Clinic presentation delay and tuberculosis treatment outcomes in the Lake Victoria region of East Africa: A multi-site prospective cohort study.

In the Lake Victoria region of East Africa, little is known about delays between tuberculosis (TB) symptom onset and presentation at a clinic. Associations between clinic presentation delay and TB treatment outcomes are also poorly understood. In 2019, we abstracted data from routine TB treatment records for all adults (n = 776) initiating TB treatment in a 6-month period across 12 health facilities near Lake Victoria.

Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study.

Geographic mobility may disrupt continuity of care and contribute to poor clinical outcomes among people receiving treatment for tuberculosis (TB). This may occur especially where health services are not well coordinated across international borders, particularly in lower and middle income country settings. In this work, we describe mobility and the relationship between mobility and unfavorable TB treatment outcomes (i.

Optimizing SARS-CoV-2 Pooled Testing Strategies Through Differentiated Pooling for Distinct Groups.

Pooled testing has been successfully used to expand SARS-CoV-2 testing, especially in settings requiring high volumes of screening of lower-risk individuals, but efficiency of pooling declines as prevalence rises. We propose a differentiated pooling strategy that independently optimizes pool sizes for distinct groups with different probabilities of infection to further improve the efficiency of pooled testing. We compared the efficiency (results obtained per test kit used) of the differentiated strategy with a traditional pooling strategy in which all samples are processed using uniform pool sizes under a range of scenarios.

Five-Year Mortality for Adults Entering Human Immunodeficiency Virus Care Under Universal Early Treatment Compared With the General US Population.

Background: Mortality among adults with human immunodeficiency virus (HIV) remains elevated over those in the US general population, even in the years after entry into HIV care. We explore whether the elevation in 5-year mortality would have persisted if all adults with HIV had initiated antiretroviral therapy within 3 months of entering care.

Methods: Among 82 766 adults entering HIV care at North American AIDS Cohort Collaboration clinical sites in the United States, we computed mortality over 5 years since entry into HIV care under observed treatment patterns.

Racial/Ethnic and Age Differences in the Direct and Indirect Effects of the COVID-19 Pandemic on US Mortality.

To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of "excess" mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age.

HIV Prevalence and the HIV Treatment Cascade Among Female Sex Workers in Cross-Border Areas in East Africa.

In cross-border areas of East Africa, sexual networks include partnerships across resident, migrant, and mobile populations, and risky behaviors can coincide with fragmented health services given the challenges of cross-border coordination. Among those most at risk are female sex workers (FSWs). We map HIV prevalence among FSWs in 14 cross-border areas, estimate associations between FSW characteristics and HIV and undiagnosed HIV, and estimate progress towards the UNAIDS 90-90-90 targets.

Magnetic-Field Directed Vapor-Phase Assembly of Low Fractal Dimension Metal Nanostructures: Experiment and Theory.

While gas-phase synthesis techniques offer a scalable approach to production of metal nanoparticles, directed assembly is challenging due to fast particle diffusion rates that lead to random Brownian aggregation. This work explores an electromagnetic-levitation technique to generate metal nanoparticle aggregates with fractal dimension () below that of diffusion limited assembly. We demonstrate that in addition to levitation and induction heating, the external magnetic field is sufficient to compete with random Brownian forces, which enables the formation of altered fractals.

Modelling and simulation of field directed linear assembly of aerosol particles.

Unlike liquid phase colloidal assembly, significantly changing the structure of fractal aggregates in the aerosol phase, is considered impractical. In this study, we discuss the possibility of applying external magnetic and electric fields, to tune the structure and fractal dimension (D) of aggregates grown in the aerosol phase. We show that external fields can be used to induce dipole moments in primary nanoparticles.

Access to HIV prevention services in East African cross-border areas: a 2016-2017 cross-sectional bio-behavioural study.

Introduction: East African cross-border areas are visited by mobile and vulnerable populations, such as men, female sex workers, men who have sex with men, truck drivers, fisher folks and young women. These groups may not benefit from traditional HIV prevention interventions available at the health facilities where they live, but may benefit from services offered at public venues identified as places where people meet new sexual partners (e.g.

Transoral Versus Endoscopic Examination in Predicting Outcomes of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.

Objectives/hypothesis: To examine the correlation between transoral and awake endoscopic examination and investigate their respective ability to predict outcomes of hypoglossal nerve stimulation (HGNS).

Study Design: Retrospective cohort study at a US medical center.

Methods: Subjects were adults with apnea-hypopnea index (AHI) >15 events/hr who underwent HGNS according to standard indications.

Establishing rod shape from spherical, peptidoglycan-deficient bacterial spores.

Chemical-induced spores of the Gram-negative bacterium are peptidoglycan (PG)-deficient. It is unclear how these spherical spores germinate into rod-shaped, walled cells without preexisting PG templates. We found that germinating spores first synthesize PG randomly on spherical surfaces.

Success of Hypoglossal Nerve Stimulation Using Mandibular Advancement During Sleep Endoscopy.

Objectives/hypothesis: Hypoglossal nerve stimulation (HGNS) effectively treats obstructive sleep apnea in select patients. Drug-induced sleep endoscopy (DISE) is required for HGNS candidacy. Data suggest that mandibular advancement (MA) devices and HGNS share similar target populations.

