementary minerals content and by the adaptability of lambs to licking behaviour. The ruminal ammonia-N concentrations of lambs receiving the urea-molasses licks fluctuated less and were maintained between 107 and 224 mg/L during the diurnal cycle. (author)

An Efficient Method for the Preparative Isolation and Purification of Flavonoid Glycosides and Caffeoylquinic Acid Derivatives from Leaves of Lonicera japonica Thunb. Using High Speed Counter-Current Chromatography (HSCCC) and Prep-HPLC Guided by DPPH-HPLC Experiments.

Science.gov (United States)

Wang, Daijie; Du, Ning; Wen, Lei; Zhu, Heng; Liu, Feng; Wang, Xiao; Du, Jinhua; Li, Shengbo

2017-02-02

In this work, the n-butanol extract from leaves of Lonicera japonica Thunb. (L. japonica) was reacted with DPPH and subjected to a HPLC analysis for the guided screening antioxidants (DPPH-HPLC experiments). Then, nine antioxidants, including flavonoid glycosides and caffeoylquinic acid derivatives, were isolated and purified from leaves of L. japonica using high speed counter-current chromatography (HSCCC) and prep-HPLC. The n-butanol extract was firstly isolated by HSCCC using methyl tert-butyl ether/n-butanol/acetonitrile/water (0.5% acetic acid) (2:2:1:5, v/v), yielding five fractions F1, F2 (rhoifolin), F3 (luteoloside), F4 and F5 (collected from the column after the separation). The sub-fractions F1, F4 and F5 were successfully separated by prep-HPLC. Finally, nine compounds, including chlorogenic acid (1), lonicerin (2), rutin (3), rhoifolin (4), luteoloside (5), 3,4-Odicaffeoylquinic acid (6), hyperoside (7), 3,5-O-dicaffeoylquinic acid (8), and 4,5-O-dicaffeoylquinic acid (9) were obtained, respectively, with the purities over 94% as determined by HPLC. The structures were identified by electrospray ionization mass spectrometry (ESI-MS), 1H- and 13C-NMR. Antioxidant activities were tested, and the isolated compounds showed strong antioxidant activities.

The possibility of the mixed valence state in the uranium intermetallic compounds: UCoGa5, U2Ru2Sn and U2RuGa8

International Nuclear Information System (INIS)

Troc, Robert

2007-01-01

The mixed valence (MV) phenomenon has been observed so far in a large number of various compounds but containing only lanthanides. These properties are usually associated with the mixing of the localised f-state and the band states. The usual valence state for magnetic uranium intermetallics is the trivalent state 5f 3 or hybridised 5f 2 6d 1 , both are nearly degenerate in energy and can compete for a stability of the compound. In some cases a gain in an energy minimum may be achieved by very fast fluctuating between these two states with a time of 10 -14 s, which does not allow to yield the ordered state even if the exchange interactions (favourite the U-U distances) would be able for that. The latter cases seem to concern the described here intermetallics: one ternary compound based on Co, UCoGa 5 , and the two uranium ternary compounds based on Ru, namely U 2 Ru 2 Sn and U 2 RuGa 8 which all crystallize in a tetragonal unit cell. All these compounds show a maximum in their temperature dependences of the magnetic susceptibility measured along and perpendicular to the c-axis. Such a behaviour, which is reminiscent of a number of Ce (Sm, Eu) and Yb compounds for which χ(T) has in the past been considered by Sales and Wohlleben (SW) by applying their ICF model or by Lawrance et al. following their scaling procedure. It turned out that these phenomenological models can also be applied to the considered here two Ru-based uranium ternaries from which some reliable energy parameters could be found. In order to further support the mixing valence scenario for the first such cases in uranium compounds presented here, the transport and thermodynamic properties are also discussed. However, some of the most important results confirming the MV state, e.g., in U 2 RuGa 8 , has recently been achieved from the inelastic neutron scattering performed in the Rutherford Appleton Laboratory on the ISIS facility. From these measurements a characteristic gap of 60 meV has been

Status epilepticus after prolonged umbilical cord occlusion is associated with greater neural injury in [corrected] fetal sheep at term-equivalent.

Directory of Open Access Journals (Sweden)

Paul P Drury

Full Text Available The majority of pre-clinical studies of hypoxic-ischemic encephalopathy at term-equivalent have focused on either relatively mild insults, or on functional paradigms of cerebral ischemia or hypoxia-ischemia/hypotension. There is surprisingly little information on the responses to single, severe 'physiological' insults. In this study we examined the evolution and pattern of neural injury after prolonged umbilical cord occlusion (UCO. 36 chronically instrumented fetal sheep at 125-129 days gestational age (term = 147 days were subjected to either UCO until mean arterial pressure was < = 8 mmHg (n = 29, or sham occlusion (n = 7. Surviving fetuses were killed after 72 hours for histopathologic assessment with acid-fuchsin thionine. After UCO, 11 fetuses died with intractable hypotension and 5 ewes entered labor and were euthanized. The remaining 13 fetuses showed marked EEG suppression followed by evolving seizures starting at 5.8 (6.8 hours (median (interquartile range. 6 of 13 developed status epilepticus, which was associated with a transient secondary increase in cortical impedance (a measure of cytotoxic edema, p<0.05. All fetuses showed moderate to severe neuronal loss in the hippocampus and the basal ganglia but mild cortical cell loss (p<0.05 vs sham occlusion. Status epilepticus was associated with more severe terminal hypotension (p<0.05 and subsequently, greater neuronal loss (p<0.05. In conclusion, profound UCO in term-equivalent fetal sheep was associated with delayed seizures, secondary cytotoxic edema, and subcortical injury, consistent with the predominant pattern after peripartum sentinel events at term. It is unclear whether status epilepticus exacerbated cortical injury or was simply a reflection of a longer duration of asphyxia.

HIV Pre-Exposure Prophylaxis Stigma as a Multidimensional Barrier to Uptake Among Women Who Attend Planned Parenthood.

Science.gov (United States)

Calabrese, Sarah K; Dovidio, John F; Tekeste, Mehrit; Taggart, Tamara; Galvao, Rachel W; Safon, Cara B; Willie, Tiara C; Caldwell, Abigail; Kaplan, Clair; Kershaw, Trace S

2018-05-22

PrEP uptake has lagged among US women. PrEP stigma is a recognized barrier to uptake among MSM but remains largely unexplored among women. This study examined the pervasiveness of PrEP stigma among US women and its implications for uptake. Setting/Methods: In a 2017 online survey of Planned Parenthood patients drawn from the three cities with the highest numbers of new HIV infections in Connecticut, 597 heterosexually-active, HIV-negative, PrEP-inexperienced women reported background characteristics, two dimensions of anticipated PrEP stigma (PrEP-user stereotypes and PrEP disapproval by others), and three indicators of potential PrEP uptake (interest in learning more about PrEP, intention to use PrEP, and comfort discussing PrEP with a provider). Participants commonly perceived PrEP-user stereotypes, with many believing that others would regard them as promiscuous (37%), HIV-positive (32%), bad (14%), or gay (11%) if they used PrEP. Thirty percent would feel ashamed to disclose PrEP use. Many participants expected disapproval by family (36%), sex partners (34%), and friends (25%). In adjusted analyses, perception of PrEP-user stereotypes was uniquely associated with lower comfort discussing PrEP with a provider. Expected PrEP disapproval by others was uniquely associated with less PrEP interest, less intention to use PrEP, and less comfort discussing PrEP with a provider. Exploratory moderation analyses suggested intention to use PrEP was greatest when participants anticipated low levels of both PrEP-user stereotypes and PrEP disapproval by others. Findings highlight the need for positive messaging targeting potential PrEP users and their social networks to increase PrEP acceptance and uptake.

Adolescent Human Immunodeficiency Virus Care Providers’ Attitudes Toward the Use of Oral Pre-Exposure Prophylaxis in Youth

Science.gov (United States)

Zimet, Gregory; Lally, Michelle; Kahn, Jessica A.

2016-01-01

Abstract Oral pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention is currently indicated for use in adults in the United States and may soon be indicated for minor adolescents. However, implementation of PrEP use among minors may present unique barriers. We conducted 15 individual, semi-structured interviews among US clinicians caring for HIV-infected and at-risk youth. The theory-driven interview guide assessed demographics, perceived role of oral PrEP in HIV prevention among adolescents, perceived barriers to and facilitating factors for use of PrEP in adolescents, and clinician-reported likelihood of prescribing PrEP. Transcripts were analyzed using framework analysis. Overall, clinicians viewed PrEP as a time-limited intervention that is one part of a comprehensive approach to HIV prevention among adolescents. Perceived barriers to prescribing to minors included concerns about: confidentiality, legality of minors consenting to PrEP without parental involvement, ability of minors to understand the risks/benefits of PrEP, the possible impact of PrEP on bone accrual, off-label use of PrEP medication in minors, and the high costs associated with PrEP use. Clinician-reported facilitating factors for prescribing PrEP to youth included educating communities and other clinicians about PrEP, ensuring adequate financial resources and infrastructure for delivering PrEP, developing formal guidance on effective behavioral interventions that should be delivered with PrEP, and gaining personal experience with prescribing PrEP. Clinicians indicated greater comfort with prescribing PrEP to adults versus minors. For PrEP to become more widely available to youth at risk for HIV infection, barriers that are unique to PrEP use in minors must be addressed. PMID:27410497

Has the ThinPrep method of cervical screening maintained its improvement over conventional smears in terms of specimen adequacy?

LENUS (Irish Health Repository)

Treacy, A

2009-04-01

Liquid-based cytology (LBC) has replaced conventional smear assessment in many centers over recent years. In our laboratory this transfer took place in 1999. At that time we performed a split sample study comparing the conventional method of cervical smear evaluation with the ThinPrep system. This split sample study identified a dramatic improvement in specimen adequacy with LBC. While 11% of conventional preparations were reported as unsatisfactory and almost 9% were reported as suboptimal, evaluation of the same cases using LBC saw this combined figure reduced to 2.3%. AIM: To evaluate whether this dramatic fall in unsatisfactory smears has been maintained with the use of LBC. The database for all smears reported for 2005 (100% LBC) was interrogated. The number of unsatisfactory reports was calculated. The reason for an unsatisfactory report was recorded for each case. The overall unsatisfactory rate was compared with that reported in the 1999 split sample study. A total of 41,312 smear tests were reported in 2005. 1,342 (3.25%) were reported as unsatisfactory. Our findings support the ongoing value of LBC in a routine cervical screening laboratory in terms of continuing to maintain a low rate of unsatisfactory smears.

Functional Knowledge of Pre-Exposure Prophylaxis for HIV Prevention Among Participants in a Web-Based Survey of Sexually Active Gay, Bisexual, and Other Men Who Have Sex With Men: Cross-Sectional Study

Science.gov (United States)

2018-01-01

Background Awareness of pre-exposure prophylaxis (PrEP) for HIV prevention is increasing, but little is known about the functional knowledge of PrEP and its impact on willingness to use PrEP. Objective The objective of this study was to assess the functional knowledge of PrEP among a sample of gay, bisexual, and other men who have sex with men (MSM) participating in a Web-based survey of sexually active MSM. Methods Men at least 18 years old, residing in the United States, and reporting sex with a man in the previous 6 months were recruited through social networking websites. PrEP functional knowledge included the following 4 questions (1) efficacy of consistent PrEP use, (2) inconsistent PrEP use and effectiveness, (3) PrEP and condom use, and (4) effectiveness at reducing sexually transmitted infections (STIs). Ordinal logistic regression was used to identify respondent characteristics associated with PrEP functional knowledge. In a subsample of participants responding to HIV prevention questions, we compared willingness to use PrEP by response to PrEP functional knowledge using logistic regression analysis adjusted for age, race and ethnicity, and education level. Results Among 573 respondents, PrEP knowledge was high regarding adherence (488/573, 85.2%), condom use (532/573, 92.8%), and STIs (480/573, 83.8%), but only 252/573 (44.0%) identified the correct efficacy. Lower functional PrEP knowledge was associated with minority race/ethnicity (P=.005), lower education (P=.01), and not having an HIV test in the past year (P=.02). Higher PrEP knowledge was associated with willingness to use PrEP (P=.009). Younger age was not associated with higher PrEP functional knowledge or willingness to use PrEP. Conclusions PrEP knowledge was generally high in our study, including condom use and consistent use but may be lacking in higher risk MSM. The majority of respondents did not correctly identify PrEP efficacy with consistent use, which could impact motivation to seek

Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation: A qualitative study.

Science.gov (United States)

Bil, Janneke P; van der Veldt, Wendy M; Prins, Maria; Stolte, Ineke G; Davidovich, Udi

2016-09-01

Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM).Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach.Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients' medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support.To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent increases in STIs

Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation

Science.gov (United States)

Bil, Janneke P.; van der Veldt, Wendy M.; Prins, Maria; Stolte, Ineke G.; Davidovich, Udi

2016-01-01

Abstract Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM). Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach. Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients’ medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support. To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent

Associations Between Participant Ratings of PREP for Strong Bonds and Marital Outcomes 1 Year Postintervention.

Science.gov (United States)

Allen, Elizabeth S; Post, Kristina M; Markman, Howard J; Rhoades, Galena K; Stanley, Scott M

2017-07-01

After completing a relationship education program, collecting participant evaluations of the program is common practice. These are generally used as an index of "consumer satisfaction" with the program, with implications for feasibility and quality. Rarely have these ratings been used as predictors of changes in marital quality, although such feedback may be the only data providers collect or have immediate access to when considering the success of their efforts. To better understand the utility of such ratings to predict outcomes, we evaluated links between participant ratings and changes in self-reported marital satisfaction and communication scores one year later for a sample of 191 Army couples who had participated in a relationship education program delivered by Army chaplains (PREP for Strong Bonds). Overall ratings of general satisfaction with the program and the leader did not predict changes in marital outcomes one year later, whereas higher ratings of how much was learned, program helpfulness, increased similarity in outlook regarding Army life, and helpfulness of communication skills training predicted greater change in communication skills one year later. Higher ratings of items reflecting intent to invest more time in the relationship, and increased confidence in constructive communication and working as a team with the spouse predicted greater increases in both marital satisfaction and communication skills one year later. The constructs of intention and confidence (akin to perceived behavioral control) suggest that the Theory of Planned Behavior may be particularly useful when considering which Army couples will show ongoing benefit after relationship education.

A novel tertiary prep-HPLC method for the isolation of single amino acids for AMS-radiocarbon measurement.

Science.gov (United States)

Fernandes, Ricardo; Koudelka, Tomas; Tholey, Andreas; Dreves, Alexander

2017-07-15

AMS-radiocarbon measurements of amino acids can potentially provide more reliable radiocarbon dates than bulk collagen analysis. Nonetheless, the applicability of such an approach is often limited by the low-throughput of existing isolation methods and difficulties in determining the contamination introduced during the separation process. A novel tertiary prep-HPLC amino acid isolation method was developed that relies on the combustion of eluted material without requiring any additional chemical steps. Amino acid separation was carried out using a gradient mix of pure water and phosphoric acid with an acetonitrile step in-between runs to remove hydrophobic molecules from the separation column. The amount of contaminant carbon and its 14 C content were determined from two-point measurements of collagen samples of known 14 C content. The amount of foreign carbon due to the isolation process was estimated at 4±1μg and its 14 C content was 0.43±0.01 F 14 C. Radiocarbon values corrected for carbon contamination have only a minor increase in uncertainties. For Holocene samples, this corresponds to an added uncertainty typically smaller than 10 14 Cyears. The developed method can be added to routine AMS measurements without implying significant operational changes and offers a level of measurement uncertainty that is suitable for many archaeological, ecological, environmental, and biological applications. Copyright © 2017. Published by Elsevier B.V.

Young Transgender Women's Attitudes Toward HIV Pre-exposure Prophylaxis.

Science.gov (United States)

Wood, Sarah M; Lee, Susan; Barg, Frances K; Castillo, Marne; Dowshen, Nadia

2017-05-01

Our primary aim was to explore themes regarding attitudes toward HIV pre-exposure prophylaxis (PrEP) among young transgender women (YTW), in order to develop a theoretical model of PrEP uptake in this population disproportionally affected by HIV. Qualitative study nested within a mixed-method study characterizing barriers and facilitators to health services for YTW. Participants completed an in-depth interview exploring awareness of and attitudes toward PrEP. Key themes were identified using a grounded theory approach. Participants (n = 25) had a mean age of 21.2 years (standard deviation 2.2, range 17-24) and were predominately multiracial (36%) and of HIV-negative or unknown status (68%). Most participants (64%) reported prior knowledge of PrEP, and 28% reported current use or intent to use PrEP. Three major content themes that emerged were variability of PrEP awareness, barriers and facilitators to PrEP uptake, and emotional benefits of PrEP. Among participants without prior PrEP knowledge, participants reported frustration that PrEP information has not been widely disseminated to YTW, particularly by health care providers. Attitudes toward PrEP were overwhelmingly positive; however, concerns were raised regarding barriers including cost, stigma, and adherence challenges. Both HIV-positive and negative participants discussed emotional and relationship benefits of PrEP, which were felt to extend beyond HIV prevention alone. A high proportion of YTW in this study had prior knowledge of PrEP, and attitudes toward PrEP were positive among participants. Our findings suggest several domains to be further explored in PrEP implementation research, including methods of facilitating PrEP dissemination and emotional motivation for PrEP uptake. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: the PROMOTE study.

Science.gov (United States)

Hensel, Kendi L; Buchanan, Steve; Brown, Sarah K; Rodriguez, Mayra; Cruser, des Anges

2015-01-01

The purpose of this study was to evaluate the efficacy of osteopathic manipulative treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and to improve selected outcomes of labor and delivery. Pregnancy research on osteopathic manipulation optimizing treatment effects was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were assigned randomly to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included 7 treatments over 9 weeks. The OMT protocol included specific techniques that were administered by board-certified OMT specialists. Outcomes were assessed with the use of self-report measures for pain and back-related functioning and medical records for delivery outcomes. There were 136 women in the OMT group: 131 women in the PUT group and 133 women in the UCO group. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back-related functioning (P < .001 for both groups), with outcomes for the OMT group similar to that of the PUT group; however, both groups were significantly improved compared with the UCO group. For secondary outcome of meconium-stained amniotic fluid, there were no differences among the groups. OMT was effective for mitigating pain and functional deterioration compared with UCO; however, OMT did not differ significantly from PUT. This may be attributed to PUT being a more active treatment than intended. There was no higher likelihood of conversion to high-risk status based on treatment group. Therefore, OMT is a safe, effective adjunctive modality to improve pain and functioning during the third trimester. Copyright © 2015 Elsevier Inc. All rights reserved.

"Since both of us are using antiretrovirals, we have been supportive to each other": facilitators and barriers of pre-exposure prophylaxis use in heterosexual HIV serodiscordant couples in Kisumu, Kenya.

Science.gov (United States)

Patel, Rena C; Stanford-Moore, Gaelen; Odoyo, Josephine; Pyra, Maria; Wakhungu, Imeldah; Anand, Keerthana; Bukusi, Elizabeth A; Baeten, Jared M; Brown, Joelle M

2016-01-01

Since 2015, the World Health Organization recommends pre-exposure prophylaxis (PrEP) for all persons at substantial risk for HIV, including HIV-uninfected partners in serodiscordant relationships in resource-limited settings. As PrEP moves from clinical trials to real-world use, understanding facilitators of and barriers to PrEP initiation and adherence is critical to successful PrEP implementation and rollout. We conducted 44 in-depth individual or couple interviews with 63 participants (30 without HIV and 33 with HIV) enrolled in the Partners Demonstration Project in Kisumu, Kenya, between August and September 2014. The semi-structured interviews discussed the following: 1) perceived advantages and disadvantages of antiretroviral therapy (ART)/PrEP; 2) reasons for accepting or declining ART/PrEP and 3) influence of prevention of transmission to partner or infant on ART/PrEP use. Transcripts from the interviews were iteratively analyzed using inductive content analysis. Our study identified three key factors that may facilitate initiation of PrEP in this population. First, participants using PrEP felt reduced stress and increased trust in their HIV serodiscordant relationships. Second, greater community-wide knowledge of PrEP was thought to likely increase PrEP acceptance. Third, greater education and counselling by providers on PrEP use was also considered to likely increase the adoption of PrEP. We also identified three key barriers to initiation of and adherence to PrEP. First, most participants who declined PrEP expressed doubts about the relative additional effectiveness of PrEP in combination with other prevention tools. Second, perceived stigma related to PrEP use was an important barrier to PrEP initiation. Third, many struggled with overcoming perceived side effects or logistical challenges of taking daily PrEP, particularly when they themselves were not ill. Leveraging the facilitators and overcoming barriers to PrEP uptake may enhance the successful

Development of Whole Slide Imaging on Smartphones and Evaluation With ThinPrep Cytology Test Samples: Follow-Up Study

Science.gov (United States)

Ma, Shuoxin; Yu, Hong; Jin, Yu-Biao; Zheng, Jun

2018-01-01

Background The smartphone-based whole slide imaging (WSI) system represents a low-cost and effective alternative to automatic scanners for telepathology. In a previous study, the development of one such solution, named scalable whole slide imaging (sWSI), was presented and analyzed. A clinical evaluation of its iOS version with 100 frozen section samples verified the diagnosis-readiness of the produced virtual slides. Objective The first aim of this study was to delve into the quantifying issues encountered in the development of an Android version. It should also provide insights into future high-resolution real-time feedback medical imaging apps on Android and invoke the awareness of smartphone manufacturers for collaboration. The second aim of this study was to further verify the clinical value of sWSI with cytology samples. This type is different from the frozen section samples in that they require finer detail on the cellular level. Methods During sWSI development on Android, it was discovered that many models do not support uncompressed camera pixel data with sufficient resolution and full field of view. The proportion of models supporting the optimal format was estimated in a test on 200 mainstream Android models. Other factors, including slower processing speed and camera preview freezing, also led to inferior performance of sWSI on Android compared with the iOS version. The processing speed was mostly determined by the central processing unit frequency in theory, and the relationship was investigated in the 200-model simulation experiment with physical devices. The camera preview freezing was caused by the lag between triggering photo capture and resuming preview. In the clinical evaluation, 100 ThinPrep cytology test samples covering 6 diseases were scanned with sWSI and compared against the ground truth of optical microscopy. Results Among the tested Android models, only 3.0% (6/200) provided an optimal data format, meeting all criteria of quality and

"How I Wish This Thing Was Initiated 100 Years Ago!" Willingness to Take Daily Oral Pre-Exposure Prophylaxis among Men Who Have Sex with Men in Kenya.

Science.gov (United States)

Karuga, Robinson Njoroge; Njenga, Serah Nduta; Mulwa, Rueben; Kilonzo, Nduku; Bahati, Prince; O'reilley, Kevin; Gelmon, Lawrence; Mbaabu, Stephen; Wachihi, Charles; Githuka, George; Kiragu, Michael

2016-01-01

The MSM population in Kenya contributes to 15% of HIV incidence. This calls for innovative HIV prevention interventions. Pre-exposure prophylaxis (PrEP) has been efficacious in preventing HIV among MSM in trials. There is limited data on the willingness to take daily oral PrEP in sub-Sahara Africa. PrEP has not been approved for routine use in most countries globally. This study aimed to document the willingness to take PrEP and barriers to uptake and adherence to PrEP in Kenya. The findings will inform the design of a PrEP delivery program as part of the routine HIV combination prevention. Eighty MSM were recruited in 2 Counties in December 2013. Quantitative data on sexual behaviour and willingness to take PrEP were collected using semi-structured interviews and analysed using SPSS. Qualitative data on knowledge of PrEP, motivators and barriers to uptake and adherence to PrEP were collected using in-depth interviews and FGDs and analysed using Nvivo. Analysis of data in willingness to take PrEP was conducted on the HIV negative participants (n = 55). 83% of MSM were willing to take daily oral HIV PrEP. Willingness to take PrEP was higher among the bi-sexual and younger men. Motivators for taking PrEP were the need to stay HIV negative and to protect their partners. History of poor medication adherence, fear of side effects and HIV stigma were identified as potential barriers to adherence. Participants were willing to buy PrEP at a subsidized price. There is willingness to take PrEP among MSM in Kenya and there is need to invest in targeted education and messaging on PrEP to enhance adherence, proper use and reduce stigma in the general population and among policy makers.

