Injection Equipment Research Articles

Cyclic Combustion Variability of Dimethyl-Ether-Fueled Agricultural Tractor Engine

Abstract Combustion in dimethyl-ether (DME)-fueled engines needs to be assessed carefully for its widespread acceptability from a drivability viewpoint. Since the test engine used in an off-highway segment, it was tested in a steady-state cycle for engine performance, combustion, emissions, and their cyclic variations, which were the only parameters to assess the drivability. This study investigated and analyzed the cyclic variations of a 100% DME-fueled engine equipped with modified mechanical fuel injection equipment. It was compared with baseline diesel to understand its positive and negative aspects. Experiments were conducted at different engine speeds (1200,1600, and 2000 rpm) and loads (No Load, 1.29, 2.59, 3.88, 5.18, and 6.47 bar brake mean effective pressure (BMEP)) . In-cylinder pressure was recorded for 250 consecutive engine cycles, and many combustion parameters were comparatively analyzed for diesel and DME fuelings. The coefficient of variation (COV) of maximum in-cylinder pressure (Pmax) was lower for DME than diesel at 1600 rpm and comparable at the other remaining engine speeds (1200 and 2000 rpm). Variations in COV of Pmax were higher at low loads and negligible at high loads for both test fuels. At 2000 rpm, the crank angle positions at which Pmax occurred were distributed in a narrow range for DME, representing higher combustion stability than baseline diesel. Variations in the maximum rate of pressure rise (RoPRmax) were lower for DME at 3.88 and 6.47 bar BMEP, while these were higher at 1.29 bar BMEP than baseline diesel. COV of indicated mean effective pressure (COVIMEP) decreased from lower to higher loads for diesel and DME fueling at 1600 and 2000 rpm engine speeds. The differences in COVIMEP between diesel and DME were negligible at higher loads, representing engine stability similar to baseline diesel. Combustion parameters assessed indicated that DME fueling led to lower cyclic variations than baseline diesel as the engine operated from lower to higher loads. At lower loads, DME fueling showed higher cyclic variations than baseline diesel.

Assessment of Injection Safety Practice in Health Care Settings: a Case from the Gambia

Unsafe injection practices transmit bloodborne pathogens on a large scale worldwide and thus the Ministry of Health was assisted in conducting an assessment of injection safety in the Gambia in 2021. Interviews and observation of injection practices in all of the public health facilities and a sample of private health facilities including NGO. A total of 81 health facilities had been involved. Sterilisation of injection material observed in 3 facilities (3.7%) for therapeutic injection. Vaccinations, used either AD syringe (83.7%) or disposable syringes (16.3%). Re-used injection equipment without sterilisation in facilities was 8.6%. Proportion of health facilities in lack of AD syringes is 6.3%. 87.3% of the health facilities the availability of AD syringes was over than 50 units. Lack of disposable syringes was 17.3% of the health facilities. In 46 health facilities (56.8%), the availability of disposable syringes was over 20 units. Lack of safety box in facilities was 50.6% (n=41). Needle stick injuries have been observed in 79.7% (n=74) of the health facilities. A proportion of 70.9% of vaccinators and 52.1% of curative injection providers reported experiencing at least one needle-stick injury. Lack of safety boxes and waste disposable facilities, unsafe behaviours and poor sharp waste management lead to unsafe injection practices in the Gambia, exposing patients, health care workers and community to bloodborne infections. A coordinated strategy, training of health workers, and encouraging of the proper disposal of sharp required to prevent injection-associated infections in the Gambia. Keywords: AD syringes, Injection, Needles, Safety boxes.

