bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modelling integrated antiretroviral treatment and harm reduction services on HIV and overdose among people who inject drugs in Tijuana, Mexico
Authors: Cepeda Javier A , Bórquez Annick , Magana Christopher , Vo Anh , Rafful Claudia , Rangel Gudelia , Medina‐Mora María E , Strathdee Steffanie , Martin Natasha K 
Published: June 2020

AbstractIntroductionThe HIV epidemic in Tijuana, Mexico is concentrated in key populations, including people who inject drugs (PWID). However, HIV interventions among PWID are minimal, and federal funding was provided for compulsory abstinence programmes associated with HIV and overdose. Alternatively, opioid agonist therapy reduces overdose, reincarceration, HIV, while improving antiretroviral therapy (ART) outcomes. We assessed potential impact and synergies of scaled‐up integrated ART and opioid agonist therapy, compared to scale‐up of each separately, and potential harms of compulsory abstinence programmes on HIV and fatal overdose among PWID in Tijuana.MethodsWe developed a dynamic model of HIV transmission and overdose among PWID in Tijuana. We simulated scale‐up of opioid agonist therapy from zero to 40% coverage among PWID. We evaluated synergistic benefits of an integrated harm reduction and ART scale‐up strategy (40% opioid agonist therapy coverage and 10‐fold ART recruitment), compared to scale‐up of each intervention alone or no scale‐up of low coverage ART and no harm reduction). We additionally simulated compulsory abstinence programmes (associated with 14% higher risk of receptive syringe sharing and 76% higher odds of overdose) among PWID.ResultsWithout intervention, HIV incidence among PWID could increase from 0.72 per 100 person‐years (PY) in 2020 to 0.92 per 100 PY in 2030. Over ten years, opioid agonist therapy scale‐up could avert 31% (95% uncertainty interval (UI): 18%, 46%) and 22% (95% UI: 10%, 28%) new HIV infections and fatal overdoses, respectively, with the majority of HIV impact from the direct effect on HIV transmission due to low ART coverage. Integrating opioid agonist therapy and ART scale‐up provided synergistic benefits, with opioid agonist therapy effects on ART recruitment/retention averting 9% more new infections compared to ART scale‐up alone. The intervention strategy could avert 48% (95% UI: 26%, 68%) of new HIV infections and one‐fifth of fatal overdoses over ten years. Conversely, compulsory abstinence programmes could increase HIV and overdoses.ConclusionsIntegrating ART with opioid agonist therapy could provide synergistic benefits and prevent HIV and overdoses among PWID in Tijuana, whereas compulsory abstinence programmes could cause harm. Policymakers should consider the benefits of integrating harm reduction and HIV services for PWID.
Integrating HIV pre‐exposure prophylaxis and harm reduction among men who have sex with men and transgender women to address intersecting harms associated with stimulant use: a modelling study
Authors: Bórquez Annick , Rich Katherine , Farrell Michael , Degenhardt Louisa , McKetin Rebecca , Tran Lucy T. , Cepeda Javier , Silva‐Santisteban Alfonso , Konda Kelika , Cáceres Carlos F. , Kelly Sherrie , Altice Frederick L. , Martin Natasha K. 
Published: June 2020