"How I Wish This Thing Was Initiated 100 Years Ago!" Willingness to Take Daily Oral Pre-Exposure Prophylaxis among Men Who Have Sex with Men in Kenya.

Directory of Open Access Journals (Sweden)

Robinson Njoroge Karuga

Full Text Available The MSM population in Kenya contributes to 15% of HIV incidence. This calls for innovative HIV prevention interventions. Pre-exposure prophylaxis (PrEP has been efficacious in preventing HIV among MSM in trials. There is limited data on the willingness to take daily oral PrEP in sub-Sahara Africa. PrEP has not been approved for routine use in most countries globally. This study aimed to document the willingness to take PrEP and barriers to uptake and adherence to PrEP in Kenya. The findings will inform the design of a PrEP delivery program as part of the routine HIV combination prevention.Eighty MSM were recruited in 2 Counties in December 2013. Quantitative data on sexual behaviour and willingness to take PrEP were collected using semi-structured interviews and analysed using SPSS. Qualitative data on knowledge of PrEP, motivators and barriers to uptake and adherence to PrEP were collected using in-depth interviews and FGDs and analysed using Nvivo. Analysis of data in willingness to take PrEP was conducted on the HIV negative participants (n = 55.83% of MSM were willing to take daily oral HIV PrEP. Willingness to take PrEP was higher among the bi-sexual and younger men. Motivators for taking PrEP were the need to stay HIV negative and to protect their partners. History of poor medication adherence, fear of side effects and HIV stigma were identified as potential barriers to adherence. Participants were willing to buy PrEP at a subsidized price.There is willingness to take PrEP among MSM in Kenya and there is need to invest in targeted education and messaging on PrEP to enhance adherence, proper use and reduce stigma in the general population and among policy makers.

Investigation of (n,γ) reactions in fissionable fluids in a hybrid reactor system

International Nuclear Information System (INIS)

Guenay, Mehtap

2014-01-01

In this study, the effect of (n,γ) reactions in spent fuel-grade (SFG)-PuO 2 , UO 2 , NpO 2 and UCO contents was investigated in a designed hybrid reactor system. In this system, the molten salt-heavy metal mixtures 93 - 85 % Li 20 Sn 80 + 5 % SFG-PuO 2 and 2 - 10 % UO 2 , 93 - 85 % Li 20 Sn 80 + 5 % SFG-PuO 2 and 2 - 10 % NpO 2 , 93 - 85 % Li 20 Sn 80 + 5 % SFG-PuO 2 and 2 - 10 % UCO were used as fluids. Beryllium (Be) is used as neutron multiplier by (n,2n) reactions. Thence, a Be zone with a width of 3 cm was used in order to contribute on fissile fuel breeding between the liquid first wall and blanket. (n,γ) reactions were calculated in the liquid first wall, blanket and shield zones, which SFG-PuO 2 , UO 2 , NpO 2 and UCO contents. 9Cr2WVTa ferritic steel with the width of 4 cm was used as the structural material. Three-dimensional nucleonic calculations were performed using the most recent version MCNPX-2.7.0 the Monte Carlo code and nuclear data library ENDF/B-VII.0. (orig.)

The Acceptability of Pre-Exposure Prophylaxis: Beliefs of Health-Care Professionals Working in Sexually Transmitted Infections Clinics and HIV Treatment Centers.

NARCIS (Netherlands)

Bil, Janneke P; Hoornenborg, Elske; Prins, Maria; Hogewoning, Arjan; Dias Goncalves Lima, Fernando; de Vries, Henry J C; Davidovich, Udi

2018-01-01

Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV infections, but is not yet implemented in the Netherlands. As the attitudes of health-care professionals toward PrEP can influence future PrEP implementation, we studied PrEP knowledge and beliefs and their association with PrEP

The Acceptability of Pre-Exposure Prophylaxis: Beliefs of Health-Care Professionals Working in Sexually Transmitted Infections Clinics and HIV Treatment Centers

NARCIS (Netherlands)

Bil, Janneke P.; Hoornenborg, Elske; Prins, Maria; Hogewoning, Arjan; Dias Goncalves Lima, Fernando; de Vries, Henry J. C.; Davidovich, Udi

2018-01-01

Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV infections, but is not yet implemented in the Netherlands. As the attitudes of health-care professionals toward PrEP can influence future PrEP implementation, we studied PrEP knowledge and beliefs and their association with PrEP

HIV Care Providers' Intentions to Prescribe and Actual Prescription of Pre-Exposure Prophylaxis to At-Risk Adolescents and Adults.

Science.gov (United States)

Mullins, Tanya L Kowalczyk; Zimet, Gregory; Lally, Michelle; Xu, Jiahong; Thornton, Sarah; Kahn, Jessica A

2017-12-01

Pre-exposure prophylaxis (PrEP) is indicated for use in US adults, and little is known about clinician intentions to prescribe and actual prescription of PrEP to adolescents younger than 18. Fifty-six clinicians who care for HIV-infected and at-risk youth completed an anonymous online survey in 2014. Primary outcomes were (1) intentions to prescribe PrEP to adolescents and adults in four risk categories [men who have sex with men (MSM), transgender women, heterosexuals with multiple partners of unknown HIV status, heterosexuals with HIV-infected partners]; and (2) actual prescription of PrEP to adolescents and adults in these risk groups. Independent variables included clinician characteristics, experience prescribing nonoccupational postexposure prophylaxis, familiarity with and knowledge of PrEP and PrEP guidance, attitudes toward PrEP, and facilitating factors for prescribing PrEP and incorporation of PrEP guidance into practice. Variables associated with intention to prescribe ("very likely to prescribe" vs. other responses) and actual prescription of PrEP stratified by age and risk category were identified in logistic regression models. Mean age was 45.9 years (standard deviation 10.7); 64% were physicians. More clinicians reported high intention to prescribe PrEP to adult versus adolescent MSM (p = 0.02) and transgender women (p = 0.001). Variables associated with intention to prescribe and prescription of PrEP differed by age and risk category. In adolescents, those variables included positive beliefs, higher number of facilitating factors, and fewer barriers to PrEP prescription. Designing strategies based on these findings that address both facilitating factors and barriers to PrEP prescription may improve PrEP uptake by at-risk youth.

Perceptions of and intentions to adopt HIV pre-exposure prophylaxis among black men who have sex with men in Los Angeles.

Science.gov (United States)

Brooks, Ronald A; Landovitz, Raphael J; Regan, Rotrease; Lee, Sung-Jae; Allen, Vincent C

2015-12-01

This study assessed perceptions of pre-exposure prophylaxis (PrEP) and their association with PrEP adoption intention among a convenience sample of 224 low socioeconomic status black men who have sex with men (BMSM) residing in Los Angeles. Participants received educational information about PrEP and completed an in-person interview. More than half (60%) of the participants indicated a high intention to adopt PrEP. Younger BMSM (18-29 years) were twice as likely to report a high intention to adopt PrEP compared to older BMSM (30+ years). Only 33% of participants were aware of PrEP and no participant had ever used PrEP. Negative perceptions were associated with a lower PrEP adoption intention and included being uncomfortable taking an HIV medicine when HIV-negative and not knowing if there are long-term side effects of taking an HIV medication. These findings suggest that BMSM may adopt PrEP but that negative perceptions may limit its uptake among this population. In order to facilitate PrEP adoption among BMSM targeted educational and community awareness programmes are needed to provide accurate information on the benefits of PrEP and to address the negative perceptions of PrEP held by local BMSM populations. © The Author(s) 2015.

How Bioethics is Complementing Human Rights in Realizing Health Access for Clinical Trial Participants: The Case of Formative PrEP Access in South Africa.

Science.gov (United States)

Singh, Jerome

2015-06-11

Following the demise of apartheid, human rights in South Africa are now constitutionally enshrined.The right to health in South Africa's Constitution has been credited with transforming the lives of millions of people by triggering programmatic reforms in HIV treatment and the prevention of mother to child transmission (MTCT) of HIV.However, a constitutionally enshrined right to health offers no guarantee that clinical trial participants will enjoy post-trial access to beneficial interventions. Using access to HIV pre-exposure prophylaxis (PrEP) in South Africa as an example, this paper argues that adherence to bioethics norms could realize the right to health for trial participants following the end of a clinical trial. Copyright 2015 Singh. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.

Science.gov (United States)

Patel, Rupa R; Mena, Leandro; Nunn, Amy; McBride, Timothy; Harrison, Laura C; Oldenburg, Catherine E; Liu, Jingxia; Mayer, Kenneth H; Chan, Philip A

2017-01-01

Pre-exposure prophylaxis (PrEP) can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island) from 2014-2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%), 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68-12.01; p = 0.003). Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.

Directory of Open Access Journals (Sweden)

Rupa R Patel

Full Text Available Pre-exposure prophylaxis (PrEP can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island from 2014-2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%, 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68-12.01; p = 0.003. Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

Preparing for pre-exposure prophylaxis: perceptions and readiness of Canadian pharmacists for the implementation of HIV pre-exposure prophylaxis.

Science.gov (United States)

Yoong, Deborah; Naccarato, Mark; Sharma, Malika; Wilton, James; Senn, Heather; Tan, Darrell Hs

2016-07-01

Pre-exposure prophylaxis (PrEP) has been shown to reduce the risk of HIV transmission but has the potential to cause harm if not used properly. Pharmacists are well-positioned to foster PrEP's efficacy but little is known whether they would endorse it as an HIV prevention tool. The objective of the study was to determine Canadian HIV pharmacists' support for PrEP and to identify current barriers to promoting PrEP. Canadian pharmacists with experience in HIV care were invited to complete an online survey about their experiences, opinions, and learning needs regarding PrEP from December 2012 to January 2013. Among the 59 surveys received, 48 met criteria for final analysis. Overall, 33 (69%) respondents would provide education positively supporting the use of PrEP and 26 (54%) believed Health Canada should approve PrEP for use in Canada. Familiarity with the concept of PrEP and practice characteristics examined did not appear to be significantly associated with support for PrEP in univariable analyses. The principal barriers to promoting PrEP included inadequate drug coverage and insufficient knowledge to educate others. Many Canadian HIV pharmacists would endorse PrEP for high-risk patients; however, wider dissemination of information and lower drug costs may be needed to make PrEP more widely promoted. © The Author(s) 2015.

Ambiguity, ambivalence, and apprehensions of taking HIV-1 pre-exposure prophylaxis among male couples in San Francisco: a mixed methods study.

Directory of Open Access Journals (Sweden)

Parya Saberi

Full Text Available We conducted a mixed-methods study to examine serodiscordant and seroconcordant (HIV-positive/HIV-positive male couples' PrEP awareness, concerns regarding health care providers offering PrEP to the community, and correlates of PrEP uptake by the HIV-negative member of the couple.Qualitative sub-study included one-on-one interviews to gain a deeper understanding of participants' awareness of and experiences with PrEP and concerns regarding health care providers offering PrEP to men who have sex with men (MSM. Quantitative analyses consisted of a cross-sectional study in which participants were asked about the likelihood of PrEP uptake by the HIV-negative member of the couple and level of agreement with health care providers offering PrEP to anyone requesting it.We used multivariable regression to examine associations between PrEP questions and covariates of interest and employed an inductive approach to identify key qualitative themes.Among 328 men (164 couples, 62% had heard about PrEP, but approximately one-quarter were mistaking it with post-exposure prophylaxis. The majority of participants had low endorsement of PrEP uptake and 40% were uncertain if health care providers should offer PrEP to anyone requesting it. Qualitative interviews with 32 men suggest that this uncertainty likely stems from concerns regarding increased risk compensation. Likelihood of future PrEP uptake by the HIV-negative member of the couple was positively associated with unprotected insertive anal intercourse but negatively correlated with unprotected receptive anal intercourse.Findings suggest that those at greatest risk may not be receptive of PrEP. Those who engage in moderate risk express more interest in PrEP; however, many voice concerns of increased risk behavior in tandem with PrEP use. Results indicate a need for further education of MSM communities and the need to determine appropriate populations in which PrEP can have the highest impact.

Ambiguity, ambivalence, and apprehensions of taking HIV-1 pre-exposure prophylaxis among male couples in San Francisco: a mixed methods study.

Science.gov (United States)

Saberi, Parya; Gamarel, Kristi E; Neilands, Torsten B; Comfort, Megan; Sheon, Nicolas; Darbes, Lynae A; Johnson, Mallory O

2012-01-01

We conducted a mixed-methods study to examine serodiscordant and seroconcordant (HIV-positive/HIV-positive) male couples' PrEP awareness, concerns regarding health care providers offering PrEP to the community, and correlates of PrEP uptake by the HIV-negative member of the couple. Qualitative sub-study included one-on-one interviews to gain a deeper understanding of participants' awareness of and experiences with PrEP and concerns regarding health care providers offering PrEP to men who have sex with men (MSM). Quantitative analyses consisted of a cross-sectional study in which participants were asked about the likelihood of PrEP uptake by the HIV-negative member of the couple and level of agreement with health care providers offering PrEP to anyone requesting it. We used multivariable regression to examine associations between PrEP questions and covariates of interest and employed an inductive approach to identify key qualitative themes. Among 328 men (164 couples), 62% had heard about PrEP, but approximately one-quarter were mistaking it with post-exposure prophylaxis. The majority of participants had low endorsement of PrEP uptake and 40% were uncertain if health care providers should offer PrEP to anyone requesting it. Qualitative interviews with 32 men suggest that this uncertainty likely stems from concerns regarding increased risk compensation. Likelihood of future PrEP uptake by the HIV-negative member of the couple was positively associated with unprotected insertive anal intercourse but negatively correlated with unprotected receptive anal intercourse. Findings suggest that those at greatest risk may not be receptive of PrEP. Those who engage in moderate risk express more interest in PrEP; however, many voice concerns of increased risk behavior in tandem with PrEP use. Results indicate a need for further education of MSM communities and the need to determine appropriate populations in which PrEP can have the highest impact.

Reinforcement of drinking by running: effect of fixed ratio and reinforcement time1

Science.gov (United States)

Premack, David; Schaeffer, Robert W.; Hundt, Alan

1964-01-01

Rats were required to complete varying numbers of licks (FR), ranging from 10 to 300, in order to free an activity wheel for predetermined times (CT) ranging from 2 to 20 sec. The reinforcement of drinking by running was shown both by an increased frequency of licking, and by changes in length of the burst of licking relative to operant-level burst length. In log-log coordinates, instrumental licking tended to be a linear increasing function of FR for the range tested, a linear decreasing function of CT for the range tested. Pause time was implicated in both of the above relations, being a generally increasing function of both FR and CT. PMID:14120150

REINFORCEMENT OF DRINKING BY RUNNING: EFFECT OF FIXED RATIO AND REINFORCEMENT TIME.

Science.gov (United States)

PREMACK, D; SCHAEFFER, R W; HUNDT, A

1964-01-01

Rats were required to complete varying numbers of licks (FR), ranging from 10 to 300, in order to free an activity wheel for predetermined times (CT) ranging from 2 to 20 sec. The reinforcement of drinking by running was shown both by an increased frequency of licking, and by changes in length of the burst of licking relative to operant-level burst length. In log-log coordinates, instrumental licking tended to be a linear increasing function of FR for the range tested, a linear decreasing function of CT for the range tested. Pause time was implicated in both of the above relations, being a generally increasing function of both FR and CT.

Awareness and attitudes of pre-exposure prophylaxis for HIV prevention among physicians in Guatemala: Implications for country-wide implementation.

Science.gov (United States)

Ross, Ian; Mejia, Carlos; Melendez, Johanna; Chan, Philip A; Nunn, Amy C; Powderly, William; Goodenberger, Katherine; Liu, Jingxia; Mayer, Kenneth H; Patel, Rupa R

2017-01-01

HIV continues to be a major health concern with approximately 2.1 million new infections occurring worldwide in 2015. In Central America, Guatemala had the highest incident number of HIV infections (3,700) in 2015. Antiretroviral pre-exposure prophylaxis (PrEP) was recently recommended by the World Health Organization (WHO) as an efficacious intervention to prevent HIV transmission. PrEP implementation efforts are underway in Guatemala and success will require providers that are knowledgeable and willing to prescribe PrEP. We sought to explore current PrEP awareness and prescribing attitudes among Guatemalan physicians in order to inform future PrEP implementation efforts. We conducted a cross-sectional survey of adult internal medicine physicians at the main teaching hospital in Guatemala City in March 2015. The survey included demographics, medical specialty, years of HIV patient care, PrEP awareness, willingness to prescribe PrEP, previous experience with post-exposure prophylaxis, and concerns about PrEP. The primary outcome was willingness to prescribe PrEP, which was assessed using a 5-point Likert scale for different at-risk population scenarios. Univariate and multivariate logistic regression was performed to identify predictors for willingness to prescribe PrEP. Eighty-seven physicians completed the survey; 66% were male, 64% were internal medicine residency trainees, and 10% were infectious disease (ID) specialists. Sixty-nine percent of physicians were PrEP aware, of which 9% had previously prescribed PrEP. Most (87%) of respondents were willing to prescribe PrEP to men who have sex with men (MSM), sex workers, injection drug users, or HIV-uninfected persons having known HIV-positive sexual partners. Concerns regarding PrEP included development of resistance (92%), risk compensation (90%), and cost (64%). Univariate logistic regression showed that younger age, being a resident trainee, and being a non-ID specialist were significant predictors for

A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians.

Science.gov (United States)

Blackstock, Oni J; Moore, Brent A; Berkenblit, Gail V; Calabrese, Sarah K; Cunningham, Chinazo O; Fiellin, David A; Patel, Viraj V; Phillips, Karran A; Tetrault, Jeanette M; Shah, Minesh; Edelman, E Jennifer

2017-01-01

Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. Cross-sectional online survey conducted in April and May 2015. Members of a national professional organization for academic primary care physicians (n = 266). PrEP awareness, PrEP adoption (ever prescribed or referred a patient for PrEP [yes/no]), provider and practice characteristics, and self-rated knowledge, attitudes, and beliefs associated with adoption. The survey response rate was 8.6 % (266/2093). Ninety-three percent of respondents reported prior awareness of PrEP. Of these, 34.9 % reported PrEP adoption. In multivariable analysis of provider and practice characteristics, compared with non-adopters, adopters were more likely to provide care to more than 50 HIV-positive patients (vs. 0, aOR = 6.82, 95 % CI 2.06-22.52). Compared with non-adopters, adopters were also more likely to report excellent, very good, or good self-rated PrEP knowledge (15.1 %, 33.7 %, 30.2 % vs. 2.5 %, 18.1 %, 23.8 %, respectively; p < 0.001) and to perceive PrEP as extremely safe (35.1 % vs. 10.7 %; p = 0.002). Compared with non-adopters, adopters were less likely to perceive PrEP as being moderately likely to increase risk behaviors ("risk compensation") (12.8 % vs. 28.8 %, p = 0.02). While most respondents were aware of PrEP, only one-third of PrEP-aware PCPs reported adoption. Adopters were more likely to have experience providing HIV care and to perceive PrEP as extremely safe, and were less likely to perceive PrEP use as leading to risk compensation. To enhance PCP adoption of PrEP, educational efforts targeting PCPs without HIV care experience should be considered, as well as training

Development of Whole Slide Imaging on Smartphones and Evaluation With ThinPrep Cytology Test Samples: Follow-Up Study.

Science.gov (United States)

Huang, Yu-Ning; Peng, Xing-Chun; Ma, Shuoxin; Yu, Hong; Jin, Yu-Biao; Zheng, Jun; Fu, Guo-Hui

2018-04-04

The smartphone-based whole slide imaging (WSI) system represents a low-cost and effective alternative to automatic scanners for telepathology. In a previous study, the development of one such solution, named scalable whole slide imaging (sWSI), was presented and analyzed. A clinical evaluation of its iOS version with 100 frozen section samples verified the diagnosis-readiness of the produced virtual slides. The first aim of this study was to delve into the quantifying issues encountered in the development of an Android version. It should also provide insights into future high-resolution real-time feedback medical imaging apps on Android and invoke the awareness of smartphone manufacturers for collaboration. The second aim of this study was to further verify the clinical value of sWSI with cytology samples. This type is different from the frozen section samples in that they require finer detail on the cellular level. During sWSI development on Android, it was discovered that many models do not support uncompressed camera pixel data with sufficient resolution and full field of view. The proportion of models supporting the optimal format was estimated in a test on 200 mainstream Android models. Other factors, including slower processing speed and camera preview freezing, also led to inferior performance of sWSI on Android compared with the iOS version. The processing speed was mostly determined by the central processing unit frequency in theory, and the relationship was investigated in the 200-model simulation experiment with physical devices. The camera preview freezing was caused by the lag between triggering photo capture and resuming preview. In the clinical evaluation, 100 ThinPrep cytology test samples covering 6 diseases were scanned with sWSI and compared against the ground truth of optical microscopy. Among the tested Android models, only 3.0% (6/200) provided an optimal data format, meeting all criteria of quality and efficiency. The image-processing speed

Primary care clinicians' experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters.

Science.gov (United States)

Krakower, Douglas S; Maloney, Kevin M; Grasso, Chris; Melbourne, Katherine; Mayer, Kenneth H

2016-01-01

An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Thirty-two clinicians (response rate=91%) completed the surveys. Nearly all clinicians (97%) had prescribed PrEP (median 20 patients, interquartile range 11-33). Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians' practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79%) rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this efficacious intervention.

Demographic differences in PrEP–related stereotypes: Implications for implementation

Science.gov (United States)

Golub, Sarit. A.; Gamarel, Kristi E.; Surace, Anthony

2015-01-01

Qualitative interviews about pre-exposure prophylaxis (PrEP) stereotypes were conducted with a subsample of 160 MSM who participated in a PrEP messaging study. Negative stereotypes about PrEP users were identified by 80% of participants. Two types of stereotypes were most common: PrEP users are HIV-infected (and lying about it), and PrEP users are promiscuous and resistant to condom use. Participants’ identification of these stereotype categories differed significantly by demographic factors (i.e. race/ethnicity, education). Expanding access to PrEP requires recognizing potential differences in the experience or anticipation of PrEP-related stereotypes that might impact willingness to discuss PrEP with providers, friends, or partners. PMID:26143247

Antiretroviral pre-exposure prophylaxis preferences among men who have sex with men in Vietnam: results from a nationwide cross-sectional survey.

