Evaluation and validation of an RT-PCR assay for specific detection of monkeypox virus (MPXV).

Monkeypox virus (MPXV) is a zoonotic orthopoxvirus within the Poxviridae family. MPXV is endemic to Central and West Africa. However, the world is currently witnessing an international outbreak with no clear epidemiological links to travel or animal exposure and with ever-increasing numbers of reported cases worldwide. Here, we evaluated and validated a new, sensitive, and specific real-time PCR-assay for MPXV diagnosis in humans and compare the performance of this novel assay against a Food & Drug Administration-cleared pan-Orthopox RT-PCR assay. We determined specificity, sensitivity, and analytic performance of the PKamp™ Monkeypox Virus RT-PCR assay targeting the viral F3L-gene. In addition, we further evaluated MPXV-PCR-positive specimens by viral culture, electron microscopy, and viral inactivation assays. The limit of detection was established at 7.2 genome copies/reaction, and MPXV was successfully identified in 20 clinical specimens with 100% correlation against the reference method with 100% sensitivity and specificity. Our results demonstrated the validity of this rapid, robust, and reliable RT-PCR assay for specific and accurate diagnosis of MPXV infection in human specimens collected both as dry swabs and in viral transport media. This assay has been approved by NYS Department of Health for clinical use.

Training obstetrician gynaecologists in HIV PrEP (pre-exposure prophylaxis): a 2-year experience.

OBJECTIVE: We aimed to evaluate the efficacy of PrEP (pre-exposure prophylaxis) training sessions for OBGYN (obstetrician gynaecologist) providers given underutilisation of PrEP among women despite a high HIV burden. METHODS: Three separate training sessions were held for providers in the OBGYN department at an academic medical centre in New York City from 2019 to 2021. The 1-hour training sessions were conducted by HIV specialists as in-person lectures or online live lectures. Participants were surveyed after the training on metrics of PrEP awareness, knowledge and comfort with management. Two-sample t-tests were used to compare difference in proportions of binomial variables and difference in means of Likert-scored answers pretraining and post-training events. RESULTS: 63 respondents completed the surveys. There were low rates (13%) of past PrEP prescription among the respondents, while awareness of PrEP as an HIV prevention strategy was high before (95%) and after (98%) the training. After the training, there was an increase in understanding the epidemiology of HIV transmission (40% to 97%, p<0.00), familiarity with the PrEP clinical trials (18% to 97%, p<0.00), comfort in determining PrEP candidacy (mean score 2.3 to 4.1, p<0.00) and comfort prescribing PrEP (mean score 2.0 to 3.6, p<0.00). After the trainings, the majority of participants reported feeling 'comfortable' or 'very comfortable' in determining candidacy for PrEP and prescribing PrEP with follow-up. CONCLUSION: Implementation of PrEP training courses for OBGYN providers increased knowledge and comfort in identifying and managing patients who may benefit from PrEP services. Increasing training among OBGYN providers serving women at risk for HIV infection is an effective tool to narrow gaps in PrEP access.

Combining Text Messaging and Telephone Counseling to Increase Varenicline Adherence and Smoking Abstinence Among Cigarette Smokers Living with HIV: A Randomized Controlled Study.

Smoking represents an important health risk for people living with HIV (PLHIV). Low adherence to smoking cessation pharmacotherapy may limit treatment effectiveness. In this study, 158 participants recruited from three HIV care centers in New York City were randomized to receive 12-weeks of varenicline (Chantix) either alone as standard care (SC) or in combination with text message (TM) support or TM plus cell phone-delivered adherence-focused motivational and behavioral therapy (ABT). Generalized linear mixed-effect models found a significant decline in varenicline adherence from week 1-12 across treatment groups. At 12-weeks, the probability of smoking abstinence was significantly higher in SC+TM+ABT than in SC. The study demonstrates the feasibility of delivering adherence-focused interventions to PLHIV who smoke. Findings suggest intensive behavioral support is an important component of an effective smoking cessation intervention for this population, and a focus on improving adherence self-efficacy may lead to more consistent adherence and higher smoking abstinence.

Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study.

