Factors Associated With Follow-Up Compliance among Clients Referred By a Local Health Department for HIV Pre-Exposure Prophylaxis

Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) is a public health strategy to limit HIV infection among at-risk populations. Local health departments (LHDs) promote PrEP initiation by referring patients to private and academic specialty care centers. However, low follow-up compliance remains a challenge in this setting. Between January 2016 and September 2018, Douglas County Health Department, a LHD in Omaha, Nebraska, externally referred 126 clients for PrEP at an academic specialty care center, and only 20 (15%) clients completed a PrEP initiation follow-up appointment. The purpose of this study is to describe the characteristics of clients referred by Douglas County STD Clinic to an academic specialty care center for HIV PrEP services and to identify factors associated with follow-up compliance within this group. Study objective and goals: The goal of this study is to characterize the client population at Douglas County STD clinic that is externally referred for HIV pre-exposure prophylaxis at UNMC. The primary study objective is to describe demographic and behavioral characteristics of clients who were referred to University of Nebraska Medical Center (UNMC) Specialty Care Center by Douglas County STD Clinic for HIV PrEP between January 2016 and September 2018.The second study objective is to identify factors that are associated with PrEP follow-up compliance among clients referred to UNMC Specialty Care Center by Douglas County STD Clinic within this study group. Methods: This was a cross-sectional study of clients referred to UNMC Specialty Care for HIV PrEP between January 2016 and September 2018 by Douglas County STD Clinic (n=126). Surveillance records were retrospectively queried and analyzed for this study. The primary outcome was successful follow-up compliance to PrEP initiation visit at UNMC. Continuous variables were recoded as categorical variables and between-group comparisons were made using Fisher’s exact tests. Estimated odds ratios for PrEP follow-up were evaluated using univariate logistic regression models with 95% confidence intervals (CI) and p \u3c 0.05 was considered significant. Results: A total of n=126 surveillance records were analyzed. Demographic characteristics were similar between individuals who were follow-up compliant (n=20) versus those who were not. In both groups, most individuals were male (100% compliant group versus 89% noncompliant group, p=0.21) with a median age of 28 years (p=0.75) and who identified as white (65% compliant versus 60% noncompliant, p=0.3). Frequencies of social and sexual behavioral characteristics were similar between both groups. History of confirmed positive STI test(s) was significantly associated with PrEP initiation follow-up compliance (p=0.03), and history of a sexual partner’s positive STI screening was associated with PrEP initiation follow-up (p=0.02). Race- and age-adjusted odds ratios (aOR) for follow-up compliant individuals with a sexual partner who had a history of confirmed STI(s) was 4.08 (95% CI: 1.42-11.76), and for those with a personal history of STI infection was 3.72 (95% CI: 1.30-10.64). Impact: The intended public health impact of this study is to reduce the number of new HIV infections among at-risk populations by improving HIV PrEP uptake and access in Douglas County, Nebraska

Induction Machine Stator Fault Tracking using the Growing Curvilinear Component Analysis

Detection of stator-based faults in Induction Machines (IMs) can be carried out in numerous ways. In particular, the shorted turns in stator windings of IM are among the most common faults in the industry. As a matter of fact, most IMs come with pre-installed current sensors for the purpose of control and protection. At this aim, using only the stator current for fault detection has become a recent trend nowadays as it is much cheaper than installing additional sensors. The three-phase stator current signatures have been used in this study to observe the effect of stator inter-turn fault with respect to the healthy condition of the IM. The pre-processing of the healthy and faulty current signatures has been done via the in-built DSP module of dSPACE after which, these current signatures are passed into the MATLAB® software for further analysis using AI techniques. The authors present a Growing Curvilinear Component Analysis (GCCA) neural network that is capable of detecting and follow the evolution of the stator fault using the stator current signature, making online fault detection possible. For this purpose, a topological manifold analysis is carried out to study the fault evolution, which is a fundamental step for calibrating the GCCA neural network. The effectiveness of the proposed method has been verified experimentally

Tracking Evolution of Stator-based Fault in Induction Machines using the Growing Curvilinear Component Analysis Neural Network

