HIV Pre-Exposure Prophylaxis (PrEP)—A Quantitative Ethics Appraisal

Background: There is now strong evidence that preventive oral antiretroviral therapy can moderately reduce likelihood of HIV infection. This concept is called HIV pre-exposure prophylaxis (PrEP). Premature closures of some previous PrEP clinical trials, secondary to ethical concerns, did not stop research. We aimed to appraise the extent of ethics considerations reporting in PrEP study documents. Methods: We conducted a systematic quantitative ethics appraisal, grounded in PrEP literature and using eight principles proposed by Ezechiel Emanuel. We developed an a priori checklist of 101 evidence-based ethics items. We obtained protocols for eleven of nineteen clinical controlled studies identified. Two reviewers independently appraised study documents against the checklist. Ethics appraisal was synthesized using adjusted percentages of items reported. Results: On average, 58 % of the 101 ethics items were mentioned or addressed in documents, with variations noted both across studies and across principles. Considerations pertaining to social value were least reported (43 % of checklist items, on average) whereas considerations related to informed consent and favorable risk-benefit ratio were most reported (75 % of checklist items, on average). Discussion: Some PrEP studies reportedly address more ethics considerations than others but, overall, ethics considerations reporting could be much improved. While this review does not allow us to comment on the actual execution of HIV PrE

T-infinity: The Dependency Inversion Principle for Rapid and Sustainable Multidisciplinary Software Development

The CFD Vision 2030 Study recommends that, NASA should develop and maintain an integrated simulation and software development infrastructure to enable rapid CFD technology maturation.... [S]oftware standards and interfaces must be emphasized and supported whenever possible, and open source models for noncritical technology components should be adopted. The current paper presents an approach to an open source development architecture, named T-infinity, for accelerated research in CFD leveraging the Dependency Inversion Principle to realize plugins that communicate through collections of functions without exposing internal data structures. Steady state flow visualization, mesh adaptation, fluid-structure interaction, and overset domain capabilities are demonstrated through compositions of plugins via standardized abstract interfaces without the need for source code dependencies between disciplines. Plugins interact through abstract interfaces thereby avoiding N 2 direct code-to-code data structure coupling where N is the number of codes. This plugin architecture enhances sustainable development by controlling the interaction between components to limit software complexity growth. The use of T-infinity abstract interfaces enables multidisciplinary application developers to leverage legacy applications alongside newly-developed capabilities. While rein, a description of interface details is deferred until the are more thoroughly tested and can be closed to modification

Trustworthy Privacy Indicators: Grades, Labels, Certifications, and Dashboards

Despite numerous groups’ efforts to score, grade, label, and rate the privacy of websites, apps, and network-connected devices, these attempts at privacy indicators have, thus far, not been widely adopted. Privacy policies, however, remain long, complex, and impractical for consumers. Communicating in some short-hand form, synthesized privacy content is now crucial to empower internet users and provide them more meaningful notice, as well as nudge consumers and data processors toward more meaningful privacy. Indeed, on the basis of these needs, the National Institute of Standards and Technology and the Federal Trade Commission in the United States, as well as lawmakers and policymakers in the European Union, have advocated for the development of privacy indicator systems. Efforts to develop privacy grades, scores, labels, icons, certifications, seals, and dashboards have wrestled with various deficiencies and obstacles for the wide-scale deployment as meaningful and trustworthy privacy indicators. This paper seeks to identify and explain these deficiencies and obstacles that have hampered past and current attempts. With these lessons, the article then offers criteria that will need to be established in law and policy for trustworthy indicators to be successfully deployed and adopted through technological tools. The lack of standardization prevents user-recognizability and dependability in the online marketplace, diminishes the ability to create automated tools for privacy, and reduces incentives for consumers and industry to invest in privacy indicators. Flawed methods in selection and weighting of privacy evaluation criteria and issues interpreting language that is often ambiguous and vague jeopardize success and reliability when baked into an indicator of privacy protectiveness or invasiveness. Likewise, indicators fall short when those organizations rating or certifying the privacy practices are not objective, trustworthy, and sustainable. Nonetheless, trustworthy privacy rating systems that are meaningful, accurate, and adoptable can be developed to assure effective and enduring empowerment of consumers. This paper proposes a framework using examples from prior and current attempts to create privacy indicator systems in order to provide a valuable resource for present-day, real world policymaking. First, privacy rating systems need an objective and quantifiable basis that is fair and accountable to the public. Unlike previous efforts through industry self-regulation, if lawmakers and regulators establish standardized evaluation criteria for privacy practices and provide standards for how these criteria should be weighted in scoring techniques, the rating system will have public accountability with an objective, quantifiable basis. If automated rating mechanisms convey to users accepted descriptions of data practices or generate scores from privacy statements based on recognized criteria and weightings rather than from deductive conclusions, then this reduces interpretive issues with any privacy technology tool. Second, rating indicators should align with legal principles of contract interpretation and the existing legal defaults for the interpretation of silence in privacy policy language. Third, a standardized system of icons, along with guidelines as to where these should be located, will reduce the education and learning curve now necessary to understand and benefit from many different, inconsistent privacy indicator labeling systems. And lastly, privacy rating evaluators must be impartial, honest, autonomous, and financially and operationally durable in order to be successful

