Quantification of HIV-1 RNA Among Men Who Have Sex With Men Using an At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study

Background: Suboptimal antiretroviral therapy (ART) adherence and disengagement in care present significant public health challenges because of the increased probability of HIV transmission. In the United States, men who have sex with men (MSM) continue to be disproportionately affected by HIV, highlighting a critical need to engage high-risk MSM living with HIV who are not engaged or retained in care. Objective: The aim of the study was to assess the feasibility of at-home blood self-collection and laboratory quantification of HIV-1 RNA viral load (VL) to report laboratory-based VL outcomes and compare self-reported and laboratory-reported VL Methods: Between 2016 and 2017, 766 US HIV-positive MSM enrolled in a Web-based behavioral intervention were invited to participate in an at-home dried blood spot (DBS) collection study using HemaSpot-HF kits (Spot On Sciences, Inc, Austin, TX) for laboratory-quantified VL. Results: Of those invited to participate, 72.3% (554/766) enrolled in the DBS study. Most (79.2%, 439/554) men enrolled reported attempting to collect their blood, 75.5% (418/554) of participants mailed a DBS specimen to the research laboratory, and 60.8% (337/554) had an adequate blood sample for VL testing. Of the 337 specimens tested for VL by the laboratory, 52.5% (177/337) had detectable VL (median: 3508 copies/mL; range: 851-1,202,265 copies/mL). Most men (83.9%, 135/161) who returned a DBS specimen with laboratory-quantified detectable VL self-reported an undetectable VL during their last clinical visit. Conclusions: Home collection of DBS samples from HIV-positive MSM is feasible and has the potential to support clinical VL monitoring. Discrepant laboratory HIV-1 RNA values and self-reported VL indicate a need to address perceived VL status, especially in the era of treatment as prevention. Most participants were willing to use an at-home DBS kit in the future, signaling an opportunity to engage high-risk MSM in long-term HIV care activities

Incidence of sexually transmitted infections during pregnancy

Prevalence of sexually transmitted infections (STI) is high among pregnant women in certain settings. We estimated STI incidence and compared STI risk in pregnant and non-pregnant women. Data came from the Methods for Improving Reproductive Health in Africa (MIRA) study conducted in South Africa and Zimbabwe 2003–2006. Women aged 18–50 years with at least one follow-up visit within 6 months of enrollment were included. Follow-up visits included laboratory testing for pregnancy, chlamydia, gonorrhea, trichomoniasis, and HIV, as well as self-report of hormonal contraceptive (HC) use, sexual behaviors and intravaginal practices. All visits were classified according to pregnancy status. Incidence of each STI was calculated using follow-up time. Cox proportional hazards models were fitted using pregnancy as a time-varying exposure and sexual behaviors and intravaginal practices as time-varying covariates. Among 4,549 women, 766 (16.8%) had a positive pregnancy test. Median follow-up time was 18 months [IQR: 12–24]. The overall incidence rate of chlamydia was 6.7 per 100 person years (py) and 9.9/100py during pregnancy; gonorrhea incidence was 2.7/100py and 4.9/100py during pregnancy; trichomoniasis incidence was 7.1/100py overall and 9.2/100py during pregnancy. Overall HIV incidence was 3.9/100py and 3.8/100py during pregnancy. In crude models, pregnancy increased risk for chlamydia (hazard ratio (HR) 1.5, 95%CI: 1.1–1.2), however there was no increased risk of any measured STI in adjusted models. STI Incidence was high during pregnancy however pregnancy did not increase STI risk after adjustment for sexual behaviors. Greater efforts are needed to help pregnant women avoid STIs

Presence of periorbital and conjunctival petechial hemorrhages in accidental pediatric drowning

Abstract The pathological findings of drowning are variable and non-specific. Petechial hemorrhages involving the periorbital region and the conjunctiva have been described in many causes of death, but are thought to be exceedingly uncommon in cases of drowning. However, such studies have not specifically addressed the pediatric population. The current study retrospectively examined 79 cases of accidental pediatric drowning for the presence of periorbital/conjunctival hemorrhages and analyzed factors that may have affected their presence. Ten victims had periorbital/ conjunctival petechial hemorrhages (13%), with five having periorbital petechiae, three having conjunctival petechiae, and two having both periorbital and conjunctival petechiae. The age and gender of the victim, site of drowning, resuscitation history and the presence of other pathological findings were not significantly associated with the presence of periorbital/conjunctival petechiae. However, as the interval between the drowning episode and autopsy increased, the incidence of periorbital/conjunctival petechiae decreased (28% for <24 h; 7% for >24 h). The presence of periorbital/conjunctival hemorrhages in a significant proportion of pediatric drowning victims confirms that the pathologist must add this finding to the spectrum of changes seen in pediatric drowning. Crow