Stator-based faults are one of the most common faults among induction motors (IMs). The conventional approach to IM control and protection employs current sensors installed on the motor. Recently, most studies have focused on fault detection by means of stator current. This paper presents an application of the Growing Curvilinear Component Analysis (GCCA) neural network aided by the Extended Park Vector Approach (EPVA) for the purpose of transforming the three-phase current signals. The GCCA is a growing neural based technique specifically designed to detect and follow changes in the input distribution, e.g. stator faults. In particular, the GCCA has proven its capability of correctly identifying and tracking stator inter-turn fault in IMs. To this purpose, the three-phase stator currents have been acquired from IMs, which start at healthy operating state and, evolve to different fault severities (up to 10%) under different loading conditions. Data has been transformed using the EPVA and pre-processed to extract statistical time domain features. To calibrate the GCCA neural network, a topological manifold analysis has been carried out to study the input features. The efficacy of the proposed method has been verified experimentally using IM with l.lkW rating and has potential for IMs with different manufacturing conditions

Contributi italiani alla nascita della Petrografia

Verso la fine del XVIII e nei primi decenni del XIX secolo alcuni esperti italiani nella prospezione e sfruttamento minerario ed interessati nelle Scienze della Terra, G. Arduino, G. Marzari Pencati, G. Brocchi, e S. Breislak, hanno correttamente riconosciuto in base ad osservazioni sul campo la natura che oggi definiremmo magmatica di corpi sia intrusivi che vulcanici all'interno di sequenze sedimentarie, in contrasto con quanto previsto dalle teorie nettunistiche di Werner, allora dominanti. Ma anche celebrati studiosi di Storia Naturale, come L. Spallanzani e G. Gioeni hanno dato un importante contributo alle ricerche sulle rocce, ed al termine del periodo è da ricordare anche C. Gemmellaro, successore di Gioeni. La Petrografia si stava allora sviluppando, nella cornice della Storia Naturale, come disciplina autonoma dalla Mineralogia e dalla Geologia quando fu possibile classificare le rocce, già suddivise da Werner in gruppi fondati su criteri sistematici embrionalmente petrografici, sulla base dei primi fondamentali lavori di Cordier (1816), von Leonhard (1823) e Brongniart (1827), che hanno introdotto una tassonomia delle rocce, ancora affetta da inconsistenze ed ingenuità, in base alla loro composizione ed origine

Sars-cov-2 and the risk assessment document in italian work; specific or generic risk even if aggravated?

In December 2019, several cases of atypical pneumonia were detected in Wuhan city, Hubei province, inland China. The initial outbreak was of considerable size first in China subsequently spread to the rest of the world. Immediately after the epidemic (which according to the World Health Organization had risen to pandemic status), the problem of whether or not to update the occupational risk assessment arose, also considering how the biological risk from SARS CoV-2 should be understood: specific or generic. To this end, we conducted a literature review to identify national health legislation and policies, examining how Italy has addressed the COVID-19 emergency in occupational health planning, in order to develop considerations on the need to update the Risk Assessment Document following the pandemic status. The data that emerged from the review of current legislation allowed us to conclude that the risk from SARS-CoV-2 is in most work activities to be understood as a generic or aggravated generic risk, requiring the employer to apply and control the preventive measures suggested by health authorities to contain the spread of the virus

Considerations on the Update of the Risk Assessment Document During the Pandemic State by COVID-19 in Italy

Immediately after the outbreak of the SARS-CoV-2 epidemic (which had risen to the level of a pandemic according to the World Health Organization), the question arose whether or not to update the risk assessment, which, as required by Legislative Decree 81/2008, with the consequent updating of the prevention measures. In light of these forecasts, we asked ourselves whether the risk of coronavirus infection should be taken into account by the employer by updating the risk assessment or not. An in-depth analysis of current legislation has led to the conclusion that the biological risk from SARS-CoV-2 is to be considered specific only in health-related activities, in other activities it can be considered exclusively generic or generic aggravated. The Risk Assessment Document can therefore only be integrated

