Experiences of diagnosis, stigma, culpability, and disclosure in male patients with hepatitis C virus: an interpretative phenomenological analysis

The current study aimed to explore the lived experience of patients with hepatitis C virus infection. Semi-structured interviews were conducted with seven male participants living with hepatitis C virus and were analysed using interpretative phenomenological analysis. Two master themes were identified: (1) diagnosis and the search for meaning and (2) impact of stigma on disclosure. Participants reported fears of contaminating others, feelings of stigma and concerns of disclosing the condition to others. Response to diagnosis, stigma and disclosure among the participants appeared to be interrelated and directly related to locus of blame for virus contraction. More specifically, hepatitis C virus transmission via medical routes led to an externalisation of culpability and an openness to disclosure. Transmission of hepatitis C virus as a direct result of intravenous drug use led to internalised blame and a fear of disclosure. The inter- and intra-personal consequences of hepatitis C virus explored in the current study have potential implications for tailoring future psychological therapy and psychoeducation to the specific needs of the hepatitis C virus population

Flight Team Development in Support of LCROSS - A Class D Mission

The LCROSS (Lunar Crater Observation and Sensing Satellite) project presented a number of challenges to the preparation for mission operations. A class D mission under NASA s risk tolerance scale, LCROSS was governed by a $79 million cost cap and a 29 month schedule from "authority to proceed" to flight readiness. LCROSS was NASA Ames Research Center s flagship mission in its return to spacecraft flight operations after many years of pursuing other strategic goals. As such, ARC needed to restore and update its mission support infrastructure, and in parallel, the LCROSS project had to newly define operational practices and to select and train a flight team combining experienced operators and staff from other arenas of ARC research. This paper describes the LCROSS flight team development process, which deeply involved team members in spacecraft and ground system design, implementation and test; leveraged collaborations with strategic partners; and conducted extensive testing and rehearsals that scaled in realism and complexity in coordination with ground system and spacecraft development. As a testament to the approach, LCROSS successfully met its full mission objectives, despite many in-flight challenges, with its impact on the lunar south pole on October 9, 2009

Microarray detection of human parainfluenzavirus 4 infection associated with respiratory failure in an immunocompetent adult.

A pan-viral DNA microarray, the Virochip (University of California, San Francisco), was used to detect human parainfluenzavirus 4 (HPIV-4) infection in an immunocompetent adult presenting with a life-threatening acute respiratory illness. The virus was identified in an endotracheal aspirate specimen, and the microarray results were confirmed by specific polymerase chain reaction and serological analysis for HPIV-4. Conventional clinical laboratory testing using an extensive panel of microbiological tests failed to yield a diagnosis. This case suggests that the potential severity of disease caused by HPIV-4 in adults may be greater than previously appreciated and illustrates the clinical utility of a microarray for broad-based viral pathogen screening

Transport and Use of a Centaur Second Stage in Space

As nations continue to explore space, the desire to reduce costs will continue to grow. As a method of cost reduction, transporting and/or use of launch system components as integral components of missions may become more commonplace in the future. There have been numerous scenarios written for using launch vehicle components (primarily space shuttle used external tanks) as part of flight missions or future habitats. Future studies for possible uses of launch vehicle upper stages might include asteroid diverter using gravity orbital perturbation, orbiting station component, raw material at an outpost, and kinetic impactor. The LCROSS (Lunar CRater Observation and Sensing Satellite) mission was conceived as a low-cost means of determining whether water exists at the polar regions of the moon. Manifested as a secondary payload with the LRO (Lunar Reconnaissance Orbiter) spacecraft aboard an Atlas V launch vehicle, LCROSS guided its spent Centaur Earth Departure Upper Stage (EDUS) into the lunar crater Cabeu's, as a kinetic impactor. This paper describes some of the challenges that the LCROSS project encountered in planning, designing, launching with and carrying the Centaur upper stage to the moon

Flight Operations for the LCROSS Lunar Impactor Mission

The LCROSS (Lunar CRater Observation and Sensing Satellite) mission was conceived as a low-cost means of determining the nature of hydrogen concentrated at the polar regions of the moon. Co-manifested for launch with LRO (Lunar Reconnaissance Orbiter), LCROSS guided its spent Centaur upper stage into the Cabeus crater as a kinetic impactor, and observed the impact flash and resulting debris plume for signs of water and other compounds from a Shepherding Spacecraft. Led by NASA Ames Research Center, LCROSS flight operations spanned 112 days, from June 18 through October 9, 2009. This paper summarizes the experiences from the LCROSS flight, highlights the challenges faced during the mission, and examines the reasons for its ultimate success

