Outcomes of Directly Observed Therapy in People Living with HIV Who Experience Homelessness and Substance Use Disorder

Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between viral suppression and all other categorical variables. Survey answers were mapped to the modified Andersen’s Behavioral Model domains and subcategories. Results: Seventy-three percent of program patients were virally suppressed after participating in the program; 42% were virally undetectable. The relationship between viral suppression and date of most recent primary care provider visit was significant (p = 0.01). Eighty percent of surveyed patient participants reported that they liked the program, and 70% said that taking ART makes them feel better. Eighty percent of patients described their health as “Fair” or “Poor” before initiating treatment with the program, while 90% of patients reported their own health as being “good”, “very good”, or “excellent” after participating. Conclusion: Results suggest that when nurse-led teams actively engage PLWH, viral suppression, and consequent undetectability, is more likely. Clear implications for practice include continuing nurse navigation to promote viral suppression

The Effects of Upstream Straight Pipe Length on Magnetic Flow Meter Accuracy

In closed conduit water systems, being able to accurately measure flow is absolutely essential. For many meter designs, including electromagnetic induction meters (also known as magnetic flow meters), the greatest accuracy is achieved when the device is calibrated correctly. Optimal meter accuracy often depends on the flow conditions associated with the upstream geometry in the pipe system. Manufacturers typically give standards for the length of straight pipe required upstream of the meter. These standards vary, however, and do not address every possible configuration that may be installed upstream of the straight pipe requirement. An investigation on the effects of the length of straight pipe between a single 90° elbow and the upstream side of magnetic flow meters was completed in this research. Eleven 10-inch meters were chosen for testing. The procedure included a baseline test with more than forty diameters of straight pipe between the elbow and the meter. The accuracy of the meter was determined over a range of flow velocities typical for operation of this type and size of meter. Further tests were performed with the meter installed only three diameters downstream of the elbow. These tests constitute Phase I. In Phase II, four meters were tested with the upstream pipe length varying from a close-coupled installation to ten diameters of straight pipe between the elbow and the meter to observe variances in accuracy with distance from the elbow. The intent of the research was to show whether manufacturer accuracy specifications are achievable in actual application. It was determined that very few meters meet the manufacturer’s specification for accuracy even when installation requirements were met. Post-factory calibrations and minimization of velocity profile disruption through consideration of upstream geometry is recommended

The Chediak-Higashi Syndrome: Spectrum of Giant Organelles in Peripheral Blood Cells

The presence of giant organelles in the cytoplasm of peripheral blood elements is diagnostic for the Chediak-Higashi syndrome. These abnormal cytoplasmic inclusions are found within neutrophils, eosinophils, basophils, lymphocytes, monocytes, and platelets. Their fine structural characteristics differ. Neutrophils demonstrate striking variability in the size, shape, and internal features of their giant organelles. Lymphocytes contain two different types of giant inclusions, one with a smoothly homogeneous substructure, the other with structures resembling microtubules. Emphasizing the ultrastructural similarities and differences of these anomalous granulations may provide valuable clues for understanding the basic defect of this inherited disorder

Composite Beams With Web Openings

The purpose of this investigation was to study the behavior and develop an ultimate strength model for composite beams with rectangular web openings. Six composite beams with concentric rectangular web openings were tested to failure. Varying moment to shear ratios were used to help develop and verify the ultimate strength model. One steel beam was tested to demonstrate the contribution of the concrete to the capacity of composite beams. Two steel sections were used, while the concrete slab size was held constant for all beams. Three elastic tests were performed on each beam before it was tested to failure. An ultimate strength model was developed to predict the strength of composite beams at the web openings in the form of moment-shear interaction diagrams. The steel is modeled as an elastic-perfectly plastic material. The yield stress of the steel is defined as a function of the assigned shear stress according to the von Mises yield criterion. The concrete is modeled for ultimate strength behavior. Concrete compressive strength is also defined as a function of the assigned shear stress, based on experimental results. Strain compatibility between the concrete and steel is assumed. The model is compared with experimental results and is used to study the effect of key parameters (material properties, opening size, and opening eccentricity) affecting the strength of composite beams with web openings. A simplified design interaction procedure is presented to conservatively guide the placement of web openings in composite beams. Based on the experimental study, it is clear that web openings can greatly reduce the strength of composite beams. It appears that the secondary bending has a sizable effect on beam behavior. The concrete in composite beams contributes, not only, to the flexural strength, but, also, to the shear capacity of the beams at web openings. The ultimate strength of composite beams at web openings is governed by the failure of the concrete. The ultimate strength model satisfactorily predicts the strength of the experimental beams