Science.gov (United States)

Oldenburg, Catherine E; Le, Bao; Huyen, Hoang Thi; Thien, Dinh Duc; Quan, Nguyen Hoang; Biello, Katie B; Nunn, Amy; Chan, Philip A; Mayer, Kenneth H; Mimiaga, Matthew J; Colby, Donn

2016-07-22

Background: The HIV/AIDS epidemic in Vietnam is concentrated in subgroups of the population, including men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is a viable strategy for HIV prevention, but knowledge about and preferences for PrEP delivery among Vietnamese MSM are not well understood. Methods: In 2015, an online survey was conducted with recruitment via social networking websites for MSM and peer recruitment. A description of daily oral, long-acting injectable, and rectal microbicide formulations of PrEP was provided to participants. Participants were asked about their prior awareness of and interest in PrEP, and ranked their most preferred PrEP modality. Multivariable logistic regression models were used to assess factors associated with having heard of PrEP and preference for each PrEP modality. Results: Of 548 participants who answered demographic and PrEP-related questions, 26.8% had previously heard of PrEP and most (65.7%) endorsed rectal microbicides as their most preferred PrEP delivery modality. Commonly-cited perceived barriers to uptake of PrEP included concern about side-effects, perception about being HIV positive, and family or friends finding out about their sexual behaviour. In multivariable models, older participants less often endorsed rectal microbicides (adjusted odds ratio (AOR) 0.95 per year, 95% confidence interval (CI) 0.91-0.99) and more often endorsed long-acting injectables (AOR 1.08 per year, 95% CI 1.03 to 1.14) as their preferred PrEP modality. Participants who were willing to pay more for PrEP less often endorsed rectal microbicides (AOR 0.81, 95% CI 0.72-0.92) and more often endorsed long-acting injectables (AOR 1.17, 95% CI 1.01-1.35) and daily oral pills (AOR 1.16, 95% CI 1.00-1.35) as their preferred form of PrEP. Conclusions: A variety of PrEP modalities were acceptable to MSM in Vietnam, but low knowledge of PrEP may be a barrier to implementation.

Baseline Preferences for Daily, Event-Driven, or Periodic HIV Pre-Exposure Prophylaxis among Gay and Bisexual Men in the PRELUDE Demonstration Project

Directory of Open Access Journals (Sweden)

Stefanie J. Vaccher

2017-12-01

Full Text Available IntroductionThe effectiveness of daily pre-exposure prophylaxis (PrEP is well established. However, there has been increasing interest in non-daily dosing schedules among gay and bisexual men (GBM. This paper explores preferences for PrEP dosing schedules among GBM at baseline in the PRELUDE demonstration project.Materials and methodsIndividuals at high-risk of HIV were enrolled in a free PrEP demonstration project in New South Wales, Australia, between November 2014 and April 2016. At baseline, they completed an online survey containing detailed behavioural, demographic, and attitudinal questions, including their ideal way to take PrEP: daily (one pill taken every day, event-driven (pills taken only around specific risk events, or periodic (daily dosing during periods of increased risk.ResultsOverall, 315 GBM (98% of study sample provided a preferred PrEP dosing schedule at baseline. One-third of GBM expressed a preference for non-daily PrEP dosing: 20% for event-driven PrEP, and 14% for periodic PrEP. Individuals with a trade/vocational qualification were more likely to prefer periodic to daily PrEP [adjusted odds ratio (aOR = 4.58, 95% confidence intervals (95% CI: (1.68, 12.49], compared to individuals whose highest level of education was high school. Having an HIV-positive main regular partner was associated with strong preference for daily, compared to event-driven PrEP [aOR = 0.20, 95% CI: (0.04, 0.87]. Participants who rated themselves better at taking medications were more likely to prefer daily over periodic PrEP [aOR = 0.39, 95% CI: (0.20, 0.76].DiscussionIndividuals’ preferences for PrEP schedules are associated with demographic and behavioural factors that may impact on their ability to access health services and information about PrEP and patterns of HIV risk. At the time of data collection, there were limited data available about the efficacy of non-daily PrEP schedules, and clinicians only recommended daily PrEP to

Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: a Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians.

Science.gov (United States)

Palummieri, Antonio; De Carli, Gabriella; Rosenthal, Éric; Cacoub, Patrice; Mussini, Cristina; Puro, Vincenzo

2017-11-28

Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in

Investigation of (n,γ) reactions in fissionable fluids in a hybrid reactor system

Energy Technology Data Exchange (ETDEWEB)

Guenay, Mehtap [Inoenue Univ., Malatya (Turkey). Physics Dept.

2014-06-15

In this study, the effect of (n,γ) reactions in spent fuel-grade (SFG)-PuO{sub 2}, UO{sub 2}, NpO{sub 2} and UCO contents was investigated in a designed hybrid reactor system. In this system, the molten salt-heavy metal mixtures 93 - 85 % Li{sub 20}Sn{sub 80} + 5 % SFG-PuO{sub 2} and 2 - 10 % UO{sub 2}, 93 - 85 % Li{sub 20}Sn{sub 80} + 5 % SFG-PuO{sub 2} and 2 - 10 % NpO{sub 2}, 93 - 85 % Li{sub 20}Sn{sub 80} + 5 % SFG-PuO{sub 2} and 2 - 10 % UCO were used as fluids. Beryllium (Be) is used as neutron multiplier by (n,2n) reactions. Thence, a Be zone with a width of 3 cm was used in order to contribute on fissile fuel breeding between the liquid first wall and blanket. (n,γ) reactions were calculated in the liquid first wall, blanket and shield zones, which SFG-PuO{sub 2}, UO{sub 2}, NpO{sub 2} and UCO contents. 9Cr2WVTa ferritic steel with the width of 4 cm was used as the structural material. Three-dimensional nucleonic calculations were performed using the most recent version MCNPX-2.7.0 the Monte Carlo code and nuclear data library ENDF/B-VII.0. (orig.)

Factors influencing uptake of pre-exposure prophylaxis: some qualitative insights from an intervention study of men who have sex with men in China.

Science.gov (United States)

Liu, Chunxing; Ding, Yingying; Ning, Zhen; Gao, Meiyang; Liu, Xing; Wong, Frank Y; He, Na

2018-02-01

Pre-exposure prophylaxis (PrEP) is a biomedical approach for preventing the acquisition of HIV in populations at substantial risk for HIV. However, its uptake among men who have sex with men (MSM) is low in China. The study aimed to identify factors that might influence MSM's uptake and use of PrEP. In-depth interviews were conducted with 32 self-identified MSM from a PrEP intervention study evaluating daily oral tenofovir disoproxil fumarate (TDF) to prevent HIV infection. Of these men, 11 were presently using the 'TDF' group; 8 from the 'change-over' group (i.e. initially used PrEP but subsequently quitted); and 13 from the non-user group. Data were analysed using thematic approach. Perception of low HIV risk, mistrust of the national PrEP program, and concerns of side effects were the main reasons for not wanting to use PrEP. Also, lack of main sexual partner's support, difficulties in adhering to the daily TDF regimen, and the inconvenient schedules in securing the medicine were the major reasons for not wanting to use or quitting the use of PrEP. On the other hand, perceived high HIV risk, beliefs in efficacy of PrEP, and worries of transmitting HIV to families were the major motives for PrEP uptake. Findings suggest that PrEP implementation strategies should first address issues including but not limited to accurate self-assessment of HIV risk, mistrust and limited knowledge about medical trials and PrEP, and ease of accessing PrEP.

Pathways of human exposure to cobalt in Katanga, a mining area of the D.R. Congo.

Science.gov (United States)

Cheyns, Karlien; Banza Lubaba Nkulu, Célestin; Ngombe, Léon Kabamba; Asosa, Jimmy Ngoy; Haufroid, Vincent; De Putter, Thierry; Nawrot, Tim; Kimpanga, Célestin Muleka; Numbi, Oscar Luboya; Ilunga, Benjamin Kabyla; Nemery, Benoit; Smolders, Erik

2014-08-15

Human exposure biomonitoring in the African Copperbelt (Katanga, southern D.R. Congo) revealed elevated cobalt (Co) exposure in the general population. This study was designed to identify the Co exposure routes for the non-occupationally exposed population in that area. The concentration of Co was measured in environmental and urine samples collected in urban and rural communities close to metal mining and/or refining plants, villages near a lake receiving effluents from metal refining plants, and control rural areas without industrial pollution. Drinking water, uncooked food items (maize flour, washed vegetables, fish and meat), indoor and outdoor dust samples were collected at each location. A food questionnaire was used to estimate dietary Co intake for adults and children. Geometric mean urine-Co (U-Co) concentrations were 4.5-fold (adults) and 6.6-fold (children) higher in the polluted than in the control area, with U-Co values being intermediate in the lakeside area. Average Co concentrations in environmental samples differed 6-40-fold between these areas. U-Co was positively correlated with most environmental Co concentrations, the highest correlations being found with Co in drinking water, vegetables and fruit. Estimated average total Co intake for adults was 63 (±42) μg/day in the control area, 94 (±55) μg/day in the lakeside villages and 570 (±100) μg Co/day in the polluted areas. U-Co was significantly related to modelled Co intake (R(2)=0.48, adults and R(2)=0.47, children; log-log relationship). Consumption of legumes, i.e. sweet potato leaves (polluted) and cereals+fish (lakeside) was the largest contributor to Co intake in adults, whereas dust ingestion appeared to contribute substantially in children in the polluted area. In conclusion, dietary Co is the main source of Co exposure in the polluted area and Co is efficiently transferred from soil and water in the human food chain. Copyright © 2014 Elsevier B.V. All rights reserved.

Willingness to use HIV pre-exposure prophylaxis among gay men, other men who have sex with men and transgender women in Myanmar.

Science.gov (United States)

Draper, Bridget L; Fowkes, Freya J I; Oo, Zaw Min; Thein, Zaw Win; Aung, Poe Poe; Veronese, Vanessa; Ryan, Claire; Thant, Myo; Hughes, Chad; Stoové, Mark

2017-07-26

HIV pre-exposure prophylaxis (PrEP) has emerged as a key component of contemporary HIV combination prevention strategies. To explore the local suitability of PrEP, country-specific acceptability studies are needed to inform potential PrEP implementation. In the context of Myanmar, in addition to resource constraints, HIV service access by gay men, other men who have sex with men, and transgender women (GMT) continues to be constrained by legislative and community stigma and marginalization. We aimed to determine PrEP acceptability among GMT in Myanmar and explore the factors associated with willingness to use PrEP. GMT were recruited in Yangon and Mandalay through local HIV prevention outreach programmes in November and December 2014. Quantitative surveys were administered by trained peer educators and collected data on demographics, sexual risk, testing history and PrEP acceptability. A modified six-item PrEP acceptability scale classified self-reported HIV undiagnosed GMT as willing to use PrEP. Multivariable logistic regression identified factors associated with willingness to use PrEP. Among 434 HIV undiagnosed GMT, PrEP awareness was low (5%). PrEP acceptability was high, with 270 (62%) GMT classified as willing to use PrEP. GMT recruited in Mandalay (adjusted odds ratio (aOR) = 1.79; 95%CI = 1.05-3.03), who perceived themselves as likely to become HIV positive (aOR = 1.82; 95%CI = 1.10-3.02), who had more than one recent regular partner (aOR = 2.94; 95%CI = 1.41-6.14), no regular partners (aOR = 2.05; 95%CI = 1.10-3.67), more than five casual partners (aOR = 2.05; 95%CI = 1.06-3.99) or no casual partners (aOR = 2.25; 95%CI = 1.23-4.11) were more likely to be willing to use PrEP. The association between never or only occasionally using condoms with casual partners and willingness to use PrEP was marginally significant (aOR = 2.02; 95%CI = 1.00-4.10). GMT who reported concern about side effects and long-term use of PrEP were less

Ghrelin increases the motivation to eat, but does not alter food palatability

Science.gov (United States)

Overduin, Joost; Figlewicz, Dianne P.; Bennett-Jay, Jennifer; Kittleson, Sepideh

2012-01-01

Homeostatic eating cannot explain overconsumption of food and pathological weight gain. A more likely factor promoting excessive eating is food reward and its representation in the central nervous system (CNS). The anorectic hormones leptin and insulin reduce food reward and inhibit related CNS reward pathways. Conversely, the orexigenic gastrointestinal hormone ghrelin activates both homeostatic and reward-related neurocircuits. The current studies were conducted to identify in rats the effects of intracerebroventricular ghrelin infusions on two distinct aspects of food reward: hedonic valuation (i.e., “liking”) and the motivation to self-administer (i.e., “wanting”) food. To assess hedonic valuation of liquid food, lick motor patterns were recorded using lickometry. Although ghrelin administration increased energy intake, it did not alter the avidity of licking (initial lick rates or lick-cluster size). Several positive-control conditions ruled out lick-rate ceiling effects. Similarly, when the liquid diet was hedonically devalued with quinine supplementation, ghrelin failed to reverse the quinine-associated reduction of energy intake and avidity of licking. The effects of ghrelin on rats' motivation to eat were assessed using lever pressing to self-administer food in a progressive-ratio paradigm. Ghrelin markedly increased motivation to eat, to levels comparable to or greater than those seen following 24 h of food deprivation. Pretreatment with the dopamine D1 receptor antagonist SCH-23390 eliminated ghrelin-induced increases in lever pressing, without compromising generalized licking motor control, indicating a role for D1 signaling in ghrelin's motivational feeding effects. These results indicate that ghrelin increases the motivation to eat via D1 receptor-dependent mechanisms, without affecting perceived food palatability. PMID:22673784

Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey

Science.gov (United States)

Pang, Joselyn; Wei, Clayton Koh Thuan; Yee, Ilias Adam; Wang, Bangyuan; Cassolato, Matteo

2017-01-01

Objective We examined willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia. Methods An online survey of 990 MSM was conducted between March and April 2016. Eligibility criteria included being biological male, Malaysian citizen, 18 years of age or above, identifying as MSM, and being HIV negative or unknown status. Participants’ demographics, sexual and drug use behaviors, attitudes towards PrEP, and preferences regarding future access to PrEP were collected. Bivariate analysis and logistic regression were performed to determine factors associated with willingness to use PrEP. Results Fewer than half of participants (44%) knew about PrEP before completing the survey. Overall, 39% of the sample were willing to take PrEP. Multivariate logistic regression indicated that Malay men (AOR: 1.73, 95% CI:1.12, 2.70), having 2 or more male anal sex partners in the past 6 months (AOR: 1.98, 95% CI: 1.29, 3.05), previous knowledge of PrEP (AOR: 1.40, 95%CI: 1.06, 1.86), lack of confidence in practising safer sex (AOR: 1.36, 95% CI: 1.02, 1.81), and having ever paid for sex with a male partner (AOR: 1.39, 95% CI: 1.01, 1.91) were independently associated with greater willingness to use PrEP, while men who identified as heterosexual were less willing to use PrEP (AOR, 0.36, 95% CI: 0.13, 0.97). Majority of participants preferred to access PrEP at affordable cost below 100 Malaysian Ringgit (USD25) per month from community based organisations followed by private or government hospitals. Conclusions Overall, MSM in Malaysia reported a relatively low level of willingness to use PrEP, although willingness was higher among those previously aware of PrEP. There is a need to provide PrEP at affordable cost, increase demand and awareness of PrEP, and to provide access to this preventative medication via diverse, integrated and tailored sexual health services. PMID:28902857

HIV Pre-Exposure Prophylaxis Interest among Female Sex Workers in Guangxi, China

Science.gov (United States)

Zou, Yunfeng; Yang, Xiaobo; Abdullah, Abu S.; Zhong, Xiaoni; Ruan, Yuhua; Lin, Xinqin; Li, Mingqiang; Wu, Deren; Jiang, Junjun; Xie, Peiyan; Huang, Jiegang; Liang, Bingyu; Zhou, Bo; Su, Jinming; Liang, Hao; Huang, Ailong

2014-01-01

Objectives Acceptability of pre-exposure prophylaxis (PrEP) and willingness to participate in a clinical trial for both safety and efficacy of PrEP were investigated among female sex workers (FSWs) in Guangxi, China. Methods A cross-sectional study was performed in three cities in Guangxi. Structured, self-administered questionnaires were used to assess the acceptability of PrEP and the willingness to participate in a clinical trial. Multivariable logistic regression models were fitted to identify predictors. Results Among 405 participants, 15.1% had heard of PrEP. If PrEP was deemed to be effective, safe and provided for free, 85.9% reported that they would accept it, and 54.3% of those who accepted PrEP said that they would participate in a clinical trial. The increased acceptability of PrEP was associated with working in male dominated venues, higher income, a poor family relationship, better HIV/AIDS knowledge, not realizing HIV risk from unfamiliar clients, not being forced to use condoms by the gatekeepers, consistent use of condoms, and use of drugs to prevent STD infection. The increased willingness to participate in a clinical trial was associated with a poor family relationship, better HIV/AIDS knowledge, not realizing HIV risk from unfamiliar clients, a willingness to adhere to daily PreP use, and not being concerned about discrimination by others. The main reason for rejecting PrEP or participating in a clinical trial was the concern about the side effects of PrEP. Conclusions Acceptability of PrEP among Guangxi FSWs is relatively high, indicating that PrEP intervention programs may be feasible for Chinese FSWs. Given the fact that most of the participants had never heard of PrEP before, and that family, gatekeepers, and social discrimination could significantly affect its acceptability, a comprehensive mix of multiple interventions is necessary for the successful implementation of a PrEP program among this population in Guangxi. PMID:24465956

Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey.

Science.gov (United States)

Lim, Sin How; Mburu, Gitau; Bourne, Adam; Pang, Joselyn; Wickersham, Jeffrey A; Wei, Clayton Koh Thuan; Yee, Ilias Adam; Wang, Bangyuan; Cassolato, Matteo; Azwa, Iskandar

2017-01-01

We examined willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia. An online survey of 990 MSM was conducted between March and April 2016. Eligibility criteria included being biological male, Malaysian citizen, 18 years of age or above, identifying as MSM, and being HIV negative or unknown status. Participants' demographics, sexual and drug use behaviors, attitudes towards PrEP, and preferences regarding future access to PrEP were collected. Bivariate analysis and logistic regression were performed to determine factors associated with willingness to use PrEP. Fewer than half of participants (44%) knew about PrEP before completing the survey. Overall, 39% of the sample were willing to take PrEP. Multivariate logistic regression indicated that Malay men (AOR: 1.73, 95% CI:1.12, 2.70), having 2 or more male anal sex partners in the past 6 months (AOR: 1.98, 95% CI: 1.29, 3.05), previous knowledge of PrEP (AOR: 1.40, 95%CI: 1.06, 1.86), lack of confidence in practising safer sex (AOR: 1.36, 95% CI: 1.02, 1.81), and having ever paid for sex with a male partner (AOR: 1.39, 95% CI: 1.01, 1.91) were independently associated with greater willingness to use PrEP, while men who identified as heterosexual were less willing to use PrEP (AOR, 0.36, 95% CI: 0.13, 0.97). Majority of participants preferred to access PrEP at affordable cost below 100 Malaysian Ringgit (USD25) per month from community based organisations followed by private or government hospitals. Overall, MSM in Malaysia reported a relatively low level of willingness to use PrEP, although willingness was higher among those previously aware of PrEP. There is a need to provide PrEP at affordable cost, increase demand and awareness of PrEP, and to provide access to this preventative medication via diverse, integrated and tailored sexual health services.

Awareness of and willingness to use oral pre-exposure prophylaxis for HIV prevention among HIV-serodiscordant heterosexual couples: a cross-sectional survey in Xinjiang, China.

Directory of Open Access Journals (Sweden)

Peierdun Mijiti

Full Text Available OBJECTIVES: We aimed to investigate the awareness of and willingness to use oral pre-exposure prophylaxis (PrEP for HIV prevention among HIV-negative partners in HIV-serodiscordant heterosexual couples in Xinjiang, China and determine factors that predict willingness to use oral PrEP. METHODS: Between November 2009 and December 2010, a cross-sectional survey was carried out among 351 HIV-negative partners in HIV-serodiscordant heterosexual couples from three cities in Xinjiang, China. Participants completed a self-administered questionnaire to assess their awareness of and willingness to use oral PrEP. Additionally, blood samples were collected to test for HIV infection. Univariate and multivariate logistic regression analyses were performed to identify predictors of willingness to use oral PrEP. RESULTS: Only 10 participants (2.8% reported having heard of PrEP, and only two reported ever using PrEP. However, 297 (84.6% reported that they were willing to use oral PrEP if it was proven to be both safe and effective. Results of multivariate analysis revealed the following independent predictors of willingness to use oral PrEP: monthly household income (adjusted odds ratio = 2.78, <1000 RMB vs. ≥ 1000 RMB, 95% confidence interval: 1.36-5.69, perceived likelihood of contracting HIV from HIV-positive partner (adjusted odds ratio = 2.63, likely vs. unlikely, 95% confidence interval: 1.12-6.19, and worrying about being discriminated against by others due to oral PrEP use (adjusted odds ratio = 9.43, No vs. Yes, 95% confidence interval: 3.78-23.50. CONCLUSIONS: Our results showed HIV-negative partners in HIV-serodiscordant heterosexual couples in China had low awareness of oral PrEP but high willingness to use oral PrEP for HIV prevention. Cost of oral PrEP should be taken into consideration in future PrEP prevention strategy. In addition, efforts should be made to reduce stigma attached to oral PrEP use, which may increase its acceptability among

Pre-Exposure Prophylaxis for HIV Prevention: Safety Concerns.

Science.gov (United States)

Tetteh, Raymond A; Yankey, Barbara A; Nartey, Edmund T; Lartey, Margaret; Leufkens, Hubert G M; Dodoo, Alexander N O

2017-04-01

Available evidence supports the efficacy of pre-exposure prophylaxis (PrEP) in decreasing the incidence of human immunodeficiency virus (HIV) infection among high-risk individuals, especially when used in combination with other behavioural preventive methods. Safety concerns about PrEP present challenges in the implementation and use of PrEP. The aim of this review is to discuss safety concerns observed in completed clinical trials on the use of PrEP. We performed a literature search on PrEP in PubMed, global advocacy for HIV prevention (Aids Vaccine Advocacy Coalition) database, clinical trials registry " http://www.clinicaltrials.gov " and scholar.google, using combination search terms 'pre-exposure prophylaxis', 'safety concerns in the use of pre-exposure prophylaxis', 'truvada use as PrEP', 'guidelines for PrEP use', 'HIV pre-exposure prophylaxis' and 'tenofovir' to identify clinical trials and literature on PrEP. We present findings associated with safety issues on the use of PrEP based on a review of 11 clinical trials on PrEP with results on safety and efficacy as at April 2016. We also reviewed findings from routine real-life practice reports. The pharmacological intervention for PrEP was tenofovir disoproxil fumarate/emtricitabine in a combined form as Truvada ® or tenofovir as a single entity. Both products are efficacious for PrEP and seem to have a good safety profile. Regular monitoring is recommended to prevent long-term toxic effects. The main adverse effects observed with PrEP are gastrointestinal related; basically mild to moderate nausea, vomiting and diarrhea. Other adverse drug effects worth monitoring are liver enzymes, renal function and bone mineral density. PrEP as an intervention to reduce HIV transmission appears to have a safe benefit-risk profile in clinical trials. It is recommended for widespread use but adherence monitoring and real-world safety surveillance are critical in the post-marketing phase to ensure that the benefits

Knowledge, Indications and Willingness to Take Pre-Exposure Prophylaxis among Transwomen in San Francisco, 2013.

Directory of Open Access Journals (Sweden)

Erin C Wilson

Full Text Available Safe and effective HIV prevention strategies are needed for transwomen. Transwomen in the US have a 34 times greater odds of being infected with HIV than all adults age 15-49, and in San Francisco, California 42.4% of transwomen are estimated to be infected with HIV. Pre-exposure prophylaxis (PrEP is the first biomedical intervention with promise for reducing HIV acquisition in transwomen. However, little is known about whether transwomen know about PrEP, are taking PrEP and would be good candidates for PrEP based on their risk profile and behaviors. A population-based dataset was analyzed to determine how many transwomen in San Francisco knew about PrEP by the end of 2013 - more than a year after iPrex results demonstrated efficacy of PrEP in preventing HIV. We found that of 233 transwomen, only 13.7% had heard of PrEP. Transwomen who were living with HIV compared to those who were HIV-negative, and those who recently injected drugs compared to non-injection drug users were more likely to have heard of PrEP. Based on CDC guidelines for PrEP among MSM and IDU, 45 (30.2% transwomen of the 149 HIV-negative transwomen in the sample were candidates for PrEP. This estimate based on CDC criteria is arguably low. Given that almost half of transwomen in San Francisco are living with HIV, this findings points to a need for further consideration of PrEP criteria that are specific and tailored to the risks for HIV faced by transwomen that are different from MSM and injection drug users. Research to scale up access and test the effectiveness of PrEP for transwomen is also urgently needed.