AbstractIntroductionAmong men who have sex with men (MSM) and transgender women (TW), stimulant use is high and has been associated with an increased risk of HIV infection, suicide and cardiovascular disease (CVD) mortality. We used epidemic modelling to investigate these intersecting health harms among MSM/TW in Lima, Peru and assess whether they could be mitigated by prioritizing HIV pre‐exposure prophylaxis (PrEP) and harm reduction interventions among MSM/TW who use stimulants.MethodsWe adapted a dynamic model of HIV transmission among MSM/TW in Lima to incorporate stimulant use and increased HIV risk, suicide and CVD mortality. Among 6% to 24% of MSM/TW using stimulants (mostly cocaine), we modelled an increased risk of unprotected anal sex (RR = 1.35 [95%CI: 1.17 to 1.57]) obtained from local data, and increased risk of suicide (SMR = 6.26 [95%CI: 2.84 to 13.80]) and CVD (SMR = 1.83 [95%CI: 0.39 to 8.57]) mortality associated with cocaine use based on a global systematic review. We estimated the proportion of health harms occurring among MSM/TW who use stimulants in the next year (01‐2020/01‐2021). We also investigated the 10‐year impact (01‐2020/01‐2030) of: (1) PrEP prioritization for stimulant‐using MSM/TW compared to random allocation, and (2) integrating PrEP with a theoretical intervention halving stimulant‐associated risk.ResultsMSM/TW in Lima will experience high HIV incidence, suicide mortality and CVD mortality (1.6/100 py, and 0.018/100 py, 0.13/100 py respectively) in 2020. Despite stimulant using MSM/TW comprising an estimated 9.5% (95%CI: 7.8 to 11.5) of all MSM/TW, in the next year, 11% 95%CI (i.e. 2.5% to 97.5% percentile) 10% to 13%) of new HIV infections, 39% (95%CI: 18% to 60%) of suicides and 15% (95%CI: 3% to 44%) of CVD deaths could occur among this group. Scaling up PrEP among all stimulant using MSM/TW could prevent 19% (95%CI: 11% to 31%) more HIV infections over 10 years compared to random allocation. Integrating PrEP and an intervention to halve stimulant‐associated risks could reduce new HIV infections by 20% (95%CI: 10% to 37%), suicide deaths by 14% (95%CI: 5% to 27%) and CVD deaths by 3% (95%CI: 0% to 16%) over a decade.ConclusionsMSM/TW who use stimulants experience a disproportionate burden of health harms. Prioritizing PrEP based on stimulant use, in addition to sexual behaviour/gender identity criteria, could increase its impact. Integrated substance use, harm reduction, mental health and HIV care among MSM/TW is needed.
Integrated screening and treatment services for HIV, hypertension and diabetes in Kenya: assessing the epidemiological impact and cost‐effectiveness from a national and regional perspective
Authors: Kasaie Parastu , Weir Brian , Schnure Melissa , Dun Chen , Pennington Jeff , Teng Yu , Wamai Richard , Mutai Kipkoech , Dowdy David , Beyrer Chris 
Published: June 2020

AbstractIntroductionAs people with HIV age, prevention and management of other communicable and non‐communicable diseases (NCDs) will become increasingly important. Integration of screening and treatment for HIV and NCDs is a promising approach for addressing the dual burden of these diseases. The aim of this study was to assess the epidemiological impact and cost‐effectiveness of a community‐wide integrated programme for screening and treatment of HIV, hypertension and diabetes in Kenya.MethodsCoupling a microsimulation of cardiovascular diseases (CVDs) with a population‐based model of HIV dynamics (the Spectrum), we created a hybrid HIV/CVD model. Interventions were modelled from year 2019 (baseline) to 2023, and population was followed to 2033. Analyses were carried at a national level and for three selected regions (Nairobi, Coast and Central).ResultsAt a national level, the model projected 7.62 million individuals living with untreated hypertension, 692,000 with untreated diabetes and 592,000 individuals in need of ART in year 2018. Improving ART coverage from 68% at baseline to 88% in 2033 reduced HIV incidence by an estimated 64%. Providing NCD treatment to 50% of diagnosed cases from 2019 to 2023 and maintaining them on treatment afterwards could avert 116,000 CVD events and 43,600 CVD deaths in Kenya over the next 15 years. At a regional level, the estimated impact of expanded HIV services was highest in Nairobi region (averting 42,100 HIV infections compared to baseline) while Central region experienced the highest impact of expanded NCD treatment (with a reduction of 22,200 CVD events). The integrated HIV/NCD intervention could avert 7.76 million disability‐adjusted‐life‐years (DALYs) over 15 years at an estimated cost of $6.68 billion ($445.27 million per year), or $860.30 per DALY averted. At a cost‐effectiveness threshold of $2,010 per DALY averted, the probability of cost‐effectiveness was 0.92, ranging from 0.71 in Central to 0.92 in Nairobi region.ConclusionsIntegrated screening and treatment of HIV and NCDs can be a cost‐effective and impactful approach to save lives of people with HIV in Kenya, although important variation exists at the regional level. Containing the substantial costs required for scale‐up will be critical for management of HIV and NCDs on a national scale.
Morphology and immunohistochemistry of the olfactory organ in the bloodfin tetra, Aphyocharax anisitsi (Ostariophysi: Characidae)
Authors: Pintos Santiago , Rincon‐Camacho Laura , Pandolfi Matias , Pozzi Andrea G. 
Published: June 2020

