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Purpose of Review Pre-exposure prophylaxis (PrEP) represents one of the most effective methods of prevention for HIV, but remains inequitable, leaving many transgender and nonbinary (trans) individuals unable to benefit from this resource. Deploying community-engaged PrEP implementation strategies for trans populations will be crucial for ending the HIV epidemic. Recent Findings While most PrEP studies have progressed in addressing pertinent research questions about gender-affirming care and PrEP at the biomedical and clinical levels, research on how to best implement gender-affirming PrEP systems at the social, community, and structural levels remains outstanding. Summary The science of community-engaged implementation to build gender-affirming PrEP systems must be more fully developed. Most published PrEP studies with trans people report on outcomes rather than processes, leaving out important lessons learned about how to design, integrate, and implement PrEP in tandem with gender-affirming care. The expertise of trans scientists, stakeholders, and trans-led community organizations is essential to building gender-affirming PrEP systems.

The need to increase the power density of traction inverters for the electrified transportation systems offers an opportunity to adopt silicon carbide (SiC) devices. To ensure the system reliability, it is critical to select a SiC power module that can dissipate a sufficient amount of power to avoid operating beyond the maximum allowed junction temperature. In this work, a comprehensive electro-thermal characterization procedure based on the virtual junction temperature concept is proposed to characterize the module’s maximum power dissipation as a function of coolant temperature. Using the characterization results, it is feasible to determine the module’s safe operating area for a traction application in terms of the switching frequency and the coolant temperature. The proposed characterization method is demonstrated on a custom 1200-V SiC module to validate its feasibility for an 800-V, 150-kVA traction inverter system. In addition, the design approach for a low-inductance bussing structure using heavy copper printed circuit board (PCB) is presented in this work, which leads to a snubberless, compact and low-cost system design. Measurements and experimental studies have been performed to validate the effectiveness of PCB bussing design. The overall volume of the inverter system is around 1.75 L, which leads to a volumetric power density of 86 kVA/L.

IntroductionEmerging evidence indicates that the COVID-19 pandemic, and the responses it has generated, have had disproportionate impacts on lesbian, gay, bisexual, transgender and queer (LGBTQ+) communities. This study seeks to build on existing information and provide regional insight.MethodsIn response, a cross-sectional survey was administered to a global sample of LGBTQ+ individuals (n=13 358) between 16 April and 20 May 2020 via the social networking application Hornet. The survey contained questions that characterise the impact of COVID-19 and associated mitigation strategies on economics, employment, mental health and access to healthcare.Results5191 (43.9%) individuals indicated they were somewhat, slightly or unable to meet basic needs with their current income, while 2827 (24.1%) and 4710 (40.1%) felt physically or emotionally unsafe in their living environment, respectively. 2202 individuals (24.7%) stated they are at risk for losing health insurance coverage. 2685 (22.7%) persons reported having skipped or cut meals as there was not enough money.ConclusionMany LGBTQ+persons who responded reported adverse consequences to mental health, economics, interruptions to care and lack of support from their government. This data is part of ongoing analyses but accentuates the unique needs of LGBTQ+ communities that will require targeted, ameliorative approaches.

BackgroundTesting for COVID-19 and linkage to services is fundamental to successful containment and control of transmission. Yet, knowledge on COVID-19 testing among transgender and non-binary communities remains limited.MethodsBetween October 2020 and November 2020, we examined the prevalence and associations of COVID-19 testing in an online sample of transgender and non-binary people (n=536). Multivariable hierarchical logistic regression analyses examined associations between COVID-19 testing and participants’ sociodemographic, mental health, substance use, gender affirmation, economic changes and healthcare experiences.ResultsPrevalence of COVID-19 testing in this sample was 35.5% (n=190/536). In the final model, transgender and non-binary participants from upper socioeconomic income background and Europe, who reported having active alcohol use disorder, limited access to gender-affirming surgery, had more than 20% reduction in income, and experienced mistreatment in a health facility due to gender identity had significantly increased odds of COVID-19 testing (all pConclusionsThese findings highlight structural disparities in COVID-19 testing and reinforce the importance of increasing testing strategies for transgender and non-binary populations.