2081. Failing to PrEPare is PrEParing to Fail: Advocating for PWID PrEP Inclusion

Abstract Background The CDC recommends that PrEP be offered to anyone with a history of injection drug use, with a particular focus on those that have injected in the past 6 months, shared injection equipment, or have sexual risk factors. Yet, PrEP remains underutilized. The SARS-CoV2 pandemic introduced additional barriers to HIV testing and substance use treatment. We sought to develop a specialty pharmacy-driven program to minimize barriers and increase education surrounding PrEP in PWID in patients admitted to the hospital with IV drug use related complications. Patients identified by the ID consultant or stewardship team were offered enrollment in the program as part of a comprehensive harm reduction strategy. Upon referral, specialty pharmacists provided phone counseling, prescribed TDF/FTC, and conducted laboratory monitoring. Methods From November 2020 through March 2022, we collected data on our accepted referrals including number of refills, laboratory appointments, reason for discharge, duration of retention in the program, and injection-related emergency department visits and hospital admissions for 90 days after program discharge. Results During the eighteen month period, 23 patients accepted referral into the program. The median age was 42 years and 47.8% were male. Despite accepting the initial referral while inpatient, 87% (n=20) of patients did not remain in the program to receive the first month's supply of TDF/FTC once discharged. Sixteen (69.6%) were not able to be contacted on the phone number provided despite multiple attempts. Four (17.4%) declined ongoing IV drug use. Eight patients (35%) had an injection related ED visit or hospitalization within 90 days of program discharge. Conclusion In conclusion, high risk PWID admitted to the hospital who agreed to PrEP with daily TDF/FTC had a low retention rate after discharge. PWID need to be included in future research studies, especially studies involving novel PrEP treatments. Disclosures All Authors: No reported disclosures.

Association of Illicit Fentanyl Use with Injection Risk Practices Among People who Inject Drugs.

We investigated theassociation between fentanyl injection frequency and sharing of injection equipment among people who inject drugs. We surveyed 249 people who inject drugs in Toronto in 2019. We estimated predicted probabilities of associations between fentanyl injection frequency and injection risk practices. In prior 6months, 117 (47.0%) of participants injected fentanyl daily, 49 (19.7%) less than daily, and 78 (31.3%) did not inject fentanyl. Participants who injected fentanyl daily shared syringes more often than those not injecting fentanyl (25.0% vs. 4.9%; χ2 = 11.54, p = 0.0007). Participants who injected fentanyl daily (42.4% vs. 11.3%; χ2 = 18.05, p < 0.0001) and less than daily (37.2% vs. 11.3%; χ2 = 5.88 p = 0.02) shared cookers more often than those not injecting fentanyl. Participants who injected fentanyl daily (30.2% vs. 9.7%; χ2 = 9.05, p = 0.003) and less than daily (30.3% vs. 9.7%; χ2 = 4.11, p = 0.04) shared filters more often than those not injecting fentanyl. No differences in probabilities of sharing equipment were detected between participants who injected fentanyl daily and less than daily. People using fentanyl reported injection practices that increased risk for infectious disease transmission.

Profiles and health risks (STIs, HCV, HIV) of injecting drug users

ObjectiveThe aim of this article is twofold: to present the sociodemographic profiles of people who inject drugs (PWID) in Togo and to assess the prevalence of health risks (sexually transmitted infections [STIs], the hepatitis C virus, and HIV), the problems linked to drug injection, and the factors characterizing PWIDs. Participants and methodsUsing a questionnaire, this cross-sectional descriptive study was conducted on 384 PWIDs in Togo. The questionnaire focused on sociodemographic characteristics, consumption history, and known health problems and risks. Snowball sampling allowed for data collection in all regions of the country. ResultsIn the sampling, the results revealed prevalence of 17% for STIs and 53% for the hepatitis C virus. The onset of medical problems and STI signs was significantly triggered when the person was female, over 25 years of age, polygamous, not attending school, unemployed, and had been using drugs for more than five years. Moreover, reused injection equipment was shown to be associated with the high STI prevalence. ConclusionDrug injection is dangerous and results in numerous health problems. This study shows that PWID vulnerability of stems from specific characteristics, such as being uneducated, single, unemployed, bereft of parents, and having a low monthly income. Additional research is required to further investigate the health risks associated with drug injection in view of providing PWIDs with comprehensive care.

