Risk scores for predicting HIV incidence among adult heterosexual populations in sub-Saharan Africa: a systematic review and meta-analysis.

This is the final version. Available on open access from Wiley via the DOI in this record. Data availability statement: All data extracted for this systematic review are contained in the manuscript and supporting information.INTRODUCTION: Several HIV risk scores have been developed to identify individuals for prioritized HIV prevention in sub-Saharan Africa. We systematically reviewed HIV risk scores to: (1) identify factors that consistently predicted incident HIV infection, (2) review inclusion of community-level HIV risk in predictive models and (3) examine predictive performance. METHODS: We searched nine databases from inception until 15 February 2021 for studies developing and/or validating HIV risk scores among the heterosexual adult population in sub-Saharan Africa. Studies not prospectively observing seroconversion or recruiting only key populations were excluded. Record screening, data extraction and critical appraisal were conducted in duplicate. We used random-effects meta-analysis to summarize hazard ratios and the area under the receiver-operating characteristic curve (AUC-ROC). RESULTS: From 1563 initial search records, we identified 14 risk scores in 13 studies. Seven studies were among sexually active women using contraceptives enrolled in randomized-controlled trials, three among adolescent girls and young women (AGYW) and three among cohorts enrolling both men and women. Consistently identified HIV prognostic factors among women were younger age (pooled adjusted hazard ratio: 1.62 [95% confidence interval: 1.17, 2.23], compared to above 25), single/not cohabiting with primary partners (2.33 [1.73, 3.13]) and having sexually transmitted infections (STIs) at baseline (HSV-2: 1.67 [1.34, 2.09]; curable STIs: 1.45 [1.17; 1.79]). Among AGYW, only STIs were consistently associated with higher incidence, but studies were limited (n = 3). Community-level HIV prevalence or unsuppressed viral load strongly predicted incidence but was only considered in 3 of 11 multi-site studies. The AUC-ROC ranged from 0.56 to 0.79 on the model development sets. Only the VOICE score was externally validated by multiple studies, with pooled AUC-ROC 0.626 [0.588, 0.663] (I2 : 64.02%). CONCLUSIONS: Younger age, non-cohabiting and recent STIs were consistently identified as predicting future HIV infection. Both community HIV burden and individual factors should be considered to quantify HIV risk. However, HIV risk scores had only low-to-moderate discriminatory ability and uncertain generalizability, limiting their programmatic utility. Further evidence on the relative value of specific risk factors, studies populations not restricted to "at-risk" individuals and data outside South Africa will improve the evidence base for risk differentiation in HIV prevention programmes. PROSPERO NUMBER: CRD42021236367.Bill and Melinda Gates FoundationMedical Research Council (MRC)UNAIDSUK Foreign, Commonwealth & Development Office (FCDO

Measurement of Analyzing Power for Proton-Carbon Elastic Scattering in the Coulomb-Nuclear Interference Region with a 22-GeV/c Polarized Proton Beam

The analyzing power for proton-carbon elastic scattering in the coulomb-nuclear interference region of momentum transfer, $9.0\times10^{-3}<-t<4.1\times10^{-2}$ (GeV/$c)^{2}$, was measured with a 21.7 GeV/$c$ polarized proton beam at the Alternating Gradient Synchrotron of Brookhaven National Laboratory. The ratio of hadronic spin-flip to non-flip amplitude, $r_5$, was obtained from the analyzing power to be $\text{Re} r_5=0.088\pm 0.058$ and $\text{Im} r_5=-0.161\pm 0.226$.Comment: 4 pages, 4 figures and 1 table. Accepted by Physical Review Letter

Experimental determination of the complete spin structure for anti-proton + proton -> anti-\Lambda + \Lambda at anti-proton beam momentum of 1.637 GeV/c

The reaction anti-proton + proton -> anti-\Lambda + \Lambda -> anti-proton + \pi^+ + proton + \pi^- has been measured with high statistics at anti-proton beam momentum of 1.637 GeV/c. The use of a transversely-polarized frozen-spin target combined with the self-analyzing property of \Lambda/anti-\Lambda decay allows access to unprecedented information on the spin structure of the interaction. The most general spin-scattering matrix can be written in terms of eleven real parameters for each bin of scattering angle, each of these parameters is determined with reasonable precision. From these results all conceivable spin-correlations are determined with inherent self-consistency. Good agreement is found with the few previously existing measurements of spin observables in anti-proton + proton -> anti-\Lambda + \Lambda near this energy. Existing theoretical models do not give good predictions for those spin-observables that had not been previously measured.Comment: To be published in Phys. Rev. C. Tables of results (i.e. Ref. 24) are available at http://www-meg.phys.cmu.edu/~bquinn/ps185_pub/results.tab 24 pages, 16 figure

Experimental Study of the Radiative Decays K+ -> mu+ nu e+e- and K+ -> e+ nu e+e-

