3,623 research outputs found

    Social-Emotional Keys to the Division of Power

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    Social organizers concerned with facilitating the reallocation of power must not overlook psychological issues. Within groups, power hierarchies are a function of individual methods of coping with social-emotional interactions. Clinical insights suggest that both empowered and disempowered people participate in the process of establishing and maintaining this hierarchial structure

    Sentinel surveillance of HIV-1 transmitted drug resistance, acute infection and recent infection.

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    BackgroundHIV-1 acute infection, recent infection and transmitted drug resistance screening was integrated into voluntary HIV counseling and testing (VCT) services to enhance the existing surveillance program in San Francisco. This study describes newly-diagnosed HIV cases and characterizes correlates associated with infection.Methodology/principal findingsA consecutive sample of persons presenting for HIV VCT at the municipal sexually transmitted infections (STI) clinic from 2004 to 2006 (N = 9,868) were evaluated by standard enzyme-linked immunoassays (EIA). HIV antibody-positive specimens were characterized as recent infections using a less-sensitive EIA. HIV-RNA pooled testing was performed on HIV antibody-negative specimens to identify acute infections. HIV antibody-positive and acute infection specimens were evaluated for drug resistance by sequence analysis. Multivariable logistic regression was performed to evaluate associations. The 380 newly-diagnosed HIV cases included 29 acute infections, 128 recent infections, and 47 drug-resistant cases, with no significant increases or decreases in prevalence over the three years studied. HIV-1 transmitted drug resistance prevalence was 11.0% in 2004, 13.4% in 2005 and 14.9% in 2006 (p = 0.36). Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) was the most common pattern detected, present in 28 cases of resistance (59.6%). Among MSM, recent infection was associated with amphetamine use (AOR = 2.67; p<0.001), unprotected anal intercourse (AOR = 2.27; p<0.001), sex with a known HIV-infected partner (AOR = 1.64; p = 0.02), and history of gonorrhea (AOR = 1.62; p = 0.03).ConclusionsNew HIV diagnoses, recent infections, acute infections and transmitted drug resistance prevalence remained stable between 2004 and 2006. Resistance to NNRTI comprised more than half of the drug-resistant cases, a worrisome finding given its role as the backbone of first-line antiretroviral therapy in San Francisco as well as worldwide. The integration of HIV-1 drug resistance, recent infection, and acute infection testing should be considered for existing HIV/STI surveillance and prevention activities, particularly in an era of enhanced efforts for early diagnosis and treatment

    Coronavirus disease 2019 (COVID-19) vaccination preparedness policies in US hospitals

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    We surveyed infectious disease specialists about early coronavirus disease 2019 (COVID-19) vaccination preparedness. Almost all responding institutions rated their facility\u27s preparedness plan as either excellent or adequate. Vaccine hesitancy and concern about adverse reactions were the most commonly anticipated barriers to COVID-19 vaccination. Only 60% believed that COVID-19 vaccination should be mandatory

    Enhancement of PCA-based fault detection system through utilising dissimilarity matrix for continuous-based process

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    This research is about enhancement of PCA-based fault detection system through utilizing dissimilarity matrix. Nowadays, the chemical process industry is highly based on the non-linear relationships between measured variables. However, the conventional PCA-based MSPC is no longer effective because it only valid for the linear relationships between measured variables. Due in order to solve this problem, the technique of dissimilarity matrix is used in multivariate statistical process control as alternative technique which models the non-linear process and can improve the process monitoring performance. The conventional PCA system was run and the dissimilarity system was developed and lastly the monitoring performance in each technique were compared and analysed to achieve aims of this research. This research is to be done by using Matlab software. The findings of this study are illustrated in the form of Hotellingā€™s T2 and Squared Prediction Errors (SPE) monitoring statistics to be analysed. As a conclusion, the dissimilarity system is comparable to the conventional method. Thus can be the other alternative ways in the process monitoring performance. Finally, it is recommended to use data from other chemical processing systems for more concrete justification of the new technique

    The Effects of Perinatal Oxycodone Exposure on Behavioral Outcome in a Rodent Model

