"To Me, Everybody Is infected": Understanding Narratives about HIV Risk among HIV-negative Black Men Who Have Sex with Men in the Deep South

For black MSM living in the Deep South, the intersection of sexuality, race, and geography impacts HIV risk substantially. Between July and September 2016, we conducted a qualitative study among HIV-negative black MSM in five southern cities in the US with elevated HIV prevalence. Analysis included assessment of interrater reliability, cluster analysis, and descriptive statistics. We enrolled 99 black MSM (mean age: 33.6; SD = 12.8; range: 17-68 years). Four overarching themes emerged: harboring fear of HIV and the internalization of HIV stigma; scrutinizing potential partners to assess riskiness and HIV status; embracing distance and isolation from those perceived as a threat to HIV status; and exhibiting self-efficacy toward HIV prevention and utilizing risk reduction strategies. Future HIV prevention efforts may benefit by balancing risk and deficit based strategies with those that emphasize resilience, address disenfranchisement via structural interventions, and assess and treat inherent trauma(s).

Limit on the Fierz Interference Term b from a Measurement of the Beta Asymmetry in Neutron Decay

In the standard model of particle physics, the weak interaction is described by vector and axial-vector couplings only. Nonzero scalar or tensor interactions would imply an additional contribution to the differential decay rate of the neutron, the Fierz interference term. We derive a limit on this hypothetical term from a measurement using spin-polarized neutrons. This method is statistically less sensitive than the determination from the spectral shape but features much cleaner systematics. We obtain a limit of b=0.017(21) at 68.27% C.L., improving the previous best limit from neutron decay by a factor of four.

HIV Prevention Via Mobile Messaging for Men Who Have Sex With Men (M-Cubed): Protocol for a Randomized Controlled Trial

Background

Men who have sex with men (MSM) continue to be the predominately impacted risk group in the United States HIV epidemic and are a priority group for risk reduction in national strategic goals for HIV prevention. Modeling studies have demonstrated that a comprehensive package of status-tailored HIV prevention and care interventions have the potential to substantially reduce new infections among MSM. However, uptake of basic prevention services, including HIV testing, sexually transmitted infection (STI) testing, condom distribution, condom-compatible lubricant distribution, and preexposure prophylaxis (PrEP), is suboptimal. Further, stronger public health strategies are needed to promote engagement in HIV care and viral load suppression among MSM living with HIV. Mobile health (mHealth) tools can help inform and encourage MSM regarding HIV prevention, care, and treatment, especially among men who lack access to conventional medical services. This protocol details the design and procedures of a randomized controlled trial (RCT) of a novel mHealth intervention that comprises a comprehensive HIV prevention app and brief, tailored text- and video-based messages that are systematically presented to participants based on the participants’ HIV status and level of HIV acquisition risk.

Objective

The objective of the RCT was to test the efficacy of the Mobile Messaging for Men (M-Cubed, or M3) app among at least 1200 MSM in Atlanta, Detroit, and New York. The goal was to determine its ability to increase HIV testing (HIV-negative men), STI testing (all men), condom use for anal sex (all men), evaluation for PrEP eligibility, uptake of PrEP (higher risk HIV-negative men), engagement in HIV care (men living with HIV), and uptake of and adherence to antiretroviral medications (men living with HIV). A unique benefit of this approach is the HIV serostatus-inclusiveness of the intervention, which includes both HIV-negative and HIV-positive MSM.

Methods

MSM were recruited through online and venue-based approaches in Atlanta, Detroit, and New York City. Men who were eligible and consented were randomized to the intervention (immediate access to the M3 app for a period of three months) or to the waitlist-control (delayed access) group. Outcomes were evaluated immediately postintervention or control period, and again three and six months after the intervention period. Main outcomes will be reported as period prevalence ratios or hazards, depending on the outcome. Where appropriate, serostatus/risk-specific outcomes will be evaluated in relevant subgroups. Men randomized to the control condition were offered the opportunity to use (and evaluate) the M3 app for a three-month period after the final RCT outcome assessment.

Results

M3 enrollment began in January 2018 and concluded in November 2018. A total of 1229 MSM were enrolled. Data collection was completed in September 2019.

Conclusions

This RCT of the M3 mobile app seeks to determine the effects of an HIV serostatus–inclusive intervention on the use of multiple HIV prevention and care-related outcomes among MSM. A strength of the design is that it incorporates a large sample and broad range of MSM with differing prevention needs in three cities with high prevalence of HIV among MSM.