Feasibility Analyses and Prospects of CO2 Geological Storage by Using Abandoned Shale Gas Wells in the Sichuan Basin, China

The geological storage of CO2 is a critical technique for reducing emissions, which significantly contributes to the mitigation of the greenhouse effect. Currently, CO2 is often geologically stored in coal seams, hydrocarbon reservoirs, and saline aquifers in order to store CO2 and improve the oil and gas recovery simultaneously. Shale formations, as candidates for CO2 storage, are drawing more attention because of their rich volumes. CO2 storage through shale formations in the Sichuan Basin, China, has tremendous potential because of the readily available CO2 injection equipment, such as abandoned shale gas wells. Therefore, we review the potential of using these wells to store CO2 in this paper. Firstly, we review the status of the geological storage of CO2 and discuss the features and filed applications for the most studied storage techniques. Secondly, we investigate the formation properties, shale gas field development process, and characteristics of the abandoned wells in the Sichuan Basin. Additionally, after carefully studying the mechanism and theoretical storage capacity, we evaluate the potential of using these abandoned wells to store CO2. Lastly, recommendations are proposed based on the current technologies and government policies. We hope this paper may provide some insights into the development of geological CO2 storage using unconventional reservoirs.

Beyond Sex: Human Monkeypox Virus is an Emerging Threat to Marginalized Populations.

The human version of the monkeypox virus (MPXV) is establishing itself to various degrees across the globe. While substantial attention has been focused on sexual risk, particularly among men who have sex with men, other populations are vulnerable to this virus. In particular, people experiencing homelessness and those with substance use disorders are vulnerable to MPXV. Overcrowded and unsanitary shelter conditions and city policies that force the relocation of people experiencing homelessness provide ample opportunity for the virus to flourish in this population. Furthermore, people with substance use disorders, specifically those who inject drugs, are at increased risk due to lack of access to sterile injection equipment. Herein, we present a spectrum of structural determinants underpinning increased risks in these populations and recommendations that could help mitigate the spread.

The role of depression in secondary HIV transmission among people who inject drugs in Vietnam: A mathematical modeling analysis.

Among people who inject drugs (PWID), depression burden is high and may interfere with HIV prevention efforts. Although depression is known to affect injecting behaviors and HIV treatment, its overall impact on HIV transmission has not been quantified. Using mathematical modeling, we sought to estimate secondary HIV transmissions and identify differences by depression among PWID. We analyzed longitudinal data from 455 PWID living with HIV in Vietnam during 2009-2013. Using a Bernoulli process model with individual-level viral load and behavioral data from baseline and 6-month follow-up visits, we estimated secondary HIV transmission events from participants to their potentially susceptible injecting partners. To evaluate differences by depression, we compared modeled transmissions per 1,000 PWID across depressive symptom categories (severe, mild, or no symptoms) in the three months before each visit. We estimated a median of 41.2 (2.5th, 97.5th percentiles: 33.2-49.2) secondary transmissions from all reported acts of sharing injection equipment with 833 injecting partners in the three months before baseline. Nearly half (41%) of modeled transmissions arose from fewer than 5% of participants in that period. Modeled transmissions per 1,000 PWID in that period were highest for severe depressive symptoms (100.4, 80.6-120.2) vs. mild (87.0, 68.2-109.4) or no symptoms (78.9, 63.4-94.1). Transmission estimates fell to near-zero at the 6-month visit. Secondary transmissions were predicted to increase with depression severity, although most arose from a small number of participants. Our findings suggest that effective depression interventions could have the important added benefit of reducing HIV transmission among PWID.

Needle and syringe programs for reducing blood-borne diseases among people who inject drugs in sub-Saharan Africa: a scoping review protocol.

This review will identify, explore, and map the literature on the characteristics and implementation modalities of needle and syringe programs for reducing blood-borne diseases among people who inject drugs in sub-Saharan Africa compared with the recommended standards by the World Health Organization and AIDS Projects Management Group. Sub-Saharan Africa bears a disproportionate burden of infectious diseases and HIV/AIDS. Needle and syringe programs have been shown to be effective in preventing transmission of infections among those who inject drugs by providing them with sterile injection equipment. The programs may also serve as avenues for addressing other issues that affect this population. This review will consider published and unpublished studies on needle and syringe programs as a method of preventing blood-borne infections among people who inject drugs in sub-Saharan Africa. The review will consider quantitative, qualitative, and mixed methods study designs, as well as systematic reviews and text and opinion papers. The electronic databases to be searched include MEDLINE, African Journals Online, CINAHL, the Cochrane Library, Embase, and TRoPHI. We will also search sources of unpublished studies and gray literature (conference abstracts, theses, etc). The search will be restricted to studies in English, with no date limit. Data extraction will be done by two independent reviewers, guided by an extraction tool developed by the reviewers. Key information, such as author, reference, and findings relevant to the review questions, will be obtained. The results will be presented as graphs, figures, and tables accompanied by a narrative summary.