F.A.R.O.G. FORUM Vol. 2, No. 2

https://digitalcommons.library.umaine.edu/francoamericain_forum/1001/thumbnail.jp

Polynomial approximation of quasipolynomials based on digital filter design principles

This contribution is aimed at a possible procedure approximating quasipolynomials by polynomials. Quasipolynomials appear in linear time-delay systems description as a natural consequence of the use of the Laplace transform. Due to their infinite root spectra, control system analysis and synthesis based on such quasipolynomial models are usually mathematically heavy. In the light of this fact, there is a natural research endeavor to design a sufficiently accurate yet simple engineeringly acceptable method that approximates them by polynomials preserving basic spectral information. In this paper, such a procedure is presented based on some ideas of discrete-time (digital) filters designing without excessive math. Namely, the particular quasipolynomial is subjected to iterative discretization by means of the bilinear transformation first; consequently, linear and quadratic interpolations are applied to obtain integer powers of the approximating polynomial. Since dominant roots play a decisive role in the spectrum, interpolations are made in their very neighborhood. A simulation example proofs the algorithm efficiency. © Springer International Publishing Switzerland 2016

Influencing users towards better passwords: Persuasive cued click-points

Usable security has unique usability challenges because the need for security often means that standard human-computerinteraction approaches cannot be directly applied. An important usability goal for authentication systems is to support users in selecting better passwords, thus increasing security by expanding the effective password space. In click-based graphical passwords, poorly chosen passwords lead to the emergence of hotspots ' portions of the image where users are more likely to select click-points, allowing attackers to mount more successful dictionary attacks. We use persuasion to influence user choice in click-based graphical passwords, encouraging users to select more random, and hence more secure, click-points. Our approach is to introduce persuasion to the Cued Click-Points graphical password scheme (Chiasson, van Oorschot, Biddle, 2007). Our resulting scheme significantly reduces hotspots while still maintaining its usability

Evaluation of 2004 Toyota Prius Hybrid Electric Drive System

The 2004 Toyota Prius is a hybrid automobile equipped with a gasoline engine and a battery- and generator-powered electric motor. Both of these motive-power sources are capable of providing mechanical-drive power for the vehicle. The engine can deliver a peak-power output of 57 kilowatts (kW) at 5000 revolutions per minute (rpm) while the motor can deliver a peak-power output of 50 kW over the speed range of 1200-1540 rpm. Together, this engine-motor combination has a specified peak-power output of 82 kW at a vehicle speed of 85 kilometers per hour (km/h). In operation, the 2004 Prius exhibits superior fuel economy compared to conventionally powered automobiles. To acquire knowledge and thereby improve understanding of the propulsion technology used in the 2004 Prius, a full range of design characterization studies were conducted to evaluate the electrical and mechanical characteristics of the 2004 Prius and its hybrid electric drive system. These characterization studies included (1) a design review, (2) a packaging and fabrication assessment, (3) bench-top electrical tests, (4) back-electromotive force (emf) and locked rotor tests, (5) loss tests, (6) thermal tests at elevated temperatures, and most recently (7) full-design-range performance testing in a controlled laboratory environment. This final test effectively mapped the electrical and thermal results for motor/inverter operation over the full range of speeds and shaft loads that these assemblies are designed for in the Prius vehicle operations. This testing was undertaken by the Oak Ridge National Laboratory (ORNL) as part of the U.S. Department of Energy (DOE) - Energy Efficiency and Renewable Energy (EERE) FreedomCAR and Vehicle Technologies (FCVT) program through its vehicle systems technologies subprogram. The thermal tests at elevated temperatures were conducted late in 2004, and this report does not discuss this testing in detail. The thermal tests explored the derating of the Prius motor design if operated at temperatures as high as is normally encountered in a vehicle engine. The continuous ratings at base speed (1200 rpm) with different coolant temperatures are projected from test data at 900 rpm. A separate, comprehensive report on this thermal control study is available [1]