Facilitators for retaining men who have sex with men in pre-exposure prophylaxis care in real world clinic settings within the United States

BACKGROUND: Pre-exposure prophylaxis (PrEP) can significantly reduce HIV acquisition especially among communities with high HIV prevalence, including men who have sex with men (MSM). Much research has been finding suboptimal PrEP persistence; however, few studies examine factors that enhance PrEP persistence in real-world settings. METHODS: We interviewed 33 patients who identified as MSM at three different PrEP clinics in three regions of the U.S. (Northeast, South, Midwest). Participants were eligible if they took PrEP and had been retained in care for a minimum of 6 months. Interviews explored social, structural, clinic-level and behavioral factors that influencing PrEP persistence. RESULTS: Through thematic analysis we identified the following factors as promoting PrEP persistence: (1) navigation to reduce out-of-pocket costs of PrEP (structural), (2) social norms that support PrEP use (social), (3) access to LGBTQ + affirming medical providers (clinical), (4) medication as part of a daily routine (behavioral), and (5) facilitation of sexual health agency (belief). DISCUSSION: In this sample, persistence in PrEP care was associated with structural and social supports as well as a high level of perceived internal control over protecting their health by taking PrEP. Patients might benefit from increased access, LGBTQ + affirming medical providers, and communications that emphasize PrEP can promote sexual health

Perspectives on long-acting formulations of pre-exposure prophylaxis (PrEP) among men who have sex with men who are non-adherent to daily oral PrEP in the United States

INTRODUCTION: Pre-exposure prophylaxis (PrEP) persistence among men who have sex with men (MSM) in real world clinical settings for HIV prevention is suboptimal. New longer-acting formulations of PrEP are becoming available, including injectables, subdermal implants, and other oral medications. These longer-acting formulations have the potential to improve retention among those who have challenges remaining adherent to daily oral PrEP. METHODS: We interviewed 49 MSM who had initiated but discontinued oral PrEP at three diverse clinics across the United States. We examined participants\u27 perspectives about long-acting PrEP formulations and how long-acting options could affect PrEP use using thematic analysis. RESULTS: Participants were not very knowledgeable about long-acting formulations of PrEP but were open to learning about them and considering use. Participants were concerned about safety and efficacy of products given that they were still newer and/or in development. Finally, participants had clear preferences for oral pills, injectables, and then subdermal implants and were most interested in options that reduced the number of visits to the clinic. CONCLUSION: Long-acting formulations of PrEP are acceptable to MSM with suboptimal PrEP persistence and have the potential to improve PrEP persistence. However, many felt they needed more information on safety, efficacy, and use to consider these options. As these long-acting formulations are implemented, public health campaigns and clinical interventions to encourage may maximize uptake particularly among those who are not currently adherent to daily oral PrEP

On extending actions of groups

Problems of dense and closed extension of actions of compact transformation groups are solved. The method developed in the paper is applied to problems of extension of equivariant maps and of construction of equivariant compactifications

direct and maternal genetic effects for body weight and price of calves sold for veal production

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Use of crossbreeding with beef bulls in dairy herds: effect on age, body weight, price, and market value of calves sold at livestock auctions.

The aim of this study was to investigate the effect of different breeds and breed crosses on age (AC, d), BW (kg), price (PR, $/kg), and market value (MV,$/calf) of purebred and crossbred calves sold for veal and beef production. The Kovieh wholesale cattle organization (Bolzano, Italy) grouped calves from sev- eral dairy herds located in the Trentino-Sudtirol region in Italy and sold them by public auctions. Data on AC, BW, PR, and MV from 96,458 calves were recorded from January 2003 to December 2007 and consisted of 4 pure breeds (2 dairy, Brown Swiss (BS) and Holstein- Friesian (HF); and 2 dual-purpose, Simmental (SI) and Alpine Grey (AG)), and 8 crossbreds by crosses of Limousin (LI) and Belgian Blue (BB) with the 4 dam breeds. Least squares means for AC, BW, PR, and MV were calculated for breeds and breed crosses with a model that included fixed effects of herd of birth, age (except for AC), sex, and breed of the calf, year and season of auction, and interactions between the main effects. The coefficients of determination of the mod- els were 0.41, 0.51, 0.84, and 0.82 for AC, BW, PR, and MV, respectively. Sex, age, and breed were the most relevant sources of variation for BW (P < 0.001), whereas breed and sex were the most important sources of variation for AC, PR, and MV (P < 0.001). Also, PR and MV were significantly influenced (P < 0.01) by all the effects included in the model, except for sea- son × age interaction in the case of MV. Market value of male was greater (P < 0.001) than that of female calves, with the exception of BS (−$28.76/calf) and HF (−$20.70/calf) purebred males. Dual-purpose pure- bred calves presented greater (P < 0.001) PR and MV than dairy purebreds (MV of $426.97/calf and$307.96/ calf for SI and AG, and $256.24/calf and$275.65/calf for BS and HF, respectively). Calves from SI and AG dams had greater (P < 0.001) BW, PR, and MV than calves from BS and HF dams. Calves from SI cows had greater (P < 0.001) BW, PR, and MV than calves from AG cows. Crossbreeding with beef bulls increased (P < 0.001) BW, PR, and MV of calves from dairy and dual- purpose dams. Crossbreeding with BB bulls increased PR (+$2.58 ± 0.04/kg; P < 0.001) and MV (+$190.84 ± 3.62/calf; P < 0.001) of calves much more than LI. The use of beef bull semen on dairy herds resulted in an economic revenue from selling crossbred calves