Understanding the nexus of aging, HIV, and substance use is key to providing appropriate services and support for their aging, HIV seropositive patients. The proportion of PLWHA aged 50 and older is growing due to a variety of factors like decreases in mortality due to highly active retroviral therapy and non-negligible HIV incidence. We describe prevalence of alcohol, tobacco, and other drug use and participation in substance use treatment and 12-step programs among 95 HIV-positive patients aged 50 and older engaged in care. Most (73.7%) smoked cigarettes in their lifetime and 46.3% were current smokers. Most were at medium (81.1%) or high risk (13.7%) for an alcohol use disorder. With respect to illicit drug use, 48.4% had used marijuana, cocaine, crack, methamphetamines, heroin, and/or prescription opiates without a prescription in the last 12 months; 23.2% met criteria for drug dependence. Marijuana was the most commonly reported illicit drug (32.6%) followed by cocaine and crack (10.5% each), heroin and prescription opiates (7.4% each), and methamphetamines (6.3%). Among those who had not used drugs in the past 12 months, 36.7% had been in a substance use treatment program and 26.5% had participated in a 12-step program in their lifetime; 8.2% were currently in treatment and 16.3% were currently participating in a 12-step program. Among those who had used an illicit drug in the past 12 months, 37.0% had never been in treatment, 34.8% had been in treatment in their lifetime, and 28.3% were currently in treatment. With respect to 12-step programs, 27.3% of those meeting dependence criteria had never participated, 45.5% had participated in their lifetimes, and 27.3% were currently participating. Our findings suggest that older adults in HIV care settings could benefit from Screening, Brief Intervention, and Referral to Treatment interventions and/or integrated services for substance abuse and medical treatment.

Work function engineering of ZnO electrodes by using p-type and n-type doped carbon nanotubes.

Transparent electrodes in organic electronic devices are strongly needed in order to replace indium tin oxide (ITO). Some of the best candidates are ZnO films, which have shown both good electronic properties and solution processability compatible with roll-to-roll production of the devices. We present the possibility to engineer the work function of ZnO by blending it with carbon nanotubes (CNTs). B-doped (p-type), N-doped (n-type) and undoped CNTs as well as their blends with ZnO have been characterized by atomic force microscopy (AFM), scanning Kelvin probe microscopy (SKPM) and Raman spectroscopy. The results of Raman spectroscopy demonstrate the substitutional doping of carbon nanotubes, which preserves their covalent structure although increasing the disorder within the nanotubes. The roughness and average shape of grains of ZnO when blended with the doped nanotubes have been measured by AFM. Finally, SKPM shows that the work function of the blends can be engineered from 4.4 ± 0.1 to 4.9 ± 0.1 eV according to the kind of nanotube that is blended even if only a small amount of nanotubes is added to the blend (0.08 wt%).

Clinical Characteristics and Outcomes of Patients With Mpox Who Received Tecovirimat in a New York City Health System.

Background: The 2022 global mpox outbreak was notable for transmission between persons outside of travel and zoonotic exposures and primarily through intimate contact. An understanding of the presentation of mpox in people with human immunodeficiency virus (HIV) and other immunocompromising conditions and knowledge of the efficacy of tecovirimat continue to evolve. Methods: This retrospective study describes clinical features and outcomes of persons with mpox who received tecovirimat. Data were obtained via medical record review of patients prescribed tecovirimat in a health system in New York City during the height of the outbreak in 2022. Results: One hundred thirty people received tecovirimat between 1 July and 1 October 2022. People with HIV (n = 80) experienced similar rates of recovery, bacterial superinfections, and hospitalization compared to patients without immunocompromising conditions. Individuals determined to be severely immunocompromised (n = 14) had a higher risk of hospitalization than those without severe immunocompromise (cohort inclusive of those with well-controlled HIV, excluding those without virologic suppression, n = 101): 50% versus 9% (P < .001). Hospitalized patients (n = 18 [13% of total]) were primarily admitted for bacterial superinfections (44.4%), with a median hospital stay of 4 days. Of those who completed follow-up (n = 85 [66%]), 97% had recovery of lesions at time of posttreatment assessment. Tecovirimat was well tolerated; there were no reported severe adverse events attributed to therapy. Conclusions: There were no significant differences in outcomes between people with HIV when evaluated as a whole and patients without immunocompromising conditions. However, mpox infection was associated with higher rates of hospitalization in those with severe immunocompromise, including patients with HIV/AIDS. Treatment with tecovirimat was well tolerated.Key Points: In our mpox cohort, people with HIV had similar rates of recovery and complications as those without HIV or other immunocompromising conditions. Severe immunocompromise was associated with a higher hospitalization rate. Tecovirimat was well tolerated, with minimal side effects.