Improving HIV outreach testing yield at cross-border venues in East Africa.

Objective: The aim of this study was to evaluate HIV testing yield under several candidate strategies for outreach testing at venues (i.e. places where people socialize and meet new sex partners) in East Africa cross-border areas.

Upper airway surgery to rescue the "untitratable" patient with OSA and obesity.

This is a case report of an 41-year-old male with obesity (body mass index 90 kg/m²), severe obstructive sleep apnea (OSA), and an apnea-hypopnea index of 90 events/h despite high bilevel positive airway pressure (BPAP). He presented to the PAP Alternatives Clinic and underwent tonsillectomy, expansion sphincter pharyngoplasty, and partial uvulectomy to improve positive airway pressure effectiveness. Postoperative BPAP retitration resolved the patient's OSA.

Estimating Hidden Population Sizes with Venue-based Sampling: Extensions of the Generalized Network Scale-up Estimator.

Background: Researchers use a variety of population size estimation methods to determine the sizes of key populations at elevated risk of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), an important step in quantifying epidemic impact, advocating for high-risk groups, and planning, implementing, and monitoring prevention, care, and treatment programs. Conventional procedures often use information about sample respondents' social network contacts to estimate the sizes of key populations of interest. A recent study proposes a generalized network scale-up method that combines two samples-a traditional sample of the general population and a link-tracing sample of the hidden population-and produces more accurate results with fewer assumptions than conventional approaches.

Multilevel Palate and Tongue Base Surgical Treatment of Obstructive Sleep Apnea: A Systematic Review and Meta-analysis.

Objective: To evaluate multilevel palate and tongue base surgery as a method of treatment of obstructive sleep apnea by comparing the pre- and postoperative apnea-hypopnea index.

Methods: We conducted a systematic review. MEDLINE and Embase databases were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for conducting systematic reviews.

The HIV care continuum among resident and non-resident populations found in venues in East Africa cross-border areas.

Introduction: HIV care and treatment in cross-border areas in East Africa face challenges perhaps not seen to the same extent in other geographic areas, particularly for mobile and migrant populations. Here, we estimate the proportion of people with HIV found in these cross-border areas in each stage of the HIV care and treatment cascade, including the proportion who knows their status, the proportion on treatment and the proportion virally suppressed.

Methods: Participants (n = 11,410) working or socializing in public places in selected East Africa cross border areas were recruited between June 2016 and February 2017 using the Priorities for Local AIDS Control Efforts method and administered a behavioural survey and rapid HIV test.

Calculating the rotational friction coefficient of fractal aerosol particles in the transition regime using extended Kirkwood-Riseman theory.

We apply our extended Kirkwood-Riseman theory to compute the translation, rotation, and coupling friction tensors and the scalar rotational friction coefficient for an aerosol fractal aggregate in the transition flow regime. The method can be used for particles consisting of spheres in contact. Our approach considers only the linear velocity of the primary spheres in a rotating aggregate and ignores rotational and coupling interactions between spheres.

Evaluation of Spacecraft Smoke Detector Performance in the Low-Gravity Environment.

In the interest of fire prevention, most materials used in the interior construction of manned spacecraft are non-flammable, however, they do produce smoke when overheated. Spacecraft smoke detectors will ideally detect smoke generated by oxidative pyrolysis (such as smoldering) in order to allow the maximum time for the crew to respond before a larger flaming fire develops. An experiment on the International Space Station (ISS) characterized smoke from overheating common spacecraft materials.

Objective and subjective scar aesthetics with topical Manuka honey post-thyroidectomy: A randomized control study.

Objective: Honey (Manuka honey) has proven to be effective in improving acute and chronic wound healing presumably due to its antibacterial and anti-inflammatory properties. The aim is to determine if Manuka honey decreases scar formation and results in a cosmetically appealing scar.

Methods: A prospective single-blinded randomized control trial was performed.

Friction factor for aerosol fractal aggregates over the entire Knudsen range.

We develop an approach for computing the hydrodynamic friction tensor and scalar friction coefficient for an aerosol fractal aggregate in the transition regime. Our approach involves solving the Bhatnagar-Gross-Krook equation for the velocity field around a sphere and using the velocity field to calculate the force on each primary sphere in the aggregate due to the presence of the other spheres. It is essentially an extension of Kirkwood-Riseman theory from the continuum flow regime to the entire Knudsen range (Knudsen number from 0.

Development and initial outcomes of an upper gastrointestinal multidisciplinary clinic.

Introduction: Patients with upper gastrointestinal cancer are often comorbid and require complex surgical treatments for their cancers, meaning that their preoperative assessment can be based around numerous outpatient assessments with multiple services. A multidisciplinary clinic (MDC) was developed for the assessment of patients with confirmed or suspected upper gastrointestinal cancers.

Methods: Face-to-face meetings were held between stakeholder services at Waitemata District Health Board, and clinic resource allocated.

Optimal detection of hypothyroidism in early stage laryngeal cancer treated with radiotherapy.

Background: Hypothyroidism following radiation therapy (RT) for treatment of Head and Neck Cancer (HNC) is a common occurrence. Rates of hypothyroidism following RT for Early Stage Laryngeal Squamous Cell Carcinoma (ES-LSCC) are among the highest. Although routine screening for hypothyroidism is recommended; its optimal schedule has not yet been established.