AbstractAmong teleost fishes, differences exist in the shape, number, and arrangement of the olfactory lamellae, the distribution of the sensory and non‐sensory epithelium, as well as, the abundance of various receptor cells. The objective of this work was to describe the morphology, immunohistochemistry, and scanning electron microscopy ultrastructure of the olfactory epithelium of the bloodfin tetra, Aphyocharax anisitsi. This is the first complete description including the anatomy, histology, and immunohistochemistry of the peripheral olfactory organ from a Characiformes. Based on the external morphology of the olfactory organ, A. anisitsi was classified as a ditermous species, with an olfactory cavity containing two openings divided by a skin flap that separates the anterior and posterior nostril. This species belongs to the group of isosmates, since the presence of accessory olfactory sacs was not observed, and non‐sensory ciliated cells were identified. A. anisitsi has an olfactory rosette with an arrow‐shaped arrangement, with differences in length between the anterior and posterior lamellae. In the olfactory epithelium, three types of olfactory receptor neurons were identified using histology and confirmed by immunohistochemistry, that is, ciliated olfactory receptor neurons in the basal region of the epithelium, microvillar olfactory receptor neurons in the middle region; and Crypt cells, in smaller numbers compared to the other neuronal types, present in the apical region. Sensory and non‐sensory areas were scattered and mixed along the lamellar lateral surface but the nasal cavity and the midline raphe lacked olfactory receptor neurons. The presence of abundant kinocilia in the non‐sensory cells could be related in A. anisitsi with ventilation and quality control of water entering the olfactory cavity. The spatial organization of the sensory and non‐sensory areas in A. anisitsi was similar to that observed in other species that also inhabit still and slow‐flowing bodies of water with high‐density vegetation.
In memory of tachycardia: A wide complex tachycardia in a young male
Authors: Siroky Gregory P. , Keller Seth , Suri Ranjit 
Published: June 2020

AbstractWe present a case of a 24‐year‐old male with palpitations and a wide complex tachycardia. Baseline electrocardiogram (ECG) after termination of tachycardia demonstrates a normal rhythm but with inferior/anterolateral T‐wave inversions (TWIs). Electrophysiologic study confirmed the diagnosis of posterior fascicular ventricular tachycardia successfully terminated by anatomic ablation of the left posterior fascicle. TWIs on the patient's baseline ECG were consistent with cardiac memory.
Hypermetabolism and Coronavirus Disease 2019
Authors: Yu Pey‐Jen , Cassiere Hugh , DeRosa Sarah , Bocchieri Karl , Yar Shiraz , Hartman Alan 
Published: June 2020

AbstractBackgroundHypermetabolism has been described in stress states such as trauma, sepsis, acute respiratory distress syndrome, and severe burn injuries. We hypothesize that patients with Coronavirus disease 2019 (COVID‐19) may develop a hypermetabolic state, which may be a major contributing factor to the extraordinary ventilatory and oxygenation demands in patients with COVID‐19.MethodResting energy expenditure (REE), carbon dioxide production (VCO2), and oxygen consumption (VO2) were measured by indirect calorimetry on 7 critically ill patients with COVID‐19.ResultsThe median measured REE was 4044 kcal/d, which was 235.7% ± 51.7% of predicted. The median VCO2 was 452 mL/min (range, 295–582 mL/min), and the median VO2 was 585 mL/min (range, 416–798 mL/min).ConclusionCritically ill patients with COVID‐19 are in an extreme hypermetabolic state. This may explain the high failure rates for mechanical ventilation for these patients and highlights the potential need for increased nutrition requirements for such patients.
Early Response of Specific IgE can Predict Satisfaction with Sublingual Immunotherapy
Authors: Kim Jin Youp , Rhee Chae‐Seo , Mun Sue Jean , Cho Seong H. , Lockey Richard F. , Han Doo Hee 
Published: June 2020