Avaliação do incremento em volume de madeira de Quassia amara L.- Simaroubaceae, em cultivo agroecológico no trópico úmido da Costa Rica.

Quassia amara é arbusto de 3 a 6 metros de altura, tendo sido retirado indiscriminadamente das florestas para extrair do caule as quassinas usadas na indústria farmacêutica e como inseticida em agricultura orgânica. Não se tem muita informação técnica acerca do crescimento desta espécie para subsidiar estratégias de manejo sustentado. Este trabalho tem como objetivo avaliar o crescimento de Q. amara L. em cultivo agroecológico na Costa Rica. O trabalho consistiu em realizar avaliações do desenvolvimento de indivíduos de Q. amara em parcelas permanentes de medições, instaladas em meio às plantações desta espécie em consórcio com essências arbóreas. Foram efetuadas medições de diâmetro do caule a 10 cm do solo e altura total. Foi observado que em função das taxas de crescimento vegetal e incrementos médio e corrente anuais (IMA e ICA), mesmo após cinco anos de plantio, a madeira de Quassia amara para extração de quassinas não está pronta para colheita

ERCP and splenic injury

Abstractendoscopic Retrograde Colangiopancreatography (eRCP) is an invasive procedure with important complications that occurs in 5%-10% of the cases. The most frequent procedure related complications are: acute pancreatitis, hemorrhage, perforation and infection. an infrequent but potentially life threatening eRCP complication is the splenic injury, with very few cases reported in the literature. We report a patient with cholecholithiasis and biliary pancreatitis who was diagnosed with a subcapsular splenic laceration a few hours after an eRCP. Clinicians should be alerted to this potential post-procedure complication associated with eRCP

Reversible and irreversible processes during cyclic voltammetry of an electrodeposited manganese oxide as catalyst for the oxygen evolution reaction

Manganese oxides have received much attention over the years among the wide range of electrocatalysts for the oxygen evolution reaction OER due to their low toxicity, high abundance and rich redox chemistry. While many previous studies focused on the activity of these materials, a better understanding of the material transformations relating to activation or degradation is highly desirable, both from a scientific perspective and for applications. We electrodeposited Na containing MnOx without long range order from an alkaline solution to investigate these aspects by cyclic voltammetry CV , scanning electron microscopy SEM and X ray absorption spectroscopy XAS at the Mn K and Mn L edges. The pristine film was assigned to a layered edge sharing Mn3 4 oxide with Mn O bond lengths of mainly 1.87 and some at 2.30 as well as Mn Mn bond lengths of 2.87 based on fits to the extended X ray fine structure EXAFS . The decrease of the currents at voltages before the onset of the OER followed power laws with three different exponents depending on the number of cycles and the Tafel slope decreases from 186 48 to 114 18 mV dec 1 after 100 cycles, which we interpret in the context of surface coverage with unreacted intermediates. Post mortem microscopy and bulk spectroscopy at the Mn K edge showed no change of the microstructure, bulk local structure or bulk Mn valence. Yet, the surface region of MnOx oxidized toward Mn4 , which explains the reduction of the currents in agreement with literature. Surprisingly, we find that MnOx reactivates after 30 minutes at open circuit OC , where the currents and also the Tafel slope increase. Reactivation processes during OC are crucial because OC is unavoidable when coupling the electrocatalysts to intermittent power sources such as solar energy for sustainable energy productio

Recent developments on the ALICE central Trigger processor

The ALI CE Central Trigger Processor has been constructed and tested, and will shortly be installed in the experimental area. In this review, we introduce the new developments in hardware and software, present a measurement of the minimum propagation time, and illustrate various trigger applications