ObjectivesTo characterise the extent to which the levels of violence and discrimination against lesbian, gay, bisexual, transgender and queer (LGBTQ+) people have changed amid COVID-19.DesignCross-sectional, secondary analysis.Setting79 countries.ParticipantsAll adults (aged ≥18 years) who used the Hornet social networking application and provided consent to participate.Main outcome measureThe main outcome was whether individuals have experienced less, or the same or more levels of discrimination and violence from specific groups (eg, police and/or military, government representatives, healthcare providers).Results7758 LGBTQ+ individuals provided responses regarding levels of discrimination and violence. A majority identified as gay (78.95%) and cisgender (94.8%). Identifying as gay or queer was associated with increased odds of experiencing the same or more discrimination from government representatives (OR=1.89, 95% CI 1.04 to 3.45, p=0.045) and healthcare providers (OR=2.51, 95% CI 0.86 to 7.36, p=0.002) due to COVID-19. Being a member of an ethnic minority was associated with increased odds of discrimination and violence from police and/or military (OR=1.32, 95% CI 1.13 to 1.54, p=0.0) and government representatives (OR=1.47, 95% CI 1.29 to 1.69, p=0.0) since COVID-19. Having a disability was significantly associated with increased odds of violence and discrimination from police and/or military (OR=1.38, 95% CI 1.15 to 1.71, p=0.0) and healthcare providers (OR=1.35, 95% CI 1.07 to 1.71, p=0.009).ConclusionsOur results suggest that despite the upending nature of the COVID-19 pandemic, around the world, government representatives, policymakers and healthcare providers continue to perpetuate systemic discrimination and fail to prevent violence against members of the LGBTQ+ community.

Background HIV services, like many medical services, have been disrupted by the COVID-19 pandemic. However, there are limited data on the impacts of the COVID-19 pandemic on HIV treatment engagement outcomes among transgender (trans) and nonbinary people. This study addresses a pressing knowledge gap and is important in its global scope, its use of technology for recruitment, and focus on transgender people living with HIV. The objective of this study is to examine correlates of HIV infection and HIV treatment engagement outcomes (i.e., currently on ART, having an HIV provider, having access to HIV treatment without burden, and remote refills) since the COVID-19 pandemic began. Methods We utilized observational data from the Global COVID-19 Disparities Survey 2020, an online study that globally sampled trans and nonbinary people (n = 902) between April and August 2020. We conducted a series of multivariable logistic regressions with lasso selection to explore correlates of HIV treatment engagement outcomes in the context of COVID-19. Results Of the 120 (13.3%) trans and nonbinary people living with HIV in this survey, the majority (85.8%) were currently on HIV treatment. A smaller proportion (69.2%) reported having access to an HIV provider since COVID-19 control measures were implemented. Less than half reported being able to access treatment without burdens related to COVID-19 (48.3%) and having the ability to remotely refill HIV prescription (44.2%). After adjusting for gender in the multivariable models, younger age and anticipated job loss were significantly associated with not having access to HIV treatment without burden. Outcomes also significantly varied by geographic region, with respondents reporting less access to an HIV provider in nearly every region outside of South-East Asia. Conclusion Our results suggest that currently taking ART, having access to an HIV provider, and being able to access HIV treatment without burden and remotely refill HIV medication are suboptimal among trans and nonbinary people living with HIV across the world. Strengthening support for HIV programs that are well-connected to trans and nonbinary communities, increasing remote access to HIV providers and prescription refills, and providing socioeconomic support could significantly improve HIV engagement in trans and nonbinary communities.

There is an urgent need to measure the impacts of COVID-19 among gay men and other men who have sex with men (MSM). We conducted a cross-sectional survey with a global sample of gay men and other MSM (n = 2732) from April 16, 2020 to May 4, 2020, through a social networking app. We characterized the economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response, and examined whether sub-groups of our study population are disproportionately impacted by COVID-19. Many gay men and other MSM not only reported economic and mental health consequences, but also interruptions to HIV prevention and testing, and HIV care and treatment services. These consequences were significantly greater among people living with HIV, racial/ethnic minorities, immigrants, sex workers, and socio-economically disadvantaged groups. These findings highlight the urgent need to mitigate the negative impacts of COVID-19 among gay men and other MSM.Existe una necesidad urgente para medir los impactos de COVID-19 entre hombres gay y otros hombres que tienen sexo con hombres (HSH). Hemos conducido una encuesta multifuncional con una prueba mundial de hombres gay y otros HSH (n = 2732) desde el 16 de Abril hasta el 4 de Mayo del 2020, a través de una aplicación de red social. Nosotros caracterizamos los impactos económicos, de salud mental, prevención del VIH y tratamiento del VIH e impactos a COVID-19 y la respuesta de COVID-19, y examinamos si subgrupos de nuestra población de estudio fueron impactados desproporcionadamente por COVID-19. Muchos hombres no tan solo reportaron consecuencias económicas y de salud mental, sino también interrupciones de prevención y de pruebas de VIH, y cuidado del VIH y servicios de tratamiento. Encontramos consecuencias más significantes entre personas viviendo con VIH, grupos raciales/etnicos, migrantes, sexo servidores, y groupos socioeconomicamente disfavorecidos. Los resultados subrayan la necesidad crucial de mitigar los impactos multifacéticos de COVID-19 entre los hombres homosexuales y otros HSH, especialmente para aquellos con vulnerabilidades entrelazadas.