Computational Evaluation of Inlet Distortion on an Ejector Powered Hybrid Wing Body at Takeoff and Landing Conditions

Due to the aft, upper surface engine location on the Hybrid Wing Body (HWB) planform, there is potential to shed vorticity and separated wakes into the engine when the vehicle is operated at off-design conditions and corners of the envelope required for engine and airplane certification. CFD simulations were performed of the full-scale reference propulsion system, operating at a range of inlet flow rates, flight speeds, altitudes, angles of attack, and angles of sideslip to identify the conditions which produce the largest distortion and lowest pressure recovery. Pretest CFD was performed by NASA and Boeing, using multiple CFD codes, with various turbulence models. These data were used to make decisions regarding model integration, characterize inlet flow distortion patterns, and help define the wind tunnel test matrix. CFD was also performed post-test; when compared with test data, it was possible to make comparisons between measured model-scale and predicted full-scale distortion levels. This paper summarizes these CFD analyses

Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns

After the epidemic: Zika virus projections for Latin America and the Caribbean

Background: Zika is one of the most challenging emergent vector-borne diseases, yet its future public health impact remains unclear. Zika was of little public health concern until recent reports of its association with congenital syndromes. By 3 August 2017 ~217,000 Zika cases and ~3,400 cases of associated congenital syndrome were reported in Latin America and the Caribbean. Some modelling exercises suggest that Zika virus infection could become endemic in agreement with recent declarations from the The World Health Organisation. Methodology/Principal findings: We produced high-resolution spatially-explicit projections of Zika cases, associated congenital syndromes and monetary costs for Latin America and the Caribbean now that the epidemic phase of the disease appears to be over. In contrast to previous studies which have adopted a modelling approach to map Zika potential, we project case numbers using a statistical approach based upon reported dengue case data as a Zika surrogate. Our results indicate that ~12.3 (0.7–162.3) million Zika cases could be expected across Latin America and the Caribbean every year, leading to ~64.4 (0.2–5159.3) thousand cases of Guillain-Barré syndrome and ~4.7 (0.0–116.3) thousand cases of microcephaly. The economic burden of these neurological sequelae are estimated to be USD ~2.3 (USD 0–159.3) billion per annum. Conclusions/Significance: Zika is likely to have significant public health consequences across Latin America and the Caribbean in years to come. Our projections inform regional and federal health authorities, offering an opportunity to adapt to this public health challenge

Complement system activation contributes to the ependymal damage induced by microbial neuraminidase

Background In the rat brain, a single intracerebroventricular injection of neuraminidase from Clostridium perfringens induces ependymal detachment and death. This injury occurs before the infiltration of inflammatory blood cells; some reports implicate the complement system as a cause of these injuries. Here, we set out to test the role of complement. Methods The assembly of the complement membrane attack complex on the ependymal epithelium of rats injected with neuraminidase was analyzed by immunohistochemistry. Complement activation, triggered by neuraminidase, and the participation of different activation pathways were analyzed by Western blot. In vitro studies used primary cultures of ependymal cells and explants of the septal ventricular wall. In these models, ependymal cells were exposed to neuraminidase in the presence or absence of complement, and their viability was assessed by observing beating of cilia or by trypan blue staining. The role of complement in ependymal damage induced by neuraminidase was analyzed in vivo in two rat models of complement blockade: systemic inhibition of C5 by using a function blocking antibody and testing in C6-deficient rats. Results The complement membrane attack complex immunolocalized on the ependymal surface in rats injected intracerebroventricularly with neuraminidase. C3 activation fragments were found in serum and cerebrospinal fluid of rats treated with neuraminidase, suggesting that neuraminidase itself activates complement. In ventricular wall explants and isolated ependymal cells, treatment with neuraminidase alone induced ependymal cell death; however, the addition of complement caused increased cell death and disorganization of the ependymal epithelium. In rats treated with anti-C5 and in C6-deficient rats, intracerebroventricular injection of neuraminidase provoked reduced ependymal alterations compared to non-treated or control rats. Immunohistochemistry confirmed the absence of membrane attack complex on the ependymal surfaces of neuraminidase-exposed rats treated with anti-C5 or deficient in C6. Conclusions These results demonstrate that the complement system contributes to ependymal damage and death caused by neuraminidase. However, neuraminidase alone can induce moderate ependymal damage without the aid of complement

A genomic storm in critically injured humans

Critical injury in humans induces a genomic storm with simultaneous changes in expression of innate and adaptive immunity genes