Ending the Epidemic: Building Health Care Capacity Through HIV and HCV Preceptorship Programs.

Since 2015, Mount Sinai HIV/HCV Center of Excellence has implemented two-day HIV and HCV preceptorships for New York State health care. Participants assessed their knowledge of and confidence to perform 13 HIV or 10 HCV prevention- and treatment-related skills, measured on a 4-point Likert scale from "not at all" to "very" knowledgeable/confident at baseline, exit survey, and a recent evaluation. Wilcoxon signed rank sum tests determined mean differences at all three time points. Between baseline to exit assessment and baseline to evaluation assessment, HIV and HCV preceptorship attendees reported significant increases in knowledge for five HIV and three HCV components and confidence for two HIV and three HCV tasks (p < .05), respectively. The preceptorship significantly and positively impacted short-term and long-term knowledge and confidence around HCV and HIV clinical skills. The implementation of HIV and HCV preceptorship programs may increase HIV and HCV treatment and prevention service efficacy within key population areas.

Graphene Oxide: Key to Efficient Charge Extraction and Suppression of Polaronic Transport in Hybrids with Poly (3-hexylthiophene) Nanoparticles.

Nanoparticles (NPs) of conjugated polymers in intimate contact with sheets of graphene oxide (GO) constitute a promising class of water-dispersible nanohybrid materials of increased interest for the design of sustainable and improved optoelectronic thin-film devices, revealing properties exclusively pre-established upon their liquid-phase synthesis. In this context, we report for the first time the preparation of a P3HTNPs-GO nanohybrid employing a miniemulsion synthesis approach, whereby GO sheets dispersed in the aqueous phase serve as a surfactant. We show that this process uniquely favors a quinoid-like conformation of the P3HT chains of the resulting NPs well located onto individual GO sheets. The accompanied change in the electronic behavior of these P3HTNPs, consistently confirmed by the photoluminescence and Raman response of the hybrid in the liquid and solid states, respectively, as well as by the properties of the surface potential of isolated individual P3HTNPs-GO nano-objects, facilitates unprecedented charge transfer interactions between the two constituents. While the electrochemical performance of nanohybrid films is featured by fast charge transfer processes, compared to those taking place in pure P3HTNPs films, the loss of electrochromic effects in P3HTNPs-GO films additionally indicates the unusual suppression of polaronic charge transport processes typically encountered in P3HT. Thus, the established interface interactions in the P3HTNPs-GO hybrid enable a direct and highly efficient charge extraction channel via GO sheets. These findings are of relevance for the sustainable design of novel high-performance optoelectronic device structures based on water-dispersible conjugated polymer nanoparticles.

Short vs. Long-Distance Avocado Supply Chains: Life Cycle Assessment Impact Associated to Transport and Effect of Fruit Origin and Supply Conditions Chain on Primary and Secondary Metabolites.

