High-risk Sexual Behavior is Associated with Post-Exposure Prophylaxis Non-adherence among Men who have Sex with Men Enrolled in a Combination Prevention Intervention.

Methamphetamine use among men who have sex with men (MSM) is associated with increased HIV prevalence, due to increased engagement in high-risk sexual behavior. Fifty-three HIV-negative, methamphetamine-using MSM were enrolled in a biobehavioral combination prevention intervention in Los Angeles, CA, to assess the feasibility of administering postexposure prophylaxis (PEP) in combination with contingency management (CM) to prevent HIV seroconversion. The study combined a CM behavioral intervention targeting reductions in methamphetamine use with a PEP biomedical intervention for HIV prevention. Those who reported recent exposure to HIV were initiated on tenofovir/emtricitabine- (Truvada)-based PEP (n=35). This secondary analysis sought to determine whether recent and/or lifetime sexual risk taking was associated with PEP adherence. Regression analyses controlling for participant sociodemographics demonstrated that, at baseline, increased number of lifetime sexually transmitted diseases (STDs; Coef.=-0.07; 95% CI=(-0.12) - (-0.01)) and recent episodes of unprotected anal intercourse (UAI; Coef.=-0.01; 95% CI= (-.01) - (-0.002)) were each associated with reductions in medication adherence. Given these associations between baseline sexual risk and PEP adherence, providers working with high-risk MSM may look to target reductions in sexual risk taking; this will reduce direct risk of HIV infection and may work to optimize medication adherence in the case of PEP initiation. Clinicaltrials.gov identifier: NCT00856323

Filament formation associated with spirochetal infection: a comparative approach to Morgellons disease

Bovine digital dermatitis is an emerging infectious disease that causes lameness, decreased milk production, and weight loss in livestock. Proliferative stages of bovine digital dermatitis demonstrate keratin filament formation in skin above the hooves in affected animals. The multifactorial etiology of digital dermatitis is not well understood, but spirochetes and other coinfecting microorganisms have been implicated in the pathogenesis of this veterinary illness. Morgellons disease is an emerging human dermopathy characterized by the presence of filamentous fibers of undetermined composition, both in lesions and subdermally. While the etiology of Morgellons disease is unknown, there is serological and clinical evidence linking this phenomenon to Lyme borreliosis and coinfecting tick-borne agents. Although the microscopy of Morgellons filaments has been described in the medical literature, the structure and pathogenesis of these fibers is poorly understood. In contrast, most microscopy of digital dermatitis has focused on associated pathogens and histology rather than the morphology of late-stage filamentous fibers. Clinical, laboratory, and microscopic characteristics of these two diseases are compared

Patient-reported outcome assessment of inflammatory arthritis patient experience with intravenously administered biologic therapy

Objective: To evaluate patient perspectives regarding utilization of intravenous (IV) therapy for inflammatory arthritis (IA). Methods: This was a single-center, non-interventional, patient questionnaire-based study of adult IA patients currently receiving IV biologics. At a single visit, patients completed the questionnaire comprising 30 questions centered on their experience receiving an intravenously administered therapy to treat their IA. The questionnaire included questions on patient demographics, disease characteristics, and previous biologic treatment for IA (subcutaneous [SC] and IV). Patients rated their level of agreement with statements regarding satisfaction with current IV biologic therapy and potential advantages and disadvantages of IV biologic therapy using a 5-point Likert scale (1= strongly disagree, 5= strongly agree). Results: One hundred patients were enrolled and completed the survey; 66% were female and the mean age was 58 years. Before IV treatment, 97% of patients received information regarding therapy options. Ninety patients ranked their satisfaction with current IV therapy as 4 or 5. The proportion of patients with an “extremely favorable” perception of IV therapy increased from 33% to 71% following initiation of their current medication. Thirty-one patients had previously received SC therapies to treat their IA. Conclusion: These results demonstrated an overall favorable perception of IV therapy among this patient population. Patients previously treated with SC therapy also had a positive shift in the perception of IV therapy after initiating IV therapy. Patients’ perception and preference for treatment options should be highly considered by the treating physician during or as part of a shared decision-making process. © 2017 Gaylis et al

On the Lagrangian structure of 3D consistent systems of asymmetric quad-equations

Recently, the first-named author gave a classification of 3D consistent 6-tuples of quad-equations with the tetrahedron property; several novel asymmetric 6-tuples have been found. Due to 3D consistency, these 6-tuples can be extended to discrete integrable systems on Z^m. We establish Lagrangian structures and flip-invariance of the action functional for the class of discrete integrable systems involving equations for which some of the biquadratics are non-degenerate and some are degenerate. This class covers, among others, some of the above mentioned novel systems.Comment: 21 pp, pdfLaTe

