bluuebunny/crossref_metadata_2025_split huggingface dataset:
LBO-1.1 Acyclovir achieves lower concentration in African HIV−, HSV-2+ women compared to non-African populations, possibly explaining lower herpes suppression
Authors: Lu Y , Hendrix C , Celum C , Baeten J , Cowan F , Delany-Moretlwe S , Reid S , Hughes J , Wald A , Corey L 
Published: July 2011

BackgroundTwo trials of acyclovir (ACV) 400 mg twice daily as daily suppressive therapy against herpes simplex virus type 2 (HSV-2) proved ineffective for prevention of HIV acquisition. Explanations for this lack of efficacy are unclear. In one of these trials, HPTN 039, ACV was modestly effective in reducing genital ulcers due to HSV-2; however, there was less reduction in the frequency of genital ulcers and higher HSV-2 DNA quantity in breakthrough lesions in women from African sites than in men from US sites. Pharmacokinetic differences of ACV have been proposed as one explanatory variable for these findings.MethodsSixty-eight HIV-negative, HSV-2 seropositive women participated in a pharmacokinetic study of ACV after completion of HPTN 039 (a phase III, randomised clinical trial of daily acyclovir 400 mg p.o. twice daily). Following a single oral dose of 400 mg of acyclovir, blood was collected over an 8 h period. An LC/MS/MS-based assay determined ACV concentrations. PK parameters were estimated using non-compartmental methods.ResultsSixty-six African women had complete PK data for evaluation. Mean (range) age was 36 (21–54) years and weight was 70 (40–129) kg. The geometric mean (95% CI) for PK parameter estimates were: Cmax 0.31 ug/ml (0.28, 0.34), AUC0-inf 1.59 ug*hr/ml (1.43, 1.76), Tmax 1.56 h (1.40, 1.80), and half-life 2.8 h (2.5, 3.0). This Cmax was lower than 8 comparable single dose ACV PK studies in non-African populations, mean 46% lower (range 28%–59% lower, all p values <0.006). Similarly, AUC was lower than all other studies, mean 38% lower (range 26%–62%, all p values <0.001). In some studies, Tmax was earlier and the half-life was shorter. Subject weight did not explain the differences.ConclusionAcyclovir exposure in black African women was lower than in comparable ACV studies of non-African populations. These statistically significant differences in drug exposure (Cmax and AUC) may be clinically significant and partly explain the modest effects of ACV on HSV-2 recurrence in these African women.
LBP-1.05 Challenges and barriers for conducting STI/HIV prevention projects targeting female sex workers within national programs in Benin and Niger
Authors: Batona G , Michel A , René K , Marie G , Évelyne A , Clément A , Kamaye I M , Hassane D 
Published: July 2011

ContextIn West Africa, HIV/STIs prevention activities targeting female sex workers (FSW) and their partners were developed and supported financially through a bilateral cooperation project. After the end of the project in Benin (2006) and Niger (2007), the national HIV/STI programs took over these interventions.Objectives(i) to identify the challenges and barriers for FSW program interventions within national programs; (ii) to assess the capacity of FSW dedicated services to treat and prevent STI efficiently.MethodsA triangulation of methods and sources of data collection were used within an evaluative approach centered on the use of the results, such as individual and collective interviews, review of data records from health centers and field observations. Quantitative data from clinical attendance were crossed with qualitative data. A conceptual framework was developed to explain the exploratory and analytical elements. The main findings were validated with the stakeholders.ResultsThere are several constraints and major challenges facing STI/HIV prevention under the responsibility of national programs, namely: (i) the deficit of synergies between two major components (communication for behavioural change and medical follow-ups), (ii) the lack of coordination and actions in the field, (iii) the abandonment of structural activities, (iv) low resource allocation for activities targeting FSW. Since the integration of the activities into the national programs, the capacity to provide prevention services to the FSW population, both in terms of coverage and of the package and the quality of services provided, has significantly declined, even if the strengthening of staff capacity in this domain remains an encouraging achievement.ConclusionsThe national programs of Benin and Niger do not yet cover sufficiently the most exposed groups (FSW and their partners) who are at the centre of the HIV epidemic. Thus, the study proposes reflection and action to improve coverage of this clientele in order better control of STIs and HIV.
LBP-1.08 Preliminary report on experience with point of care syphilis and HIV testing in hard-to-reach populations in outreach settings in Edmonton, Canada
Authors: Bergman J , Plitt S , Gratrix J , Conroy P , Li J , Rocco K , Fenton J , Archibald C , Wong T , Singh A 
Published: July 2011