Avocado consumption and trade are increasing worldwide, with North America and Europe being the main importing regions. Spain is the major European avocado producer (90% of the production), yet it only supplies 10% of the market. Consequently, more than 90% of the avocados consumed in Europe are imported from overseas, mainly from Chile and Peru. In this work, the Life Cycle Assessment (LCA) impact associated with the transport of two avocado supply chains (short (Spanish) and long (Chilean)) and the effect of the fruit origin and distance of both chains on primary and secondary metabolites from harvest to edible ripeness were evaluated using a gas chromatography-mass spectrometry (GC-MS) and liquid chromatography coupled to diode array detection (LC-DAD) based metabolite analysis. The LCA transport impact of the fresh supply chain from production centers in Chile (Quillota) and Spain (Malaga), and then the distribution to several cities in Europe, suggested road export from Spain to European capitals to have the lowest impact (0.14 to 0.22 kg CO2 eq/kg of avocado). When export from Chile was considered, the option of oceanic freight to European ports closer to final destinations was clearly a better option (0.21 to 0.26 kg CO2 eq/kg) than via the Algeciras port in Spain followed by road transport to final destinations in European capitals (0.34 to 0.43 kg CO2 eq/kg), although the situation could be somewhat different if the avocados are transported from the destination ports in northern Europe to long-distance capitals in other European countries. Fruit origin had a significant impact on avocado primary and secondary metabolites. The conditions of the supply chain itself (10 d in cold storage in regular conditions vs. 30 d cold storage + controlled atmosphere conditions) largely influence the fate of some metabolites that certainly affect the pool of metabolites at edible ripeness. The long-assumed hypothesis that the longer the supply chain the more negative impact on nutritional and functional compounds might not hold in this case, as long as transport conditions are adequate in terms of temperature, atmosphere conditions, and time considering distance from origin to destination.

Association between median household income, state Medicaid expansion status, and COVID-19 outcomes across US counties.

OBJECTIVE: To study the relationship between county-level COVID-19 outcomes (incidence and mortality) and county-level median household income and status of Medicaid expansion of US counties. METHODS: Retrospective analysis of 3142 US counties was conducted to study the relationship between County-level median-household-income and COVID-19 incidence and mortality per 100,000 people in US counties, January-20th-2021 through December-6th-2021. County median-household-income was log-transformed and stratified by quartiles. Multilevel-mixed-effects-generalized-linear-modeling adjusted for county socio-demographic and comorbidities and tested for Medicaid-expansion-times-income-quartile interaction on COVID-19 outcomes. RESULTS: There was no significant difference in COVID-19 incidence-rate across counties by income quartiles or by Medicaid expansion status. Conversely, for non-Medicaid-expansion states, counties in the lowest income quartile had a 41% increase in COVID-19 mortality-rate compared to counties in the highest income quartile. Mortality-rate was not related to income in counties from Medicaid-expansion states. CONCLUSIONS: Median-household-income was not related to COVID-19 incidence-rate but negatively related to COVID-19 mortality-rate in US counties of states without Medicaid-expansion.

Factors associated with high-grade Erectile Dysfunction (ED) in tuberculosis patients from a hospital in Lima, Peru. / Factores asociados a Disfunción Eréctil (DE) alto grado en pacientes con tuberculosis de un Hospital de Lima, Perú.

OBJECTIVE: To determine the prevalence and factors associated with high-grade ED in Lima, Peru. MATERIAL AND METHODS: Analytical cross-sectional study in tuberculosis patients treated in an out patient clinic of a public hospital in Lima, Peru in 2018. High grade SD was the dependent variable, using the IIEF-5 questionnaire and the independent variables were sexual orientation, history of previous pathology, location of tuberculosis, type of treatment scheme and presence of hemoptysis. Prevalence ratios (PR) were estimated using simple and multiple regression models. RESULTS: Of 189 patients, the majority presented pulmonary tuberculosis (98.9%), overweight (25.9%) and just over half had high-grade ED (52.9%). In the simple regression it was found that the factors associated with presenting high-grade SD were age in years (RP=1.11), reporting diabetes (RP=2.09), having multi-drug resistant TB (RP=1.51) and presenting a treatment time from 1 year to more (RP=1.87). In the multiple regression, the variables that were associated with a higher frequency of high-grade TB were age in years (RP=1.11), a history of diabetes (RP=1.66) and having MDR TB (RP=2.04). CONCLUSIONS: This study suggests a high prevalence of ED in patients with TB, where four out of ten presented high-grade ED. Being older, having a history of diabetes and using an MDR treatment were positively associated with the development of high-grade ED. Studies with designs close to causality are required to know the real magnitude of the influence of clinical and therapeutic characteristics on the development of high-grade ED.

