15 research outputs found
How Virtual Powers Plants Can Advance Electrification and Mitigate Infrastructure Needs As We Race to Meet Our Climate Challenges
This paper explores three contemporary case studies of how distributed energy resources have been aggregated into Virtual Power Plants (VPPs) to provide resilient, low carbon solutions for our climate challenge in a manner that can mitigate demands on our energy infrastructure. These recent case studies will analyze distributed energy resources and how they can be aggregated to participate in wholesale electric markets to reduce the demand for larger utility scale resources while also providing grid services locally. These case studies build on previous research on distributed energy resources we have performed at our Institute for Energy and the Environment. The cases will consider how Federal Energy Regulatory Commission (“FERC” or “Commission”) Orders 841 and 2222 will help remove the barriers to effective participation in regional markets and explore the remaining conflicts with overlapping state and federal jurisdiction. We will conclude with lessons learned to promote the growth of VPPs in a manner that enhances electrification and promotes resilience as we transition to a low carbon future
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Test performance and acceptability of self- versus provider-collected swabs for high-risk HPV DNA testing in female-to-male trans masculine patients
Background: High-risk human papillomavirus (hrHPV) causes virtually all cervical cancers. Trans masculine (TM) people (those assigned female at birth who identify with a gender other than female) have low uptake of conventional cervical cancer screening. Self-collected hrHPV DNA testing has high levels of acceptability among cisgender (non-transgender) females and may support increased cervical cancer screening uptake in TM individuals. Objective: To assess the test performance and acceptability of self-collected vaginal specimens in comparison to provider-collected cervical swabs for hrHPV DNA detection in TM individuals ages 21–64 years. Methods: Between March 2015-September 2016, 150 TM participants with a cervix (mean age = 27.5 years; SD = 5.7) completed a one-time study visit comprised of a self-report survey, self-collected vaginal HPV DNA swab, clinician-administered cervical HPV swab, and brief interview on acceptability of clinical procedures. Participants were randomized to complete either self- or provider-collection first to minimize ordering effects. Self- and provider-collected samples were tested for 13 hrHPV DNA types using a DNA Hybridization Assay. The primary outcome variable was the concordance (kappa statistic) and performance (sensitivity, specificity) of self-collected vaginal HPV DNA specimens versus provider-collected cervical HPV swabs as the gold standard. Results: Of the 131 participants completing both the self- and provider-collected HPV tests, 21 cases of hrHPV were detected by the provider cervical swab (gold standard; 16.0% hrHPV prevalence); 15 of these cases were accurately detected by the self-collected vaginal swab (71.4% concordance) (Kappa = 0.75, 95% Confidence Interval [CI]: 0.59, 0.92; p<0.001). Compared to the provider-collected cervical hrHPV DNA sample (gold standard), the self-collected vaginal hrHPV DNA test demonstrated a sensitivity of 71.4% (95% CI: 0.52, 0.91; p = 0.0495) and specificity of 98.2% (95% CI: 0.96, 1.00; p<0.0001). Over 90% of participants endorsed a preference for the self-collected vaginal swab over provider-collected cervical swab. Conclusion: Self-collected vaginal swabs are highly acceptable to TM as a means to test for hrHPV DNA. Test performance of this self-collection method for hrHPV detection in TM is consistent with previous studies in cisgender females. Self-collected vaginal swab testing for hrHPV DNA represents a reasonable and patient-centered strategy for primary cervical cancer screening in TM patients unwilling to undergo provider collection of specimens via speculum exam
Concordance of self-collected vaginal HPV DNA hybridization assay to the provider-collected cervical HPV DNA specimen and to the provider-collected cervical cytology.
<p>Concordance of self-collected vaginal HPV DNA hybridization assay to the provider-collected cervical HPV DNA specimen and to the provider-collected cervical cytology.</p
Descriptive characteristics of trans masculine sample (N = 150).
<p>Descriptive characteristics of trans masculine sample (N = 150).</p
Concordance of the provider-collected cervical HPV DNA specimen to the provider-collected vaginal HPV DNA specimen, and of the self-collected vaginal HPV DNA hybridization assay to the provider-collected vaginal HPV DNA specimen.
<p>Concordance of the provider-collected cervical HPV DNA specimen to the provider-collected vaginal HPV DNA specimen, and of the self-collected vaginal HPV DNA hybridization assay to the provider-collected vaginal HPV DNA specimen.</p