Antiretroviral Drug Activity in Macaques Infected during Pre-Exposure Prophylaxis Has a Transient Effect on Cell-Associated SHIV DNA Reservoirs.

Directory of Open Access Journals (Sweden)

Mian-Er Cong

Full Text Available Pre-exposure prophylaxis (PrEP with emtricitabine and tenofovir disoproxil fumarate (FTC/TDF is a novel HIV prevention strategy. Suboptimal PrEP adherence and HIV infection creates an opportunity for continued antiretroviral drug activity during undiagnosed infection. We previously showed that macaques infected with SHIV during PrEP with FTC/TDF display reduced acute plasma viremias and limited virus diversity. We investigated the effect of PrEP on acute SHIV DNA dynamics and on the size of the persistent virus reservoir in lymphoid tissues.Cell-associated SHIV DNA levels in PBMCs were measured in 8 macaques infected during PrEP with FTC/TDF or single-agent TAF and was compared to those seen in untreated infections (n = 10. PrEP breakthrough infections continued treatment with 1-2 weekly drug doses to model suboptimal drug exposure during undiagnosed HIV infection in humans. SHIV DNA was also measured in lymphoid tissues collected from FTC/TDF PrEP breakthroughs after 1 year of infection.Compared to untreated controls, PrEP infections had reduced plasma RNA viremias both at peak and throughout weeks 1-12 (p<0.005. SHIV DNA levels were also reduced at peak and during the first 12 weeks of infection (p<0.043 but not throughout weeks 12-20. At 1 year, SHIV DNA reservoirs in lymphoid tissues were similar in size among macaques that received PrEP or placebo.Antiviral drug activity due to PrEP limits acute SHIV replication but has only a transient effect on cell-associated SHIV DNA levels. Our model suggests that suboptimal drug exposure in persons that are taking PrEP and become infected with HIV may not be sufficient to reduce the pool of HIV-infected cells, and that treatment intensification may be needed to sustain potential virological benefits from the PrEP regimen.

Acceptability and willingness to use HIV pre-exposure prophylaxis among HIV-negative men who have sex with men in Switzerland.

Science.gov (United States)

Gredig, Daniel; Uggowitzer, Franziska; Hassler, Benedikt; Weber, Patrick; Nideröst, Sibylle

2016-01-01

Pre-exposure prophylaxis (PrEP) is discussed as an additional HIV prevention method targeting men who have sex with men (MSM). So far, PrEP has not been approved in Switzerland and only little is known about the acceptability of PrEP among MSM living in Switzerland. Given the slow uptake of PrEP among MSM in the USA, the objectives of the study were to investigate the acceptability for PrEP and to identify factors influencing the acceptability for this prevention method and the willingness to adopt it. During a 4-month period we conducted five focus group discussions with 23 consecutively sampled HIV-negative MSM aged 22-60 years living in Switzerland. We analyzed the data according to qualitative content analysis. The acceptability of PrEP varied considerably among the participants. Some would use PrEP immediately after its introduction in Switzerland because it provides an alternative to condoms which they are unable or unwilling to use. Others were more ambivalent towards PrEP but still considered it (1) an additional or alternative protection to regular condom use, (2) an option to engage in sexual activities with less worries and anxieties or (3) a protection during receptive anal intercourse independently of the sexual partner's protective behaviour. Some participants would not consider using PrEP at all: they do not see any benefit in PrEP as they have adopted safer sex practices and did not mention any problems with condom use. Others are still undecided and could imagine using an improved form of PrEP. The results provide a valuable basis for a model explaining the acceptability of PrEP among MSM and suggest including the personal HIV protection strategy in the considerations adopted.

Primary Care Physicians' Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs.

Science.gov (United States)

Edelman, E Jennifer; Moore, Brent A; Calabrese, Sarah K; Berkenblit, Gail; Cunningham, Chinazo; Patel, Viraj; Phillips, Karran; Tetrault, Jeanette M; Shah, Minesh; Fiellin, David A; Blackstock, Oni

2017-04-01

Pre-exposure prophylaxis for HIV (PrEP) is recommended for people who inject drugs (PWID). Despite their central role in disease prevention, willingness to prescribe PrEP to PWID among primary care physicians (PCPs) is largely understudied. We conducted an online survey (April-May 2015) of members of a society for academic general internists regarding PrEP. Among 250 respondents, 74% (n = 185) of PCPs reported high willingness to prescribe PrEP to PWID. PCPs were more likely to report high willingness to prescribe PrEP to all other HIV risk groups (p's < 0.03 for all pair comparisons). Compared with PCPs delivering care to more HIV-infected clinic patients, PCPs delivering care to fewer HIV-infected patients were more likely to report low willingness to prescribe PrEP to PWID (Odds Ratio [95% CI] = 6.38 [1.48-27.47]). PCP and practice characteristics were not otherwise associated with low willingness to prescribe PrEP to PWID. Interventions to improve PCPs' willingness to prescribe PrEP to PWID are needed.

United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.

Science.gov (United States)

Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J

2016-05-01

The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US family planning providers' knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning. Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed. Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives or physicians assistants). Among potential prescribers, 38% correctly defined PrEP [95% confidence interval (CI): 32.5-42.8], 37% correctly stated the efficacy of PrEP (95% CI: 32.0-42.4), and 36% chose the correct HIV test after a recent exposure (95% CI: 30.6-40.8). Characteristics of those who answered knowledge questions correctly included age less than 35 years, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education. To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing. US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods

The profitability and production of a beef herd on transitional ...

African Journals Online (AJOL)

user

2014-08-23

Aug 23, 2014 ... providing protein in a drought during summer to first calf heifers may increase .... 350-500. Wet season lick supplementation (summer). Cows with ... at weaning, ICP (days), conception rate (%) and price of lick per treatment ...

?How I Wish This Thing Was Initiated 100 Years Ago!? Willingness to Take Daily Oral Pre-Exposure Prophylaxis among Men Who Have Sex with Men in Kenya

OpenAIRE

Karuga, Robinson Njoroge; Njenga, Serah Nduta; Mulwa, Rueben; Kilonzo, Nduku; Bahati, Prince; O?reilley, Kevin; Gelmon, Lawrence; Mbaabu, Stephen; Wachihi, Charles; Githuka, George; Kiragu, Michael

2016-01-01

Background The MSM population in Kenya contributes to 15% of HIV incidence. This calls for innovative HIV prevention interventions. Pre-exposure prophylaxis (PrEP) has been efficacious in preventing HIV among MSM in trials. There is limited data on the willingness to take daily oral PrEP in sub-Sahara Africa. PrEP has not been approved for routine use in most countries globally. This study aimed to document the willingness to take PrEP and barriers to uptake and adherence to PrEP in Kenya. Th...

"Why should I take drugs for your infection?": outcomes of formative research on the use of HIV pre-exposure prophylaxis in Nigeria.

Science.gov (United States)

Idoko, John; Folayan, Morenike Oluwatoyin; Dadem, Nancin Yusufu; Kolawole, Grace Oluwatosin; Anenih, James; Alhassan, Emmanuel

2015-04-10

Nigeria has the second highest number of new HIV infections annually. Therefore, it is important to explore new strategies for preventing new infections. The introduction of pre-exposure prophylaxis (PrEP) for use by persons at high risk of HIV infection has new potential in preventing new HIV infections. The aim of this study is to explore the public opinion, community interest, and perceptions about the use and access to PrEP in Nigeria. This formative study used a mixed method approach to collect data on public opinions and perceptions on appropriate target groups for PrEP access, community interest, perceptions about the use of PrEP as an HIV-prevention tool, how best to communicate with participants about PrEP, concerns about PrEP use by serodiscordant couples, and suggestions for the design and implementation of a PrEP demonstration project. Telephone and in-depth interviews were conducted, and focus group discussions and consultative meetings were held with critical stakeholders engaged in HIV-prevention, treatment, care, and support programmes in Nigeria. An online survey was also conducted. HIV serodiscordant couples were identified as the appropriate target group for PrEP use. Most respondents felt that PrEP use by key affected populations would help reduce the HIV incidence. Stigma was identified as a major concern and a potential barrier for the acceptance and use of PrEP by HIV serodiscordant couples. Electronic and print media were identified as important means for massive public education to prevent stigma and create awareness about PrEP. In a male dominated society such as Nigeria, HIV-negative male partners in serodiscordant relationships may resist enrolment in PrEP programmes. This may be complicated by the fact that the identified index partner in most serodiscordant relationships in Nigeria is an HIV-positive woman, who is often diagnosed during pregnancy. PrEP uptake and use by HIV serodiscordant couples in Nigeria may face notable but

[Relationships between ectoparasites and grooming behavior of Tylonycteris pachypus and T. robustula].

Science.gov (United States)

Zhang, Li-Biao; Zhang, Guang-Liang; Tang, Zhan-Hui; Hong, Ti-Yu

2013-12-01

Grooming behavior is evolved in animals in response to the costs associated with ectoparasites. In this study, ecotparasite densities and grooming behavior-including licking and scratching-of wild-caught lesser bamboo bat (Tylonycteris pachypus) and greater bamboo bat (T. robustula) were analyzed. The results indicated that both the frequencies and durations of licking were higher than those of scratching in both bat species, though T. pachypus licked more but scratched less than T. robustula. There were no difference in the durations of licking and scratching between the two bat species, and the durations and frequencies of grooming behavior of the two bat species were irrelevant with ectoparasite densities. These findings suggest that the grooming behavior of T. pachypus and T. robustula might be modulated by both the central control (programmed grooming) model and the peripheral stimulation (stimulus driven) model.

Acceptability of microbicidal vaginal rings and oral pre-exposure prophylaxis for HIV prevention among female sex workers in a high-prevalence US city.

Science.gov (United States)

Peitzmeier, Sarah M; Tomko, Catherine; Wingo, Erin; Sawyer, Anne; Sherman, Susan G; Glass, Nancy; Beyrer, Chris; Decker, Michele R

2017-11-01

Biomedical HIV prevention tools including oral pre-exposure prophylaxis (PrEP) and vaginal microbicidal rings hold unique value for high-risk women who may have limited capacity for condom negotiation, including the key populations of sex workers and drug users. Commercial sex is a PrEP indicator in CDC guidelines, yet little is known about female sex workers' (FSWs) knowledge of and attitudes toward PrEP or the recently developed monthly vaginal microbicide rings. We describe knowledge and attitudes toward PrEP and microbicide rings in a sample of 60 mostly drug-using FSWs in Baltimore, Maryland, a high HIV-prevalence US city. Just 33% had heard of PrEP, but 65% were interested in taking daily oral PrEP and 76% were interested in a microbicide vaginal ring; 87% were interested in at least one of the two methods. Results suggest method mix will be important as biomedical tools for HIV prophylaxis are implemented and scaled up in this population, as 12% were interested in PrEP but not vaginal rings, while 19% were interested in vaginal rings but not in PrEP. Self-efficacy for daily oral adherence was high (79%) and 78% were interested in using PrEP even if condoms were still necessary. Women who had experienced recent client-perpetrated violence were significantly more interested in PrEP (86% vs 53%, p = 0.009) and microbicidal rings (91% vs 65%, p = 0.028) than women who had not recently experienced violence. No differences were observed by demographics nor HIV risk behaviors, suggesting broad potential interest in daily PrEP and monthly-use vaginal microbicides in this high-risk population.

The Vaginal Microbiome and its Potential to Impact Efficacy of HIV Pre-exposure Prophylaxis for Women.

Science.gov (United States)

Velloza, Jennifer; Heffron, Renee

2017-10-01

This review describes existing evidence addressing the potential modulation of pre-exposure prophylaxis (PrEP) products, specifically 1% tenofovir (TFV) gel and oral tenofovir-based PrEP, by vaginal dysbiosis and discusses future considerations for delivering novel, long-acting PrEP products to women at high risk for vaginal dysbiosis and HIV. We describe results from analyses investigating the modification of PrEP efficacy by vaginal dysbiosis and studies of biological mechanisms that could render PrEP ineffective in the presence of specific microbiota. A secondary analysis from the CAPRISA-004 cohort demonstrated that there is no effect of the 1% TFV gel in the presence of non-Lactobacillus dominant microbiota. Another recent analysis comparing oral tenofovir-based PrEP efficacy among women with and without bacterial vaginosis in the Partners PrEP Study found that oral PrEP efficacy is not modified by bacterial vaginosis. Gardnerella vaginalis, commonly present in women with vaginal dysbiosis, can rapidly metabolize TFV particularly when it is locally applied and thereby prevent TFV integration into cells. Given that vaginal dysbiosis appears to modulate efficacy for 1% TFV gel but not for oral tenofovir-based PrEP, vaginal dysbiosis is potentially less consequential to HIV protection from TFV in the context of systemic drug delivery and high product adherence. Vaginal dysbiosis may undermine the efficacy of 1% TFV gel to protect women from HIV but not the efficacy of oral PrEP. Ongoing development of novel ring, injectable, and film-based PrEP products should investigate whether vaginal dysbiosis can reduce efficacy of these products, even in the presence of high adherence.

Differing Experiences with Pre-Exposure Prophylaxis in Boston Among Lesbian, Gay, Bisexual, and Transgender Specialists and Generalists in Primary Care: Implications for Scale-Up.

Science.gov (United States)

Krakower, Douglas S; Ware, Norma C; Maloney, Kevin M; Wilson, Ira B; Wong, John B; Mayer, Kenneth H

2017-07-01

The Centers for Disease Control and Prevention estimates that one in four sexually active men who have sex with men (MSM) could decrease their HIV risk by using HIV pre-exposure prophylaxis (PrEP). Because many MSM access healthcare from primary care providers (PCPs), these clinicians could play an important role in providing access to PrEP. Semistructured qualitative interviews were conducted with 31 PCPs in Boston, MA, to explore how they approach decisions about prescribing PrEP to MSM and their experiences with PrEP provision. Purposive sampling included 12 PCPs from an urban community health center specializing in the care of lesbian, gay, bisexual, and transgender persons ("LGBT specialists") and 19 PCPs from a general academic medical center ("generalists"). Analyses utilized an inductive approach to identify emergent themes. Both groups of PCPs approached prescribing decisions about PrEP as a process of informed decision-making with patients. Providers would defer to patients' preferences if they were unsure about the appropriateness of PrEP. LGBT specialists and generalists were at vastly different stages of adopting PrEP into practice. For LGBT specialists, PrEP was a disruptive innovation that rapidly became normative in practice. Generalists had limited experience with PrEP; however, they desired succinct decision-support tools to help them achieve proficiency, because they considered preventive medicine to be central to their professional role. As generalists vastly outnumber LGBT specialists in the United States, interventions to support PrEP provision by generalists could accelerate the scale-up of PrEP for MSM nationally, which could in turn decrease HIV incidence for this priority population.

High levels of adherence to a rectal microbicide gel and to oral Pre-Exposure Prophylaxis (PrEP) achieved in MTN-017 among men who have sex with men (MSM) and transgender women.

Science.gov (United States)

Carballo-Diéguez, Alex; Balán, Ivan C; Brown, William; Giguere, Rebecca; Dolezal, Curtis; Leu, Cheng-Shiun; Marzinke, Mark A; Hendrix, Craig W; Piper, Jeanna M; Richardson, Barbra A; Grossman, Cynthia; Johnson, Sherri; Gomez, Kailazarid; Horn, Stephanie; Kunjara Na Ayudhya, Ratiya Pamela; Patterson, Karen; Jacobson, Cindy; Bekker, Linda-Gail; Chariyalertsak, Suwat; Chitwarakorn, Anupong; Gonzales, Pedro; Holtz, Timothy H; Liu, Albert; Mayer, Kenneth H; Zorrilla, Carmen; Lama, Javier; McGowan, Ian; Cranston, Ross D

2017-01-01

Trials to assess microbicide safety require strict adherence to prescribed regimens. If adherence is suboptimal, safety cannot be adequately assessed. MTN-017 was a phase 2, randomized sequence, open-label, expanded safety and acceptability crossover study comparing 1) daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF), 2) daily use of reduced-glycerin 1% tenofovir (RG-TFV) gel applied rectally, and 3) RG-TFV gel applied before and after receptive anal intercourse (RAI)-if participants had no RAI in a week, they were asked to use two doses of gel within 24 hours. Product use was assessed by mixed methods including unused product return count, text messaging reports, and qualitative plasma TFV pharmacokinetic (PK) results. Convergence interviews engaged participants in determining the most accurate number of doses used based on product count and text messaging reports. Client-centered adherence counseling was also used. Participants (N = 187) were men who have sex with men and transgender women enrolled in the United States (42%), Thailand (29%), Peru (19%) and South Africa (10%). Mean age was 31.4 years (range 18-64 years). Based on convergence interviews, over an 8-week period, 94% of participants had ≥80% adherence to daily tablet, 41% having perfect adherence; 83% had ≥80% adherence to daily gel, 29% having perfect adherence; and 93% had ≥80% adherence to twice-weekly use during the RAI-associated gel regimen, 75% having perfect adherence and 77% having ≥80% adherence to gel use before and after RAI. Only 4.4% of all daily product PK results were undetectable and unexpected (TFV concentrations <0.31 ng/mL) given self-reported product use near sampling date. The mixed methods adherence measurement indicated high adherence to product use in all three regimens. Adherence to RAI-associated rectal gel use was as high as adherence to daily oral PrEP. A rectal microbicide gel, if efficacious, could be an alternative for individuals uninterested in

High levels of adherence to a rectal microbicide gel and to oral Pre-Exposure Prophylaxis (PrEP achieved in MTN-017 among men who have sex with men (MSM and transgender women.

Directory of Open Access Journals (Sweden)

Alex Carballo-Diéguez

Full Text Available Trials to assess microbicide safety require strict adherence to prescribed regimens. If adherence is suboptimal, safety cannot be adequately assessed. MTN-017 was a phase 2, randomized sequence, open-label, expanded safety and acceptability crossover study comparing 1 daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF, 2 daily use of reduced-glycerin 1% tenofovir (RG-TFV gel applied rectally, and 3 RG-TFV gel applied before and after receptive anal intercourse (RAI-if participants had no RAI in a week, they were asked to use two doses of gel within 24 hours. Product use was assessed by mixed methods including unused product return count, text messaging reports, and qualitative plasma TFV pharmacokinetic (PK results. Convergence interviews engaged participants in determining the most accurate number of doses used based on product count and text messaging reports. Client-centered adherence counseling was also used. Participants (N = 187 were men who have sex with men and transgender women enrolled in the United States (42%, Thailand (29%, Peru (19% and South Africa (10%. Mean age was 31.4 years (range 18-64 years. Based on convergence interviews, over an 8-week period, 94% of participants had ≥80% adherence to daily tablet, 41% having perfect adherence; 83% had ≥80% adherence to daily gel, 29% having perfect adherence; and 93% had ≥80% adherence to twice-weekly use during the RAI-associated gel regimen, 75% having perfect adherence and 77% having ≥80% adherence to gel use before and after RAI. Only 4.4% of all daily product PK results were undetectable and unexpected (TFV concentrations <0.31 ng/mL given self-reported product use near sampling date. The mixed methods adherence measurement indicated high adherence to product use in all three regimens. Adherence to RAI-associated rectal gel use was as high as adherence to daily oral PrEP. A rectal microbicide gel, if efficacious, could be an alternative for individuals

[Compliancy of pre-exposure prophylaxis for HIV infection in men who have sex with men in Chengdu].

Science.gov (United States)

Xu, J Y; Mou, Y C; Ma, Y L; Zhang, J Y

2017-05-10

Objective: To evaluate the compliancy of HIV pre-exposure prophylaxis (PrEP) in men who have sex with men (MSM) in Chengdu, Sichuan province, and explore the influencing factors. Methods: From 1 July 2013 to 30 September 2015, a random, open, multi-center and parallel control intervention study was conducted in 328 MSM enrolled by non-probability sampling in Chengdu. The MSM were divided into 3 groups randomly, i.e. daily group, intermittent group (before and after exposure) and control group. Clinical follow-up and questionnaire survey were carried out every 3 months. Their PrEP compliances were evaluated respectively and multivariate logistic regression analysis was conducted to identify the related factors. Results: A total of 141 MSM were surveyed, in whom 59(41.8 % ) had good PrEP compliancy. The PrEP compliancy rate was 69.0 % in daily group, higher than that in intermittent group (14.3 % ), the difference had significance ( χ (2)=45.29, P <0.001). Multivariate logistic analysis indicated that type of PrEP was the influencing factors of PrEP compliancy. Compared with daily group, the intermittent group had worse PrEP compliancy ( OR =0.07, 95 %CI : 0.03-0.16). Conclusion: The PrEP compliance of the MSM in this study was poor, the compliancy would be influenced by the type of PrEP.

HIV pre-exposure prophylaxis and health and community systems in the Global South: Thailand case study.

Science.gov (United States)

Colby, Donn; Srithanaviboonchai, Kriengkrai; Vanichseni, Suphak; Ongwandee, Sumet; Phanuphak, Nittaya; Martin, Michael; Choopanya, Kachit; Chariyalertsak, Suwat; van Griensven, Frits

2015-01-01

Pre-exposure prophylaxis (PrEP) is recommended by the World Health Organization as an effective method of HIV prevention for individuals at risk for infection. In this paper, we describe the unique role that Thailand has played in the global effort to combat the HIV epidemic, including its role in proving the efficacy of PrEP, and discuss the opportunities and challenges of implementing PrEP in a middle-income country. Thailand was one of the first countries in the world to successfully reverse a generalized HIV epidemic. Despite this early success, HIV prevalence has remained high among people who inject drugs and has surged among men who have sex with men (MSM) and transgender women (TGW). Two pivotal trials that showed that the use of oral antiretroviral medication as PrEP can reduce HIV transmission were conducted partially or entirely at Thai sites. Demonstration projects of PrEP, as well as clinical trials of alternative PrEP regimens, began or will begin in 2014-2015 in Thailand and will provide additional data and experience on how to best implement PrEP for high-risk individuals in the community. Financing of drug costs, the need for routine laboratory monitoring and lack of awareness about PrEP among at-risk groups all present challenges to the wider implementation of PrEP for HIV prevention in Thailand. Although significant challenges to wider use remain, PrEP holds promise as a safe and highly effective method to be used as part of a combined HIV prevention strategy for MSM and TGW in Thailand.

Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa.

Science.gov (United States)

Heffron, Renee; Ngure, Kenneth; Odoyo, Josephine; Bulya, Nulu; Tindimwebwa, Edna; Hong, Ting; Kidoguchi, Lara; Donnell, Deborah; Mugo, Nelly R; Bukusi, Elizabeth A; Katabira, Elly; Asiimwe, Stephen; Morton, Jennifer; Morrison, Susan; Haugen, Harald; Mujugira, Andrew; Haberer, Jessica E; Ware, Norma C; Wyatt, Monique A; Marzinke, Mark A; Frenkel, Lisa M; Celum, Connie; Baeten, Jared M

2017-11-06

Introduction : Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered.  Methods : We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa.  The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results : We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP.  Ninety-seven percent (97%) of HIV-negative partners initiated PrEP, and when PrEP was dispensed, objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected.  A total of 4 incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, pproject for African HIV-negative individuals whose partners were known to be living with HIV.  Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation.

