Public Health Outcomes as a Measure of Efficacy of Syringe Exchange Programs

Introduction. A syringe exchange is a public health intervention that offers nonjudgmental services to intravenous drug users (IVDU), providing clean syringes in exchange for used syringes. While prior studies demonstrated that syringe exchanges can reduce transmission of HIV, hepatitis C, and other blood-borne pathogens, other measures of health improvements have been less studied. Methods. 91 members of Vermont CARES syringe exchange program were surveyed on their healthcare practices. New members were defined asprogram. Results. Long-term members tended to have a primary care provider (PCP). Lack of insurance and fear of judgment were commonly cited reasons for not having a PCP. Long-term members were significantly less likely (p=0.04) to use costly emergency department (ED) services and less likely to reuse their own or another person\u27s needles. Long-term members were more likely to be in addiction treatment and reported a greater desire to abstain from drug use. New members were more likely to obtain hepatitis C and HIV testing in the past year. Discussion. Subjects responded positively to the possibility of accessing PCP services through VT CARES, offering a continuation of the nonjudgmental healthcare environment. Decreased ED visits significantly correlated with longer membership, reflecting the positive impact of the syringe exchange education services on reducing healthcare costs. Decreased testing among long-term members may reflect prior knowledge of their status. Long-term members were less likely to reuse their own needles or ones used by another person, suggesting the distribution of clean syringes encourages safer injection practices.https://scholarworks.uvm.edu/comphp_gallery/1247/thumbnail.jp

Midface Including Le Fort Level Injuries

Le Fort fractures occur at uniform weak areas in the midface often due to blunt impact to the face. Sporting injuries are a common cause of facial trauma; however, use of protective equipment has reduced the number of sports-related injuries. All patients with traumatic injuries should be evaluated using Advanced Trauma Life Support protocol. Le Fort fractures can contribute to airway obstruction, and urgent intubation may be indicated. Surgery is indicated for most displaced Le Fort fractures to restore function and facial harmony. To facilitate reduction, the original occlusive relationship should be restored by placing the patient in MMF

Facilitators and Barriers to Prescribing PreExposure Prophylaxis (PrEP) for the Prevention of HIV

Background: What is PrEP and who gets it? PrEP is the use of medication by individuals to prevent HIV contraction, approved in 2012 after demonstrating safety and efficacy in the iPrEx study and Partners PrEP2 trials. HIV infection risk is 92% lower in patients using PrEP. Truvada®, a combination of tenofovir and emtricitabine taken orally daily, is the only approved PrEP regimen and is intended to compliment other prevention strategies such as condoms. HIV negative-individuals at risk for exposure to HIV have been identified as men who have sex with men (MSM), IV drug users, heterosexuals who have unprotected sex with partners of unknown HIV status, and those in serodiscordant relationships. Barriers to PrEP Implementation PrEP is effective when patients adhere; however, both the medical community and some high-risk populations have been slow to adopt it as an HIV prevention strategy. Surveys have shown clinicians perceived barriers to PrEP such as adverse side effects, viral drug resistance, increased high-risk behavior, cost, and training. HIV in Vermont New diagnoses of HIV among Vermont residents has remained relatively stable over the last twenty years. Vermont CARES, a non-profit, offers free and anonymous HIV tests and in-person risk-reduction counseling. Clients are increasingly asking about PrEP as a prevention strategy, but the response from the medical community is difficult to ascertain.https://scholarworks.uvm.edu/comphp_gallery/1235/thumbnail.jp

E-QED: Electrical Bug Localization During Post-Silicon Validation Enabled by Quick Error Detection and Formal Methods

During post-silicon validation, manufactured integrated circuits are extensively tested in actual system environments to detect design bugs. Bug localization involves identification of a bug trace (a sequence of inputs that activates and detects the bug) and a hardware design block where the bug is located. Existing bug localization practices during post-silicon validation are mostly manual and ad hoc, and, hence, extremely expensive and time consuming. This is particularly true for subtle electrical bugs caused by unexpected interactions between a design and its electrical state. We present E-QED, a new approach that automatically localizes electrical bugs during post-silicon validation. Our results on the OpenSPARC T2, an open-source 500-million-transistor multicore chip design, demonstrate the effectiveness and practicality of E-QED: starting with a failed post-silicon test, in a few hours (9 hours on average) we can automatically narrow the location of the bug to (the fan-in logic cone of) a handful of candidate flip-flops (18 flip-flops on average for a design with ~ 1 Million flip-flops) and also obtain the corresponding bug trace. The area impact of E-QED is ~2.5%. In contrast, deter-mining this same information might take weeks (or even months) of mostly manual work using traditional approaches