Trial Registration

ClinicalTrials.gov NCT03666247; https://clinicaltrials.gov/ct2/show/NCT03666247

International Registered Report Identifier (IRRID)

DERR1-10.2196/16439

Measurement of the Weak Axial-Vector Coupling Constant in the Decay of Free Neutrons Using a Pulsed Cold Neutron Beam

We present a precision measurement of the axial-vector coupling constant g_{A} in the decay of polarized free neutrons. For the first time, a pulsed cold neutron beam was used for this purpose. By this method, leading sources of systematic uncertainty are suppressed. From the electron spectra we obtain λ=g_{A}/g_{V}=-1.27641(45)_{stat}(33)_{sys}, which confirms recent measurements with improved precision. This corresponds to a value of the parity violating beta asymmetry parameter of A_{0}=-0.11985(17)_{stat}(12)_{sys}. We discuss implications on the Cabibbo-Kobayashi-Maskawa matrix element V_{ud} and derive a limit on left-handed tensor interaction.

Constraints on the Dark Matter Interpretation n→χ+e^{+}e^{-} of the Neutron Decay Anomaly with the PERKEO II Experiment

Discrepancies from in-beam- and in-bottle-type experiments measuring the neutron lifetime are on the 4σ standard deviation level. In a recent publication Fornal and Grinstein proposed that the puzzle could be solved if the neutron would decay on the one percent level via a dark decay mode, one possible branch being n→χ+e^{+}e^{-}. With data from the Perkeo II experiment we set limits on the branching fraction and exclude a one percent contribution for 95% of the allowed mass range for the dark matter particle.

Gravity resonance spectroscopy constrains dark energy and dark matter scenarios

We report on precision resonance spectroscopy measurements of quantum states of ultracold neutrons confined above the surface of a horizontal mirror by the gravity potential of Earth. Resonant transitions between several of the lowest quantum states are observed for the first time. These measurements demonstrate that Newton's inverse square law of gravity is understood at micron distances on an energy scale of 10-14  eV. At this level of precision, we are able to provide constraints on any possible gravitylike interaction. In particular, a dark energy chameleon field is excluded for values of the coupling constant β>5.8×108 at 95% confidence level (C.L.), and an attractive (repulsive) dark matter axionlike spin-mass coupling is excluded for the coupling strength gsgp>3.7×10-16 (5.3×10-16) at a Yukawa length of λ=20  μm (95% C.L.).

Expression of AtMHX, an Arabidopsis vacuolar metal transporter, is repressed by the 5' untranslated region of its gene

AtMHX is an Arabidopsis tonoplast transporter that can exchange protons with Mg2+ and Zn2+ ions. This transporter, which may play a role in ion homeostasis of plants, is encoded by a single gene in Arabidopsis. The molecular mechanisms that regulate the expression of this transporter are practically unknown. While AtMHX transcript can be easily visualized, expression of the corresponding protein is apparently low. To understand whether AtMHX expression is repressed at the translational level, the 5' untranslated region (5' UTR) of this gene was fused to reporter genes. In vitro analyses showed that the 5' UTR of AtMHX can repress the translation of downstream coding sequences. The major cause of the repression was efficient initiation at an upstream open-reading-frame (uORF) included in the 5' UTR. Although the sequence context of the upstream AUG (uAUG) codon was highly unfavourable, it was recognized by over 90% of the scanning ribosomes both in vitro and in vivo. The inhibitory effect of the uORF was mediated by imposing the need for reinitiation and not by ribosome stalling, as the inhibition was not dependent on the amino-acid sequence of the uORF peptide. The efficiency of reinitiation was low. The in vivo studies, carried out with transiently transformed tobacco plants, indicated that alternations in the Mg2+ or Zn2+ levels did not affect the rate of translation. These data suggest that AtMHX expression is repressed by the 5' UTR of its gene.

Primary squamous cell carcinoma of the endometrium

All reported cases of primary squamous cell carcinoma of the endometrium and the effectiveness of the different treatment modalities in the world literature are reviewed. We present the first reported case of primary squamous cell carcinoma of the endometrium treated by radical hysterectomy, pelvic and para-aortic lymphadenectomy. The patient is without signs of disease 4 years after surgery. This is the longest follow-up of all reported cases. There are very few cases from which is to conclusively predict the best mode of therapy. The current standard of treatment is total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without pelvic and para-aortic lymph node sampling, depending on the histology and depth of the myometrial invasion. Adjuvant therapy includes radiation therapy according to the extent of disease.

Laparoscopic retrieval of a migrating intrapelvic pin: case report and review of the literature

Migration of orthopedic implants is a well documented phenomenon. Prompt recognition and immediate retrieval may prevent significant and potentially fatal sequelae. The following report describes a unique case in which laparoscopic techniques were successfully used to recover a migrating intrapelvic pin.

Blood pressure and salt intake in Malawi: an urban rural study

A significant difference between the blood pressures of rural and urban Malawians was found in both sexes, was present at the age of 15 years, and was associated with obesity but not with smoking, alcohol consumption, occupation or housing. Pulse rate was significantly lower in the urban group. These differences were accompanied by low potassium and sodium intake although the sodium intake in the urban group was double that in the rural group. No direct relation between blood pressure and urinary electrolytes was found.