Development of dynamic grouting under laboratory and field conditions

AbstractWhen it comes to underground structures, water ingress from the surrounding formations leads to several environmental, economic and sustainability issues. To obtain the sealing, the grouting of rock fractures is done. Today, in the grouting operations, which are commonly conducted in almost all the tunnel and subsurface infrastructure projects, the pressure applied is static. This type of applied pressure might be suitable for the large fracture apertures &gt; 100 μm, but it has been acknowledged that it is difficult to obtain sufficient penetration through smaller apertures, where filtration of cement particles starts to occur. Research is already done to overcome this issue by applying dynamic grouting pressure instead of static. It was proved that this approach erodes the formed filter cakes and improves grout penetrability in fractures below 100 μm. This research focuses on low‐frequency rectangular pressure impulse as an alternative to other methods. The goal is to improve grout spread in micro‐fractures (especially in apertures &lt; 70 μm). During the investigation, a prototype dynamic injection equipment was built and tested under laboratory conditions. The 4 m variable aperture long slot (VALS) was used in the experiments to simulate rock fractures. The test showed better grout penetrability using dynamic pressure approach. At the current time of writing this article, preparation works are done for field test of prototype equipment at SKB Hard Rock Laboratory (HRL) at Äspö, Sweden.

The association of gender with receptive and distributive needle sharing among individuals who inject drugs

BackgroundInjection drug use and needle sharing remains a public health concern due to the associated risk of HIV, HCV and skin and soft tissue infections. Studies have shown gendered differences in the risk environment of injection drug use, but data are currently limited to smaller urban cohorts.MethodsTo assess the relationship between gender and needle sharing, we analyzed publicly available data from the 2010–2019 National Survey on Drug Use and Health (NSDUH) datasets. Chi-square tests were conducted for descriptive analyses and multivariable logistic regression models were built adjusting for survey year, age, HIV status, and needle source.ResultsAmong the entire sample, 19.8% reported receptive needle sharing, 18.8% reported distributive sharing of their last needle, and 37.0% reported reuse of their own needle during last injection. In comparison with men, women had 34% increased odds (OR 1.34, 95% CI 1.11–1.55) of receptive needle sharing and 67% increased odds (OR 1.67, 95% CI 1.41–1.98) of distributive needle sharing. Reuse of one's own needle did not differ by gender.ConclusionsIn this nationally representative sample, we found that women are more likely in comparison with men to share needles both through receptive and distributive means. Expansion of interventions, including syringe service programs, to increase access to sterile injection equipment is of great importance.

Geographic Transmission and Epidemic History of HIV-1 CRF01_AE, CRF07_BC, and HCV Subtype-6w among Taiwanese Persons Who Inject Drugs.

Persons who inject drugs (PWID) and their risk-related behaviors (e.g., unprotected sex and sharing needles/syringes/other injection equipment) have caused severe public health problems, especially in the rapid spread of HIV-1 and HCV. Here, we reconstructed the epidemic history of HIV-1 circulating recombinant form (CRF) 01_AE, CRF07_BC, and HCV subtype-6w among Taiwanese PWID. The timescales were estimated using phylogenetic and Bayesian coalescent analyses. The results revealed that CRF01_AE started to circulate in the Taiwanese PWID population in central Taiwan at 1992.5 (95% credible region: 1988.8–1995.9) and spread to other regions of Taiwan, while CRF07_BC was first identified in southern Taiwan at 2000.0 (95% CR: 1997.8–2002.2) and then spread northward to central-northern Taiwan. All HCV-6 strains were from Asia (that is, China, Myanmar, Taiwan, and Vietnam) and originated in 1928.1 (95% CR: 1890.2–1966.0). Furthermore, subtype-6w isolates from different regions of Taiwan appeared to share a common source that existed in the mid-1990s (95% CR: 1985.0–2001.8) or thereabouts. The routes of drug trafficking and the resulting high prevalence of HIV-1/HCV co-infections among PWID might have contributed to the virus transmission and promoted its spread worldwide. Long-term monitoring and policy implementation in at-risk populations would be useful for disease control.