BackgroundEdmonton is in the midst of a syphilis outbreak occurring largely in high risk and hard-to-reach populations. Point of care (POC) testing for syphilis and HIV offers the opportunity for immediate and rapid access to testing, and in the case of syphilis, immediate treatment. POC syphilis tests have not been previously evaluated in clinical settings in Canada.MethodsSince 14 February 2011, treponemal syphilis (Bioline Syphilis 3.0) and HIV (INSTI HIV-1/HIV-2 Antibody Test) POC testing, using whole blood from a finger prick specimen, has been offered to outreach clients in Edmonton. POC results were compared to standard testing from simultaneously collected serum specimens. Baseline demographics, sexual and drug use risk behaviour information were collected. Age and gender were collected on individuals who refused POC testing. A descriptive analysis was performed on the characteristics and outcomes of participants and those who refused.ResultsAs of 15 April 2011, 146 individuals had been offered POC testing; 85.6% (n=125) consented. Among participants, 59.2% (74) were male [vs 66.7% (14) of non-participants, p=0.5)] and the median age was 29 yrs (IQR 24–36 yrs) [vs non-participants median age 29 yrs (IQR 25–45 yrs), p=0.2)]. The majority of participants (83.2%; 104) were heterosexual, 59.2% (69) were Aboriginal, and 30.4% (38) reported injection drug use. Among females, 62.7% (32) reported sex trade involvement, while among males, 21.6% (16) reported sex with a sex trade worker. Of 121 syphilis treponemal POC tests, 5 (4.1%) were positive, all in old treated cases of syphilis that were asymptomatic for infectious syphilis at the time of testing. Two syphilis POC (1.7%) tests were falsely negative when compared to the standard screening test (Architect Syphilis TP Microparticles, Abbott Laboratories, Illinois, USA); both were in individuals previously treated for syphilis. Of 123 HIV POC tests, 2 (1.6%) were reactive, both newly diagnosed cases as confirmed by GS HIV-1 Western Blot (BioRad Laboratories, California, USA); both were negative by syphilis POC tests.ConclusionPreliminary results from Edmonton suggest that POC testing for syphilis and HIV is well accepted among high-risk populations in outreach settings in Edmonton. This ongoing study will assess the utility of these tests in mitigating the further spread of both syphilis and HIV through POC testing, and in the case of syphilis, POC treatment.
LBP-1.09 Services utilisation and health related variables of person living with HIV/AIDS in community in Taiwan
Authors: Chiou P Y , Lin L C 
Published: July 2011