Ethnic differences in out-of-hospital cardiac arrest among Middle Eastern Arabs and North African populations living in Qatar

Aims: There are very few studies comparing epidemiology and outcomes of out-of-hospital cardiac arrest (OHCA) in different ethnic groups. Previous ethnicity studies have mostly determined OHCA differences between African American and Caucasian populations. The aim of this study was to compare epidemiology, clinical presentation, and outcomes of OHCA between the local Middle Eastern Gulf Cooperation Council (GCC) Arab and the migrant North African populations living in Qatar. Methods: This was a retrospective cohort study of Middle Eastern GCC Arabs and migrant North African patients with presumed cardiac origin OHCA resuscitated by Emergency Medical Services (EMS) in Qatar, between June 2012 and May 2015. Results: There were 285 Middle Eastern GCC Arabs and 112 North African OHCA patients enrolled during the study period. Compared with the local GCC Arabs, univariate analysis showed that the migrant North African OHCA patients were younger and had higher odds of initial shockable rhythm, pre-hospital interventions (defibrillation and amioderone), pre-hospital scene time, and decreased odds of risk factors (hypertension, respiratory disease, and diabetes) and pre-hospital response time. The survival to hospital discharge had greater odds for North African OHCA patients which did not persist after adjustment. Multivariable logistic regression showed that North Africans were associated with lower odds of diabetes (OR 0.48, 95% CI 0.25–0.91, p = 0.03), and higher odds of initial shockable rhythm (OR 2.86, 95% CI 1.30–6.33, p = 0.01) and greater scene time (OR 1.02 95% CI 1.0–1.04, p = 0.02). Conclusions: North African migrant OHCA patients were younger, had decreased risk factors and favourable OHCA rhythm and received greater ACLS interventions with shorter pre-hospital response times and longer scene times leading to better survival.Peer reviewedFinal Accepted Versio

Yield response of corn and grain sorghum to row offsets on subsurface drip laterals

Subsurface drip irrigation (SDI) is a micro-irrigation system that could be adopted by producers in the semi-arid regions around the world for efficient use of water. Yet, several crop management issues related to SDI system need to be addressed to assess the feasibility of SDI. One such issue is the impact of crop row placement on crop performance, irrigation water use efficiency and yield under SDI. A study was conducted in the Southern U.S. Great Plains, in which drip tape laterals were buried 30 cm deep at 153 cm spacing, with two crop rows planted at 76 cm spacing, and irrigated with one tape. Corn (Zea mays L.) and grain sorghum (Sorghum bicolor L.) rows were offset from equidistance from the drip tape by 0, 8, 15, 23, and 38 cm using high precision guidance system (real time kinematics). This resulted in 5 treatments and 4 replications. This treatment structure was imposed on three irrigation (high, medium and low) regimes. Analysis of Variance showed no interaction between offset treatments and irrigation or year in corn and grain sorghum yields. The row offset did not impact the overall yield as the yield loss in row farther from the tape was compensated by the increased yield in row moved closer to the tape. The yield distribution ranged from 50% in both rows for 0 cm offset to 59% in row closer to the tape for 38 cm offset. The findings of this study suggests that while driver accuracy is important to maintain equal yields in neighboring crop rows, the overall yields are affected more by irrigation and climatic conditions and not by the row offsets with respect to SDI tape. This data suggests that SDI can be successful regardless of access to high precision guidance systems.Peer reviewedPlant and Soil Science

