scholarly journals Understanding the Acceptability of Subdermal Implants as a Possible New HIV Prevention Method: Multi-Stage Mixed Methods Study

10.2196/16904 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e16904
Author(s):  
Christine Tagliaferri Rael ◽  
Cody Lentz ◽  
Alex Carballo-Diéguez ◽  
Rebecca Giguere ◽  
Curtis Dolezal ◽  
...  
Keyword(s):  
Side Effects ◽  
Literature Review ◽  
Scientific Literature ◽  
Mixed Methods Study ◽  
Web Based ◽  
Stage 4 ◽  
Subdermal Implants ◽  
Contraceptive Implants ◽  
Stage 1 ◽  
Oral Prep

Background A long-acting implant for HIV pre-exposure prophylaxis (PrEP) is in development in the Sustained Long-Action Prevention Against HIV (SLAP-HIV) trial. This could provide an alternative to oral PrEP. Objective Our mixed methods study aimed to understand (1) users’ experiences with a similar subdermal implant for contraception and (2) factors influencing the likelihood that gay and bisexual men (GBM) would use a proposed PrEP implant. Methods Work was completed in 4 stages. In stage 1, we conducted a scientific literature review on existing subdermal implants, focusing on users’ experiences with implant devices. In stage 2, we reviewed videos on YouTube, focusing on the experiences of current or former contraceptive implant users (as these implants are similar to those in development in SLAP-HIV). In stage 3, individuals who indicated use of a subdermal implant for contraception in the last 5 years were recruited via a web-based questionnaire. Eligible participants (n=12 individuals who liked implants a lot and n=12 individuals who disliked implants a lot) completed in-depth phone interviews (IDIs) about their experiences. In stage 4, results from IDIs were used to develop a web-based survey for HIV-negative GBM to rate their likelihood of using a PrEP implant on a scale (1=very unlikely and 5=very likely) based on likely device characteristics and implant concerns identified in the IDIs. Results In the scientific literature review (stage 1), concerns about contraceptive implants that could apply to the PrEP implants in development included potential side effects (eg, headache), anticipated high cost of the device, misconceptions about PrEP implants (eg, specific contraindications), and difficulty accessing PrEP implants. In the stage 2 YouTube review, individuals who had used contraceptive implants reported mild side effects related to their device. In stage 3, implant users reported that devices were comfortable, unintrusive, and presented only minor discomfort (eg, bruising) before or after insertion and removal. They mainly reported removing or disliking the device due to contraceptive-related side effects (eg, prolonged menstruation). Participants in the stage 4 quantitative survey (N=304) were mainly gay (204/238, 85.7%), white (125/238, 52.5%), cisgender men (231/238, 97.1%), and 42.0% (73/174) of them were on oral PrEP. Not having to take a daily pill increased the likelihood of using PrEP implants (mean 4.13). Requiring >1 device to achieve 1 year of protection (mean range 1.79-2.94) mildly discouraged PrEP implant use. Participants did not mind moderate bruising, a small scar, tenderness, or bleeding after insertion or removal, and an implant with a size slightly larger than a matchstick (mean ratings 3.18-3.69). Conclusions PrEP implants are promising among GBM. Implant features and insertion or removal-related concerns do not seem to discourage potential users. To ensure acceptability, PrEP implants should require the fewest possible implants for the greatest protection duration.

scholarly journals Understanding the Acceptability of Subdermal Implants as a Possible New HIV Prevention Method: Multi-Stage Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Christine Tagliaferri Rael ◽  
Cody Lentz ◽  
Alex Carballo-Diéguez ◽  
Rebecca Giguere ◽  
Curtis Dolezal ◽  
...  
Keyword(s):  
Side Effects ◽  
Literature Review ◽  
Scientific Literature ◽  
Mixed Methods Study ◽  
Web Based ◽  
Stage 4 ◽  
Subdermal Implants ◽  
Contraceptive Implants ◽  
Stage 1 ◽  
Oral Prep