BackgroundNon-profit organisation (NPO) is a major type to provide the services to response the needs for people living with HIV and AIDS (PLWHA) in the community in Taiwan. The purposes of the study were to describe the services and investigate the effect of the services utilisation of the services on health related variables for PLWHA.MethodsStratified random sampling and cross-sectional survey methods were used. The self-administered questionnaires include the Demographic, Utilisation and Satisfaction of the Non-Profit Organisation Services Questionnaire, CD4 count and virus load, Customised Adherence Self-Report Questionnaire, Beck Depression Inventory-II (BDI-II), and Medical Outcomes Study Short-Form Health Survey (SF-36) were used to collect date. In Utilisation and Satisfaction of the Non-Profit Organisation Services Questionnaire, the nine services form NPOs were generalised. Data were analysed using forward stepwise multiple regressions.ResultsThere were 202 study subjects (n=178, 88.1% male) and the mean age was 42.54 (SD 10.44) years. The mean virus load and CD4 count were 11 031.07 (SD 67 153.41) m/l and 425.03 (SD 209.30) mm3. The total number of service types which had had accepted by participants was 4.65 (SD 1.67). The services with highest number of users were group or activities (n=174, 86.1%) and counselling (n=137, 67.8%). Of the 137 participants who had used the counselling service, 126 (92%) will keep using counselling service. The result indicated that higher frequency of financial aid and counselling services were predictive to the lower depression level of BDI-II (F=17.51, R2=0.60, p=0.001). Higher frequency of access for medical care service could predict the higher adherence rate to cART of Customised Adherence Self-Report Questionnaire (F=6.85, R2=0.41, p=0.013). Higher frequency of access for medical care service and higher adherence rate for cART were collaboratively the predictors to the higher CD4 count (F=17.24, R2=0.55, p=0.009). The service of access for medical care, BDI-II, and CD4 were significant with quality of life for SF-36 (F=17.31, R2=0.66, p<0.000).ConclusionsThe utilisations of financial aid, counselling, and access for medical care services that provided by NPO in Taiwan were significantly with the health related variables which included the depression, adherence, CD4, and quality of life. The result could provide suggestions about refining the contents of services and promoting their function and the quality of life of PLWHA.
LBP-1.11 Acceptability of short-course AZT prevention regimen by HIV infected pregnant women; should VCT in the antenatal setting be modified
Authors: Aziz S Abdulah , Mubiru D , Rose N 
Published: July 2011

BackgroundAcceptability VCT by pregnant women is critical in the contest of trials accessing interventions to reduce mother to- child transmission of HIV. We studied the logistics and uptake of short–course oral AZT regimen by HIV-infected women after VCT in areas of Uganda.MethodsFrom June 2004, a pilot project on the feasibility of short-course AZT was launched in an antenatal clinic in mulago hospital. All pregnant women hear a 15- min talk by clinic nurses a bout mother to- child transmission of HIV and are offered voluntary pre- and post-test counselling by lay community volunteers. Consenting HIV-positive women are offered AZT (300 mg twice daily) from 36 weeks gestation until labour, one tablet at onset of labour, and then every 3 h delivery. HIV positive women are counselled and supported on their choice of infant.ResultsOver a 6-month period, 1062 antenatal women were offered VCT, 247 (22%) underwent pre-test counselling and 206 (18%) agreed to be tested. Among those tested 78 (38%) were HIV-positive, of these 17(83%) returned to collect results, including 65 HIV positive women. As of September 2004, 40 (62%) women consented for AZT, 17 women have completed the regimen, 5 are currently receiving drug, 7 are eligible to start AZT and 11 women dropped out of the study (preterm births, incorrect dates, failure to notify nurses during labour, and non-compliances). Of the 17 women who received AZT, 12 opted for formula feeding and five women chose breast feeding.ConclusionHIV prevalence in this setting is estimated at 30% of 332 projected HIV infected women seen, only 40(12%) women actually received AZT. The major barrier appears to be entrance into counselling. When counselled, most HIV-pregnant women choose to receive AZT prophylaxis. New approaches to antenatal HIV counselling and testing are urgently required to improve future acceptance of VCT and the successful implementation of antiretroviral pro-phylaxis.
LBP-1.01 The interdiction project: an innovative program for HIV + persons to reduce HIV and STD co-infection and improve HIV treatment outcomes phase II
Authors: Frimpong S , Wilson M , Mitchell-Samon L M , Azarian T 
Published: July 2011

