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Background Care cascades can inform providers about differences in engagement and retention in care between patient populations thereby improving participation by targeting interventions more effectively. The objective of this study was to assess the uptake and retention of participants along the anal cancer screening algorithm within a single HIV clinic. Methods Retrospective procedural and demographic data were collected within a Ryan White HIV/AIDS Program clinic from 18 December 2017 to 29 May 2021. A care cascade was constructed among eligible participants who engaged and were retained in the anal cancer screening algorithm. Engagement was defined as having at least one anal Pap smear. Retention was defined as having a follow-up anal Pap smear, and/or high resolution anoscopy, as indicated. Risk ratios (RR) were calculated to reveal factors associated with initiation and retention in screening. Results Of 821 eligible participants, 312 (38%) engaged in screening and 205 (66%) were retained in care. Anoreceptive intercourse was positively associated with engagement (RR 2.81, 95% confidence interval [CI] 2.05–3.90, pConclusions Overall engagement in anal cancer screening is low within our clinic, particularly among men, but retention in the screening program is notably better, especially among those with abnormal cytology. Target populations have been identified to increase awareness, and qualitative studies are underway to understand perceptions and barriers to engagement in anal cancer screening.

The work presents the most known and used (in laboratory practice) ways of removing degraded adhesives from the surface or from the assemblies / consolidations of works performed on organic support, of a cellulosic nature.

Background Prevalence of anal cancer is increasing among people with HIV (PWH). Screening for anal cancer involves evaluating cytology and biopsy with high-resolution anoscopy (HRA) if indicated. In this study, we sought to identify the prevalence of abnormal anal cytology and biopsy-proven high-grade dysplasia, defined as anal intraepithelial neoplasia 2 and 3 (AIN2+). Methods Demographic and clinical data were collected from participants age ≥30 years with ≥1 anal Pap smear performed during the study period (12/18/2017–05/29/2021). A subgroup analysis was performed on those with ≥1 HRA. Logistic regression estimated adjusted odds ratios (aORs) for variables of interest such as age, race, gender, presence of HPV strains, and sexual practices. Results Of 317 participants, 48% (n = 152) had abnormal cytology (93% low-grade squamous intraepithelial lesion [SIL] or atypical cells of undetermined significance [ASCUS] and 7% high-grade SIL). Most with abnormal cytology proceeded to HRA (n = 136/152). Of those with HRA, 62% (n = 84/136) had AIN2+. History of anoreceptive intercourse (aOR 4.62; 95% CI 1.08–23.09; P = .047), HPV 16 (aOR 4.13; 95% CI 1.63–11.30; P = .004), and “other” high-risk HPV strains (aOR 5.66; 95% CI 2.31–14.78; P < .001) were significantly associated with AIN2+. Conclusions Nearly half of those screened had abnormal cytology, highlighting the high prevalence of anal dysplasia in PWH. Though only 7% had high-grade SIL on cytology, 62% of those biopsied had AIN2+, suggesting that cytology underestimates the severity of dysplasia on biopsy. HPV 16 and “other” high-risk strains were associated with AIN2 + and could be considered for risk-stratifying patients in the screening algorithm.