Inhibition of the \u3cem\u3edapE\u3c/em\u3e-Encoded \u3cem\u3eN\u3c/em\u3e-Succinyl- ʟ, ʟ-diaminopimelic Acid Desuccinylase from \u3cem\u3eNeisseria meningitidis\u3c/em\u3e by ʟ-Captopril

Binding of the competitive inhibitor ʟ-captopril to the dapE-encoded N-succinyl-ʟ, ʟ-diaminopimelic acid desuccinylase from Neisseria meningitidis (NmDapE) was examined by kinetic, spectroscopic, and crystallographic methods. ʟ-Captopril, an angiotensin-converting enzyme (ACE) inhibitor, was previously shown to be a potent inhibitor of the DapE from Haemophilus influenzae (HiDapE) with an IC50 of 3.3 μM and a measured Ki of 1.8 μM and displayed a dose-responsive antibiotic activity toward Escherichia coli. ʟ-Captopril is also a competitive inhibitor of NmDapE with a Ki of 2.8 μM. To examine the nature of the interaction of ʟ-captopril with the dinuclear active site of DapE, we have obtained electron paramagnetic resonance (EPR) and magnetic circular dichroism (MCD) data for the enzymatically hyperactive Co(II)-substituted forms of both HiDapE and NmDapE. EPR and MCD data indicate that the two Co(II) ions in DapE are antiferromagnetically coupled, yielding an S = 0 ground state, and suggest a thiolate bridge between the two metal ions. Verification of a thiolate-bridged dinuclear complex was obtained by determining the three-dimensional X-ray crystal structure of NmDapE in complex with ʟ-captopril at 1.8 Å resolution. Combination of these data provides new insights into binding of ʟ-captopril to the active site of DapE enzymes as well as important inhibitor–active site residue interaction’s. Such information is critical for the design of new, potent inhibitors of DapE enzymes

Optimization by Quantum Annealing: Lessons from hard 3-SAT cases

The Path Integral Monte Carlo simulated Quantum Annealing algorithm is applied to the optimization of a large hard instance of the Random 3-SAT Problem (N=10000). The dynamical behavior of the quantum and the classical annealing are compared, showing important qualitative differences in the way of exploring the complex energy landscape of the combinatorial optimization problem. At variance with the results obtained for the Ising spin glass and for the Traveling Salesman Problem, in the present case the linear-schedule Quantum Annealing performance is definitely worse than Classical Annealing. Nevertheless, a quantum cooling protocol based on field-cycling and able to outperform standard classical simulated annealing over short time scales is introduced.Comment: 10 pages, 6 figures, submitted to PR

SAT-based Explicit LTL Reasoning

We present here a new explicit reasoning framework for linear temporal logic (LTL), which is built on top of propositional satisfiability (SAT) solving. As a proof-of-concept of this framework, we describe a new LTL satisfiability tool, Aalta\_v2.0, which is built on top of the MiniSAT SAT solver. We test the effectiveness of this approach by demonnstrating that Aalta\_v2.0 significantly outperforms all existing LTL satisfiability solvers. Furthermore, we show that the framework can be extended from propositional LTL to assertional LTL (where we allow theory atoms), by replacing MiniSAT with the Z3 SMT solver, and demonstrating that this can yield an exponential improvement in performance

Gender and sexual orientation differences in cognition across adulthood : age is kinder to women than to men regardless of sexual orientation

Despite some evidence of greater age-related deterioration of the brain in males than in females, gender differences in rates of cognitive aging have proved inconsistent. The present study employed web-based methodology to collect data from people aged 20-65 years (109,612 men; 88,509 women). As expected, men outperformed women on tests of mental rotation and line angle judgment, whereas women outperformed men on tests of category fluency and object location memory. Performance on all tests declined with age but significantly more so for men than for women. Heterosexuals of each gender generally outperformed bisexuals and homosexuals on tests where that gender was superior; however, there were no clear interactions between age and sexual orientation for either gender. At least for these particular tests from young adulthood to retirement, age is kinder to women than to men, but treats heterosexuals, bisexuals, and homosexuals just the same

Dynamics of Wetting Fronts in Porous Media

We propose a new phenomenological approach for describing the dynamics of wetting front propagation in porous media. Unlike traditional models, the proposed approach is based on dynamic nature of the relation between capillary pressure and medium saturation. We choose a modified phase-field model of solidification as a particular case of such dynamic relation. We show that in the traveling wave regime the results obtained from our approach reproduce those derived from the standard model of flow in porous media. In more general case, the proposed approach reveals the dependence of front dynamics upon the flow regime.Comment: 4 pages, 2 figures, revte