Background/ObjectivesSTD/HIV field investigations and the initial findings of Interdiction Project reveal that some persons with HIV infection have unprotected sex, multiple anonymous sex partners, and don't disclose their HIV status. Consistent condom use is low; recurrent co-infection with STDs and HIV transmission to sex partners is high. The Interdiction Project is a clinic-based, individual-level HIV intervention that combines linkage for treatment adherence/risk reduction education and testing with ongoing monitoring of patient care and epidemiologic data system. This project targets HIV positive persons who present with a new STD or history of unprotected sex.MethodsThis is a prospective STD intervention follow-up study of 69 patients referred by HIV/AIDS and STD clinic providers and STD/HIV investigation specialist. Project staff conducted initial HIV/AIDS and STD transmission prevention and treatment monitoring knowledge plus risk assessment, intensive practical STD and HIV/AIDS health education, condom negotiation, condom skill training, sex partner elicitation for rapid HIV testing and linkage to care. STD and STD morbidity rates 18 months prior to follow-up were compared to 18 months of follow-up after referral. We analysed follow-up data to determine the STD rates, undetectable HIV viral loads and how Interdiction Project may help reduce the spread of HIV and STD co-infections.ResultsInitial findings revealed high STD morbidity since HIV diagnosis and 26 clients had 48 STDs before referral. Overall STD rate was 50.7% (35/69) at referral, 14% consistent condom use always but 96% intend to use condoms and sex partner HIV positivity rate was 30% (6/20). HIV genotype resistance was 34% (14/41). At 18 months of follow-up, significant overall STD morbidity rate reduced from 74.3% to 25.4%, RR 0.34 (95% CI 0.22 to 0.52) and RR of STD reduced from 72.5% to 23.2%, RR 0.32 (95% CI 0.20 to 0.50). Achieving higher perfect knowledge score from pre- to post-education knowledge assessment correlated with reduction in STD and STD morbidity. Significant STD rates reduction was noted for many risk categories. Clients who had undetectable viral load on HAART increased from 50% (17/34) at referral to 88.2% (30/34) at 6–9 months and 77.4% (24/31) from 13 to 18 months of follow-up.Conclusion/ImplicationInterdiction Project applies concepts of clinical epidemiology similar to in-patient hospital infection control processes and may help HIV/AIDS patients to achieve undetectable HIV viral load, reduce STD co-infection and HIV transmission. The findings suggest that epidemiologic work to reduce the spread of HIV, STD co-infection and resistant HIV must be an important component of HIV/AIDS programs and will require collaborative work by medical providers and intensive practical health education by knowledgeable HIV/AIDS health educator/epidemiologist.
Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest
Authors: Mooney Michael R. , Unger Barbara T. , Boland Lori L. , Burke M. Nicholas , Kebed Kalie Y. , Graham Kevin J. , Henry Timothy D. , Katsiyiannis William T. , Satterlee Paul A. , Sendelbach Sue , Hodges James S. , Parham William M. 
Published: July 2011

Background—
Therapeutic hypothermia (TH) improves survival and confers neuroprotection in out-of-hospital cardiac arrest (OHCA), but TH is underutilized, and regional systems of care for OHCA that include TH are needed.

Methods and Results—
The Cool It protocol has established TH as the standard of care for OHCA across a regional network of hospitals transferring patients to a central TH-capable hospital. Between February 2006 and August 2009, 140 OHCA patients who remained unresponsive after return of spontaneous circulation were cooled and rewarmed with the use of an automated, noninvasive cooling device. Three quarters of the patients (n=107) were transferred to the TH-capable hospital from referring network hospitals. Positive neurological outcome was defined as Cerebral Performance Category 1 or 2 at discharge. Patients with non–ventricular fibrillation arrest or cardiogenic shock were included, and patients with concurrent ST-segment elevation myocardial infarction (n=68) received cardiac intervention and cooling simultaneously. Overall survival to hospital discharge was 56%, and 92% of survivors were discharged with a positive neurological outcome. Survival was similar in transferred and nontransferred patients. Non–ventricular fibrillation arrest and presence of cardiogenic shock were associated strongly with mortality, but survivors with these event characteristics had high rates of positive neurological recovery (100% and 89%, respectively). A 20% increase in the risk of death (95% confidence interval, 4% to 39%) was observed for every hour of delay to initiation of cooling.

Conclusions—
A comprehensive TH protocol can be integrated into a regional ST-segment elevation myocardial infarction network and achieves broad dispersion of this essential therapy for OHCA.
Correlated k-Distribution Treatment of Cloud Optical Properties and Related Radiative Impact
Authors: Lu Peng , Zhang Hua , Li Jiangnan 
Published: July 2011