ObjectiveTo investigate predictive parameters at baseline and during the early response to sublingual immunotherapy (SLIT) for house dust mites in allergic rhinitis patients.Study DesignRetrospective cohort study.MethodsPatients were treated with SLIT for at least 3 years and serological tests performed at baseline and at 1‐year follow‐up to investigate predictive parameters. Satisfaction with SLIT, 4 nasal symptoms, and quality of life were evaluated before and after 3 years of SLIT. Sixty‐one patients were enrolled and divided into two groups depending on their satisfaction after 3 years of SLIT: 43 were satisfied (70.5%) and 18 were not (29.5%).ResultsImmunological parameters at baseline did not differ significantly between the satisfactory and unsatisfactory groups. However, changes in both Dermatophagoides pteronyssinus (Dp)– and D. farinae (Df)–specific IgEs were significantly higher in the unsatisfactory group than in the satisfactory group during the early response to SLIT (P = .006 and P = .045, respectively).ConclusionThe changes in both Dp‐ and Df‐specific IgE levels during early response may be indicators for favorable long‐term treatment outcomes with SLIT. These results suggest that clinicians could measure these immunological parameters 1 year after Dp and Df SLIT to indicate potential responders versus nonresponders.Level of Evidence2b Laryngoscope, 131:467–472, 2021
Chance‐constrained multi‐objective approach for hazardous materials routing and scheduling under demand and service time uncertainty
Authors: Moghaddam Kamran S. , Azadian Farshid 
Published: June 2020

AbstractThe transportation of hazardous materials (hazmat) is a challenging problem that often requires a trade‐off between conflicting objectives. In practice, the complexity of the problem is exacerbated due to the lack of sufficient and reliable historical data. In this research, a stochastic multi‐objective optimization model for hazardous materials (hazmat) vehicle routing and scheduling problem is developed. The goal is to find optimal links and routes to obtain a trade‐off between the safe and fast distribution of hazmat through a transport network under customers' demand and service time uncertainty. We utilized a hybrid game theory based compromise programming to develop a solution algorithm to determine the Pareto‐optimal solutions, which are based on the total travel distance and total risk imposed on the transportation process. Computational results of a realistic numerical case study demonstrate the effectiveness of the proposed model and the solution algorithm in obtaining Pareto‐optimal solutions.
A Convenient Prognostic Tool and Staging System for Progressive Supranuclear Palsy
Authors: Golbe Lawrence I. , Ohman‐Strickland Pamela , Beisser Emily B. , Elghoul Francesca T. 
Published: June 2020

ABSTRACTBackgroundProgressive supranuclear palsy (PSP) causes major disability, shortens life, and as yet has no disease‐modifying and little symptomatic treatment. A convenient prognostic tool is needed to assist patients, families, and clinicians in planning care.ObjectivesWe calculated times to acquisition of certain disease milestones and death.MethodsWe followed a cohort of 417 patients with PSP–Richardson syndrome from 1995 to 2016, applying the Progressive Supranuclear Palsy Rating Scale (PSPRS) at each visit. We generated median times to acquisition of 13 milestones using the input variables of sex, onset age, rate of disease progression from motor symptom onset to initial visit, and PSPRS score at the baseline. Of the outcome milestones, 5 were stages of a new, provisional PSP staging system. The other 8 milestones comprised death and disabling levels of cognitive loss, gaze palsy, dysarthria, dysphagia, and gait/balance impairment.ResultsWe derived median times to milestones, with 25th and 75th percentiles and 95% confidence intervals of the median for baseline PSPRS scores from 25 to 65 (scale range, 0–100). Sex and initial progression velocity significantly influenced the death milestone, but not most of the others. Median time to death ranged from 4.8 years for a man with PSPRS score of 25 and a slow progression velocity from onset to initial visit of 0.51 PSPRS points/month to 1.8 years for a woman with PSPRS 65 and rapid initial velocity of 2.25 points/month.ConclusionsWe have created a convenient, inexpensive, noninvasive reference for counseling patients with PSP–Richardson syndrome on approximate time to encountering 13 life‐altering disease milestones.
From combinations to multitarget‐directed ligands: A continuum in Alzheimer's disease polypharmacology
Authors: Albertini Claudia , Salerno Alessandra , de Sena Murteira Pinheiro Pedro , Bolognesi Maria L. 
Published: June 2020

AbstractThe continued drug discovery failures in complex neurodegenerative diseases, including Alzheimer's disease (AD), has raised questions about the classical paradigm “one‐drug, one‐target, one‐disease.” In parallel, the ever‐increasing awareness of the multiplicity of the underlying pathways has led to the affirmation of polypharmacological approaches. Polypharmacology, which broadly embodies the use of pharmaceutical agents acting on multiple targets, seems to be the best way to restore the complex diseased network and to provide disease‐modifying effects in AD. In this review, our aim is to provide a roadmap into a world that is still only partly explored and that should be seen as a continuum of pharmacological opportunities, from drug combinations to multitarget‐directed ligands (both codrugs and hybrids). Each modality has unique features that can be effectively exploited by medicinal chemists. We argue that understanding their advantages and drawbacks is very helpful in choosing a proper approach and developing successful AD multitarget drug‐discovery endeavors. We also briefly dwell on (co)target validation, an aspect that is quite often neglected, but critical for an efficient clinical translation. We substantiate our discussion with instructive examples taken from the recent literature. Our wish is that, in spite of the specter of the high attrition rates, best researchers preferring to enter, stay, and progress in the field would help grow the sector and develop AD polypharmacology to full potential.
Generative Adversarial Networks (GANs) Based Synthetic Sampling for Predictive Modeling
Authors: Barigye Stephen J. , García de la Vega José M. , Perez‐Castillo Yunierkis 
Published: June 2020