BACKGROUND A long-acting implant for HIV pre-exposure prophylaxis (PrEP) is in development in the Sustained Long-Action Prevention Against HIV (SLAP-HIV) trial. This could provide an alternative to oral PrEP. OBJECTIVE Our mixed methods study aimed to understand (1) users’ experiences with a similar subdermal implant for contraception and (2) factors influencing the likelihood that gay and bisexual men (GBM) would use a proposed PrEP implant. METHODS Work was completed in 4 stages. In stage 1, we conducted a scientific literature review on existing subdermal implants, focusing on users’ experiences with implant devices. In stage 2, we reviewed videos on YouTube, focusing on the experiences of current or former contraceptive implant users (as these implants are similar to those in development in SLAP-HIV). In stage 3, individuals who indicated use of a subdermal implant for contraception in the last 5 years were recruited via a web-based questionnaire. Eligible participants (n=12 individuals who liked implants a lot and n=12 individuals who disliked implants a lot) completed in-depth phone interviews (IDIs) about their experiences. In stage 4, results from IDIs were used to develop a web-based survey for HIV-negative GBM to rate their likelihood of using a PrEP implant on a scale (1=very unlikely and 5=very likely) based on likely device characteristics and implant concerns identified in the IDIs. RESULTS In the scientific literature review (stage 1), concerns about contraceptive implants that could apply to the PrEP implants in development included potential side effects (eg, headache), anticipated high cost of the device, misconceptions about PrEP implants (eg, specific contraindications), and difficulty accessing PrEP implants. In the stage 2 YouTube review, individuals who had used contraceptive implants reported mild side effects related to their device. In stage 3, implant users reported that devices were comfortable, unintrusive, and presented only minor discomfort (eg, bruising) before or after insertion and removal. They mainly reported removing or disliking the device due to contraceptive-related side effects (eg, prolonged menstruation). Participants in the stage 4 quantitative survey (N=304) were mainly gay (204/238, 85.7%), white (125/238, 52.5%), cisgender men (231/238, 97.1%), and 42.0% (73/174) of them were on oral PrEP. Not having to take a daily pill increased the likelihood of using PrEP implants (mean 4.13). Requiring >1 device to achieve 1 year of protection (mean range 1.79-2.94) mildly discouraged PrEP implant use. Participants did not mind moderate bruising, a small scar, tenderness, or bleeding after insertion or removal, and an implant with a size slightly larger than a matchstick (mean ratings 3.18-3.69). CONCLUSIONS PrEP implants are promising among GBM. Implant features and insertion or removal-related concerns do not seem to discourage potential users. To ensure acceptability, PrEP implants should require the fewest possible implants for the greatest protection duration.

scholarly journals Evaluation of subdermal implants among family planning acceptors in a tertiary hospital, Nigeria

2020 ◽  
Vol 8 (2) ◽  
pp. 271-278
Author(s):  
Nonye-Enyidah Esther Ijeoma ◽  
Enyidah Nonyenim Solomon
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Formal Education ◽  
Tertiary Hospital ◽  
The Body ◽  
University Teaching ◽  
Unintended Pregnancies ◽  
Subdermal Implants ◽  
Pearl Index ◽  
Contraceptive Implants