Background The coronavirus pandemic has necessitated a range of population-based measures to stem the spread of infection. These measures may be associated with disruptions to other health services including for gay, bisexual, and other men who have sex with men (MSM) at risk for or living with HIV. Here, we assess the relationship between stringency of COVID-19 control measures and interruptions to HIV prevention and treatment services for MSM. Setting Data for this study were collected between April 16, 2020, and May 24, 2020, as part of a COVID-19 Disparities Survey implemented by the gay social networking app, Hornet. Pandemic control measures were quantified using the Oxford Government Response Tracker Stringency Index: each country received a score (0-100) based on the number and strictness of 9 indicators related to restrictions, closures, and travel bans. Methods We used a multilevel mixed-effects generalized linear model with Poisson distribution to assess the association between stringency of pandemic control measures and access to HIV services. Results A total of 10,654 MSM across 20 countries were included. Thirty-eight percent (3992/10,396) reported perceived interruptions to in-person testing, 55% (5178/9335) interruptions to HIV self-testing, 56% (5171/9173) interruptions to pre-exposure prophylaxis, and 10% (990/9542) interruptions to condom access. For every 10-point increase in stringency, there was a 3% reduction in the prevalence of perceived access to in-person testing (aPR: 0·97, 95% CI: [0·96 to 0·98]), a 6% reduction in access to self-testing (aPR: 0·94, 95% CI: [0·93 to 0·95]), and a 5% reduction in access to pre-exposure prophylaxis (aPR: 0·95, 95% CI: [0·95 to 0·97]). Among those living with HIV, 20% (218/1105) were unable to access their provider; 65% (820/1254) reported being unable to refill their treatment prescription remotely. Conclusions More stringent responses were associated with decreased perceived access to services. These results support the need for increasing emphasis on innovative strategies in HIV-related diagnostic, prevention, and treatment services to minimize service interruptions during this and potential future waves of COVID-19 for gay men and other MSM at risk for HIV acquisition and transmission.

Background The traditional model of promotion and tenure in the health professions relies heavily on formal scholarship through teaching, research, and service. Institutions consider how much weight to give activities in each of these areas and determine a threshold for advancement. With the emergence of social media, scholars can engage wider audiences in creative ways and have a broader impact. Conventional metrics like the h-index do not account for social media impact. Social media engagement is poorly represented in most curricula vitae (CV) and therefore is undervalued in promotion and tenure reviews. Objective The objective was to develop crowdsourced guidelines for documenting social media scholarship. These guidelines aimed to provide a structure for documenting a scholar’s general impact on social media, as well as methods of documenting individual social media contributions exemplifying innovation, education, mentorship, advocacy, and dissemination. Methods To create unifying guidelines, we created a crowdsourced process that capitalized on the strengths of social media and generated a case example of successful use of the medium for academic collaboration. The primary author created a draft of the guidelines and then sought input from users on Twitter via a publicly accessible Google Document. There was no limitation on who could provide input and the work was done in a democratic, collaborative fashion. Contributors edited the draft over a period of 1 week (September 12-18, 2020). The primary and secondary authors then revised the draft to make it more concise. The guidelines and manuscript were then distributed to the contributors for edits and adopted by the group. All contributors were given the opportunity to serve as coauthors on the publication and were told upfront that authorship would depend on whether they were able to document the ways in which they met the 4 International Committee of Medical Journal Editors authorship criteria. Results We developed 2 sets of guidelines: Guidelines for Listing All Social Media Scholarship Under Public Scholarship (in Research/Scholarship Section of CV) and Guidelines for Listing Social Media Scholarship Under Research, Teaching, and Service Sections of CV. Institutions can choose which set fits their existing CV format. Conclusions With more uniformity, scholars can better represent the full scope and impact of their work. These guidelines are not intended to dictate how individual institutions should weigh social media contributions within promotion and tenure cases. Instead, by providing an initial set of guidelines, we hope to provide scholars and their institutions with a common format and language to document social media scholarship.