Zero-field spin relaxation of the positive muon in copper

The spin relaxation of the ..mu../sup +/ in high purity single crystal and polycrystalline copper has been measured at temperatures between 0.5/sup 0/K and 5.2/sup 0/K by the zero-field ..mu../sup +/SR technique. In both types of sample the experiments show a temperature independent dipolar width ..delta../sub z/ = 0.389 +- 0.003 ..mu..s/sup -1/ and a hopping rate decreasing from approx. 0.5 ..mu..s/sup -1/ at 0.5/sup 0/K to approx. 0.05 ..mu..s/sup -1/ above 5/sup 0/K. This is the first direct proof of a dynamic effect in the low temperature ..mu../sup +/ spin relaxation in copper. The relationship between the zero-field and transverse-field dipolar widths is discussed, and the measured zero-field width is found to be approx. 10% larger than expected based on the known transverse-field widths. A new ..mu../sup +/SR spectrometer has been constructed and used in this work. The spectrometer and the associated beam lines and data acquisition facilities are discussed

OpenScout: Open Source Hardware Mobile Robot

OpenScout is a low-cost open source hardware and software mobile robot that can be used for both indoor and outdoor tasks, transporting up to 15 kg of payload. It is designed to be easily and cheaply (350 USD) buildable and modifiable by non-specialists, and to function as a new standard physical platform for robotics research and real-world tasks, replacing current proprietary options. It uses four-wheel differential drive steering, and a hinged body which enables the wheels to drive over small obstacles without the need for suspension. Example applications include last mile and factory floor delivery, site survey and site monitoring

Small ruminant lentivirus genetic subgroups associate with sheep TMEM154 genotypes.

Abstract: Small ruminant lentiviruses (SRLVs) are prevalent in North American sheep and a major cause of production losses for the U.S. sheep industry. Sheep susceptibility to SRLV infection is influenced by genetic variation within the ovine transmembrane 154 gene (TMEM154). Animals with either of two distinct TMEM154 haplotypes that both encode glutamate at position 35 of the protein (E35) are at greater risk of SRLV infection than those homozygous with a lysine (K35) haplotype. Prior to this study, it was unknown if TMEM154 associations with infection are influenced by SRLV genetic subgroups. Accordingly, our goals were to characterize SRLVs naturally infecting sheep from a diverse U.S. Midwestern flock and test them for associations with TMEM154 E35K genotypes. Two regions of the SRLV genome were targeted for proviral amplification, cloning, sequence analysis, and association testing with TMEM154 E35K genotypes: gag and the transmembrane region of env. Independent analyses of gag and env sequences showed that they clustered in two subgroups (1 and 2), they were distinct from SRLV subtypes originating from Europe, and that subgroup 1 associated with hemizygous and homozygous TMEM154 K35 genotypes and subgroup 2 with hemi- and homozygous E35 genotypes (gag p < 0.001, env p = 0.01). These results indicate that SRLVs in the U.S. have adapted to infect sheep with specific TMEM154 E35K genotypes. Consequently, both host and SRLV genotypes affect the relative risk of SRLV infection in sheep

Scn1b deletion in adult mice results in seizures and SUDEP

Pathogenic lossâ ofâ function variants in SCN1B are linked to Dravet syndrome (DS). Previous work suggested that neuronal pathfinding defects underlie epileptogenesis and SUDEP in the Scn1b null mouse model of DS. We tested this hypothesis by inducing Scn1b deletion in adult mice that had developed normally. Epilepsy and SUDEP, which occur by postnatal day 21 in Scn1b null animals, were observed within 20 days of induced Scn1b deletion in adult mice, suggesting that epileptogenesis in SCN1Bâ DS does not result from defective brain development. Thus, the developmental brain defects observed previously in Scn1b null mice may model other coâ morbidities of DS.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149575/1/acn3785.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149575/2/acn3785_am.pd