Method and a Device for Testing the Friction Force in Precision Pairs of Injection Apparatus of the Self-Ignition Engines

This article reviews the state of the knowledge and technology in the field of friction-loss measurements in internal combustion piston engines. The dependencies that describe the loss of energy in combustion engines and injection apparatus are presented. Currently, very little can be found in the literature on the study of frictional forces in injection apparatus, but mainly in the piston–cylinder group, so this work significantly fills that gap. The aim of this article is to construct a device and to develop a method for assessing the technical state of injector nozzles to minimize friction losses in internal combustion engines at the stages of evaluation, design, production and operation. This article presents a stand for determining the maximum friction forces due to gravity loading by water-jet control. This article also presents test results on the maximum friction force between a needle and a body of injector nozzles in piston combustion engines on a designed and purpose-built stand outside of the combustion engine. Various designs and injector nozzles are made from various types of alloy steel for marine and automotive piston internal combustion engines fueled with distillation or residual fuels, and are tested. The research concerned conventional elements for the injection apparatus as well as electronically controlled subsystems. Precision pairs of injection equipment are selected for the tests: new ones are employed after the storage period and operated in natural conditions. The elements dismantled from the internal combustion engines are tested in the presence of fuel or calibration oil of similar properties. The maximum static frictional forces under the hydrostatic loading are measured, alongside the parameters for the dynamic movement of the nozzle needles from bodies of the injector nozzle as time, speed, acceleration and dynamic force. The influence of the angular position of the needle in relation to the bodies of the precision pairs conventional internal combustion engines, the diametral clearance between the nozzle body and needle, and the surface conditions on the values of the maximum friction force are also presented. Errors in shape and position result in the uniqueness of the friction force at the mutual angular position of the needle in relation to the nozzle body, and the decrease in diametral clearance and deterioration of the surface state increase the friction losses. A model was elaborated of the influence of various factors on the value of the maximum friction force.

Romania, a Harbour of HIV-1 Subtype F1: Where Are We after 33 Years of HIV-1 Infection?

Infection with the human immunodeficiency virus (HIV) has been a major public health concern worldwide for more than 30 years, including in Romania. The F1 HIV-1 subtype was exported from Angola to Romania most probably because of the two countries’ close political connections. Patients infected with HIV-1 via re-used and improperly sterilized injection equipment and through transfusions of unscreened blood, also known as the “Romanian cohort”, were the most common type of HIV-1 infection in Romania in the early 1990s, when the virus’s presence was recognized. Recently, subtype B started to increase in our country, mostly diagnosed in people using intravenous drugs or in men having sex with men. The evolution of the HIV-1 infection in Romania has been unique, with a dominance of the subtype F1, making it different from other countries in Europe.

Improving Harm Reduction Services: A Qualitative Study on the Perspectives of Highly Marginalized Persons Who Inject Drugs in Montreal

Harm reduction (HR) is an alternative to the moralization of drug use and a pragmatic public health approach aimed at minimizing harms associated with use. This study sought to gain the perspectives of persons who inject drugs (PWID) on the adequacy of services provided by HR organizations in Montreal. Twenty-two semi-structured interviews and two focus groups were conducted with 30 participants. Some of the key advantages of HR perceived by participants include access to injection equipment, psychosocial support, and reduced social isolation. However, many wanted more opportunities for social insertion and greater value to be placed on their knowledge and life experiences (e.g., experiential knowledge of the street scene, drug use, sex work, or homelessness). This study suggests that PWID who access HR services in Montreal are interested in paid work opportunities in environments that promote power sharing, and activities that are conducted and managed by and for them.