Constrained least - squares parameter estimation for a double layer capacitor

This paper presents an estimation of the parameters for a Double Layer Super Capacitor (DLC) that is modelled with a two-branch circuit. The estimation is achieved using a constrained minimization technique, which is developed off-line and uses a single constraint to write the matrix equation. The model is algebraically manipulated to obtain a matrix equation, and a signal processing system is developed to prepare the signals for the identification algorithms. The proposed method builds on the results obtained using an unconstrained ordinary least-squares (OLS) technique. The method is tested both in simulation and experimentally, using a specially-designed experimental rig. A current ramp input is used to generate the corresponding output voltage and its derivatives. The results obtained from the constrained off-line minimization algorithm are compared with those obtained using a traditional off-line estimation method. The discussion of the results shows that the proposed method outperforms the traditional estimation technique. In summary, this paper contributes to the field of DLC parameter estimation by introducing a new off-line constrained minimization technique. The results obtained from the simulations and experimental rig demonstrate the effectiveness of the proposed method with two of three parameters showing relative errors less than 5%

Assessment of capillary volumetric blood microsampling for the analysis of central nervous system drugs and metabolites

Therapeutic drug monitoring (TDM) is an important tool for correlating the administered drug dose to drug and metabolite concentrations in the body and to therapeutic and adverse effects. In the case of treatment with drugs active on the central nervous system (CNS), frequent TDM becomes really useful, especially for patient compliance checking and for therapy optimisation. The selective serotonin reuptake inhibitors (SSRIs) fluoxetine and sertraline, chosen as target compounds for this study, are two antidepressants mainly used for major depression, but also for obsessive-compulsive disorder associated with neurodegenerative diseases and for eating disorders. Microsampling approaches can be used to make TDM patient-friendly, by means of minimally invasive fingerpricking instead of classic invasive venipuncture. In this study, an innovative volumetric microsampling approach based on the use of hemaPEN technology is proposed to simultaneously obtain four identical dried whole blood microsamples by means of a single capillary sampling. The developed strategy shows significant advantages in terms of blood collection and storage, fast and feasible extraction procedure and sensitive LC-MS/MS analysis, also providing satisfactory validation results (extraction yield >81%, RSD <12.0%, and <6.3% loss in analyte stability after 3 months). The proposed methodology has proven to be sound and reliable for application to the TDM of psychiatric patients treated with antidepressant drugs such as fluoxetine and sertraline. The original capillary volumetric microsampling procedure using hemaPEN has been demonstrated to be suitable for the accurate sampling of capillary whole blood, in order to be successfully exploited in self- and home-sampling procedures in future and to pave the way for precision medicine approaches for the treatment of CNS disorders

Disposal of green roofs: A contribution to identifying an “Allowed by legislation” end–of–life scenario and facilitating their environmental analysis

The rapid and widespread deployment of green roofs requires the need to address their disposal and to assess the environmental impact of this phase of their life cycle to understand whether their current large-scale application may pose a problem. A review of the literature on green roofs environmental performance (particularly Life Cycle Assessment studies) has highlighted the lack of a standardized, commonly adopted, procedure for determining the treatments, recovery and/or disposal, to be assigned to waste from the removal of green roofs. In this regard, it should be mentioned that there is a lack of ad hoc legislation on the disposal of this technology (to the best of the authors’ knowledge, even at the international level). In this paper, an attempt procedure is introduced to identify the end-of-life scenario of green roofs that does not conflict with the current regulations regarding wastes. Specifically, the procedure relies on an “attempt classification” of the waste from individual green roof elements and the priority criterion for intervention. This procedure might thus be used temporarily by technicians, pending the issuance of guidelines specifically dedicated to green roofs disposal, to model their end-of-life and thus assess the environmental impact of this phase of the life cycle. The feasibility of this proposal was verified through a field application. Besides the methodological proposal, the results of the work indicated the need to review the current waste legislation and update it -at least the Italian one - to also consider new materials used in green transition technologies

Petrofabric, compositional features and seismic properties of metamorphic rocks: a multiple approach

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