OBJETIVO: Determinar la prevalencia y factores asociados a DE (disfunción eréctil) alto grado en Lima, Perú.MATERIAL Y MÉTODOS: Estudio transversal analítico en pacientes tuberculosos atendidos en consultorio externo de un hospital público de Lima, Perú en el 2018. La DE alto grado fue la variable dependiente, utilizando el cuestionario IIEF-5 y las variables independientes fueron la orientación sexual, historia de patología previa, localización de tuberculosis, tipo de esquema de tratamiento y presencia de hemoptisis. Se estimaron razones de prevalencia (RP) utilizando modelos de regresión simple y múltiple. RESULTADOS: De 189 pacientes, la mayoría presentaba tuberculosis pulmonar (98,9%), sobrepeso (25,9%) y poco más de la mitad tuvo DE alto grado (52,9%). En la regresión simple se encontró que los factores asociados a presentar DE alto grado fueron la edad en años (RP=1,11), reportar diabetes (RP=2,09), tener TB multidrogo-resistente (RP=1,51) y presentar un tiempo de tratamiento de 1 año a más (RP=1,87). En la regresión múltiple, las variables que se asociaron a una mayor frecuencia de TB alto grado fueron la edad en años (RP=1,11), el antecedente de diabetes (RP=1,66) y tenerTB MDR (tuberculosis multirresistente) (2,04). CONCLUSIONES: Este estudio sugiere una alta prevalencia de DE en pacientes con TB, donde cuatro de cada diez presentaron DE alto grado. Tener mayor edad, presentar antecedente de diabetes y utilizar untratamiento MDR se asociaron positivamente al desarrollo de DE alto grado. Se requieren estudios con diseños cercanos hacia la causalidad para conocer la magnitud real de la influencia de características clínicas y terapéuticas en el desarrollo de DE alto grado.

[Coinfection between dengue and covid-19: need for approach in endemic zones.] / Coinfección entre dengue y COVID-19: Necesidad de abordaje en zonas endémicas.

The impact caused by the 2019 coronavirus disease (COVID-19) in different parts of the world, currently reaches 745, 308 infected and 35,307 deaths according to the latest reports. In this context, in our country, an area of ​​epidemiological relevance is the Peruvian Amazon, due to the distribution of endemic diseases such as metaxemic diseases (Dengue, Malaria, among others), where the problem increases due to the COVID infection. -19 can lead to false positives in Dengue screening tests. Thus leading to a delay in the diagnosis of COVID-19 infection and further spread of the virus, since in most cases of Dengue there are no warning signs and treatment is ambulatory. This article seeks to express an opinion on the need to address cases of coinfection between Dengue and Covid-19 in endemic areas.

El impacto que ha originado la enfermedad por coronavirus 2019 (COVID-19) en diferentes partes del mundo, alcanza en la actualidad 597, 072 personas contagiadas y 27,364 fallecidas según los últimos reportes. En ese contexto, en nuestro país, una zona de relevancia epidemiológica es la amazonia peruana, debido a la distribución de enfermedades endémicas como las enfermedades metaxénicas (Dengue, Malaria entre otras), en donde el problema se incrementa debido a que la infección por COVID-19 puede llevar a falsos positivos en las pruebas de cribado para Dengue. Conllevando de esa forma a un retraso en el diagnóstico de la infección por COVID-19 y una mayor diseminación del virus, debido a que en la mayor parte de los casos de Dengue no se presentan signos de alarma y el tratamiento es ambulatorio. Este artículo busca emitir una opinión sobre la necesidad del abordaje de casos de coinfección entre Dengue y Covid-19 en zonas endémicas.

Reducing non-injection drug use in HIV primary care: A randomized trial of brief motivational interviewing, with and without HealthCall, a technology-based enhancement.