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    Opiate addiction is now a major public health problem. Perinatal insults and exposure to opiates such as morphine in utero are well known to affect development of the hypothalamicā€“pituitaryā€“adrenal axis of the offspring adversely and are associated with a higher risk of developing neurobehavioral problems. Oxycodone is now one of the most frequently abused pain killers during pregnancy; however, limited data are available regarding whether and how perinatal oxycodone exposure (POE) alters neurobehavioral outcomes of the offspring. We demonstrated that exposure to 0.5 mg/kg/day oxycodone in utero was associated with hyperactivity in adult rats in an open field. No significant effects of POE were detected on isolation-induced ultrasonic vocalizations in the early postnatal period or on learning and memory in the water maze in adult offspring. Our findings are consistent with hyperactivity problems identified in children exposed to opiates in utero

    Variability in Pediatric Infectious Disease Consultants' Recommendations for Management of Community-Acquired Pneumonia

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    Community-acquired pneumonia (CAP) is a common childhood infection. CAP complications, such as parapneumonic empyema (PPE), are increasing and are frequently caused by antibiotic-resistant organisms. No clinical guidelines currently exist for management of pediatric CAP and no published data exist about variations in antibiotic prescribing patterns. Our objectives were to describe variation in CAP clinical management for hospitalized children by pediatric infectious disease consultants and to examine associations between recommended antibiotic regimens and local antibiotic resistance levels. (MRSA) in their community.e or clindamycin use and clindamycin resistance, however, respondents were more likely to recommend an anti-MRSA agent when MRSA prevalence increased.Substantial variability exists in recommendations for CAP management. Development of clinical guidelines via antimicrobial stewardship programs and dissemination of data about local antibiotic resistance patterns represent opportunities to improve care

    HIV-1 RNA genital tract shedding after cryotherapy for visual inspection with acetic acid-positive cervical lesions in western Kenya

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    Objectives: To quantify genital tract HIV-1 RNA (GT-HIV RNA) shedding among women living with HIV (WLHIV) before and after cryotherapy treatment for visual inspection with acetic acid (VIA) positive cervical lesions. Methods:We conducted a prospective, longitudinal study of 39 WLHIV on antiretroviral treatment (ART) undergoing cryotherapy for VIA positive lesions in Kenya from 2015-2017. Eligibility for cryotherapy were lesions that covered Results: Detectable GT-HIV RNA was found in 4/39 (10%) participants pre-cryotherapy, 1/30 (3.3%) and 3/26 (11.5%) participants at the 2- and 8-weeks post-cryotherapy, respectively. Only 6/39 (13%) participants had detectable GT-HIV RNA at any point during the study. 2/6 had recent high PVL (range: 49,124-150,695 copies/mL) within 3 months of starting the study and detectable GT-HIV RNA at follow-up visits. 4/6 had undetectable recent PVL within 3-11 months of the study but each had detectable GT-HIV RNA pre-cryotherapy. The mean GT-HIV RNA among 4/39 WLHIV with shedding at pre-cryotherapy was 43,109 (range: 21,812-73,625) copies/mL. Only one participant had GT-HIV RNA (73,125 copies/mL) at 2-weeks post-cryotherapy (N=30); she had no shedding pre-cryotherapy but had a PVL of 49,124 copies/mL 3 months before the study. The mean GT-HIV RNA at 8-weeks post-cryotherapy (N=26) was 44,668 (range: 21,256-64,812) copies/mL among three participants. One of the 3 had high PVL of 150,695 copies/mL 3 months prior to cryotherapy while 2/3 had GT-HIV RNA shedding at baseline despite undetectable most recent PVL. However, their undetectable PVL was 8-11 months prior to cryotherapy which may not accurately reflect PVL at baseline. Conclusions: The majority of GT-HIV RNA shedding was detected before cryotherapy. This finding suggests that cryotherapy was not the primary cause of GT-HIV RNA shedding. Non-adherence to ART might have played a major role. The small sample size and failure to perform paired GT-HIV RNA and PVL tests at each visit are limitations of the study. Further research on the effect of cryotherapy on GT-HIV RNA shedding in ART non-adherent compared to ART-adherent WLHIV is needed
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