Implementation and Operational Research: A Cost-Effective, Clinically Actionable Strategy for Targeting HIV Preexposure Prophylaxis to High-Risk Men Who Have Sex With Men.

Science.gov (United States)

Ross, Eric L; Cinti, Sandro K; Hutton, David W

2016-07-01

Preexposure prophylaxis (PrEP) is effective at preventing HIV infection among men who have sex with men (MSM), but there is uncertainty about how to identify high-risk MSM who should receive PrEP. We used a mathematical model to assess the cost-effectiveness of using the HIV Incidence Risk Index for MSM (HIRI-MSM) questionnaire to target PrEP to high-risk MSM. We simulated strategies of no PrEP, PrEP available to all MSM, and eligibility thresholds set to HIRI-MSM scores between 5 and 45, in increments of 5 (where a higher score predicts greater HIV risk). Based on the iPrEx, IPERGAY, and PROUD trials, we evaluated PrEP efficacies from 44% to 86% and annual costs from $5900 to 8700. We designate strategies with incremental cost-effectiveness ratio (ICER) ≤$100,000/quality-adjusted life-year (QALY) as "cost-effective." Over 20 years, making PrEP available to all MSM is projected to prevent 33.5% of new HIV infections, with an ICER of $1,474,000/QALY. Increasing the HIRI-MSM score threshold reduces the prevented infections, but improves cost-effectiveness. A threshold score of 25 is projected to be optimal (most QALYs gained while still being cost-effective) over a wide range of realistic PrEP efficacies and costs. At low cost and high efficacy (IPERGAY), thresholds of 15 or 20 are optimal across a range of other input assumptions; at high cost and low efficacy (iPrEx), 25 or 30 are generally optimal. The HIRI-MSM provides a clinically actionable means of guiding PrEP use. Using a score of 25 to determine PrEP eligibility could facilitate cost-effective use of PrEP among high-risk MSM who will benefit from it most.

Assessing the need for a pre-exposure prophylaxis programme using the social media app Grindr®.

Science.gov (United States)

Hampel, B; Kusejko, K; Braun, D L; Harrison-Quintana, J; Kouyos, R; Fehr, J

2017-11-01

HIV pre-exposure prophylaxis (PrEP) is not approved in Switzerland and therefore must be paid for by the users themselves. We conducted a survey to find out whether men who have sex with men (MSM) in Switzerland are already taking PrEP, or are considering using it, and whether it is being taken under medical supervision or not. Grindr® is a geosocial networking app for MSM. Between 5 and 24 January 2017, users of the app who were located in Switzerland by a global positioning system (GPS) were asked to participate in a ten-question survey on PrEP use. Of the 2455 people who took part in the survey, 1893 were included in the analysis. Eighty-two participants (4.3%) reported that they were currently taking PrEP, 64 of whom (78%) said that they were under medical supervision. Seven PrEP users (9%) declared that they had not taken an HIV test within the previous 12 months. Nine hundred and forty-four (49.9%) were considering taking PrEP in the next 6 months, and 1474 (77.9%) were considering taking it at some point in the future. In an online survey carried out among sexually active MSM in Switzerland, only a minority of the individuals approached responded that they were currently using PrEP. However, the majority of participants were considering taking PrEP in the future. We identified a substantial proportion of PrEP users taking PrEP outside a medical setting. Hence, a national programme facilitating access to medical care and providing PrEP is urgently needed. © 2017 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

Awareness and willingness to use HIV pre-exposure prophylaxis among men who have sex with men in low- and middle-income countries: a systematic review and meta-analysis

Science.gov (United States)

Yi, Siyan; Tuot, Sovannary; Mwai, Grace W; Ngin, Chanrith; Chhim, Kolab; Pal, Khoundyla; Igbinedion, Ewemade; Holland, Paula; Choub, Sok Chamreun; Mburu, Gitau

2017-01-01

Abstract Introduction: To facilitate provision of pre-exposure prophylaxis (PrEP) in low- and middle-income countries (LMIC), a better understanding of potential demand and user preferences is required. This review assessed awareness and willingness to use oral PrEP among men who have sex with men (MSM) in LMIC. Methods: Electronic literature search of Cochrane library, Embase, PubMed, PsychINFO, CINHAL, Web of Science, and Google Scholar was conducted between July and September 2016. Reference lists of relevant studies were searched, and three authors contacted for additional data. Non-peer reviewed publications were excluded. Studies were screened for inclusion, and relevant data abstracted, assessed for bias, and synthesized. Results: In total, 2186 records were identified, of which 23 studies involving 14,040 MSM from LMIC were included. The proportion of MSM who were aware of PrEP was low at 29.7% (95% CI: 16.9–44.3). However, the proportion willing to use PrEP was higher, at 64.4% (95% CI: 53.3–74.8). Proportions of MSM aware of PrEP was <50% in 11 studies and 50–70% in 3 studies, while willingness to use PrEP was <50% in 6 studies, 50–70% in 9 studies, and over 80% in 5 studies. Several factors affected willingness to use PrEP. At the individual domain, poor knowledge of PrEP, doubts about its effectiveness, fear of side effects, low perception of HIV risk, and the need to adhere or take medicines frequently reduced willingness to use PrEP, while PrEP education and motivation to maintain good health were facilitators of potential use. Demographic factors (education, age, and migration) influenced both awareness and willingness to use PrEP, but their effects were not consistent across studies. At the social domain, anticipated stigma from peers, partners, and family members related to sexual orientation, PrEP, or HIV status were barriers to potential use of PrEP, while partner, peer, and family support were facilitators of potential use. At the

Which Patients in the Emergency Department Should Receive Preexposure Prophylaxis? Implementation of a Predictive Analytics Approach.

Science.gov (United States)

Ridgway, Jessica P; Almirol, Ellen A; Bender, Alvie; Richardson, Andrew; Schmitt, Jessica; Friedman, Eleanor; Lancki, Nicola; Leroux, Ivan; Pieroni, Nina; Dehlin, Jessica; Schneider, John A

2018-04-19

Emergency Departments (EDs) have the potential to play a crucial role in HIV prevention by identifying and linking high-risk HIV-negative clients to preexposure prophylaxis (PrEP) care, but it is difficult to perform HIV risk assessment for all ED patients. We aimed to develop and implement an electronic risk score to identify ED patients who are potential candidates for PrEP. Using electronic medical record (EMR) data, we used logistic regression to model the outcome of PrEP eligibility. We converted the model into an electronic risk score and incorporated it into the EMR. The risk score is automatically calculated at triage. For patients whose risk score is above a given threshold, an automated electronic alert is sent to an HIV prevention counselor who performs real time HIV prevention counseling, risk assessment, and PrEP linkage as appropriate. The electronic risk score includes the following EMR variables: age, gender, gender of sexual partner, chief complaint, and positive test for sexually transmitted infection in the prior 6 months. A risk score ≥21 has specificity of 80.6% and sensitivity of 50%. In the first 5.5 months of implementation, the alert fired for 180 patients, 34.4% (62/180) of whom were women. Of the 51 patients who completed risk assessment, 68.6% (35/51) were interested in PrEP, 17.6% (9/51) scheduled a PrEP appointment, and 7.8% (4/51) successfully initiated PrEP. The measured number of successful PrEP initiations is likely an underestimate, as it does include patients who initiated PrEP with outside providers or referred acquaintances for PrEP care.

Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: a mixed methods study.

Science.gov (United States)

Brooks, Ronald A; Landovitz, Raphael J; Kaplan, Rachel L; Lieber, Eli; Lee, Sung-Jae; Barkley, Thomas W

2012-02-01

The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP. Participants reported engaging in sexual risk behaviors that place them at risk for HIV infection. Participants also reported a high level of acceptability for PrEP and willingness to adopt PrEP for HIV prevention. Qualitative themes explaining future PrEP adoption included: (1) the opportunity to engage in sex using a noncondom HIV prevention method, (2) protection from HIV infection, and (3) less anxiety when engaging in sex with an HIV-positive partner. Associated with the future adoption of PrEP, a majority (64%) of participants indicated the likelihood for an increase in sexual risk behaviors and a majority (60%) of participants also indicated the likelihood for a decrease or abandonment of condom use, both of which are in contrast to the findings from the large iPrEx study. These findings suggest that the use of PrEP by HIV-negative GBM in serodiscordant relationships carries with it the potential for risk compensation. The findings suggest that PrEP only be offered as part of a comprehensive HIV prevention strategy that includes ongoing risk reduction counseling in the delivery of PrEP to help moderate risk compensation.

Adherence to antiretroviral prophylaxis for HIV prevention: a substudy cohort within a clinical trial of serodiscordant couples in East Africa.

Directory of Open Access Journals (Sweden)

Jessica E Haberer

Full Text Available Randomized clinical trials of oral antiretroviral pre-exposure prophylaxis (PrEP for HIV prevention have widely divergent efficacy estimates, ranging from 0% to 75%. These discrepancies are likely due to differences in adherence. To our knowledge, no studies to date have examined the impact of improving adherence through monitoring and/or intervention, which may increase PrEP efficacy, or reported on objective behavioral measures of adherence, which can inform PrEP effectiveness and implementation.Within the Partners PrEP Study (a randomized placebo-controlled trial of oral tenofovir and emtricitabine/tenofovir among HIV-uninfected members of serodiscordant couples in Kenya and Uganda, we collected objective measures of PrEP adherence using unannounced home-based pill counts and electronic pill bottle monitoring. Participants received individual and couples-based adherence counseling at PrEP initiation and throughout the study; counseling was intensified if unannounced pill count adherence fell to 80% adherence. Study limitations include potential shortcomings of the adherence measures and use of a convenience sample within the substudy cohort.The high PrEP adherence achieved in the setting of active adherence monitoring and counseling support was associated with a high degree of protection from HIV acquisition by the HIV-uninfected partner in heterosexual serodiscordant couples. Low PrEP adherence was associated with sexual behavior, alcohol use, younger age, and length of PrEP use. Please see later in the article for the Editors' Summary.

HIV Prevention After Discontinuing Pre-Exposure Prophylaxis: Conclusions From a Case Study

Directory of Open Access Journals (Sweden)

Kai J. Jonas

2018-05-01

Full Text Available Pre-exposure prophylaxis (PrEP with tenofovir disoproxil fumarate in combination with emtricitabine (FTC is a highly effective form of HIV prevention. Endeavors of health-care providers and activists in many countries over the world are directed at making access to PrEP possible, or increasing PrEP use among men-who-have-sex-with-men (MSM. We argue while this effort is necessary, we also need to consider modes of HIV prevention after a period of PrEP use. PrEP uptake is not a one-way street, meaning that individuals may discontinue PrEP use, either voluntarily and involuntarily. Voluntary discontinued PrEP use in conjunction with decreased or no HIV risk exposure is unproblematic, but involuntary discontinuations with continuous high level of HIV risk exposure calls for tailored post-PrEP use HIV prevention. We present a case study of an MSM individual who discontinued PrEP for medical reasons (renal function and seroconverted soon afterward, to illustrate the need for tailored HIV prevention post-PrEP. Furthermore, we provide additional contexts of PrEP discontinuation leading to populations that are in need for post-PrEP types of HIV prevention. Subsequently, we present suggestions for modes of post-PrEP HIV prevention based on knowledge–communication–choice model. Community organization and health-care providers should consider and prepare their HIV prevention consulting protocols for such types of clients and add post-PrEP HIV prevention measures to their consulting offer.

Willingness to use pre-exposure prophylaxis among Black and White men who have sex with men in Atlanta, Georgia.

Science.gov (United States)

Rolle, Charlotte-Paige; Rosenberg, Eli S; Luisi, Nicole; Grey, Jeremy; Sanchez, Travis; Del Rio, Carlos; Peterson, John L; Frew, Paula M; Sullivan, Patrick S; Kelley, Colleen F

2017-08-01

PrEP willingness may be different among black and white men who have sex with men (MSM) given known disparities in HIV incidence, sociodemographic factors, and healthcare access between these groups. We surveyed 482 black and white HIV-negative MSM in Atlanta, GA about their willingness to use pre-exposure prophylaxis (PrEP) and facilitators and barriers to PrEP willingness. Overall, 45% (215/482) of men indicated interest in using PrEP. Engaging in recent unprotected anal intercourse (UAI) was the only factor significantly associated with PrEP willingness in multivariate analyses (OR 1.73, 95% CI 1.13, 2.65). Willing men identified "extra protection" against HIV as the most common reason for interest in using PrEP, whereas unwilling men most commonly cited not wanting to take medication daily, and this reason was more common among white MSM (42.3% of white MSM vs. 28.9% of black MSM, p = 0.04). Most men indicated willingness to use PrEP if cost was <50 dollars/month; however, more black MSM indicated willingness to use PrEP only if cost were free (17.9% of white MSM vs. 25.9% of black MSM, p = 0.03). Overall, these data are useful to scale up PrEP interventions targeting at-risk MSM in Atlanta and highlight the need for implementation of low cost-programs, which will be especially important for black MSM.

Acceleration and deceleration capacity of fetal heart rate in an in-vivo sheep model.

Directory of Open Access Journals (Sweden)

Massimo W Rivolta

Full Text Available BACKGROUND: Fetal heart rate (FHR variability is an indirect index of fetal autonomic nervous system (ANS integrity. FHR variability analysis in labor fails to detect early hypoxia and acidemia. Phase-rectified signal averaging (PRSA is a new method of complex biological signals analysis that is more resistant to non-stationarities, signal loss and artifacts. It quantifies the average cardiac acceleration and deceleration (AC/DC capacity. OBJECTIVE: The aims of the study were: (1 to investigate AC/DC in ovine fetuses exposed to acute hypoxic-acidemic insult; (2 to explore the relation between AC/DC and acid-base balance; and (3 to evaluate the influence of FHR decelerations and specific PRSA parameters on AC/DC computation. METHODS: Repetitive umbilical cord occlusions (UCOs were applied in 9 pregnant near-term sheep to obtain three phases of MILD, MODERATE, and SEVERE hypoxic-acidemic insult. Acid-base balance was sampled and fetal ECGs continuously recorded. AC/DC were calculated: (1 for a spectrum of T values (T = 1÷50 beats; the parameter limits the range of oscillations detected by PRSA; (2 on entire series of fetal RR intervals or on "stable" series that excluded FHR decelerations caused by UCOs. RESULTS: AC and DC progressively increased with UCOs phases (MILD vs. MODERATE and MODERATE vs. SEVERE, p<0.05 for DC [Formula: see text] = 2-5, and AC [Formula: see text] = 1-3. The time evolution of AC/DC correlated to acid-base balance (0.4<[Formula: see text]<0.9, p<0.05 with the highest [Formula: see text] for [Formula: see text]. PRSA was not independent from FHR decelerations caused by UCOs. CONCLUSIONS: This is the first in-vivo evaluation of PRSA on FHR analysis. In the presence of acute hypoxic-acidemia we found increasing values of AC/DC suggesting an activation of ANS. This correlation was strongest on time scale dominated by parasympathetic modulations. We identified the best performing [Formula: see text] parameters

The Danish STR sequence database: duplicate typing of 363 Danes with the ForenSeq™ DNA Signature Prep Kit.

Science.gov (United States)

Hussing, C; Bytyci, R; Huber, C; Morling, N; Børsting, C

2018-05-24

Some STR loci have internal sequence variations, which are not revealed by the standard STR typing methods used in forensic genetics (PCR and fragment length analysis by capillary electrophoresis (CE)). Typing of STRs with next-generation sequencing (NGS) uncovers the sequence variation in the repeat region and in the flanking regions. In this study, 363 Danish individuals were typed for 56 STRs (26 autosomal STRs, 24 Y-STRs, and 6 X-STRs) using the ForenSeq™ DNA Signature Prep Kit to establish a Danish STR sequence database. Increased allelic diversity was observed in 34 STRs by the PCR-NGS assay. The largest increases were found in DYS389II and D12S391, where the numbers of sequenced alleles were around four times larger than the numbers of alleles determined by repeat length alone. Thirteen SNPs and one InDel were identified in the flanking regions of 12 STRs. Furthermore, 36 single positions and five longer stretches in the STR flanking regions were found to have dubious genotyping quality. The combined match probability of the 26 autosomal STRs was 10,000 times larger using the PCR-NGS assay than by using PCR-CE. The typical paternity indices for trios and duos were 500 and 100 times larger, respectively, than those obtained with PCR-CE. The assay also amplified 94 SNPs selected for human identification. Eleven of these loci were not in Hardy-Weinberg equilibrium in the Danish population, most likely because the minimum threshold for allele calling (30 reads) in the ForenSeq™ Universal Analysis Software was too low and frequent allele dropouts were not detected.

Composition and physical properties of arugula, shepherd's purse, and upland cress oils

Science.gov (United States)

The fatty acid, tocopherol and phytosterol profiles of arugula [AO; Eruca vesicaria (L.) Cav. subsp. sativa (Mill.) Thell.], upland cress [UCO; Barbarea verna (Mill.) Asch.], and shepherd's purse [SPO; Capsella bursa-pastoris (L.) Medik.] oils are reported, along with their physical properties. The...

Knowledge, attitudes, and beliefs about HIV pre-exposure prophylaxis among US Air Force Health Care Providers

OpenAIRE

Hakre, Shilpa; Blaylock, Jason M; Dawson, Peter; Beckett, Charmagne; Garges, Eric C; Michael, Nelson L; Danaher, Patrick J; Scott, Paul T; Okulicz, Jason F

2016-01-01

Abstract Providers are central to effective implementation of HIV pre-exposure prophylaxis (PrEP). Primary care providers (PCP) and infectious disease physicians (ID) in the US Air Force (USAF) participated in a cross-sectional survey regarding knowledge, attitudes, and beliefs toward HIV PrEP. Characteristics associated with PrEP knowledge were assessed in univariate and multivariate analyses. Among 403 (40% of 1015 providers) participants, 9% (PCP 383, ID 20) ever prescribed PrEP. In univar...

REACHING THE COMPUTING HELP DESK

CERN Multimedia

Miguel MARQUINA; Roger WOOLNOUGH; IT/User Support

1999-01-01

The way to contact the Computing Help Desk (also known as 'UCO' and hosted by IT Division as an entry point for general computing issues) has been streamlined in order to facilitate access to it. A new telephone line and email address have been set: Phone number: 78888Email: Helpdesk@cern.chhopefully easier to remember. Both entries are operational since last December. The previous number and email address remain valid and have been turned into aliases of the above. However we encourage using the latter at your convenience from now on. For additional information please see the article published at the CERN Computing Newsletter 233:http://consult.cern.ch/cnl/233/art_uco.htmlDo not hesitate to contact us (by email to User.Relations@cern.ch) for additional information or feedback regarding this matter.Nicole Cremel, Miguel Marquina, Roger WoolnoughIT/UserSupport

Behaviour around the time of calving in dairy cows

DEFF Research Database (Denmark)

Jensen, Margit Bak

2012-01-01

. Within minutes after calving cows stood up and licked their calves; second parity cows had a longer latency to stand than later parity cows. Sniffing and licking the calf peaked during the first hour after calving and decreased during the five successive hours, while calves’ sniffing the cow peaked...

AGR-2 Irradiation Test Final As-Run Report

Energy Technology Data Exchange (ETDEWEB)

Collin, Blaise P. [Idaho National Lab. (INL), Idaho Falls, ID (United States). VHTR Program

2014-08-01

This document presents the as-run analysis of the AGR-2 irradiation experiment. AGR-2 is the second of the planned irradiations for the Advanced Gas Reactor (AGR) Fuel Development and Qualification Program. Funding for this program is provided by the U.S. Department of Energy as part of the Very High Temperature Reactor (VHTR) Technology Development Office (TDO) program. The objectives of the AGR-2 experiment are to: 1. Irradiate UCO (uranium oxycarbide) and UO₂ (uranium dioxide) fuel produced in a large coater. Fuel attributes are based on results obtained from the AGR-1 test and other project activities. 2. Provide irradiated fuel samples for post-irradiation experiment (PIE) and safety testing. 3. Support the development of an understanding of the relationship between fuel fabrication processes, fuel product properties, and irradiation performance. The primary objective of the test was to irradiate both UCO and UO₂ TRISO (tristructural isotropic) fuel produced from prototypic scale equipment to obtain normal operation and accident condition fuel performance data. The UCO compacts were subjected to a range of burnups and temperatures typical of anticipated prismatic reactor service conditions in three capsules. The test train also includes compacts containing UO₂ particles produced independently by the United States, South Africa, and France in three separate capsules. The range of burnups and temperatures in these capsules were typical of anticipated pebble bed reactor service conditions. The results discussed in this report pertain only to U.S.-produced fuel.

AGR-2 Irradiation Test Final As-Run Report

Energy Technology Data Exchange (ETDEWEB)

Collin, Blaise P. [Idaho National Lab. (INL), Idaho Falls, ID (United States). VHTR Program

2014-08-01

This document presents the as-run analysis of the AGR-2 irradiation experiment. AGR-2 is the second of the planned irradiations for the Advanced Gas Reactor (AGR) Fuel Development and Qualification Program. Funding for this program is provided by the U.S. Department of Energy as part of the Very High Temperature Reactor (VHTR) Technical Development Office (TDO) program. The objectives of the AGR-2 experiment are to: (a) Irradiate UCO (uranium oxycarbide) and UO₂ (uranium dioxide) fuel produced in a large coater. Fuel attributes are based on results obtained from the AGR-1 test and other project activities. (b) Provide irradiated fuel samples for post-irradiation experiment (PIE) and safety testing. (c) Support the development of an understanding of the relationship between fuel fabrication processes, fuel product properties, and irradiation performance. The primary objective of the test was to irradiate both UCO and UO₂ TRISO (tri-structural isotropic) fuel produced from prototypic scale equipment to obtain normal operation and accident condition fuel performance data. The UCO compacts were subjected to a range of burnups and temperatures typical of anticipated prismatic reactor service conditions in three capsules. The test train also includes compacts containing UO₂ particles produced independently by the United States, South Africa, and France in three separate capsules. The range of burnups and temperatures in these capsules were typical of anticipated pebble bed reactor service conditions. The results discussed in this report pertain only to U.S. produced fuel.

Acceptability of pre-exposure prophylaxis among men who have sex with men and transgender women in Northern Thailand.

Directory of Open Access Journals (Sweden)

Daniel Yang

Full Text Available Northern Thailand has a high burden HIV epidemic among MSM and TG. Oral pre-exposure prophylaxis (PrEP with tenofovir-emtricitabine has demonstrated efficacy in preventing HIV among MSM and TG in Chiang Mai, Thailand. Determinants of PrEP acceptability are needed to gauge the potential uptake of this prevention strategy.From January to February 2012, 238 MSM and TG participants, who self-reported as HIV-uninfected or of unknown status, completed a self-administered survey on hand-held computers. Participants were recruited by venue-day-time sampling and asked to rate their likelihood of using oral PrEP for HIV prevention with an efficacy of 50%. PrEP acceptability was defined as being "very likely" to use PrEP. Odds ratios and 95% CIs were calculated to identify correlates of acceptability.131 MSM and 107 TG responded, with mean ages of 23.7 and 21.8, respectively. 24% of MSM engaged primarily in receptive anal sex vs. 74% of TG. 21% of MSM and 44% of TG reported regular medication use. Prior awareness of PrEP was high at 66% among both MSM and TG respondents. 41% of MSM and 37% of TG were "very likely" to use PrEP. Among MSM, factors associated with PrEP acceptability included a prior history of STIs (AOR 4.6; 95%CIs 1.7-12.6, previous HIV testing (AOR 2.4 95%CIs 1.1-5.3, regularly planned sex (AOR 2.8 95%CIs 1.1-7.2, and infrequent sex (AOR 2.9 95%CIs 1.3-6.3. Among TG, factors associated with acceptability included prior awareness of PrEP (AOR 3.3; 95%CIs 1.2-9.0 and having private insurance (AOR 5.0; 95%CIs 1.3-19.0.MSM and TG in Northern Thailand are distinct groups in terms of sexual behaviors, patterns of medication use, and correlates of PrEP acceptability. Efforts to maximize PrEP uptake should include expanded HIV testing services and the provision of financial subsidies to reduce the cost of PrEP.

Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence – a narrative review

Directory of Open Access Journals (Sweden)

Haire BG

2015-10-01

Full Text Available Bridget G Haire Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW, Australia Abstract: Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings – whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma – unfavorable associations – can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity. PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. PrEP

Willingness of community-recruited men who have sex with men in Washington, DC to use long-acting injectable HIV pre-exposure prophylaxis.

Directory of Open Access Journals (Sweden)

Matthew E Levy

Full Text Available Clinical trials are currently investigating the safety and efficacy of long-acting injectable (LAI agents as HIV pre-exposure prophylaxis (PrEP. Using National HIV Behavioral Surveillance data, we assessed the self-reported willingness of men who have sex with men (MSM to use LAI PrEP and their preference for LAI versus daily oral PrEP.In 2014, venue-based sampling was used to recruit MSM aged ≥18 years in Washington, DC. Participants completed an interviewer-administered survey followed by voluntary HIV testing. This analysis included MSM who self-reported negative/unknown HIV status at study entry. Correlates of being "very likely" to use LAI PrEP and preferring it to daily oral PrEP were identified using multivariable logistic regression.Of 314 participants who self-reported negative/unknown HIV status, 50% were <30 years old, 41% were non-Hispanic Black, 37% were non-Hispanic White, and 14% were Hispanic. If LAI PrEP were offered for free or covered by health insurance, 62% were very likely, 25% were somewhat likely, and 12% were unlikely to use it. Regarding preferred PrEP modality, 67% chose LAI PrEP, 24% chose oral PrEP, and 9% chose neither. Correlates of being very likely versus somewhat likely/unlikely to use LAI PrEP included age <30 years (aOR 1.64; 95% CI 1.00-2.68, reporting ≥6 (vs. 1 sex partners in the last year (aOR 2.60; 95% CI 1.22-5.53, previous oral PrEP use (aOR 3.67; 95% CI 1.20-11.24, and being newly identified as HIV-infected during study testing (aOR 4.83; 95% CI 1.03-22.67. Black (vs. White men (aOR 0.48; 95% CI 0.24-0.96 and men with an income of <$20,000 (vs. ≥$75,000; aOR 0.37; 95% CI 0.15-0.93 were less likely to prefer LAI to oral PrEP.If LAI PrEP were found to be efficacious, its addition to the HIV prevention toolkit could facilitate more complete PrEP coverage among MSM at risk for HIV.

Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence - a narrative review.

Science.gov (United States)

Haire, Bridget G

2015-01-01

Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP) as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings - whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma - unfavorable associations - can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use) and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity). PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. PrEP access needs to be reframed as a positive and responsible option to help people remain HIV-negative.

Effectiveness and cost effectiveness of oral pre-exposure prophylaxis in a portfolio of prevention programs for injection drug users in mixed HIV epidemics.

Directory of Open Access Journals (Sweden)

Sabina S Alistar

Full Text Available BACKGROUND: Pre-exposure prophylaxis with oral antiretroviral treatment (oral PrEP for HIV-uninfected injection drug users (IDUs is potentially useful in controlling HIV epidemics with a significant injection drug use component. We estimated the effectiveness and cost effectiveness of strategies for using oral PrEP in various combinations with methadone maintenance treatment (MMT and antiretroviral treatment (ART in Ukraine, a representative case for mixed HIV epidemics. METHODS AND FINDINGS: We developed a dynamic compartmental model of the HIV epidemic in a population of non-IDUs, IDUs who inject opiates, and IDUs in MMT, adding an oral PrEP program (tenofovir/emtricitabine, 49% susceptibility reduction for uninfected IDUs. We analyzed intervention portfolios consisting of oral PrEP (25% or 50% of uninfected IDUs, MMT (25% of IDUs, and ART (80% of all eligible patients. We measured health care costs, quality-adjusted life years (QALYs, HIV prevalence, HIV infections averted, and incremental cost effectiveness. A combination of PrEP for 50% of IDUs and MMT lowered HIV prevalence the most in both IDUs and the general population. ART combined with MMT and PrEP (50% access averted the most infections (14,267. For a PrEP cost of $950, the most cost-effective strategy was MMT, at $520/QALY gained versus no intervention. The next most cost-effective strategy consisted of MMT and ART, costing $1,000/QALY gained compared to MMT alone. Further adding PrEP (25% access was also cost effective by World Health Organization standards, at $1,700/QALY gained. PrEP alone became as cost effective as MMT at a cost of $650, and cost saving at $370 or less. CONCLUSIONS: Oral PrEP for IDUs can be part of an effective and cost-effective strategy to control HIV in regions where injection drug use is a significant driver of the epidemic. Where budgets are limited, focusing on MMT and ART access should be the priority, unless PrEP has low cost.

Effectiveness and Cost Effectiveness of Oral Pre-Exposure Prophylaxis in a Portfolio of Prevention Programs for Injection Drug Users in Mixed HIV Epidemics

Science.gov (United States)

Alistar, Sabina S.; Owens, Douglas K.; Brandeau, Margaret L.

2014-01-01

Background Pre-exposure prophylaxis with oral antiretroviral treatment (oral PrEP) for HIV-uninfected injection drug users (IDUs) is potentially useful in controlling HIV epidemics with a significant injection drug use component. We estimated the effectiveness and cost effectiveness of strategies for using oral PrEP in various combinations with methadone maintenance treatment (MMT) and antiretroviral treatment (ART) in Ukraine, a representative case for mixed HIV epidemics. Methods and Findings We developed a dynamic compartmental model of the HIV epidemic in a population of non-IDUs, IDUs who inject opiates, and IDUs in MMT, adding an oral PrEP program (tenofovir/emtricitabine, 49% susceptibility reduction) for uninfected IDUs. We analyzed intervention portfolios consisting of oral PrEP (25% or 50% of uninfected IDUs), MMT (25% of IDUs), and ART (80% of all eligible patients). We measured health care costs, quality-adjusted life years (QALYs), HIV prevalence, HIV infections averted, and incremental cost effectiveness. A combination of PrEP for 50% of IDUs and MMT lowered HIV prevalence the most in both IDUs and the general population. ART combined with MMT and PrEP (50% access) averted the most infections (14,267). For a PrEP cost of $950, the most cost-effective strategy was MMT, at $520/QALY gained versus no intervention. The next most cost-effective strategy consisted of MMT and ART, costing $1,000/QALY gained compared to MMT alone. Further adding PrEP (25% access) was also cost effective by World Health Organization standards, at $1,700/QALY gained. PrEP alone became as cost effective as MMT at a cost of $650, and cost saving at $370 or less. Conclusions Oral PrEP for IDUs can be part of an effective and cost-effective strategy to control HIV in regions where injection drug use is a significant driver of the epidemic. Where budgets are limited, focusing on MMT and ART access should be the priority, unless PrEP has low cost. PMID:24489747

Pre-exposure prophylaxis of HIV

Science.gov (United States)

Naswa, Smriti; Marfatia, Y. S.

2011-01-01

Pre-exposure prophylaxis (PrEP) is an experimental approach to HIV prevention and consists of antiretroviral drugs to be taken before potential HIV exposure in order to reduce the risk of HIV infection and continued during periods of risk. An effective PrEP could provide an additional safety net to sexually active persons at risk, when combined with other prevention strategies. Women represent nearly 60% of adults infected with HIV and PrEP can be a female-controlled prevention method for women who are unable to negotiate condom use. Two antiretroviral nucleoside analog HIV-1 reverse transcriptase inhibitor drugs are currently under trial as PrEP drugs, namely tenofovirdisoproxilfumarate (TDF) alone and TDF in combination with emricitabine (FTC), to be taken as daily single dose oral drugs. There are 11 ongoing trials of ARV-based prevention in different at risk populations across the world. The iPrex trial showed that daily use of oral TDF/FTC by MSM resulted in 44% reduction in the incidence of HIV. This led to publication of interim guidance by CDC to use of PrEP by health providers for MSM. Few other trials are Bangkok Tenofovir Study, Partners PrEP Study, FEM-PrEP study, and VOICE (MTN-003) study. Future trials are being formulated for intermittent PrEP (iPrEP) where drugs are taken before and after sex, “stand-in dose” iPrEP, vaginal or rectal PrEP, etc. There are various issues/concerns with PrEP such as ADRs and resistance to TDF/FTC, adherence to drugs, acceptability, sexual disinhibition, use of PrEP as first line of defense for HIV without other prevention strategies, and cost. The PrEP has a potential to address unmet need in public health if delivered as a part of comprehensive toolkit of prevention services, including risk-reduction, correct and consistent use of condoms, and diagnosis and treatment of sexually transmitted infections. PMID:21799568

Correlates of willingness to initiate pre-exposure prophylaxis and anticipation of practicing safer drug- and sex-related behaviors among high-risk drug users on methadone treatment.

Science.gov (United States)

Shrestha, Roman; Karki, Pramila; Altice, Frederick L; Huedo-Medina, Tania B; Meyer, Jaimie P; Madden, Lynn; Copenhaver, Michael

2017-04-01

Although people who use drugs (PWUD) are key populations recommended to receive pre-exposure prophylaxis (PrEP) to prevent HIV, few data are available to guide PrEP delivery in this underserved group. We therefore examined the willingness to initiate PrEP and the anticipation of HIV risk reduction while on PrEP among high-risk PWUD. In a cross-sectional study of 400 HIV-negative, opioid dependent persons enrolled in a methadone program and reporting recent risk behaviors, we examined independent correlates of being willing to initiate PrEP. While only 72 (18%) were aware of PrEP, after being given a description of it, 251 (62.7%) were willing to initiate PrEP. This outcome was associated with having neurocognitive impairment (aOR=3.184, p=0.004) and higher perceived HIV risk (aOR=8.044, p<0.001). Among those willing to initiate PrEP, only 12.5% and 28.2%, respectively, indicated that they would always use condoms and not share injection equipment while on PrEP. Consistent condom use was associated with higher income (aOR=8.315, p=0.016), always using condoms with casual partners (aOR=6.597, p=0.001), and inversely associated with ongoing drug injection (aOR=0.323, p=0.027). Consistent safe injection, however, was inversely associated with age (aOR=0.948, p=0.035), ongoing drug injection (aOR=0.342, p<0.001), and perceived HIV risk (aOR=0.191, p=0.019). While willingness to initiate PrEP was high and correlated with being at elevated risk for HIV, anticipated higher risk behaviors in this group even while on PrEP suggests that the next generation of HIV prevention approaches may need to combine biomedical and behavioral components to sustain HIV risk reduction over time. Copyright © 2017 Elsevier B.V. All rights reserved.

Healthcare Provider Contact and Pre-exposure Prophylaxis in Baltimore Men Who Have Sex With Men

Science.gov (United States)

Raifman, Julia R.G.; Flynn, Colin; German, Danielle

2018-01-01

Introduction Pre-exposure prophylaxis (PrEP) safely and effectively prevents HIV in populations at high risk, including men who have sex with men (MSM). PrEP scale-up depends upon primary care providers and community-based organizations (CBOs) sharing PrEP information. This study aimed to determine whether healthcare provider or CBO contact was associated with PrEP awareness among Baltimore MSM. Methods This study used 2014 Baltimore MSM National HIV Behavioral Surveillance data, which included data on health care, HIV and sexually transmitted infection testing, and receipt of condoms from CBOs. In 2015, associations were estimated between healthcare contacts and PrEP awareness through logistic regression models controlling for age, race, and education and clustering by venue. Comparative analyses were conducted with HIV testing as outcome. Results There were 401 HIV-negative participants, of whom 168 (42%) were aware of PrEP. Visiting a healthcare provider in the past 12 months, receiving an HIV test from a provider, and having a sexually transmitted infection test in the past 12 months were not significantly associated with PrEP awareness. PrEP awareness was associated with being out to a healthcare provider (OR = 2.97, 95% CI=1.78, 4.96, p<0.001); being tested for HIV (OR=1.50, 95% CI = 1.06, 2.13, p = 0.023); and receiving condoms from an HIV/AIDS CBO (OR = 2.59, 95% CI = 1.43, 4.64, p = 0.001). By contrast, HIV testing was significantly associated with most forms of healthcare contact. Conclusions PrEP awareness is not associated with most forms of healthcare contact, highlighting the need for guidelines and trainings to support provider discussion of PrEP with MSM. PMID:27662698

HIV pre-exposure prophylaxis: Exploring the potential for expanding the role of pharmacists in public health.

Science.gov (United States)

Okoro, Olihe; Hillman, Lisa

2018-05-19

The study objectives were to a) assess knowledge and experience; b) describe perceptions and attitudes; and c) identify training needs of community-based pharmacists regarding HIV pre-exposure prophylaxis (PrEP). This was a cross-sectional survey study. The survey was administered online to pharmacists practicing in a community setting in the state of Minnesota. Measures included knowledge of and experience with HIV PrEP, perceptions and attitudes towards pharmacists' involvement, and HIV PrEP-specific training needs for pharmacists. With a survey response rate of approximately 13% (n = 347), most respondents (76.4%) agreed that HIV PrEP can be beneficial in high-risk populations. Forty-six percent of respondents were not aware of U.S. Food and Drug Administration approval of emtricitabine and tenofovir disoproxil fumarate for PrEP. Most respondents (71.1%) were "not at all familiar" with Centers for Disease Control and Prevention guidelines for PrEP. Twenty-one percent of respondents had sufficient knowledge to counsel patients on PrEP. Experience with counseling on PrEP (21.8%), having dispensed PrEP in the last 2 years (33.1%), fewer years in practice (≤10 years), location of practice site (urban or suburban), and having received HIV continuing education in the last 2 years (33.0%) were associated with more knowledge of HIV PrEP. Top concerns with counseling were knowledge about the medication and behavior modification. The most frequently indicated primary concerns with implementing PrEP initiatives were identifying appropriate candidates and patient adherence. As pharmacists' roles continue to expand, relevant content in pharmacy education and requisite training (including continuing education) are critical to addressing knowledge gaps and competencies that will enable pharmacists engage more effectively in public health efforts such as HIV prevention. Published by Elsevier Inc.

Adherence to antiretroviral prophylaxis for HIV prevention: a substudy cohort within a clinical trial of serodiscordant couples in East Africa.

Science.gov (United States)

Haberer, Jessica E; Baeten, Jared M; Campbell, James; Wangisi, Jonathan; Katabira, Elly; Ronald, Allan; Tumwesigye, Elioda; Psaros, Christina; Safren, Steven A; Ware, Norma C; Thomas, Katherine K; Donnell, Deborah; Krows, Meighan; Kidoguchi, Lara; Celum, Connie; Bangsberg, David R

2013-01-01

Randomized clinical trials of oral antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention have widely divergent efficacy estimates, ranging from 0% to 75%. These discrepancies are likely due to differences in adherence. To our knowledge, no studies to date have examined the impact of improving adherence through monitoring and/or intervention, which may increase PrEP efficacy, or reported on objective behavioral measures of adherence, which can inform PrEP effectiveness and implementation. Within the Partners PrEP Study (a randomized placebo-controlled trial of oral tenofovir and emtricitabine/tenofovir among HIV-uninfected members of serodiscordant couples in Kenya and Uganda), we collected objective measures of PrEP adherence using unannounced home-based pill counts and electronic pill bottle monitoring. Participants received individual and couples-based adherence counseling at PrEP initiation and throughout the study; counseling was intensified if unannounced pill count adherence fell to counseling, and HIV testing. A total of 1,147 HIV-uninfected participants were enrolled: 53% were male, median age was 34 years, and median partnership duration was 8.5 years. Fourteen HIV infections occurred among adherence study participants--all of whom were assigned to placebo (PrEP efficacy = 100%, 95% confidence interval 83.7%-100%, pmarriage were associated with >80% adherence. Study limitations include potential shortcomings of the adherence measures and use of a convenience sample within the substudy cohort. The high PrEP adherence achieved in the setting of active adherence monitoring and counseling support was associated with a high degree of protection from HIV acquisition by the HIV-uninfected partner in heterosexual serodiscordant couples. Low PrEP adherence was associated with sexual behavior, alcohol use, younger age, and length of PrEP use. Please see later in the article for the Editors' Summary.

Optimal uses of antiretrovirals for prevention in HIV-1 serodiscordant heterosexual couples in South Africa: a modelling study.

Directory of Open Access Journals (Sweden)

Timothy B Hallett

2011-11-01

Full Text Available Antiretrovirals have substantial promise for HIV-1 prevention, either as antiretroviral treatment (ART for HIV-1-infected persons to reduce infectiousness, or as pre-exposure prophylaxis (PrEP for HIV-1-uninfected persons to reduce the possibility of infection with HIV-1. HIV-1 serodiscordant couples in long-term partnerships (one member is infected and the other is uninfected are a priority for prevention interventions. Earlier ART and PrEP might both reduce HIV-1 transmission in this group, but the merits and synergies of these different approaches have not been analyzed.We constructed a mathematical model to examine the impact and cost-effectiveness of different strategies, including earlier initiation of ART and/or PrEP, for HIV-1 prevention for serodiscordant couples. Although the cost of PrEP is high, the cost per infection averted is significantly offset by future savings in lifelong treatment, especially among couples with multiple partners, low condom use, and a high risk of transmission. In some situations, highly effective PrEP could be cost-saving overall. To keep couples alive and without a new infection, providing PrEP to the uninfected partner could be at least as cost-effective as initiating ART earlier in the infected partner, if the annual cost of PrEP is 70% effective.Strategic use of PrEP and ART could substantially and cost-effectively reduce HIV-1 transmission in HIV-1 serodiscordant couples. New and forthcoming data on the efficacy of PrEP, the cost of delivery of ART and PrEP, and couples behaviours and preferences will be critical for optimizing the use of antiretrovirals for HIV-1 prevention. Please see later in the article for the Editors' Summary.

Facilitators and Barriers to Pre-Exposure Prophylaxis Willingness Among Young Men Who Have Sex with Men Who Use Geosocial Networking Applications in California.

Science.gov (United States)

Holloway, Ian W; Tan, Diane; Gildner, Jennifer L; Beougher, Sean C; Pulsipher, Craig; Montoya, Jorge A; Plant, Aaron; Leibowitz, Arleen

2017-12-01

While correlates of pre-exposure prophylaxis (PrEP) uptake have been explored among older men who have sex with men (MSM), less is known about the facilitators and barriers that encourage uptake among younger MSM (YMSM). This study explores the association between willingness to take PrEP and demographic characteristics, sexual risk, and substance use, and attitudinal factors among YMSM in California who use geosocial networking applications (GSN apps). Based on survey data from YMSM recruited through GSN apps (n = 687), PrEP willingness was positively associated with Hispanic ethnicity [adjusted odds ratio (aOR): 1.73; confidence interval (CI): 1.01-2.98; p = 0.046], concerns about drug effects (aOR: 0.46; CI: 0.33-0.65; p < 0.001), medical mistrust (aOR: 0.71; CI: 0.53-0.96; p < 0.001), and concerns about adherence (aOR: 0.65; CI: 0.49-0.89; p = 0.005). PrEP willingness was positively associated with medium (aOR: 1.87; CI: 1.14-3.07; p = 0.014) and high concern (aOR: 1.84; CI: 1.13-3.01; p < 0.001) about contracting HIV and perceived benefits of taking PrEP (aOR: 2.59; CI: 1.78-3.78; p < 0.001). In addition to emphasizing the benefits of using PrEP, campaigns that address concerns regarding adherence and side effects may increase interest in and demand for PrEP among YMSM. More opportunities are needed to educate YMSM about PrEP, including addressing their concerns about this new prevention strategy. Providers should speak openly and honestly to YMSM considering PrEP about what to do if side effects occur and how to handle missed doses. Outreach using GSN apps for PrEP education and screening may be an effective way to reach YMSM.

Cost-Effectiveness of Pre-exposure HIV Prophylaxis During Pregnancy and Breastfeeding in Sub-Saharan Africa

Science.gov (United States)

Wheeler, Stephanie B.; Stranix-Chibanda, Lynda; Hosek, Sybil G.; Watts, D. Heather; Siberry, George K.; Spiegel, Hans M. L.; Stringer, Jeffrey S.; Chi, Benjamin H.

2016-01-01

Introduction: Antiretroviral pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition is cost-effective when delivered to those at substantial risk. Despite a high incidence of HIV infection among pregnant and breastfeeding women in sub-Saharan Africa (SSA), a theoretical increased risk of preterm birth on PrEP could outweigh the HIV prevention benefit. Methods: We developed a decision analytic model to evaluate a strategy of daily oral PrEP during pregnancy and breastfeeding in SSA. We approached the analysis from a health care system perspective across a lifetime time horizon. Model inputs were derived from existing literature and local sources. The incremental cost-effectiveness ratio (ICER) of PrEP versus no PrEP was calculated in 2015 U.S. dollars per disability-adjusted life year (DALY) averted. We evaluated the effect of uncertainty in baseline estimates through one-way and probabilistic sensitivity analyses. Results: PrEP administered to pregnant and breastfeeding women in SSA was cost-effective. In a base case of 10,000 women, the administration of PrEP averted 381 HIV infections but resulted in 779 more preterm births. PrEP was more costly per person ($450 versus $117), but resulted in fewer disability-adjusted life years (DALYs) (3.15 versus 3.49). The incremental cost-effectiveness ratio of $965/DALY averted was below the recommended regional threshold for cost-effectiveness of $6462/DALY. Probabilistic sensitivity analyses demonstrated robustness of the model. Conclusions: Providing PrEP to pregnant and breastfeeding women in SSA is likely cost-effective, although more data are needed about adherence and safety. For populations at high risk of HIV acquisition, PrEP may be considered as part of a broader combination HIV prevention strategy. PMID:27355502

Effects of Pre-exposure Prophylaxis for the Prevention of HIV Infection on Sexual Risk Behavior in Men Who Have Sex with Men: A Systematic Review and Meta-analysis.

Science.gov (United States)

Traeger, Michael W; Schroeder, Sophia E; Wright, Edwina J; Hellard, Margaret E; Cornelisse, Vincent J; Doyle, Joseph S; Stoové, Mark A

2018-03-02

HIV pre-exposure prophylaxis (PrEP) is effective in reducing HIV risk in men who have sex with men (MSM). However concerns remain that risk compensation in PrEP users may lead to decreased condom use and increased incidence of sexually transmitted infections (STIs). We assessed the impact of PrEP on sexual risk outcomes in MSM. We conducted a systematic review of open-label trials and observational studies published to August 2017 reporting sexual risk outcomes (STI diagnoses, condom use, number of sexual partners) in the context of daily oral PrEP use in HIV-negative MSM and transgender women. Pooled effect estimates were calculated using random-effects meta-analysis and a qualitative review and risk of bias assessment were performed. Sixteen observational studies and one open-label trial met selection criteria. Eight studies with 4388 participants reported STI prevalence and 13 studies with 5008 participants reported change in condom use. PrEP use was associated with a significant increase in rectal chlamydia (odds ratio [OR]=1.59; 95%CI 1.19-2.13; p=0.002; heterogeneity I 2=23%) and an increase in any STI diagnosis (OR=1.24; 95%CI 0.99-1.54; p=0.059; I 2=50%). The association of PrEP use with STI diagnoses was stronger in later studies. Most studies showed evidence of an increase in condomless sex among PrEP users. Findings highlight the importance of efforts to minimize STIs among PrEP users and their sexual partners. Monitoring of risk compensation among MSM in the context of PrEP scale-up is needed to assess the impact of PrEP on the sexual health of MSM and to inform preventive strategies.