Background Age-related chronic conditions are becoming more concerning for people with human immunodeficiency virus (PWH). We aimed to identify characteristics associated with multimorbidity and evaluate for association between multimorbidity and human immunodeficiency virus (HIV) outcomes. Methods Cohorts included PWH aged 45–89 with ≥1 medical visit at one Ryan White HIV/AIDS Program (RWHAP) Southeastern HIV clinic in 2006 (Cohort 1) or 2016 (Cohort 2). Multimorbidity was defined as ≥2 chronic diseases. We used multivariable logistic regression to assess for associations between characteristics and multimorbidity and between multimorbidity and HIV outcomes. Results Multimorbidity increased from Cohort 1 (n = 149) to Cohort 2 (n = 323) (18.8% vs 29.7%, P < .001). Private insurance was associated with less multimorbidity than Medicare (Cohort 1: adjusted odds ratio [aOR] = 0.15, 95% confidence interval [CI] = 0.02–0.63; Cohort 2: aOR = 0.53, 95% CI = 0.27–1.00). In Cohort 2, multimorbidity was associated with female gender (aOR, 2.57; 95% CI, 1.22–5.58). In Cohort 1, black participants were less likely to be engaged in care compared with non-black participants (aOR, 0.72; 95% CI, 0.61–0.87). In Cohort 2, participants with rural residences were more likely to be engaged in care compared with those with urban residences (aOR, 1.23; 95% CI, 1.10–1.38). Multimorbidity was not associated with differences in HIV outcomes. Conclusions Although PWH have access to RWHAP HIV care, PWH with private insurance had lower rates of multimorbidity, which may reflect better access to preventative non-HIV care. In 2016, multimorbidity was higher for women. The RWHAP and RWHAP Part D could invest in addressing these disparities related to insurance and gender., At one HIV clinic, multimorbidity prevalence increased among older people with HIV from 2006 to 2016. Private insurance was associated with decreased multimorbidity compared with Medicare in 2006 and 2016, which may reflect better access to preventative non-HIV care.

Background For comprehensive care, it is recommended that people living with HIV who are sexually active have annual multisite testing for gonorrhea and chlamydia. Appropriate testing is defined by testing at all sites of sexual exposure (urogenital, pharyngeal, rectal). In the first year of 3 site testing at our HIV clinic, we aimed to describe (1) the rate of appropriate sexually transmitted infection (STI) testing, (2) the factors associated with STI diagnosis, and (3) the percentage of extragenital STIs that would have been missed with only urogenital testing. Methods Participants were > 14 years old with > 1 in-person medical visit at the Ryan White HIV/AIDS Program clinic in 2019. We collected demographics, reported sexual activity, and STI test dates and results. Controlling for number of sites tested, a log-binomial model was used to estimate the association of different characteristics with an STI diagnosis. Results For this cohort (n=857; Table 1), 44% reported sexual activity, 34% reported no sexual activity and 22% had no sexual activity information recorded. Of 1185 STI tests performed for 491 participants, 51 STIs were diagnosed in 33 participants. One STI was diagnosed for a female (0.7%). Overall, 68% (253/375) received appropriate urogenital testing, 63% (85/134) received appropriate pharyngeal testing and 69% (72/105) received appropriate rectal testing. For male participants with > 1 STI test (n=347), Hispanic ethnicity was associated with an STI diagnosis (Table 2). Of those with concurrent extragenital and urogenital tests, 96% of people with an STI (n=26) were positive at only an extragenital site. Table 1: Study Participants’ Characteristics Table 2: Factors Associated with Being Diagnosed With a Sexually Transmitted Infection for Men Living With HIV: Frequencies and Results of Univariable and Multivariable Log-binomial Model Conclusion Nearly a quarter of participants had no sexual activity information recorded in the year, which is an area for improvement. Despite newly adopting 3 site testing, appropriate extragenital and urogenital testing rates were similar and were high compared with national averages. There was no obvious clinician/patient bias against extragenital testing. Hispanic male participants’ higher STI diagnosis rate may point to more condomless sex in this population. Based on the identification of many infections exclusively at extragenital sites, we likely missed STIs previously. This highlights the importance of 3 site testing availability and testing at all appropriate sites. Disclosures Kathleen A. McManus, MD, MSCR, Gilead Sciences, Inc (Research Grant or Support, Shareholder)

The paper focuses on two works of art, Chrysanthemums and Roses, painted by Stefan Luchian, a representative painter for the modern Romanian art from the beginning of the 20th century. The two paintings were analyzed by several non-invasive techniques (optical microscopy, grazing light and UV examination, IR reflectography, XRF and Raman spectrometry) in order to get information concerning the chromatic and to assess the state of conservation. The study is focused in particular on yellow, red and white pigments, which are different in the two pictorial compositions: in Chrysanthemums the predominant pigments are Madder lake, cadmium yellow and zinc white mixed with lead white, while in Roses cinnabar, strontium yellow and lead white were found, according to the XRF and Raman analysis.