A Two Micron All-Sky Survey View of the Sagittarius Dwarf Galaxy: II. Swope Telescope Spectroscopy of M Giant Stars in the Dynamically Cold Sagittarius Tidal Stream

We present moderate resolution (~6 km/s) spectroscopy of 284 M giant candidates selected from the Two Micron All Sky Survey photometry. Radial velocities (RVs) are presented for stars mainly in the south, with a number having positions consistent with association to the trailing tidal tail of the Sagittarius (Sgr) dwarf galaxy. The latter show a clear RV trend with orbital longitude, as expected from models of the orbit and destruction of Sgr. A minimum 8 kpc width of the trailing stream about the Sgr orbital midplane is implied by verified RV members. The coldness of this stream (dispersion ~10 km/s) provides upper limits on the combined contributions of stream heating by a lumpy Galactic halo and the intrinsic dispersion of released stars, which is a function of the Sgr core mass. The Sgr trailing arm is consistent with a Galactic halo containing one dominant, LMC-like lump, however some lumpier halos are not ruled out. An upper limit to the total M/L of the Sgr core is 21 in solar units. A second structure that roughly mimics expectations for wrapped, leading Sgr arm debris crosses the trailing arm in the Southern Hemisphere; however, this may also be an unrelated tidal feature. Among the <13 kpc M giants toward the South Galactic Pole are some with large RVs that identify them as halo stars, perhaps part of the Sgr leading arm near the Sun. The positions and RVs of Southern Hemisphere M giants are compared with those of southern globular clusters potentially stripped from the Sgr system and support for association of Pal 2 and Pal 12 with Sgr debris is found. Our discussion includes description of a masked-filtered cross-correlation methodology that achieves better than 1/20 of a resolution element RVs in moderate resolution spectra.Comment: 41 pages, 6 figures, Astronomical Journal, in press (submitted Nov. 24, 2003; tentatively scheduled for July 2004 issue

Adenovirus and Herpesvirus Diversity in Free Ranging Great Apes in the Sangha Region of the Republic of Congo

Infectious diseases have caused die-offs in both free-ranging gorillas and chimpanzees. Understanding pathogen diversity and disease ecology is therefore critical for conserving these endangered animals. To determine viral diversity in free-ranging, non-habituated gorillas and chimpanzees in the Republic of Congo, genetic testing was performed on great-ape fecal samples collected near Odzala-Kokoua National Park. Samples were analyzed to determine ape species, identify individuals in the population, and to test for the presence of herpesviruses, adenoviruses, poxviruses, bocaviruses, flaviviruses, paramyxoviruses, coronaviruses, filoviruses, and simian immunodeficiency virus (SIV). We identified 19 DNA viruses representing two viral families, Herpesviridae and Adenoviridae, of which three herpesviruses had not been previously described. Co-detections of multiple herpesviruses and/or adenoviruses were present in both gorillas and chimpanzees. Cytomegalovirus (CMV) and lymphocryptovirus (LCV) were found primarily in the context of co-association with each other and adenoviruses. Using viral discovery curves for herpesviruses and adenoviruses, the total viral richness in the sample population of gorillas and chimpanzees was estimated to be a minimum of 23 viruses, corresponding to a detection rate of 83%. These findings represent the first description of DNA viral diversity in feces from free-ranging gorillas and chimpanzees in or near the Odzala-Kokoua National Park and form a basis for understanding the types of viruses circulating among great apes in this region

"After my husband's circumcision, I know that I am safe from diseases": Women's Attitudes and Risk Perceptions Towards Male Circumcision in Iringa, Tanzania.

While male circumcision reduces the risk of female-to-male HIV transmission and certain sexually transmitted infections (STIs), there is little evidence that circumcision provides women with direct protection against HIV. This study used qualitative methods to assess women's perceptions of male circumcision in Iringa, Tanzania. Women in this study had strong preferences for circumcised men because of the low risk perception of HIV with circumcised men, social norms favoring circumcised men, and perceived increased sexual desirability of circumcised men. The health benefits of male circumcision were generally overstated; many respondents falsely believed that women are also directly protected against HIV and that the risk of all STIs is greatly reduced or eliminated in circumcised men. Efforts to engage women about the risks and limitations of male circumcision, in addition to the benefits, should be expanded so that women can accurately assess their risk of HIV or STIs during sexual intercourse with circumcised men