Repercussions of the COVID-19 pandemic on medical waste management

The COVID-19 pandemic is a global outbreak that also changes the generation of medical waste in hospital. The increasing number of people infected with the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) virus indirectly requires the management of infectious waste from patients to be safe and not have the potential to spread. The purpose of this study was to analyze the medical waste management in a hospital located in Jakarta City, Indonesia. This study employed direct observation and used secondary data in the analysis. Meanwhile, to determine the effect of the population infected with SARS-Cov-2 on medical generation, One Way ANOVA analysis was used. Data from May, 2020 showed that medical waste generation increased from 25.6 kg/month to 192.3 kg/month. The ANOVA significance test showed a value of 0.013; this indicates that the number of the infected population significantly affects the generation of medical waste. Medical waste that found during a pandemic becomes more complex, including hazmat clothes, masks, gloves, medical headgear, used bandages, injection and infusion equipment, eating and drinking utensils for patients exposed to COVID-19, and used swab and rapid test equipment.

Діагностика паливної апаратури, приводу клапанів газорозподілу та форсунок змащення циліндрів сучасних двотактних двигунів

The application of a vibration sensor with an in-cylinder pressure sensor extends the capabilities of internal combustion engines and compressor diagnostics for various types of plants and installations, such as marine diesel engines, refrigeration piston compressors, aircraft engines. The fuel injection equipment malfunctions as valve as valve train system malfunctions could be detected from the experimental indicated diagrams P(V), P(deg) of the engine cylinder operating process as it is known. The main indicators are the following: the shape of the diagram and the parameters of working cycle – the maximum combustion pressure Pmax, the compression pressure Pcomp, mean indicated pressure IMEP, etc. However, it should be considered that different types of malfunctions could have the same reflection on the indicated diagram. For instance, the late fuel injection and the fuel-injection equipment wear could have almost similar effects on the indicated diagram and main diagnostic parameters. Another example is the low compression pressure Pcomp, which could be caused by the cylinder or compression rings wear and by the exhaust valves wrong timing or valve leakage. It should also be mentioned that many types of malfunctions at their early stages are very difficult to detect and clarify based solely on the indicated diagrams analysis. The detection of such malfunctions usually requires the direct measurements of the fuel injection pressure and injector’s needle lift diagrams with accurate valve timing measurements. However, mentioned measurements could be performed under laboratory conditions and are difficult to apply under engine operating conditions. The vibration sensor application could be a reasonable alternative to the direct measurements, as it allows the determination of the injector’s needle lift-off and landing timing, high-pressure fuel pump cut-off and discharge timing, the preheated heavy fuel circulation start/stop timing as well as gas-distribution valves opening and closing timing, the oscillation frequency, and amplitude from the refrigeration system piston compressor valve operation and the cylinder oil injector timing. The vibration sensor has a magnetic basement that allows its easy mounting on the engine parts. All this information could be directly measured during engines and compressor trials by the vibration sensor applied in the advanced diagnostic systems.

The Role of Context in Integrating Buprenorphine into a Drop-In Center in Kampala, Uganda, Using the Consolidated Framework for Implementation Research.

Background: Although Africa has long borne the brunt of the human immunodeficiency virus (HIV) epidemic, until recently, the continent has been considered largely free of illicit drug use and injection drug use in particular. In Uganda, the number of people who use or inject drugs (PWUD and PWID, respectively) has increased, and PWID are a key population at high risk for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. However, harm reduction practices, including providing clean injection equipment and medication-assisted treatment (MAT), have only recently been piloted in the country. This project aims to integrate buprenorphine into a harm reduction drop-in center (DIC). Methods: The Consolidated Framework for Implementation Research was used to guide our preparations to integrate buprenorphine into existing practices at a harm reduction DIC. We conducted key informant interviews with members of a community advisory board and DIC staff to document this process, its successes, and its failures. Results: Results indicate that criminalization of drug use and stigmatization of PWUD challenged efforts to provide buprenorphine treatment in less regulated community settings. Conclusions: DIC staff and their commitment to harm reduction and advocacy facilitated the process of obtaining necessary approvals.