Paintings signed by Nicolae Grigorescu and Stefan Luchian, exponents of Romanian Modern Art were selected for a technical study on easel painting canvases. Both the physical integrity and the appearance of the artefacts derive mainly from the strength of the canvas and the physical and chemical characteristics of the fibres imparting their response to deterioration. In order to determine a deterioration pattern for canvases subjected to environmental stress, a simulation on flax fibres samples was performed using a climatic lab chamber. Structural changes of lignocellulosic materials were monitored by attenuated total reflectance infrared (ATR-FTIR) and FT-Raman spectroscopy. Changes in the intensity of FT-Raman signals of flax fibres indicate the evolution of the degradation phenomena due to environmental stress.

The deterioration of the natural polymers is a very complex process, and a problem that can be best addressed through modelling. The approach for modelling the rheological behaviour of different cellulose-based textile fibres (cotton, hemp, flax) when subjected to a hydrothermal treatment, followed by exposure to different doses of gamma-rays (5, 10, 15 and 25 kGy) is presented here. In order to predict the optimum radiation dose limit and hydrothermal aging time, the mathematical model was developed using MATLAB computational technique. To study the mechanical behaviour of the tested fibres, tensile tests were carried out using a TINIUS OLSEN dynamometer H5KT according to ISO 2062 norm. The model of correlation between the mechanical properties of the fibres and the independent variables was based on a polynomial second-degree equation, with the Least-Squares fitting approach that led to the coefficients of the mathematical model.

In order to investigate the effect of gamma rays on cultural heritage materials, samples of silk and wool fabrics were subjected to accelerated ageing testing and then irradiated with different gamma-ray doses: 10 and 25 kGy. In the data analysis, combining thermal analysis (TG and DTG), infrared spectroscopy (FTIR-ATR) and mechanical tests allowed us to explore the changes in physical and chemical features for silk and wool, in relationship to the radiation doses. This analytical protocol offers a way to examine the behaviour of the textiles made of wool and silk within museum collections and their response to gamma-rays irradiation treatment. An exposure to a dose of 10 kGy did not cause significant changes in the tested properties; however, higher doses initiated irreversible loss in the physical and chemical stability of protein-based fabrics. Increasing the irradiation dose above 10 kGy has drastic effects in the loss of elasticity and the mechanical resistance of the tested yarns.

The icon Descending of the Saint Spirit from Bucium Church, dating in the year 1814 and was done in tempera on wood technology. The characterization of cultural heritage materials is essential for the comprehension of their degradation mechanisms. The present study aims at identifying the pigments in the various layers, establishing the possible existence of an organic binder and scientifically evaluating the state of preservation. To this end, were used non-destructive methods, as: microscopic (SEM), XRF and spectroscopic (FTIR).

Waxes as a component of seals, are recognized in our history as adhesives, for surface coating purposes, modeling or casting materials and also in conservation practice. The waxes with mineral, vegetable and animal origin should be connected to modern methods of analysis, due to their complex composition: long chain hydrocarbons, acids, alcohols, esters. They support many mechanical damages in library and archive collections: cracking, pieces lost by an excessive handling of documents. In this paper the compositional analyses of some wax seals belonging to some paper samples have been achieved by Raman spectroscopy and Fourier transform infrared spectroscopy (FTIR) - for molecular structural information of wax materials, by gas chromatography / mass spectrometry (GC/MS) - for evidence of some compounds resulted from degraded wax seal, and by optical microscopy (OM) and scanning electron microscopy (SEM) - for visualization of the damaging effect on the wax seal. All these analytical investigations have been achieved for wax seals detached from the paper samples recovered from two disaffected pulp and paper factories - Letea and Busteni (Romania) belonging to Romanian industrial patrimony.