Radiation osteitis of the clavicle

The bone alterations in the region of the clavicle (3 cases) are similar to those we have observed and described elsewhere in the skeleton i.e., the mandible, maxillary and ethmoid bones. Rarefaction is the result of three different types of bone destruction: osteoclasia, a kind of osteocytic osteolysis only observed after irradiation and obviously related with infection, and a pure demineralization of the osseous tissue by contact with pus. Reconstruction processes, although unable to prevent spontaneous fracture, are also present and correspond to islets of chondroid tissue surrounded by lamellar bone. However, these recently deposited calcified tissues are already necrotic since most of their lacunae are empty.Les modifications osseuses dans la région de la clavicule (3 observations) sont semblables à celles observées ailleurs dans le squelette, par exemple la mandibule, le maxillaire et l’os ethmoïde. La raréfaction osseuse est le résultat de trois types différents de destruction: l’ostéoclasie, une espèce d’ostéolyse ostéocytaire observée après irradiation, en rapport certain avec une infection et une déminéralisation pure du tissu osseux en contact avec du pus. Les phénomènes de reconstruction, bien qu’incapables d’éviter une fracture spontanée, sont également présents et ils correspondent à des îlots de tissu chondroïde au sein de travées d’os lamellaire. Cependant ces tissus calcifiés récemment déposés sont déjà nécrosés puisque les ostéoplastes sont vides

Research and applications: Artificial intelligence

The program is reported for developing techniques in artificial intelligence and their application to the control of mobile automatons for carrying out tasks autonomously. Visual scene analysis, short-term problem solving, and long-term problem solving are discussed along with the PDP-15 simulator, LISP-FORTRAN-MACRO interface, resolution strategies, and cost effectiveness

Nonequilibrium brittle fracture propagation: Steady state, oscillations and intermittency

A minimal model is constructed for two-dimensional fracture propagation. The heterogeneous process zone is presumed to suppress stress relaxation rate, leading to non-quasistatic behavior. Using the Yoffe solution, I construct and solve a dynamical equation for the tip stress. I discuss a generic tip velocity response to local stress and find that noise-free propagation is either at steady state or oscillatory, depending only on one material parameter. Noise gives rise to intermittency and quasi-periodicity. The theory explains the velocity oscillations and the complicated behavior seen in polymeric and amorphous brittle materials. I suggest experimental verifications and new connections between velocity measurements and material properties.Comment: To appear in Phys. Rev. Lett., 6 pages, self-contained TeX file, 3 postscript figures upon request from author at [email protected] or [email protected], http://cnls-www.lanl.gov/homepages/rafi/rafindex.htm

Stresses in isostatic granular systems and emergence of force chains

Progress is reported on several questions that bedevil understanding of granular systems: (i) are the stress equations elliptic, parabolic or hyperbolic? (ii) how can the often-observed force chains be predicted from a first-principles continuous theory? (iii) How to relate insight from isostatic systems to general packings? Explicit equations are derived for the stress components in two dimensions including the dependence on the local structure. The equations are shown to be hyperbolic and their general solutions, as well as the Green function, are found. It is shown that the solutions give rise to force chains and the explicit dependence of the force chains trajectories and magnitudes on the local geometry is predicted. Direct experimental tests of the predictions are proposed. Finally, a framework is proposed to relate the analysis to non-isostatic and more realistic granular assemblies.Comment: 4 pages, 2 figures, Corrected typos and clkearer text, submitted to Phys. Rev. Let

The development of the British Red Cross' psychosocial framework: 'calmer'

This paper presents the history, development and approach of the new psychosocial framework which in 2008 was adopted by the British Red Cross, and a piece of research designed to review its fitness for purpose as an educational tool. The framework CALMER is a single, overarching approach for considering and delivering psychosocial services across all of the British Red Cross. It is being included in all relevant training programmes, such as within first aid and psychosocial support and within services in emergency response, event first aid, health and social care, international tracing and message and refugee services and across human resources. The framework includes six prompts which should be followed sequentially, with guidance on facilitative behaviours within each. The research considered the levels of confidence and worry of participants on one day training programmes delivered to three different groups of personnel in three different countries. While finding support for the CALMER framework, further recommendations are made for future research

(Anti-)Evaporation of Schwarzschild-de Sitter Black Holes

We study the quantum evolution of black holes immersed in a de Sitter background space. For black holes whose size is comparable to that of the cosmological horizon, this process differs significantly from the evaporation of asymptotically flat black holes. Our model includes the one-loop effective action in the s-wave and large N approximation. Black holes of the maximal mass are in equilibrium. Unexpectedly, we find that nearly maximal quantum Schwarzschild-de Sitter black holes anti-evaporate. However, there is a different perturbative mode that leads to evaporation. We show that this mode will always be excited when a pair of cosmological holes nucleates.Comment: 16 pages, LaTeX2e; submitted to Phys. Rev.