AIMS: In HIV-infected individuals, non-injection drug use (NIDU) compromises many health outcomes. In HIV primary care, the efficacy of brief motivational interviewing (MI) to reduce NIDU is unknown, and drug users may need greater intervention. We designed an enhancement to MI, HealthCall (HC), for daily patient self-monitoring calls to an interactive voice response (IVR) phone system, and provided participants with periodic personalized feedback. To reduce NIDU among HIV primary care patients, we compared the efficacy of MI+HealthCall to MI-only and an educational control condition. DESIGN: Participants age >18 with >4days of NIDU during the prior 30days were recruited from large urban HIV primary care clinics. Of the 240 participants, 83 were randomly assigned to control, 77 to MI-only, and 80 to MI+HC. Counselors provided educational control, MI-only or MI+HC at baseline. At 30 and 60days (end-of-treatment), counselors briefly discussed drug use, moods and health behaviors, using HealthCall-generated graphs with MI+HC patients. Primary outcomes (last 30days) were number of days used primary drug (NumDU), and total quantity of primary drug used (dollar amount spent; QuantU), derived from the Time-Line Follow-Back. FINDINGS: Across all groups, at end-of-treatment, frequency and quantity of NIDU decreased, with significantly greater reductions in the MI-Only group. A twelve-month post-treatment follow-up indicated sustained benefits of MI+HC and MI-only relative to control. CONCLUSIONS: Brief interventions can be successfully used to reduce non-injection drug use in HIV primary care. IVR-based technology may not be sufficiently engaging to be effective. Future studies should investigate mobile technology to deliver a more engaging version of HealthCall to diverse substance abusing populations.

Associations Between Neurocognitive Impairment and Biomarkers of Poor Physiologic Reserve in a Clinic-Based Sample of Older Adults Living with HIV.

Data from a cross-sectional study of a clinic-based sample of older people living with HIV (PLWH; n = 100) were used to examine associations between biomarkers of physical health and neurocognitive impairment (NCI). In this sample, anemia, chronic kidney disease (CKD) stages 4-5, and hypocalcemia were associated with impairment in executive functioning or processing speed. Furthermore, participants with anemia were more likely to have CD4+ T cell counts <200 cells/mm3 (χ2 [1] = 19.57, p < .001); hypocalcemia (χ2 [1] = 17.55, p < .001); and CKD 4-5 (χ2 [2] = 10.12, p = .006). Black and Hispanic participants were more likely to be anemic compared to other races and ethnicities (χ2 [3] = 12.76, p = .005). Common medical conditions (e.g., anemia, hypocalcemia, CKD) should be investigated as potential contributors to NCI in older PLWH. Additionally, laboratory testing in racial/ethnic minority PLWH may help inform NCI screening.

Crystal methamphetamine, its analogues, and HIV infection: medical and psychiatric aspects of a new epidemic.

The use of the recreational drug crystal methamphetamine among younger homosexual men is expanding, and with it, unsafe sex behaviors that increase the transmission of human immunodeficiency virus (HIV). This article reviews available literature on the medical and psychiatric morbidities associated with methamphetamine abuse in HIV-infected patients. Medical complications include hypertension, hyperthermia, rhabdoymyolysis, and stroke. One fatal case of ingestion of methamphetamine with HIV medication has been documented. Two fatal cases of ingestion of HIV medication with the amphetamine analogue n-methyl-3,4 methylenedioxymethamphetamine (MDMA, or "ecstasy") have also been reported. Some molecular researchers suggest that dopaminergic systems are vulnerable to the combined neurotoxicity of HIV infection and methamphetamine. Population surveys indicate high rates of HIV infection among methamphetamine abusers and high rates of unprotected anal intercourse during drug intoxication. Intoxication can sometimes produce paranoia, auditory hallucinations, and, occasionally, violent behavior. Amphetamine withdrawal commonly results in symptoms of depression. Methamphetamine is a new challenge related to treatment and prevention of HIV infection.

Microwave-assisted sidewall functionalization of single-wall carbon nanotubes by Diels-Alder cycloaddition.

The first Diels-Alder cycloaddition of o-quinodimethane to SWNT has been performed under microwave irradiation.

Cycloaddition of benzyne to SWCNT: towards CNT-based paddle wheels.

The cycloaddition of benzyne to SWCNT has been carried out for the first time. Raman spectroscopy, TGA, HR-TEM, UV-vis-NIR as well as XPS have been used for products characterization.

Acute renal failure after initiation of tenofovir disoproxil fumarate.

Despite initial evidence suggesting a relatively benign safety profile, several subsequent case reports have detailed nephrotoxicity in patients using tenofovir disoproxil fumarate for the treatment of HIV. We report a case of rapid renal failure that developed into an HIV-naïve patient initiated on an antiretroviral regimen that included tenofovir.