AbstractIn the present report we evaluate the possible utility of the Generative Adversarial Networks (GANs) in mapping the chemical structural space for molecular property profiles, with the goal of subsequently yielding synthetic (artificial) samples for ligand‐based molecular modeling. Two case studies are considered: BACE‐1 (β‐Secretase 1) and DENV (Dengue Virus) inhibitory activities, with the former focused on data populating and the latter on data balancing tasks. We train GANs using subsamples extracted from datasets for each bioactivity endpoint, and apply the trained networks in generating synthetic examples from the respective bioactivity chemical spaces. Original and synthetic samples are pooled together and employed to build BACE‐1 and DENV inhibitory activity classifiers and their performance evaluated over tenfold external validation sets. In both case studies, the obtained classifiers demonstrate satisfactory predictivity with the former yielding accuracy (ACC) and Mathew's correlation coefficient (MCC) values of 0.80 and 0.59, while the latter produces balanced accuracy(BACC) and MCC values of 0.81 and 0.70, respectively. Moreover, the statistics of these classifiers are compared with those of other models in the literature demonstrating comparable to better performance. These results suggest that GANs may be useful in mapping the chemical space for molecular property profiles of interest, and thus allow for the extraction of synthetic examples for computational modeling.
A miniaturized electromagnetically coupled patch antenna design using eroded ground plane
Authors: Sahoo Amiya Bhusana , Mangaraj Biswa Binayak 
Published: June 2020

AbstractA novel electromagnetically coupled circular patch antenna (CPA) with an eroded ground plane is proposed for the wireless local area network (WLAN) application. First, a simple CPA is designed for 2.4‐GHz WLAN band. At this frequency, the physical size of the CPA is large. Therefore, a CPA is designed at a higher frequency with much lesser dimensions, and some portion of the ground plane is eroded to observe the percentage of resonant frequency reduction. In order to avail the WLAN services at 2.4 GHz, a CPA is optimally designed at 5.76 GHz based on the same proportionality technique with an eroded ground plane. This miniaturized antenna resonates at 2.4 GHz frequency with excellent reflection and radiation characteristics. The simulation software ANSYS high‐frequency structure simulator is considered for the design of the proposed CPA. The CPA is physically fabricated and its characteristics are validated with the simulation result. It is also compared with some of the antennas available in the literature for the WLAN application. The comparative study shows that the proposed CPA is a miniaturized one with attractive performance parameters.
Technical Note: Deep Learning approach for automatic detection and identification of patient positioning devices for radiation therapy
Authors: Thomas David H. , Schubert Leah K. , Vinogradskiy Yevgeniy , Nath Sameer , Kavanagh Brian , Miften Moyed , Jones Bernard 
Published: June 2020

PurposeAutomatic detection and identification of setup devices, using a deep convolutional neural network (CNN) for real‐time multiclass object detection, has the potential to reduce errors in the treatment delivery process by avoiding documentation errors.MethodsA database of the setup device photos from the most recent 1200 patients treated at our institution was downloaded from the record and verify (R&V) system along with the corresponding setup notes. Images were manually labeled with bounding boxes of each device. A real‐time object detection CNN using the “you only look once” (YOLOv2) architecture was trained using transfer learning of a pretrained CNN (ResNet50). The CNN was trained to detect and identify 11 of the most common treatment accessories used at our institution.ResultsUsing transfer learning of a CNN for multiclass object detection, we are able to automatically detect and identify setup devices in photographs with an accuracy of 96%.ConclusionsAutomation in radiation oncology has the potential to reduce risk. Automatic detection of setup devices is possible using a CNN and transfer learning. This work shows both the value of incident learning systems (ILS) in practice knowledge dissemination, and shows how automation of clinical processes and less reliance on manual documentation has the potential for risk reduction in radiation oncology treatments.