Maintenance on extended-release naltrexone is associated with reduced injection opioid use among justice-involved persons with opioid use disorder

IntroductionOpioid use disorder (OUD) and injection drug use (IDU) place justice-involved individuals at increased risk for acquiring or transmitting HIV or hepatitis C virus (HCV). Methadone and buprenorphine have been associated with reduced opioid IDU; however, the effect of extended-release naltrexone (XR-NTX) on this behavior is incompletely studied. MethodsThis study examined injection opioid use and shared injection equipment behavior from a completed double-blind placebo-controlled trial of XR-NTX among 88 justice-involved participants with HIV and OUD. Changes in participants' self-reported daily injection opioid use and shared injection equipment was evaluated pre-incarceration, during incarceration, and monthly post-release for 6 months. The study also assessed differences in time to first opioid injection post-release. The research team performed intention to treat and “as treated” (high treatment versus low treatment) analyses. ResultsFifty-eight of 88 participants (69.5 %) endorsed IDU and 26 (29.5 %) reported sharing injection equipment in the 30 days pre-incarceration; 2 participants (2.2 %) reported IDU during incarceration; 19 (21.6 %) reported IDU one month post-release from prison or jail. Fifty-four (61.4 %) participants had an HIV RNA below 200 copies/mL and 62 (70.5 %) were baseline HCV antibody positive. The 6-month follow-up rate was 49.5 % and 50.5 % for those who received XR-NTX and placebo, respectively, which was not significantly different (p = 0.822). Participants in the XR-NTX and placebo groups had similar low mean opioid injection use post-release and time to first injection opioid use in the Intention-to-treat analysis. In the as-treated analysis, participants in the high treatment group had significantly lower mean proportion of days injecting opioids (13.8 % high treatment versus 22.8 % low treatment, p = 0.02) by month 1, which persisted up to 5 months post-release (0 % high treatment vs 24.3 % low treatment, p < 0.001) and experienced a longer time to first opioid injection post-release (143.8 days high treatment vs 67.4 days low treatment, p < 0.001). ConclusionsInjection opioid use was low during incarceration and remained low post-release in this justice-involved population. Retention on XR-NTX was associated with reduced intravenous opioid use, which has important implications for reducing transmission of HIV and HCV.

Fuel lubricity and its laboratory evaluation

This literature review paper discusses the subject of lubricating properties of liquid hydrocarbon-based fuels and laboratory bench tests applied in lubricity evaluation. The analysis was made in order to highlight the importance of fuel lubricity evaluation, especially application of relatively rapid laboratory tests. Inadequate lubricity may lead to an excessive wear of fuel injection system components and in some cases ? even to catastrophic failure what, in turn, manifests itself in higher replacement costs, shortened service life, inefficient engine performance and increased tailpipe emissions. Nowadays, when more and more rigorous emissions standards for transportation fuels are continuously established, the satisfactory fuel lubricity is of great importance. Lubricity determines the antiwear behaviour of the lubricant over the regime of boundary lubrication when the moving surfaces are separated only by a very thin fluid film adhering to them. The most important role in forming such films is played by polar compounds and aromatic hydrocarbons that are naturally present in crude oil derived fuels. However, the refinery processes applied in fuel production remove them, thus reducing the lubricity. Fuel lubricity problems were first defined in the mid-1960s and resulted from more severe refining and treatment processes applied in the production of aviation kerosene. In those days, injection equipment failures in aircraft turbine engines were reported. Then, in the late 1980s, similar problems were revealed after the implementation by US and NATO forces of ?The Single Fuel Forward? policy which mandated that all military vehicles must be operable with kerosene-based fuel. Lubricity problems regarding diesel fuel emerged in the late 1990s when some countries set limits on the sulphur and aromatic hydrocarbon content in this fuel. The paraffinic diesel fuel produced by the Fischer-Tropsch synthesis or hydrotreatment process that is more commonly applied nowadays also possesses very low lubricating properties. Generally, to provide good fuel lubricity, various additives are applied and bench tests are mostly employed to estimate their effectiveness. Since 1960 many test rigs have been developed. Several inter-laboratory test programs were carried out to select the best bench tests that would show good correlation with field experience. Among them, only BOCLE, HFFR, and SLBOCLE test methods become industry standards.