BACKGROUND The traditional model of promotion and tenure in the health professions relies heavily on formal scholarship through teaching, research, and service. Institutions consider how much weight to give activities in each of these areas and determine a threshold for advancement. With the emergence of social media, scholars can engage wider audiences in creative ways and have a broader impact. Conventional metrics like the h-index do not account for social media impact. Social media engagement is poorly represented in most curricula vitae (CV) and therefore is undervalued in promotion and tenure reviews. OBJECTIVE The objective was to develop crowdsourced guidelines for documenting social media scholarship. These guidelines aimed to provide a structure for documenting a scholar’s general impact on social media, as well as methods of documenting individual social media contributions exemplifying innovation, education, mentorship, advocacy, and dissemination. METHODS To create unifying guidelines, we created a crowdsourced process that capitalized on the strengths of social media and generated a case example of successful use of the medium for academic collaboration. The primary author created a draft of the guidelines and then sought input from users on Twitter via a publicly accessible Google Document. There was no limitation on who could provide input and the work was done in a democratic, collaborative fashion. Contributors edited the draft over a period of 1 week (September 12-18, 2020). The primary and secondary authors then revised the draft to make it more concise. The guidelines and manuscript were then distributed to the contributors for edits and adopted by the group. All contributors were given the opportunity to serve as coauthors on the publication and were told upfront that authorship would depend on whether they were able to document the ways in which they met the 4 International Committee of Medical Journal Editors authorship criteria. RESULTS We developed 2 sets of guidelines: Guidelines for Listing All Social Media Scholarship Under Public Scholarship (in Research/Scholarship Section of CV) and Guidelines for Listing Social Media Scholarship Under Research, Teaching, and Service Sections of CV. Institutions can choose which set fits their existing CV format. CONCLUSIONS With more uniformity, scholars can better represent the full scope and impact of their work. These guidelines are not intended to dictate how individual institutions should weigh social media contributions within promotion and tenure cases. Instead, by providing an initial set of guidelines, we hope to provide scholars and their institutions with a common format and language to document social media scholarship.

BackgroundGlobally, the coronavirus pandemic has necessitated a range of population-based measures in order to stem the spread of infection and reduce COVID-19-related morbidity and mortality. These measures may be associated with disruptions to other health services including for gay, bisexual, and other men who have sex with men (MSM) at risk for or living with HIV. Here, we assess the relationship between stringency of COVID-19 mitigation strategies and interruptions to HIV prevention and treatment services for MSM.MethodsData for this study were collected as part of a COVID-19 Disparities Survey implemented by the gay social networking app Hornet, with data collected between April 16th, 2020 and May 24th, 2020. Data were assessed for countries where at least 50 participants completed the survey, to best evaluate country-level heterogeneity. We used a modified Poisson regression model, with clustering at the country-level, to assess the association between stringency of pandemic control measures and access to HIV services. Pandemic control measures were quantified using the Oxford Government Response Tracker Stringency Index; each country received a score (0-100) based on the number and strictness of nine indicators related to school and workplace closures and travel bans.ResultsA total of 10,654 MSM across 20 countries were included in these analyses. The mean age was 34.2 (standard deviation: 10.8), and 12% (1264/10540) of participants reported living with HIV. The median stringency score was 82.31 (Range:[19.44, Belarus]-[92.59, Ukraine]). For every ten-point increase in stringency, there was a 3% reduction in the prevalence of access to in-person testing (aPR: 0.97, 95% Cl:[0.96, 0.98]), a 6% reduction in the prevalence of access to self-testing (aPR: 0.94, 95% Cl:[0.93, 0.95]), and a 5% reduction in access to PrEP (aPR: 0.95, 95% Cl:[0.95, 0.97]). Among those living with HIV, close to one in five (n = 218/1105) participants reported being unable to access their provider either in-person or via telemedicine during the COVID-19 pandemic, with a greater proportion of interruptions to treatment services reported in Belarus and Mexico. Almost half (n = 820/1254) reported being unable to refill their HIV medicine prescription remotely.ConclusionsMore stringent government responses were associated with decreased access to HIV diagnostic, prevention, and treatment services. To minimize increases in HIV-related morbidity and mortality, innovative strategies are needed to facilitate minimize service interruptions to MSM communities during this and potential future waves of COVID-19.

