PrEP for people who use opioids: A NIDA clinical trials network survey study in Southern U.S. cities where HIV incidence is high.

BACKGROUND: People who use opioids (PWUO) are at increased risk for HIV. Pre-exposure prophylaxis (PrEP) is effective but underutilized as HIV prevention among PWUO. This study examined predictors of willingness to take daily oral PrEP and long-acting injectable (LAI) PrEP among PWUO across eight Southern urban cities with high HIV incidence. METHODS: HIV-negative PWUO (N = 308) seeking services in community-based programs participated in this cross-sectional survey study. Measures included demographics, sexual risk behavior, substance use frequency, and awareness of and willingness to take oral and injectable PrEP. Data were analyzed using mixed-effects models. RESULTS: Willingness to take daily oral and LAI PrEP was moderately high (69.16% and 62.02%, respectively). Half had heard of PrEP, but only 4% had ever taken it. Only education and condomless vaginal sex predicted willingness to take oral PrEP. Only education predicted willingness to take LAI PrEP. Polysubstance use was prevalent, with substantial proportions of PWUO reporting frequent use of injection drugs (opioids or stimulants, 79.5%), non-injection opioids (73.3%), non-injection stimulants (71.1%), cannabis (62.6%), and hazardous drinking (29.6%). About 20% reported past-year condomless anal sex, and one-third reported past-year condomless vaginal sex. CONCLUSIONS: PWUO in this study were amenable to PrEP, particularly in light of education and condomless vaginal sex. Careful consideration for matching PrEP messaging to the PWUO audience is needed. PrEP promotion should expand beyond men who have sex with men to include groups such as these predominantly heterosexual, polysubstance-using PWUO with HIV risk who were open to both formulations of PrEP.

Perry syndrome: Novel DCTN1 mutation in a large kindred and first observation of prodromal disease.

INTRODUCTION: Perry syndrome (PS) is a hereditary neurodegenerative disorder caused by mutations in the DCTN1 gene and characterized by TDP-43 pathology. As the diagnosis is usually made at the advanced stages of the disease, there are no studies on the asymptomatic mutation carriers and their conversion to overt disease. METHODS: We personally examined 27 members of the large kindred of 104 individuals with familial parkinsonism. We evaluated each case with clinical (neurological examination; motor and non-motor scales), genetic testing (whole-exome or Sanger sequencing), and laboratory (neurofilament light, NFL; glial fibrillary acidic protein, GFAP) measures. Autopsy study was done on two individuals. RESULTS: The mean age at evaluation was 49 years. Comorbidities were present in 20 cases, including sleep problems (n = 15 total, sleep apnea in 7), dysautonomia (n = 10), weight loss (n = 8), and anxiety/depression (n = 8). Neurological abnormalities were present in 18, including parkinsonism (n = 7), isolated tremor (n = 2), and varied isolated signs in individual cases. Cognition and smell were preserved. Genetic testing revealed a novel c.200G > T (Gly67Val) mutation in the DCTN1 gene in 10 individuals. The mutation, segregated with the PS phenotype (n = 4), was absent in gnomAD, and in silico predictions indicated it was pathogenic. Three young mutation carriers were monosymptomatic (prodromal), and three were asymptomatic. Plasma NFL and GFAP values were similar among the cases. Autopsy studies showed typical PS neuropathological findings. CONCLUSIONS: We identified a novel pathogenic Gly67Val DCTN1 mutation. We report prodromal disease of PS in some mutation carriers; however, more investigation is necessary to confirm this observation.

Evaluation of the bio-drying process of municipal solid waste using rotating drums Bio-drying rotary drum.

Most of the municipal solid waste collected is disposed of in landfills and controlled landfills. However, efficient ways of recovering these wastes have emerged, such as bio-drying. This technique uses the exothermic degradation reaction of organic matter carried out by microorganisms along with aeration to reduce the moisture of the waste. The objective of the research was to test the bio-drying technique in a rotary drum. For this purpose, three rotary drums were built, and the tested residue was synthetically produced. The aeration rate tested was 1 liter per kilogram per minute, and rotation was performed for one minute every three hours. The analyses performed on the residues were moisture content, volatile solids, calorific value, particle size, and temperature profile. The residues entered the bio-drying process with a moisture content of 52%, 49%, and 54% and went out with 15%, 13%, and 10% for drum 1, 2, and 3, respectively, a reduction of more than 70%. The calorific value increased by 95%, 88%, and 122% for drum 1, 2, and 3, respectively. During the process, no leachate generation was observed.

Barreira capilar construida com residuo pre-tratado mecanica e biologicamente / Capillary barrier constructed with mechanical biological treatment waste

O controle da entrada de água de chuva no interior do aterro de resíduos sólidos urbanos durante sua construção e após seu fechamento é crucial para manter o controle da geração de lixiviado. Este fator pode contribuir para a elevação de gastos com tratamento e monitoramento e para a instabilidade mecânica do aterro. Por esta razão, o sistema de cobertura final de um aterro de resíduos sólidos urbanos é decisivo ao controle da entrada de água no mesmo. Na maioria dos casos, o sistema de cobertura final é composto por solo compactado. Frequentemente, um solo adequado para a cobertura não é encontrado nos arredores do aterro; portanto, recursos têm que ser despendidos para o transporte do mesmo até o devido local. Uma alternativa seria a utilização de uma barreira capilar construída com resíduos pré-tratados mecânica e biologicamente. No entanto, o uso deste material para esta construção ainda não foi bem estudado, e as diversas variáveis envolvidas no funcionamento de uma barreira capilar construída com resíduos sólidos pré-tratados mecânica e biologicamente são desconhecidas. O objetivo deste trabalho foi analisar os parâmetros envolvidos no funcionamento de uma barreira capilar construída exclusivamente de resíduos sólidos urbanos pré-tratados mecânica e biologicamente. Observou-se que este utilizado como material de uma barreira capilar pode funcionar de maneira equivalente àquela construída com solo, sendo boa a sua capacidade de retenção da água de chuva.

The control of rainwater entry into the municipal solid waste landfill during its construction and after its closure is crucial to keep track of leachate generation. This is a factor that may contribute to the increase of costs on treatment and monitoring and to the mechanical instability of the landfill. For this reason, the final cover system of a municipal solid waste landfill is critical for controling the water entering into the landfill. In most cases, the final cover system is made of compacted soil. Often, suitable soil for landfilling is not found in its surroundings, and resources must be expended in transporting the soil to the landfill site. An alternative would be to use a capillary barrier constructed with mechanical and biologically pretreated waste. However, the use of this material to construct capillary barriers has not been studied and several variables involved in the operation of a capillary barrier constructed with municipal solid mechanical and biologically pretreated waste landfill are unknown. The objective of this study was to analyze the parameters involved in the operation of a capillary barrier built exclusively solid waste pre-treated mechanically and biologically. It was observed that the MSW MBT used as a capillary barrier material may function similarly to that constructed with soil, with a good capacity for rain water retention.