AbstractA new scheme of water cloud optical properties is proposed for correlated k-distribution (CKD) models, in which the correlation in spectral distributions between the gaseous absorption coefficient and cloud optical properties is maintained. This is an extension of the CKD method from gas to cloud by dealing with the gas absorption coefficient and cloud optical properties in the same way.Compared to the results of line-by-line benchmark calculations, the band-mean cloud optical property scheme can overestimate cloud solar heating rate, with a relative error over 30% in general. Also, the error in the flux at the top of the atmosphere can be up to 20 W m−2 at a solar zenith angle of 0°. However, the error is considerably reduced by applying the new proposed CKD cloud scheme. The physical explanation of the large error for the band-mean cloud scheme is the absence of a spectral correlation between the gaseous absorption coefficient and the cloud optical properties. The overestimation of the solar heating rate at the cloud-top layer could affect the moisture circulation and limit the growth of cloud. It is found that the error in the longwave cooling rate caused by the band-mean cloud scheme is very small. In the infrared, the local thermal emission strongly affects the spectral distribution of the radiative flux, which makes the correlation between the gaseous absorption coefficient and cloud optical properties very weak. Therefore, there is no obvious advantage in emphasizing the spectral correlation between gas and cloud.
A Study of Impacts of Coupled Model Initial Shocks and State–Parameter Optimization on Climate Predictions Using a Simple Pycnocline Prediction Model
Authors: Zhang S. 
Published: July 2011

AbstractA skillful decadal prediction that foretells varying regional climate conditions over seasonal–interannual to multidecadal time scales is of societal significance. However, predictions initialized from the climate-observing system tend to drift away from observed states toward the imperfect model climate because of the model biases arising from imperfect model equations, numeric schemes, and physical parameterizations, as well as the errors in the values of model parameters. Here, a simple coupled model that simulates the fundamental features of the real climate system and a “twin” experiment framework are designed to study the impact of initialization and parameter optimization on decadal predictions. One model simulation is treated as “truth” and sampled to produce “observations” that are assimilated into other simulations to produce observation-estimated states and parameters. The degree to which the model forecasts based on different estimates recover the truth is an assessment of the impact of coupled initial shocks and parameter optimization on climate predictions of interests. The results show that the coupled model initialization through coupled data assimilation in which all coupled model components are coherently adjusted by observations minimizes the initial coupling shocks that reduce the forecast errors on seasonal–interannual time scales. Model parameter optimization with observations effectively mitigates the model bias, thus constraining the model drift in long time-scale predictions. The coupled model state–parameter optimization greatly enhances the model predictability. While valid “atmospheric” forecasts are extended 5 times, the decadal predictability of the “deep ocean” is almost doubled. The coherence of optimized model parameters and states is critical to improve the long time-scale predictions.
Impact of ENSO on the Atmospheric Variability over the North Atlantic in Late Winter—Role of Transient Eddies
Authors: Li Ying , Lau Ngar-Cheung 
Published: July 2011

Abstract
The dynamical mechanism for the late-winter teleconnection between El Niño–Southern Oscillation (ENSO) and the North Atlantic Oscillation (NAO) is examined using the output from a 2000-yr integration of a coupled general circulation model (GCM). The coupled model captures many salient features of the observed behavior of both ENSO and NAO, as well as their impact on the surface climate in late winter. Both the observational and model data indicate more occurrences of negative phase of NAO in late winter during El Niño events, and positive NAO in La Niña episodes.
The potential role of high-frequency transient eddies in the above teleconnection is diagnosed. During El Niño winters, the intensified transient disturbances along the equatorward-shifted North Pacific storm track extend their influences farther downstream. The eddy-induced negative height tendencies are found to be more coherent and stronger over North Atlantic than that over North Pacific. These negative height tendencies over the North Atlantic are coincident with the southern lobe of NAO, and thus favor more occurrences of negative NAO events.
During those El Niño winters with relatively strong SST warming in eastern equatorial Pacific, the eastward extension of eddy activity is reinforced by the enhanced near-surface baroclinicity over the subtropical eastern Pacific. This flow environment supports a stronger linkage between the Pacific and Atlantic storm tracks, and is more conducive to a negative NAO phase.
These model results are supported by a parallel analysis of various observational datasets. It is further demonstrated that these transient eddy effects can be reproduced in atmospheric GCM integrations subjected to ENSO-related SST forcing in the tropical Pacific.