Background: Subdermal contraceptive implants are safe, convenient, very effective and reversible. Though they have numerous benefits, their use is still discontinued due to various reasons including side effects in the body of acceptors. Objective: To determine and compare the prevalence rates, side effects, discontinuation rates and indications for discontinuation of two subdermal implants (Jadelle and Implanon) at Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria. Methods: A retrospective study of 874 clients attending family planning clinic at the RSUTH from 1st January, 2015 – 31st December, 2019 was conducted. Their records were retrieved from the clinic and reviewed. Data was extracted, coded and analyzed using the statistical package for social sciences (SPSS) IBM version 25.0 (Armonk, NY). Result: Four hundred and twenty five women used subdermal implants out of 874 acceptors of contraceptives within the study period giving an uptake rate of 48.6%. Implanon was more preferred accounting for 66.6% and Jadelle 33.4%. The mean age was 33.24+4.13 years. Most age group was 30-34 years accounting for 51.3%. Age range was 20-48 years and most (80%) were multiparous. Most (99.1%) were Christians and 98.4% were married. Only one client (0.2%) had no formal education. Seventy three (26.4%) acceptors discontinued the use. Most were due to desire for pregnancy (46.4%) and menorrhagia (24.1%). Four unintended pregnancies occurred giving a Pearl index of 0.9. Conclusion: Subdermal implants are safe and effective. Menstrual abnormality and desire for pregnancy were the commonest reasons for discontinuation.

scholarly journals Network Biomarkers of Bladder Cancer Based on a Genome-Wide Genetic and Epigenetic Network Derived from Next-Generation Sequencing Data

2016 ◽  
Vol 2016 ◽  
pp. 1-18 ◽  
Author(s):  
Cheng-Wei Li ◽  
Bor-Sen Chen
Keyword(s):  
Cell Proliferation ◽  
Bladder Cancer ◽  
Side Effects ◽  
Regulatory Networks ◽  
Multiple Drug ◽  
Genome Wide ◽  
Stage 4 ◽  
Network Biomarkers ◽  
Stage 1 ◽  
Generation Sequencing

Epigenetic and microRNA (miRNA) regulation are associated with carcinogenesis and the development of cancer. By using the available omics data, including those from next-generation sequencing (NGS), genome-wide methylation profiling, candidate integrated genetic and epigenetic network (IGEN) analysis, and drug response genome-wide microarray analysis, we constructed an IGEN system based on three coupling regression models that characterize protein-protein interaction networks (PPINs), gene regulatory networks (GRNs), miRNA regulatory networks (MRNs), and epigenetic regulatory networks (ERNs). By applying system identification method and principal genome-wide network projection (PGNP) to IGEN analysis, we identified the core network biomarkers to investigate bladder carcinogenic mechanisms and design multiple drug combinations for treating bladder cancer with minimal side-effects. The progression of DNA repair and cell proliferation in stage 1 bladder cancer ultimately results not only in the derepression of miR-200a and miR-200b but also in the regulation of the TNF pathway to metastasis-related genes or proteins, cell proliferation, and DNA repair in stage 4 bladder cancer. We designed a multiple drug combination comprising gefitinib, estradiol, yohimbine, and fulvestrant for treating stage 1 bladder cancer with minimal side-effects, and another multiple drug combination comprising gefitinib, estradiol, chlorpromazine, and LY294002 for treating stage 4 bladder cancer with minimal side-effects.

Effect of the patient's age on radiotherapy-based adverse effect.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19575-e19575
Author(s):  
Yillar Okur ◽  
Birsen Yucel ◽  
Ebru Atasever Akkas ◽  
Mehmet Fuat Eren ◽  
Nalan Akgul Babacan ◽  
...  
Keyword(s):  
Side Effects ◽  
Radiation Oncology ◽  
Radiation Therapy Oncology Group ◽  
Eastern Cooperative Oncology Group ◽  
Significant Other ◽  
Oncology Group ◽  
Number Of Patients ◽  
Stage 4 ◽  
Acute Side Effects ◽  
Stage 1