Awareness and willingness to use HIV pre-exposure prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention.

Directory of Open Access Journals (Sweden)

Ingrid Young

Full Text Available To investigate the awareness of, and willingness to use, HIV Pre-Exposure Prophylaxis (PrEP, and willingness to take part in a PrEP study among gay and bisexual men in Scotland.Cross-sectional survey of 17 gay commercial venues in Glasgow and Edinburgh in May 2011 (N = 1515, 65.2% response rate; 1393 are included in the analyses.Just under one-third of participants had heard of PrEP (n = 434; 31.2%, with awareness associated with being aged older than 35 years, talking to UAI partners about HIV, and with having had an HIV or STI test in the previous 12 months. Around half were willing to take part in a PrEP study (n = 695; 49.9% or to take PrEP on a daily basis (n = 756; 54.3%. In multivariate analysis, willingness to take PrEP was associated with lower levels of education, regular gay scene attendance, 'high-risk' unprotected anal intercourse (UAI and testing for HIV or STI in the previous 12 months. Reasons for not wanting to participate in a PrEP study or take PrEP included perceptions of low personal risk of HIV and concerns with using medication as an HIV prevention method.There is a willingness to engage in new forms of HIV prevention and research amongst a significant number of gay and bisexual men in Scotland. Future biomedical HIV interventions need to consider the links between sexual risk behaviour, testing, and potential PrEP use.

The Promise of Pre-Exposure Prophylaxis for Black Men Who Have Sex with Men: An Ecological Approach to Attitudes, Beliefs, and Barriers

Science.gov (United States)

Parker, Caroline M.; Parker, Richard G.; Wilson, Patrick A.; Garcia, Jonathan; Hirsch, Jennifer S.

2016-01-01

Abstract Research has demonstrated the clinical effectiveness of pre-exposure prophylaxis (PrEP) for HIV prevention, but little is known about how factors at the individual-, interpersonal-, community-, and structural levels impact PrEP use for black men who have sex with men (BMSM). We advance existing work by examining how all levels of the ecological framework must be addressed for PrEP to be successfully implemented as an effective HIV prevention approach. We interviewed 31 BMSM three times each and 17 community stakeholders once each; interviews were taped, transcribed, and analyzed using the constant comparative method. Factors that influence how BMSM experienced PrEP emerged across all levels of the ecological framework: At the individual level, respondents were wary of giving medication to healthy people and of the potential side-effects. At the interpersonal level, BMSM believed that PrEP use would discourage condom use and that PrEP should only be one option for HIV prevention, not the main option. At the community level, men described not trusting the pharmaceutical industry and described PrEP as an option for others, not for themselves. At the structural level, BMSM talked about HIV and sexuality-related stigmas and how they must overcome those before PrEP engagement. BMSM are a key population in the US National HIV/AIDS Strategy, yet few individuals believe that PrEP would be personally helpful. Our research indicates the urgent need to raise awareness and address structural stigma and policies that could be substantial barriers to the scale-up and implementation of PrEP-related services. PMID:27220036

Counseling Framework for HIV-Serodiscordant Couples on the Integrated Use of Antiretroviral Therapy and Pre-exposure Prophylaxis for HIV Prevention.

Science.gov (United States)

Morton, Jennifer F; Celum, Connie; Njoroge, John; Nakyanzi, Agnes; Wakhungu, Imeldah; Tindimwebwa, Edna; Ongachi, Snaidah; Sedah, Eric; Okwero, Emmanuel; Ngure, Kenneth; Odoyo, Josephine; Bulya, Nulu; Haberer, Jessica E; Baeten, Jared M; Heffron, Renee

2017-01-01

For HIV-serodiscordant couples, integrated delivery of antiretroviral therapy (ART) for HIV-positive partners and time-limited pre-exposure prophylaxis (PrEP) for negative partners virtually eliminates HIV transmission. Standardized messaging, sensitive to the barriers and motivators to HIV treatment and prevention, is needed for widespread scale-up of this approach. Within the Partners Demonstration Project, a prospective interventional project among 1013 serodiscordant couples in Kenya and Uganda, we offered ART to eligible HIV-positive partners and PrEP to HIV-negative partners before ART initiation and through the HIV-positive partner's first 6 months of ART use. We conducted individual and group discussions with counseling staff to elicit the health communication framework and key messages about ART and PrEP that were delivered to couples. Counseling sessions for serodiscordant couples about PrEP and ART included discussions of HIV serodiscordance, PrEP and ART initiation and integrated use, and PrEP discontinuation. ART messages emphasized daily, lifelong use for treatment and prevention, adherence, viral suppression, resistance, side effects, and safety of ART during pregnancy. PrEP messages emphasized daily dosing, time-limited PrEP use until the HIV-positive partner sustained 6 months of high adherence to ART, adherence, safety during conception, side effects, and other risks for HIV. Counseling messages for HIV-serodiscordant couples are integral to the delivery of time-limited PrEP as a "bridge" to ART-driven viral suppression. Their incorporation into programmatic scale-up will maximize intervention impact on the global epidemic.

76 FR 70397 - Proposed Flood Elevation Determinations

Science.gov (United States)

2011-11-14

... Branch Road. Salt Lick Branch (backwater effects At the Licking River None +924 Unincorporated Areas of... upstream of West County Road 100 North. Goose Creek At the upstream side of None +591 City of Logansport.... Approximately 355 feet None +901 upstream of Clyde Holliday Cemetery Road. Brushy Fork (backwater effects from...

"What I Did over My Summer Vacation..."

Science.gov (United States)

Techniques: Making Education and Career Connections, 1997

1997-01-01

A tech prep summer camp was designed to give ninth graders a taste of tech prep before they were asked to choose a high school path. Parents were invited to dinner to learn about tech prep programs and their potential for successful careers. (JOW)

Skin denervation does not alter cortical potentials to surface concentric electrode stimulation: A comparison with laser evoked potentials and contact heat evoked potentials.

Science.gov (United States)

La Cesa, S; Di Stefano, G; Leone, C; Pepe, A; Galosi, E; Alu, F; Fasolino, A; Cruccu, G; Valeriani, M; Truini, A

2018-01-01

In the neurophysiological assessment of patients with neuropathic pain, laser evoked potentials (LEPs), contact heat evoked potentials (CHEPs) and the evoked potentials by the intraepidermal electrical stimulation via concentric needle electrode are widely agreed as nociceptive specific responses; conversely, the nociceptive specificity of evoked potentials by surface concentric electrode (SE-PREPs) is still debated. In this neurophysiological study we aimed at verifying the nociceptive specificity of SE-PREPs. We recorded LEPs, CHEPs and SE-PREPs in eleven healthy participants, before and after epidermal denervation produced by prolonged capsaicin application. We also used skin biopsy to verify the capsaicin-induced nociceptive nerve fibre loss in the epidermis. We found that whereas LEPs and CHEPs were suppressed after capsaicin-induced epidermal denervation, the surface concentric electrode stimulation of the same denervated skin area yielded unchanged SE-PREPs. The suppression of LEPs and CHEPs after nociceptive nerve fibre loss in the epidermis indicates that these techniques are selectively mediated by nociceptive system. Conversely, the lack of SE-PREP changes suggests that SE-PREPs do not provide selective information on nociceptive system function. Capsaicin-induced epidermal denervation abolishes laser evoked potentials (LEPs) and contact heat evoked potentials (CHEPs), but leaves unaffected pain-related evoked potentials by surface concentric electrode (SE-PREPs). These findings suggest that unlike LEPs and CHEPs, SE-PREPs are not selectively mediated by nociceptive system. © 2017 European Pain Federation - EFIC®.

HIV/AIDS conspiracy beliefs and intention to adopt preexposure prophylaxis among black men who have sex with men in Los Angeles.

Science.gov (United States)

Brooks, Ronald A; Allen, Vincent C; Regan, Rotrease; Mutchler, Matt G; Cervantes-Tadeo, Ramon; Lee, Sung-Jae

2018-03-01

In the United States, black men who have sex with men (MSM) are the group most affected by the HIV/AIDS epidemic. Pre-exposure prophylaxis (PrEP) is an important new HIV prevention strategy that may help reduce new HIV infections among black MSM. This analysis examined the association between HIV/AIDS conspiracy beliefs and intentions to adopt PrEP among 224 black MSM. The likelihood of adopting PrEP was assessed and more than half (60%) of the study population indicated a high intention to adopt PrEP. HIV/AIDS genocidal and treatment-related conspiracies were assessed using scales previously validated with black MSM. Almost two-thirds (63%) endorsed at least one of eight HIV/AIDS conspiracy beliefs presented. In multivariable analyses, black MSM who agreed with the genocidal or treatment-related conspiracy beliefs scales had a lower intention to adopt PrEP (Adjusted Odds Ratio [AOR] = 0.73, 95% CI = 0.54, 0.99 and AOR = 0.36, 95% CI = 0.23, 0.55, respectively). Our findings indicate that preexisting HIV/AIDS conspiracy beliefs may deter some black MSM from adopting PrEP. We suggest strategies PrEP implementers may want to employ to address the influence that HIV/AIDS conspiracy beliefs may have on the adoption of PrEP among black MSM, a population disproportionately affected by HIV/AIDS.

Limited SHIV env diversification in macaques failing oral antiretroviral pre-exposure prophylaxis.

Science.gov (United States)

Zheng, Qi; Ruone, Susan; Switzer, William M; Heneine, Walid; García-Lerma, J Gerardo

2012-05-09

Pre-exposure prophylaxis (PrEP) with daily Truvada [a combination of emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF)] is a novel HIV prevention strategy recently found to prevent HIV transmission among men who have sex with men and heterosexual couples. Acute infection in adherent persons who fail PrEP will inevitably occur under concurrent antiretroviral therapy, thus raising questions regarding the potential impact of PrEP on early viral dynamics. We investigated viral evolution dynamics in a macaque model of PrEP consisting of repeated rectal exposures to SHIV162P3 in the presence of PrEP. Four macaques were infected during daily or intermittent PrEP with FTC or FTC/TDF, and five were untreated controls. SHIV env sequence evolution was monitored by single genome amplification with phylogenetic and sequence analysis. Mean nucleotide divergence from transmitted founder viruses calculated 17 weeks (range = 12-20) post peak viremia was significantly lower in PrEP failures than in control animals (7.2 × 10-3 compared to 1.6 × 10-2 nucleotide substitutions per site per year, respectively, p diversification during early infection might enhance immune control by slowing the selection of escape mutants.

Long acting systemic HIV pre-exposure prophylaxis: an examination of the field.

Science.gov (United States)

Lykins, William R; Luecke, Ellen; Johengen, Daniel; van der Straten, Ariane; Desai, Tejal A

2017-12-01

Oral pre-exposure prophylaxis for the prevention of HIV-1 transmission (HIV PrEP) has been widely successful as demonstrated by a number of clinical trials. However, studies have also demonstrated the need for patients to tightly adhere to oral dosing regimens in order to maintain protective plasma and tissue concentrations. This is especially true for women, who experience less forgiveness from dose skipping than men in clinical trials of HIV PrEP. There is increasing interest in long-acting (LA), user-independent forms of HIV PrEP that could overcome this adherence challenge. These technologies have taken multiple forms including LA injectables and implantables. Phase III efficacy trials are ongoing for a LA injectable candidate for HIV PrEP. This review will focus on the design considerations for both LA injectable and implantable platforms for HIV PrEP. Additionally, we have summarized the existing LA technologies currently in clinical and pre-clinical studies for HIV PrEP as well as other technologies that have been applied to HIV PrEP and contraceptives. Our discussion will focus on the potential application of these technologies in low resource areas, and their use in global women's health.

lammerooie op suur winterveld; (b) Naspeen

African Journals Online (AJOL)

Utilization of monensin in protein-energy licks by lactating ewes on sour winter veld; (b) Postweaning. High (HEL) and low. (LEL) energy protein licks, with and without monensin, were fed to Oohne Merino ewes before and after weaning on Oohne sourveld during the winter. Creep feed and growth rations with and without ...

Barriers to Access and Adoption of Pre-Exposure Prophylaxis for the Prevention of HIV Among Men Who Have Sex With Men (MSM) in a Relatively Rural State.

Science.gov (United States)

Hubach, Randolph D; Currin, Joseph M; Sanders, Carissa A; Durham, André R; Kavanaugh, Katherine E; Wheeler, Denna L; Croff, Julie M

2017-08-01

Biomedical intervention approaches, including antiretroviral pre-exposure prophylaxis (PrEP), have been demonstrated to reduce HIV incidence among several at-risk populations and to be cost effective. However, there is limited understanding of PrEP access and uptake among men who have sex with men (MSM) residing in relatively rural states. Twenty semistructured interviews were conducted (August-November 2016) to assess opinions of and perceived barriers to accessing and adopting PrEP among MSM residing in Oklahoma. Participants perceived substantial barriers to accessing PrEP including a stigmatizing environment and less access to quality, LGBT-sensitive medical care. Overall, geographic isolation limits access to health providers and resources that support sexual health for Oklahoma MSM. Addressing stigma situated across ecological levels in an effort to increase adoption of PrEP by MSM residing in rural states remains necessary. Without this, social determinants may continue to negatively influence PrEP adoption and sexual health outcomes.

[Willingness and influencing factors of using pre-exposure prophylaxis among 301 men have sex with men in Wuhan city, 2015].

Science.gov (United States)

Xie, P Y; Wang, X; Liu, P L; Tan, X D; Zhou, W

2017-11-06

Objective: To understand willingness and influencing factors of using pre-exposure prophylaxis (Pr-EP) among men who have sex with men (MSM). Methods: Snow ball sampling was employed to recruit MSM in the social spaces (like bars and bathrooms) with focused activities by MSM and internet (QQ and Wechat) in Wuhan between August and November, 2015. 304 MSM were considered eligible when they were self-identified MSM and has had sex with men in the previous 12 months, over the age of 18 and have full civil liability. On-site and online questionnaire surveys were conducted by self-designed questionnaires to collect information including demographic characteristics, sexual risks and practices, awareness of PrEP, and willingness to use PrEP. A total of 301 qualified questionnaires were obtained. Multivariate logistic regression models were constructed to identify factors associated with willingness to use Pr-EP. Results: The mean age of surveyed MSM were (27.51±8.31) years, between18-61. 149 on-site survey, online were152; 131 MSM have regular homosexual partners, 170 MSM have not regular homosexual partners. Only 17.28% (52/301) had heard of Pr-EP before this survey, 18.32% (24/130) had heard of Pr-EP among those who had regular homosexual partners and those who had not accounted for 16.47% (28/170). 74.42% (224/301) had willingness to use Pr-EP after they knew Pr-EP was safe and effective through the survey. The proportion among those who had regular homosexual partners was 74.05%(74), and the proportion among those who had not was 74.71% (127); Among those who had regular homosexual partners, results suggested that those who were married/cohabiting were more likely to report a willingness to use PrEP compared to unmarried/divorced or widowed ( OR= 5.60), compared with homosexual, heterosexuality was associated with decreased odds of willingness to use Pr-EP ( OR= 0.22), compared with HIV status of sexual partner was negative or uncertain, positive infection status was

Motion-insensitive carotid intraplaque hemorrhage imaging using 3D inversion recovery preparation stack of stars (IR-prep SOS) technique.

Science.gov (United States)

Kim, Seong-Eun; Roberts, John A; Eisenmenger, Laura B; Aldred, Booth W; Jamil, Osama; Bolster, Bradley D; Bi, Xiaoming; Parker, Dennis L; Treiman, Gerald S; McNally, J Scott

2017-02-01

Carotid artery imaging is important in the clinical management of patients at risk for stroke. Carotid intraplaque hemorrhage (IPH) presents an important diagnostic challenge. 3D magnetization prepared rapid acquisition gradient echo (MPRAGE) has been shown to accurately image carotid IPH; however, this sequence can be limited due to motion- and flow-related artifact. The purpose of this work was to develop and evaluate an improved 3D carotid MPRAGE sequence for IPH detection. We hypothesized that a radial-based k-space trajectory sequence such as "Stack of Stars" (SOS) incorporated with inversion recovery preparation would offer reduced motion sensitivity and more robust flow suppression by oversampling of central k-space. A total of 31 patients with carotid disease (62 carotid arteries) were imaged at 3T magnetic resonance imaging (MRI) with 3D IR-prep Cartesian and SOS sequences. Image quality was determined between SOS and Cartesian MPRAGE in 62 carotid arteries using t-tests and multivariable linear regression. Kappa analysis was used to determine interrater reliability. In all, 25 among 62 carotid plaques had carotid IPH by consensus from the reviewers on SOS compared to 24 on Cartesian sequence. Image quality was significantly higher with SOS compared to Cartesian (mean 3.74 vs. 3.11, P SOS acquisition yielded sharper image features with less motion (19.4% vs. 45.2%, P SOS (kappa = 0.89), higher than that of Cartesian (kappa = 0.84). By minimizing flow and motion artifacts and retaining high interrater reliability, the SOS MPRAGE has important advantages over Cartesian MPRAGE in carotid IPH detection. 1 J. Magn. Reson. Imaging 2017;45:410-417. © 2016 International Society for Magnetic Resonance in Medicine.

Preparing Patients for Cancer Chemotherapy: Effect of Coping Preparation and Relaxation Interventions.

Science.gov (United States)

Burish, Thomas G.; And Others

1991-01-01

Sixty cancer chemotherapy patients were randomly assigned to one of four treatments: relaxation training with guided relaxation imagery (RT), general coping preparation (PREP), both RT and PREP, or routine clinic treatment only. Found that PREP intervention increased patients' knowledge of disease and treatment, reduced anticipatory side effects,…

Pre-exposure prophylaxis for MSM and transgender persons in early adopting countries

NARCIS (Netherlands)

Hoornenborg, Elske; Krakower, Douglas S.; Prins, Maria; Mayer, Kenneth H.

2017-01-01

: Pre-exposure prophylaxis (PrEP) is a potent and underutilized HIV prevention tool. In this paper we review the state of knowledge regarding PrEP implementation for men who have sex with men and transgender persons in early adopting countries. We focus on implementation of PrEP in demonstration

Men who have sex with men more often chose daily than event-driven use of pre-exposure prophylaxis: baseline analysis of a demonstration study in Amsterdam.

NARCIS (Netherlands)

Hoornenborg, Elske; Achterbergh, Roel Ca; van der Loeff, Maarten F Schim; Davidovich, Udi; van der Helm, Jannie J; Hogewoning, Arjan; van Duijnhoven, Yvonne Thp; Sonder, Gerard Jb; de Vries, Henry Jc; Prins, Maria

The Amsterdam PrEP project is a prospective, open-label demonstration study at a large sexually transmitted infection (STI) clinic. We examined the uptake of PrEP; the baseline characteristics of men who have sex with men (MSM) and transgender persons initiating PrEP; their choices of daily versus

Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation: A qualitative study

NARCIS (Netherlands)

Bil, Janneke P.; van der Veldt, Wendy M.; Prins, Maria; Stolte, Ineke G.; Davidovich, Udi

2016-01-01

Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use

Scientific Growth and Identity Development during a Postbaccalaureate Program: Results from a Multisite Qualitative Study.

Science.gov (United States)

Remich, Robin; Naffziger-Hirsch, Michelle E; Gazley, J Lynn; McGee, Richard

2016-01-01

This report builds upon our previous study, which described five patterns of why college graduates join National Institutes of Health (NIH)-funded diversity-focused Postbaccalaureate Research Education Programs (PREP). A 2015 report from the NIH showed that a high fraction of PREP participants matriculate into PhD and MD/PhD programs. This current study reveals how participants change during PREP, the program elements that facilitate change, and how identity as a graduate student and future scientist develops. Data come from in-depth interviews done at the beginning and end of PREP with 48 individuals from seven PREP programs. Results reveal three domains of development: academics, research, and presentation of oneself; each domain contains a developmental continuum. Key attributes of PREP enabling development include opportunities to attend graduate-level classes and seminars; time to practice reading literature; extended lab time with one's own project; high and explicit expectations from mentors; and multiple opportunities to talk about science and improve communication skills. PREP enabled participants to develop their identities as graduate students and to anticipate being seen by others as highly prepared for PhD training. After PREP, 85% (n = 41) started the PhD or MD/PhD, making PREP an intervention approach with great potential to broaden participation in biomedical PhD programs. © 2016 R. Remich et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Heber D. Curtis: The Re-entry Graduate Student at UVa Who Became an Outstanding Dynamical Astronomer

Science.gov (United States)

Osterbrock, D. E.

1998-09-01

Heber D. Curtis, the great pioneer of nebular and galactic research, later observatory director at Allegheny and then at the University of Michigan, was a dynamical astronomer in the earliest days of photographic radial-velocity measurements. He did his undergraduate work in classical languages at Michigan, where as a student he showed no apparent interest in astronomy. Curtis's first jobs were teaching Latin and Greek at Napa College, then at the College of the Pacific. Both had small Clark refractors and he began observing, then measuring, visual double stars. He decided to become an astronomer, and spent the summers of 1897 and 1898 as a special student at Lick Observatory, and of 1899 at Ann Arbor. In 1900, at the age of 28, married and with two small children, Curtis entered the University of Virginia as a full-time graduate student. Both Yerkes and Lick Observatories had declined to accept him. At Charlottesville Curtis did his Ph.D. thesis on the orbit of Comet 1898 I, received his degree in 1902, and immediately joined the Lick staff. His work on spectroscopic binaries and high-velocity stars at Mount Hamilton and at the Lick Southern Hemisphere Observatory, will be described in this paper. W. W. Campbell and Curtis published the First Catalogue of Spectroscopic Binaries in 1905; it listed all 140 of these objects then known. In 1909, Curtis was recalled to Lick to take over the Crossley reflector and thus left the field of dynamical astronomy. At Santiago, his assistant was George F. Paddock, a UVa M.A. in astronomy who based his Ph.D. thesis on Chile observational data. When Ormond Stone, UVa professor of astronomy and Leander McCormick Observatory director, retired in 1912, Curtis was the first choice to succeed him, but declined the post to remain at Lick.

Oxytocin decreases sweet taste sensitivity in mice.

Science.gov (United States)

Sinclair, Michael S; Perea-Martinez, Isabel; Abouyared, Marianne; St John, Steven J; Chaudhari, Nirupa

2015-03-15

Oxytocin (OXT) suppresses food intake and lack of OXT leads to overconsumption of sucrose. Taste bud cells were recently discovered to express OXT-receptor. In the present study we tested whether administering OXT to wild-type mice affects their licking behavior for tastants in a paradigm designed to be sensitive to taste perception. We injected C57BL/6J mice intraperitoneally (i.p.) with 10mg/kg OXT and assayed their brief-access lick responses, motivated by water deprivation, to NaCl (300mM), citric acid (20mM), quinine (0.3mM), saccharin (10mM), and a mix of MSG and IMP (100mM and 0.5mM respectively). OXT had no effect on licking for NaCl, citric acid, or quinine. A possible effect of OXT on saccharin and MSG+IMP was difficult to interpret due to unexpectedly low lick rates to water (the vehicle for all taste solutions), likely caused by the use of a high OXT dose that suppressed licking and other behaviors. A subsequent experiment focused on another preferred tastant, sucrose, and employed a much lower OXT dose (0.1mg/kg). This modification, based on our measurements of plasma OXT following i.p. injection, permitted us to elevate plasma [OXT] sufficiently to preferentially activate taste bud cells. OXT at this low dose significantly reduced licking responses to 0.3M sucrose, and overall shifted the sucrose concentration - behavioral response curves rightward (mean EC50saline=0.362M vs. EC50OXT=0.466M). Males did not differ from females under any condition in this study. We propose that circulating oxytocin is another factor that modulates taste-based behavior. Copyright © 2014 Elsevier Inc. All rights reserved.

