Reacting plume inversion on urban geometries through gradient based design methodologies

An increased focus on domestic security in recent years has brought attention to several important application areas where computational fluid dynamics (CFD) has the ability to make a significant impact. In particular, disaster mitigation and post-event forensic activities are of interest. This work investigates a procedure built on gradient based design methods to allow for the solution of the so-called inverse chemistry problem in urban environments. The inverse chemistry problem consists of computing a release location based on the sensing of chemical byproducts of the release and the ability to compute an accurate flow field on the geometry of interest. In this study, Washington DC is simulated under conditions of a hazardous plume. A CFD solver is implemented which allows for the solution of the preconditioned finite-rate Navier-Stokes equations as well as the in situ computation of design gradients

A hybrid method for flows in local chemical equilibrium and nonequilibrium

The primary objective of this work is to develop a more efficient chemically active compressible Euler equation solver. Currently, a choice between the physical accuracy of a finite-rate solver or the computational efficiency of an equilibrium flow solver must be made. The number of species modeled continues to increase with available computational resources. A method of further leveraging the increase in computational power is desired. The hybrid chemistry scheme proposed here attempts to maintain the accuracy of finite-rate schemes while retaining some of the cost savings associated with equilibrium chemistry solvers. The method given uses a full finite-rate flux in regions where chemistry is slow compared to the advection rate and an equilibrium chemistry scheme in regions where the chemistry outpaces the fluid transport. Control volume switching is based on a locally defined Damk ̈ohler number. This method could be extremely useful for full reaction path modeling or the tracking of a very large number of species. The cost of symmetric Gauss-Seidel iterations grows like the number of species plus four, quantity squared. Thus, eliminating the increased cost of solving for a large number of unknowns in regions where it is unjustified can be very useful. Tenasi, a University of Tennessee SimCenter research code, is used as a base for the new solver. The hybrid method is implemented and tested with an explicit solution technique in one dimension. In combination with a five species air chemistry model, a high-temperature shock tube is used as a verification test case. Results are compared with those from pure equilibrium, full finite-rate, perfect gas Euler, and exact perfect gas Riemann solvers. Timings are also given, suggesting the cost savings that would be possible should the hybrid method be extended using implicit algorithms

Transcriptomic signatures of NK cells suggest impaired responsiveness in HIV-1 infection and increased activity post-vaccination

Natural killer (NK) cells limit viral replication by direct recognition of infected cells, antibody-dependent cellular cytotoxicity (ADCC), and releasing cytokines. Although growing evidence supports NK cell antiviral immunity in HIV-1 infection, further knowledge of their response is necessary. Here we show that NK cells responding to models of direct cell recognition, ADCC, and cytokine activation have unique transcriptional fingerprints. Compared with healthy volunteers, individuals with chronic HIV-1 infection have higher expression of genes commonly associated with activation, and lower expression of genes associated with direct cell recognition and cytokine stimulation in their NK cells. By contrast, NK cell transcriptional profiles of individuals receiving a modified vaccinia Ankara (MVA) vectored HIV-1 vaccine show upregulation of genes associated with direct cell recognition. These findings demonstrate that targeted transcriptional profiling provides a sensitive assessment of NK cell activity, which helps understand how NK cells respond to viral infections and vaccination

Immunophenotyping of Rhesus CMV

A vaccine to ameliorate cytomegalovirus (CMV)‐related pathogenicity in transplantation patients is considered a top priority. A therapeutic vaccine must include components that elicit both neutralizing antibodies, and highly effective CD8 T‐cell responses. The most important translational model of vaccine development is the captive‐bred rhesus macaque ( Macaca mulatta ) of Indian origin. There is a dearth of information on rhesus cytomegalovirus (rhCMV)‐specific CD8 T cells due to the absence of well‐defined CD8 T‐cell epitopes presented by classical MHC‐I molecules. In the current study, we defined two CD8 T‐cell epitopes restricted by high‐frequency Mamu alleles: the Mamu‐A1*002:01 restricted VY9 (VTTLGMALY aa291‐299) epitope of protein IE‐1, and the Mamu‐A1*008:01 restricted NP8 (NPTDRPIP aa96‐103) epitope of protein phosphoprotein 65‐2. We developed tetramers and determined the level, phenotype, and functional capability of the two epitope‐specific T‐cell populations in circulation and various tissues. We demonstrated the value of these tetramers for in situ tetramer staining. Here, we first provided critical reagents and established a flow cytometric staining strategy to study rhCMV‐specific T‐cell responses in up to 40% of captive‐bred rhesus macaques. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals LLC on behalf of International Society for Advancement of Cytometry

Strategies for gender-equitable HIV services in rural India

The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system

Enhanced infection prophylaxis reduces mortality in severely immunosuppressed HIV-infected adults and older children initiating antiretroviral therapy in Kenya, Malawi, Uganda and Zimbabwe: the REALITY trial

Meeting abstract FRAB0101LB from 21st International AIDS Conference 18–22 July 2016, Durban, South Africa. Introduction: Mortality from infections is high in the first 6 months of antiretroviral therapy (ART) among HIV‐infected adults and children with advanced disease in sub‐Saharan Africa. Whether an enhanced package of infection prophylaxis at ART initiation would reduce mortality is unknown. Methods: The REALITY 2×2×2 factorial open‐label trial (ISRCTN43622374) randomized ART‐naïve HIV‐infected adults and children >5 years with CD4 <100 cells/mm3. This randomization compared initiating ART with enhanced prophylaxis (continuous cotrimoxazole plus 12 weeks isoniazid/pyridoxine (anti‐tuberculosis) and fluconazole (anti‐cryptococcal/candida), 5 days azithromycin (anti‐bacterial/protozoal) and single‐dose albendazole (anti‐helminth)), versus standard‐of‐care cotrimoxazole. Isoniazid/pyridoxine/cotrimoxazole was formulated as a scored fixed‐dose combination. Two other randomizations investigated 12‐week adjunctive raltegravir or supplementary food. The primary endpoint was 24‐week mortality. Results: 1805 eligible adults (n = 1733; 96.0%) and children/adolescents (n = 72; 4.0%) (median 36 years; 53.2% male) were randomized to enhanced (n = 906) or standard prophylaxis (n = 899) and followed for 48 weeks (3.8% loss‐to‐follow‐up). Median baseline CD4 was 36 cells/mm3 (IQR: 16–62) but 47.3% were WHO Stage 1/2. 80 (8.9%) enhanced versus 108(12.2%) standard prophylaxis died before 24 weeks (adjusted hazard ratio (aHR) = 0.73 (95% CI: 0.54–0.97) p = 0.03; Figure 1) and 98(11.0%) versus 127(14.4%) respectively died before 48 weeks (aHR = 0.75 (0.58–0.98) p = 0.04), with no evidence of interaction with the two other randomizations (p > 0.8). Enhanced prophylaxis significantly reduced incidence of tuberculosis (p = 0.02), cryptococcal disease (p = 0.01), oral/oesophageal candidiasis (p = 0.02), deaths of unknown cause (p = 0.02) and (marginally) hospitalisations (p = 0.06) but not presumed severe bacterial infections (p = 0.38). Serious and grade 4 adverse events were marginally less common with enhanced prophylaxis (p = 0.06). CD4 increases and VL suppression were similar between groups (p > 0.2). Conclusions: Enhanced infection prophylaxis at ART initiation reduces early mortality by 25% among HIV‐infected adults and children with advanced disease. The pill burden did not adversely affect VL suppression. Policy makers should consider adopting and implementing this low‐cost broad infection prevention package which could save 3.3 lives for every 100 individuals treated