Experiment 865 at the Brookhaven AGS obtained 410 K+ -> e+ nu e+e- and 2679 K+ -> mu+ nu e+e- events including 10% and 19% background. The branching ratios were measured to be (2.48+-0.14(stat.)+-0.14(syst.))x10^-8 (m_ee>150 MeV) and (7.06+-0.16+-0.26)x10^-8 (m_ee>145 MeV), respectively. Results for the decay form factors are presented.Comment: 4 pages, 3 figures, RevTeX

Measurement of Spin Transfer Observables in Antiproton-Proton -> Antilambda-Lambda at 1.637 GeV/c

Spin transfer observables for the strangeness-production reaction Antiproton-Proton -> Antilambda-Lambda have been measured by the PS185 collaboration using a transversely-polarized frozen-spin target with an antiproton beam momentum of 1.637 GeV/c at the Low Energy Antiproton Ring at CERN. This measurement investigates observables for which current models of the reaction near threshold make significantly differing predictions. Those models are in good agreement with existing measurements performed with unpolarized particles in the initial state. Theoretical attention has focused on the fact that these models produce conflicting predictions for the spin-transfer observables D_{nn} and K_{nn}, which are measurable only with polarized target or beam. Results presented here for D_{nn} and K_{nn} are found to be in disagreement with predictions from existing models. These results also underscore the importance of singlet-state production at backward angles, while current models predict complete or near-complete triplet-state dominance.Comment: 5 pages, 3 figure

A new measurement of the properties of the rare decay K -> pi+ e+ e-

A large low-background sample of events (10300) has been collected for the rare decay of kaons in flight K+ -> pi+ e+ e- by experiment E865 at the Brookhaven AGS. The decay products were accepted by a broad band high-resolution charged particle spectrometer with particle identification. The branching ratio (2.94 +- 0.05(stat.) +- 0.13(syst.) +- 0.05(model))*10**{-7} was determined normalizing to events from the decay chain K+ -> pi+ pi0; pi0 -> e+ e- gamma. From the analysis of the decay distributions the vector nature of this decay is firmly established now, and limits on scalar and tensor contributions are deduced. From the (e+ e-) invariant mass distribution the decay form factor f(z)=f0(1+ delta*z) (z=M(ee)**2/m(K)**2) is determined with delta=2.14 +- 0.13 +- 0.15. Chiral QCD perturbation theory predictions for the form factor are also tested, and terms beyond leading order O(p**4) are found to be important.Comment: 4 pages, 5 figure

The extreme European summer 2012

The European summer of 2012 was marked by strongly contrasting rainfall anomalies, which led to flooding in northern Europe and droughts and wildfires in southern Europe. This season was not an isolated event, rather the latest in a string of summers characterized by a southward shifted Atlantic storm track as described by the negative phase of the SNAO. The degree of decadal variability in these features suggests a role for forcing from outside the dynamical atmosphere, and preliminary numerical experiments suggest that the global SST and low Arctic sea ice extent anomalies are likely to have played a role and that warm North Atlantic SSTs were a particular contributing factor. The direct effects of changes in radiative forcing from greenhouse gas and aerosol forcing are not included in these experiments, but both anthropogenic forcing and natural variability may have influenced the SST and sea ice changes

Explaining Extreme Events of 2012 from a Climate Perspective

Attribution of extreme events is a challenging science and one that is currently undergoing considerable evolution. In this paper are 19 analyses by 18 different research groups, often using quite different methodologies, of 12 extreme events that occurred in 2012. In addition to investigating the causes of these extreme events, the multiple analyses of four of the events, the high temperatures in the United States, the record low levels of Arctic sea ice, and the heavy rain in northern Europe and eastern Australia, provide an opportunity to compare and contrast the strengths and weaknesses of the various methodologies. The differences also provide insights into the structural uncertainty of event attribution, that is, the uncertainty that arises directly from the differences in analysis methodology. In these cases, there was considerable agreement between the different assessments of the same event. However, different events had very different causes. Approximately half the analyses found some evidence that anthropogenically caused climate change was a contributing factor to the extreme event examined, though the effects of natural fluctuations of weather and climate on the evolution of many of the extreme events played key roles as well.Peer Reviewe

Experimental determination of the complete spin structure for p¯p→ Λ¯Λ at p{p¯}= 1.637 GeV/c

The reaction p.p → ^^ → .pπ+pπ− has been measured with high statistics at a beam momentum of pp. = 1.637 GeV/c. The use of a transversely polarized frozen-spin target combined with the self-analyzing property of ^/^ decay allows access to unprecedented information on the spin structure of the interaction. The most general spin-scattering matrix can be written in terms of 11 real parameters for each bin of scattering angle; each of these parameters is determined with reasonable precision. From these results, all conceivable spin correlations are determined with inherent self-consistency. Good agreement is found with the few previously existing measurements of spin observables in p.p → ^^ near this energy. Existing theoretical models do not give good predictions for those spin observables that had not been previously measured