Genetic control of a central pattern generator: rhythmic oromotor movement in mice is controlled by a major locus near Atp1a2.

Directory of Open Access Journals (Sweden)

John D Boughter

Full Text Available Fluid licking in mice is a rhythmic behavior that is controlled by a central pattern generator (CPG located in a complex of brainstem nuclei. C57BL/6J (B6 and DBA/2J (D2 strains differ significantly in water-restricted licking, with a highly heritable difference in rates (h(2≥0.62 and a corresponding 20% difference in interlick interval (mean ± SEM = 116.3±1 vs 95.4±1.1 ms. We systematically quantified motor output in these strains, their F(1 hybrids, and a set of 64 BXD progeny strains. The mean primary interlick interval (MPI varied continuously among progeny strains. We detected a significant quantitative trait locus (QTL for a CPG controlling lick rate on Chr 1 (Lick1, and a suggestive locus on Chr 10 (Lick10. Linkage was verified by testing of B6.D2-1D congenic stock in which a segment of Chr 1 of the D2 strain was introgressed onto the B6 parent. The Lick1 interval on distal Chr 1 contains several strong candidate genes. One of these is a sodium/potassium pump subunit (Atp1a2 with widespread expression in astrocytes, as well as in a restricted population of neurons. Both this subunit and the entire Na(+/K(+-ATPase molecule have been implicated in rhythmogenesis for respiration and locomotion. Sequence variants in or near Apt1a2 strongly modulate expression of the cognate mRNA in multiple brain regions. This gene region has recently been sequenced exhaustively and we have cataloged over 300 non-coding and synonymous mutations segregating among BXD strains, one or more of which is likely to contribute to differences in central pattern generator tempo.

Reactions and Receptivity to Framing HIV Prevention Message Concepts About Pre-Exposure Prophylaxis for Black and Latino Men Who Have Sex with Men in Three Urban US Cities.

Science.gov (United States)

Mimiaga, Matthew J; Closson, Elizabeth F; Battle, Shanice; Herbst, Jeffrey H; Denson, Damian; Pitts, Nicole; Holman, Jeremy; Landers, Stewart; Mansergh, Gordon

2016-10-01

Men who have sex with men (MSM) of color are disproportionately affected by HIV in the United States. Pre-exposure prophylaxis (PrEP) using antiretroviral medications is a newer biomedical prevention modality with established efficacy for reducing the risk of acquiring HIV. We conducted formative qualitative research to explore audience reactions and receptivity to message concepts on PrEP as part of the development of prevention messages to promote PrEP awareness among black and Latino MSM in the United States. In 2013, 48 black and 42 Latino (total study sample = 90) mixed HIV serostatus MSM from Chicago, Ft. Lauderdale, and Kansas City participated in either an individual interview or focus group discussion. Men were recruited online and at community-based organizations in each city. We elicited feedback on the comprehensibility, credibility, and relevance of two draft messages on PrEP. The messages included efficacy estimates from iPrEx, a phase III clinical trial to ascertain whether the antiretroviral medication tenofovir/emtricitabine disoproxil fumarate (commercially known as Truvada ® ) could safely and effectively prevent HIV acquisition through sex among MSM and transgender women. With participants' consent, the interviews and focus groups were recorded and transcribed. The data were then summarized and analyzed using a qualitative descriptive approach. The majority of men were unfamiliar with PrEP. It was suggested that additional information about the medication and clinical trials establishing efficacy was needed to enhance the legitimacy and relevancy of the messages. Participants sought to form an opinion of PrEP that was grounded in their own interpretation of the efficacy data. However, confusion about nonadherence among clinical trial subjects and individual versus average risk limited comprehension of these messages. Thematic overlaps suggest that message believability was connected to participants' ability to derive meaning from the PrEP

The Potential Impact of Pre-Exposure Prophylaxis for HIV Prevention among Men Who Have Sex with Men and Transwomen in Lima, Peru: A Mathematical Modelling Study

Science.gov (United States)

Caceres, Carlos F.; Segura, Eddy R.; Grant, Robert M.; Garnett, Geoff P.; Hallett, Timothy B.

2012-01-01

Background HIV pre-exposure prophylaxis (PrEP), the use of antiretroviral drugs by uninfected individuals to prevent HIV infection, has demonstrated effectiveness in preventing acquisition in a high-risk population of men who have sex with men (MSM). Consequently, there is a need to understand if and how PrEP can be used cost-effectively to prevent HIV infection in such populations. Methods and Findings We developed a mathematical model representing the HIV epidemic among MSM and transwomen (male-to-female transgender individuals) in Lima, Peru, as a test case. PrEP effectiveness in the model is assumed to result from the combination of a “conditional efficacy” parameter and an adherence parameter. Annual operating costs from a health provider perspective were based on the US Centers for Disease Control and Prevention interim guidelines for PrEP use. The model was used to investigate the population-level impact, cost, and cost-effectiveness of PrEP under a range of implementation scenarios. The epidemiological impact of PrEP is largely driven by programme characteristics. For a modest PrEP coverage of 5%, over 8% of infections could be averted in a programme prioritising those at higher risk and attaining the adherence levels of the Pre-Exposure Prophylaxis Initiative study. Across all scenarios, the highest estimated cost per disability-adjusted life year averted (uniform strategy for a coverage level of 20%, US$1,036–US$4,254) is below the World Health Organization recommended threshold for cost-effective interventions, while only certain optimistic scenarios (low coverage of 5% and some or high prioritisation) are likely to be cost-effective using the World Bank threshold. The impact of PrEP is reduced if those on PrEP decrease condom use, but only extreme behaviour changes among non-adherers (over 80% reduction in condom use) and a low PrEP conditional efficacy (40%) would adversely impact the epidemic. However, PrEP will not arrest HIV transmission in

The potential impact of pre-exposure prophylaxis for HIV prevention among men who have sex with men and transwomen in Lima, Peru: a mathematical modelling study.

Directory of Open Access Journals (Sweden)

Gabriela B Gomez

Full Text Available HIV pre-exposure prophylaxis (PrEP, the use of antiretroviral drugs by uninfected individuals to prevent HIV infection, has demonstrated effectiveness in preventing acquisition in a high-risk population of men who have sex with men (MSM. Consequently, there is a need to understand if and how PrEP can be used cost-effectively to prevent HIV infection in such populations.We developed a mathematical model representing the HIV epidemic among MSM and transwomen (male-to-female transgender individuals in Lima, Peru, as a test case. PrEP effectiveness in the model is assumed to result from the combination of a "conditional efficacy" parameter and an adherence parameter. Annual operating costs from a health provider perspective were based on the US Centers for Disease Control and Prevention interim guidelines for PrEP use. The model was used to investigate the population-level impact, cost, and cost-effectiveness of PrEP under a range of implementation scenarios. The epidemiological impact of PrEP is largely driven by programme characteristics. For a modest PrEP coverage of 5%, over 8% of infections could be averted in a programme prioritising those at higher risk and attaining the adherence levels of the Pre-Exposure Prophylaxis Initiative study. Across all scenarios, the highest estimated cost per disability-adjusted life year averted (uniform strategy for a coverage level of 20%, US$1,036-US$4,254 is below the World Health Organization recommended threshold for cost-effective interventions, while only certain optimistic scenarios (low coverage of 5% and some or high prioritisation are likely to be cost-effective using the World Bank threshold. The impact of PrEP is reduced if those on PrEP decrease condom use, but only extreme behaviour changes among non-adherers (over 80% reduction in condom use and a low PrEP conditional efficacy (40% would adversely impact the epidemic. However, PrEP will not arrest HIV transmission in isolation because of its

The Computer as Means of Communication for Peer-Review Groups

NARCIS (Netherlands)

van der Geest, Thea; Remmers, Tim

1994-01-01

In a scientific-writing course, 15 of 54 students used a review-supporting computer program, PREP-EDITOR (PREP), to communicate with their peers about drafts. In an exploratory study, 10 students were interviewed regularly: 5 used PREP and 5 met face-to-face to exchange comments on drafts. The study

SYSTEMATICITY OF L1 THAI LEARNERS' ENGLISH INTERLANGUAGE OF DEPENDENT PREPOSITIONS

Directory of Open Access Journals (Sweden)

Piyaboot Sumonsriworakun

2017-01-01

Full Text Available The study investigates systematicity in English interlanguage of dependent prepositions among L1 Thai learners of L2 English. It is hypothesized that Thai learners show non-random use of English dependent prepositions in their English interlanguage, and that the systematicity is largely attributable to cross-linguistic influence and certain cognitive factors. To test the hypothesis, 30 L1 Thai undergraduate students of L2 English at elementary, intermediate, and advanced proficiency levels took two tests: a Thai–English translation test and a cloze test. The tests involved four types of relationship between English and Thai dependent prepositions: (1 [–prep] in English but [+prep] in Thai, (2 [+prep] in English but [–prep] in Thai, (3 [+prep1] in English but [+prep2] in Thai, and (4 [+prep] in English and [+prep] in Thai. The findings demonstrate that systematicity occurred in the learners’ English usage of prepositions of all such types, possibly due to negative transfer from the learners’ native language. Also, the L2 learners tended to exhibit such systematicity irrespective of their English proficiency level. It may be assumed that the cognitive aspect of L2 learners’ working memory is involved in processing the usage of the four types of English dependent prepositions. The results of the study are expected to shed light on the problems of L2 English interlanguage of dependent prepositions among L1 Thai learners.

Safety of oral tenofovir disoproxil fumarate-based HIV pre-exposure prophylaxis use in lactating HIV-uninfected women.

Science.gov (United States)

Mugwanya, Kenneth K; John-Stewart, Grace; Baeten, Jared

2017-07-01

In settings where HIV is prevalent in heterosexual populations, pregnancy and postpartum breastfeeding periods can be associated with substantial HIV acquisition risk. Pre-exposure prophylaxis (PrEP) with daily oral tenofovir disoproxil fumarate (TDF)/emtricitabine is an attractive HIV prevention option for women who are lactating but data are limited on its safety during the lactation period. Areas covered: We provide a concise synthesis and summary of current evidence on the safety of TDF-based PrEP during breastfeeding. We conducted a review, searching Pubmed database and major PrEP conferences for primary studies with TDF-based PrEP exposure during postpartum breastfeeding. Expert opinion: TDF-based oral PrEP is an effective female-controlled HIV prevention option. There is evidence supporting the safety of TDF use for infant outcomes during breastfeeding in antiretroviral treatment regimens for HIV and hepatitis B virus, and more limited, but consistently safe, data from use of TDF as PrEP. The potential for risk is arguably outweighed for at-risk individuals by HIV prevention benefits, including indirect protection to the infant as a result of preventing HIV in the breastfeeding mother. As PrEP delivery is scaled up in heterosexual populations in high HIV prevalence settings and for at-risk persons in other settings, implementation science studies can provide a framework to increase the accrual of safety, acceptability, and use data related to PrEP during lactation.

Alignment of adherence and risk for HIV acquisition in a demonstration project of pre-exposure prophylaxis among HIV serodiscordant couples in Kenya and Uganda: a prospective analysis of prevention-effective adherence.

Science.gov (United States)

Haberer, Jessica E; Kidoguchi, Lara; Heffron, Renee; Mugo, Nelly; Bukusi, Elizabeth; Katabira, Elly; Asiimwe, Stephen; Thomas, Katherine K; Celum, Connie; Baeten, Jared M

2017-07-25

Adherence is essential for pre-exposure prophylaxis (PrEP) to protect against HIV acquisition, but PrEP use need not be life-long. PrEP is most efficient when its use is aligned with periods of risk - a concept termed prevention-effective adherence. The objective of this paper is to describe prevention-effective adherence and predictors of adherence within an open-label delivery project of integrated PrEP and antiretroviral therapy (ART) among HIV serodiscordant couples in Kenya and Uganda (the Partners Demonstration Project). We offered PrEP to HIV-uninfected participants until the partner living with HIV had taken ART for ≥6 months (a strategy known as "PrEP as a bridge to ART"). The level of adherence sufficient to protect against HIV was estimated in two ways: ≥4 and ≥6 doses/week (per electronic monitoring). Risk for HIV acquisition was considered high if the couple reported sex with 25 years, older male partners and desire for relationship success. Predictors of not achieving sufficient adherence were no longer being a couple, delayed PrEP initiation, >6 months  of follow-up, ART use >6 months  by the partner living with HIV and problem alcohol use. Over three-quarters of participant-visits by HIV-uninfected partners in serodiscordant couples achieved prevention-effective adherence with PrEP. Greater adherence was observed during months with HIV risk and the strongest predictor of achieving sufficient adherence was sexual activity.

A rediscussion of the atmospheric extinction and the absolute spectral-energy distribution of Vega

International Nuclear Information System (INIS)

Hayes, D.S.; Latham, D.W.

1975-01-01

For both the Lick and the Palomar calibrations of the spectral-energy distribution of Vega, the atmospheric extinction was treated incorrectly. We present a model for extinction in the Earth's atmosphere and use this model to calculate corrections to the Lick and Palomar calibrations. We also describe a method that can be used to fabricate mean extinction coefficients for any mountain observatory. We combine selected portions of the corrected Lick and corrected Palomar calibrations with the new Mount Hopkins calibration to generate an absolute spectral-energy distibution of Vega over the wavelength range 3300--10,800 A. Until better measurements become available, we recommend the use of this calibration for all practical applications

Spectroscopic Classification of SN 2018bek as a Young Type II Supernova

Science.gov (United States)

Xiang, Danfeng; Wang, Xiaofeng; Zhang, Kaicheng; Li, Wenxiong; DerKacy, James; Baron, Eddie; Brink, Thomas; Zheng, Weikang; Filippenko, Alex; Lin, Han; Rui, Liming; Hu, Lei; Hu, Maokai; Zhang, Tianmeng; Zhang, Jujia

2018-05-01

We obtained a few optical spectra of SN 2018bek,discovered by Jaroslaw Grzegorzek,on UT May 05-09 2018 with the 3.5m telescope (+Dual Imaging Spectrograph) at the Apache Point Observatory, the 2.16-m telescope(+BFOSC) at Xinglong Observatory of NAOC, and the Lick 3.0-m telescope (+Kast) at Lick Observatory.

Benutting van monensin in proteien-energielekke deur lammerooie ...

African Journals Online (AJOL)

17 Jun 1983 ... Utilization of monensin in protein-energy licks by lactating ewes on sour winter veld; (a) Preweaning. The influence of monensin, at a level of 0,36 mg/kg body mass, to ewes in high and low energy licks (HEL and LEL) and in creep feed for lambs was investigated during the 1979 to 1981 winter seasons.

Defining success with HIV pre-exposure prophylaxis: A prevention-effective adherence paradigm

Science.gov (United States)

Haberer, Jessica E.; Bangsberg, David R.; Baeten, Jared M.; Curran, Kathryn; Koechlin, Florence; Amico, K. Rivet; Anderson, Peter; Mugo, Nelly; Venter, Francois; Goicochea, Pedro; Caceres, Carlos; O’Reilly, Kevin

2015-01-01

Clinical trial data have shown that oral pre-exposure prophylaxis (PrEP) is efficacious when taken as prescribed; however, PrEP adherence is complex and must be understood within the context of variable risk for HIV infection and use of other HIV prevention methods. Different levels of adherence may be needed in different populations to achieve HIV prevention, and the optimal methods for achieving the necessary adherence for both individual and public health benefits are unknown. Guidance for PrEP use must consider these questions to determine the success of PrEP-based HIV prevention programs. In this article, we propose a new paradigm for understanding and measuring PrEP adherence, termed prevention-effective adherence, which incorporates dynamic HIV acquisition risk behaviors and the use of HIV alternative prevention strategies. We discuss the need for daily PrEP use only during periods of risk for HIV exposure, describe key issues for measuring and understanding relevant behaviors, review lessons from another health prevention field (i.e., family planning), and provide guidance for prevention-effective PrEP use. Moreover, we challenge emerging calls for sustained, near perfect PrEP adherence regardless of risk exposure and offer a more practical and public health-focused vision for this prevention intervention. PMID:26103095

Optimal costs of HIV pre-exposure prophylaxis for men who have sex with men.

Directory of Open Access Journals (Sweden)

Jennie McKenney

Full Text Available Men who have sex with men (MSM are disproportionately affected by HIV due to their increased risk of infection. Oral pre-exposure prophylaxis (PrEP is a highly effictive HIV-prevention strategy for MSM. Despite evidence of its effectiveness, PrEP uptake in the United States has been slow, in part due to its cost. As jurisdictions and health organizations begin to think about PrEP scale-up, the high cost to society needs to be understood.We modified a previously-described decision-analysis model to estimate the cost per quality-adjusted life-year (QALY gained, over a 1-year duration of PrEP intervention and lifetime time horizon. Using updated parameter estimates, we calculated: 1 the cost per QALY gained, stratified over 4 strata of PrEP cost (a function of both drug cost and provider costs; and 2 PrEP drug cost per year required to fall at or under 4 cost per QALY gained thresholds.When PrEP drug costs were reduced by 60% (with no sexual disinhibition to 80% (assuming 25% sexual disinhibition, PrEP was cost-effective (at <$100,000 per QALY averted in all scenarios of base-case or better adherence, as long as the background HIV prevalence was greater than 10%. For PrEP to be cost saving at base-case adherence/efficacy levels and at a background prevalence of 20%, drug cost would need to be reduced to $8,021 per year with no disinhibition, and to $2,548 with disinhibition.Results from our analysis suggest that PrEP drug costs need to be reduced in order to be cost-effective across a range of background HIV prevalence. Moreover, our results provide guidance on the pricing of generic emtricitabine/tenofovir disoproxil fumarate, in order to provide those at high risk for HIV an affordable prevention option without financial burden on individuals or jurisdictions scaling-up coverage.

Prevention of rectal SHIV transmission in macaques by daily or intermittent prophylaxis with emtricitabine and tenofovir.

Directory of Open Access Journals (Sweden)

J Gerardo García-Lerma

2008-02-01

Full Text Available In the absence of an effective vaccine, HIV continues to spread globally, emphasizing the need for novel strategies to limit its transmission. Pre-exposure prophylaxis (PrEP with antiretroviral drugs could prove to be an effective intervention strategy if highly efficacious and cost-effective PrEP modalities are identified. We evaluated daily and intermittent PrEP regimens of increasing antiviral activity in a macaque model that closely resembles human transmission.We used a repeat-exposure macaque model with 14 weekly rectal virus challenges. Three drug treatments were given once daily, each to a different group of six rhesus macaques. Group 1 was treated subcutaneously with a human-equivalent dose of emtricitabine (FTC, group 2 received orally the human-equivalent dosing of both FTC and tenofovir-disoproxil fumarate (TDF, and group 3 received subcutaneously a similar dosing of FTC and a higher dose of tenofovir. A fourth group of six rhesus macaques (group 4 received intermittently a PrEP regimen similar to group 3 only 2 h before and 24 h after each weekly virus challenge. Results were compared to 18 control macaques that did not receive any drug treatment. The risk of infection in macaques treated in groups 1 and 2 was 3.8- and 7.8-fold lower than in untreated macaques (p = 0.02 and p = 0.008, respectively. All six macaques in group 3 were protected. Breakthrough infections had blunted acute viremias; drug resistance was seen in two of six animals. All six animals in group 4 that received intermittent PrEP were protected.This model suggests that single drugs for daily PrEP can be protective but a combination of antiretroviral drugs may be required to increase the level of protection. Short but potent intermittent PrEP can provide protection comparable to that of daily PrEP in this SHIV/macaque model. These findings support PrEP trials for HIV prevention in humans and identify promising PrEP modalities.

76 FR 63229 - Airworthiness Directives; The Boeing Company Model 737-100, -200, -200C, -300, -400, and -500...

Science.gov (United States)

2011-10-12

... potential for ignition sources inside fuel tanks caused by latent failures, alterations, repairs, or... automatic shutoff system for the center and auxiliary tank fuel boost pumps, as applicable, and installing a... installing the un-commanded on (UCO) protection system for the center and auxiliary tank fuel boost pumps, as...

Quantum ferromagnet in the proximity of the tricritical point

Czech Academy of Sciences Publication Activity Database

Opletal, P.; Prokleška, J.; Valenta, J.; Proschek, P.; Tkáč, V.; Tarasenko, R.; Běhounková, M.; Matoušková, Šárka; Abd-Elmeguid, M. M.; Sechovský, V.

2017-01-01

Roč. 2, JUN 13 2017 (2017), č. článku 29. ISSN 2397-4648 Institutional support: RVO:67985831 Keywords : metamagnetic transition * high-pressure * liquid * UCoAL * state * destruction * criticality Subject RIV: BM - Solid Matter Physics ; Magnetism OBOR OECD: Condensed matter physics (including formerly solid state physics , supercond.)

HIV Preexposure Prophylaxis and Condomless Sex: Disentangling Personal Values From Public Health Priorities.

Science.gov (United States)

Calabrese, Sarah K; Underhill, Kristen; Mayer, Kenneth H

2017-10-01

Daily HIV preexposure prophylaxis (PrEP) is an effective form of HIV protection that remains unknown and inaccessible for many people in the United States despite receiving federal approval over five years ago. PrEP is supported by the public health community, but forgoing condoms while taking PrEP has proven controversial; this controversy may be contributing to the lag in PrEP uptake. We argue that limiting PrEP access based on anticipated or actual sexual behavior contradicts the goals of public health research and practice and is not scientifically justified. As evidence for the effectiveness of novel forms of biomedical HIV protection emerges, public health professionals need to accept new definitions of "protected sex" and ensure that their personal values do not override empirical evidence when determining public health priorities.

Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation

Directory of Open Access Journals (Sweden)

Galindo Gabriel R

2012-11-01

Full Text Available Abstract Background An international randomized clinical trial (RCT on pre-exposure prophylaxis (PrEP as an human immunodeficiency virus (HIV-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM and male-to-female transgender women. Within the context of the HIV epidemic in the United States (US, MSM and transgender women are the most appropriate groups to target for PrEP implementation at the population level; however, their perspectives on evidenced-based biomedical research and the results of this large trial remain virtually unknown. In this study, we examined the acceptability of individual daily use of PrEP and assessed potential barriers to community uptake. Methods We conducted semi-structured interviews with an ethnoracially diverse sample of thirty HIV-negative and unknown status MSM (n = 24 and transgender women (n = 6 in three California metropolitan areas. Given the burden of disease among ethnoracial minorities in the US, we purposefully oversampled for these groups. Thematic coding and analysis of data was conducted utilizing an approach rooted in grounded theory. Results While participants expressed general interest in PrEP availability, results demonstrate: a lack of community awareness and confusion about PrEP; reservations about PrEP utilization, even when informed of efficacious RCT results; and concerns regarding equity and the manner in which a PrEP intervention could be packaged and marketed in their communities. Conclusions In order to effectively reduce HIV health disparities at the population level, PrEP implementation must take into account the uptake concerns of those groups who would actually access and use this biomedical intervention as a prevention strategy. Recommendations addressing these concerns are provided.