Utilizing data collected by the Monitoring the Future project between 2005-2015, this study assesses the effect of risk and protective factors in shaping the graduation expectations of urban American Indian/Alaska Native (AI/AN) students as compared to their non-Hispanic White (NHW) peers. The responses of nearly 150,000 8th- and 10th-grade students reveal that single race and multi-race AI/AN students experienced 13 of 15 risk factors at higher proportions than NHW students, and 12 of 15 risk factors corresponded to single race AI/AN students and a third of risk factors corresponded to multi-race AI/AN students having higher odds of expecting not to graduate. Additionally, for the majority of the 14 protective factors analyzed, both single race and multi-race AI/AN students showed lower odds of expecting to graduate compared to their NHW peers.

The requirements on volumetric density of power electronic converters in electric vehicles are increasing, since more space is needed for electronic systems and passenger capacity. The U.S. Department of Energy (DOE) has set the 2020 target for vehicular power electronic systems as 13.4 kW/l. Achieving high power density using commercial off-the-shelf (COTS) parts is challenging because these components have various form factors leading to unused spaces, as well as cooling and airflow issues. In this work, a high-power-density traction inverter, rated at 50-kW with the peak power at 74-kW, is designed and built using all COTS components. The system is tested under resistive-inductive loads and a dynamometer-based driving schedule. A power density of 13.64 kW/l was accomplished and possibilities for volume reduction to achieve 25 kW/l are evaluated revealing the challenges to achieve even higher power densities using COTS technologies.

BackgroundWe characterised the impact of COVID-19 on the socioeconomic conditions, access to gender affirmation services and mental health outcomes in a sample of global transgender (trans) and non-binary populations.MethodsBetween 16 April 2020 and 3 August 2020, we conducted a cross-sectional survey with a global sample of trans and non-binary people (n=849) through an online social networking app. We conducted structural equational modelling procedures to determine direct, indirect and overall effects between poor mental health (ie, depression and anxiety) and latent variables across socioecological levels: social (ie, reduction in gender affirming services, socioeconomic loss impact) and environmental factors (ie, COVID-19 pandemic environment).ResultsAnxiety (45.82%) and depression (50.88%) in this sample were prevalent and directly linked to COVID-19 pandemic environment. Adjusted for gender identity, age, migrant status, region, education and level of socioeconomic status, our final model showed significant positive associations between relationships of (1) COVID-19 pandemic environment and socioeconomic loss impact (β=0.62, pConclusionThe study results supported the importance of bolstering access to gender affirming services and strengthening socioeconomic opportunities and programmatic support to buffer the impact of COVID-19 pandemic environment on poor mental health among trans and non-binary communities globally.

High power density is an important requirement for traction motor drives as transportation systems continue their electrification trends. Increasing power density requires a system-level approach addressing all inverter components; particularly, power modules, thermal management system, and dc-link capacitor bank. This paper focuses on designing a distributed dc-link capacitor bank using multi-layer series-connected ceramic capacitors (MLSCs) which have higher operating temperature, lower ESL and lower volume than film capacitors. The paper addresses the design of a busbar assembly connecting several MLSCs to the inverter power modules and the power source. The main design goals are distributing the capacitors across the power modules to provide a short path to high-frequency current components, minimizing parasitic inductances, and achieving similar current profiles among all MLSCs. ANSYS™ Q3D simulations are used to evaluate the busbar current density. The impedance as function of frequency is measured on the prototyped busbar assembly. Experimental tests verify the proposed design ideas.

Various methods have been proposed to perform real-time ripple current estimation, which is critical for the performance improvement of ac motor drives. In this work, a novel ripple current prediction (RCP) approach is firstly proposed, which combines the advantages of both equivalent circuit based and machine model based methods. The proposed RCP method is accurate and effective in practical applications. Then a frequency-modulated (FM) space-vector pulse-width modulation (SVPWM) is proposed to actively control the ripple current by adjust the switching frequency on a cycle-by-cycle basis. The proposed FM-SVPWM has the capability to maintain the same amount of ripple current using reduced switching frequency or reduce the current ripple without increasing the switching frequency. Extensive simulation studies have been performed to validate the feasibility and effectiveness of the proposed methods.