e19575 Background: We aim to determine the acute side effects of radiotherapy and the contribution of age to side effect occurrence in patients treated with radiotherapy. Methods: The data of 346 patients having treatment at Cumhuriyet University Radiation Oncology Department in 2010 and 2011 were analyzed. The patients were evaluated according to Radiation Therapy Oncology Group (RTOG) one a week after starting to radiotherapy. Results: There were 167 women (48%) and 179 men (52%). Two-hundred-forty-seven (71%) of the patients were under the age of 65, 99 (29) were above the age of 65. Eastern Cooperative Oncology Group (ECOG) performance situation was 0, 1 and 2 in 278 (80%), 51 (15%) and 19 (5%) patients. Stage 1, 2, 3 and without metastasis stage 4 were found in 30 (9%), 105 (30%), 172 (50%) and 39 (11%) patients. Radiotherapy was applied to 55 head and neck regions (16%), 31 brains (9%), 86 breasts (25%), 30 thoraxes (9%), 52 abdomens (15%) and 90 pelvises (26%). Fifty-four patients (55%) of above the age of 65 received radiotherapy, 45 patients (45%) received chemoradiotherapy. One-hundred-twenty-six patients (51%) of under the age of 65, received radiotherapy and 121 patients (49%) received chemoradiotherapy. For all the patients, the ratio of radiotherapy dependent side effects was 89% (307). The verage time for occurrence was two weeks. When the treatment was over, the number of patients who lost more than five kg was 42 (12%). ECOG difference was seen in 70 (18%) patients. Twelve of them (4%) showed recovery in ECOG performance, 50 (16%) patients showed disruption. Seventy-nine patients (23%) had a interruption in treatment because of the side effects. The occurrence of dermal side effects was higher in the group of patients below the age of 65 and the occurrence of genitourinary side effects was higher in patients above the age of 65. Thedifferences for both of the side effects were statistically significant. Other side effects and time showed no difference between the patients under 65 and patients above 65. Conclusions: The age does not affect the acute side effects of radiotherapy or chemoradiotherapy, so that both groups can tolerate radiotherapy and chemoradiotherapy.

Alterations in the number of motoneurons containing immunoreactive calcitonin gene-related peptide(CGRP)& choline acetyltransferase(ChAT) in the cervical spinal cord of the wobbler mouse during the development of the motoneuron disease

1995 ◽  
Vol 53 ◽  
pp. 970-971
Author(s):  
L. Vacca-Galloway ◽  
Y.Q. Zhang ◽  
P. Bose ◽  
S.H. Zhang
Keyword(s):  
Spinal Cord ◽  
Early Stage ◽  
Cervical Spinal Cord ◽  
Wild Type Mouse ◽  
Reflex Response ◽  
Mouse Strains ◽  
Behavioral Tests ◽  
Wobbler Mouse ◽  
Stage 4 ◽  
Stage 1

The Wobbler mouse (wr) has been studied as a model for inherited human motoneuron diseases (MNDs). Using behavioral tests for forelimb power, walking, climbing, and the “clasp-like reflex” response, the progress of the MND can be categorized into early (Stage 1, age 21 days) and late (Stage 4, age 3 months) stages. Age-and sex-matched normal phenotype littermates (NFR/wr) were used as controls (Stage 0), as well as mice from two related wild-type mouse strains: NFR/N and a C57BI/6N. Using behavioral tests, we also detected pre-symptomatic Wobblers at postnatal ages 7 and 14 days. The mice were anesthetized and perfusion-fixed for immunocytochemical (ICC) of CGRP and ChAT in the spinal cord (C3 to C5).Using computerized morphomety (Vidas, Zeiss), the numbers of IR-CGRP labelled motoneurons were significantly lower in 14 day old Wobbler specimens compared with the controls (Fig. 1). The same trend was observed at 21 days (Stage 1) and 3 months (Stage 4). The IR-CGRP-containing motoneurons in the Wobbler specimens declined progressively with age.

SARS-CoV-2 Biology Insights, Part I. Genome-wide structure and druggability: literature review (Preprint)

2020 ◽  
Author(s):  
Laura Lafon-Hughes
Keyword(s):  
Side Effects ◽  
Literature Review ◽  
Host Cell ◽  
Nucleoside Analogs ◽  
Viral Proteins ◽  
Therapeutic Strategies ◽  
Adverse Side Effects ◽  
Viral Proteases ◽  
Genome Wide ◽  
Therapeutic Alternatives

BACKGROUND COVID-19 pandemic prompts the study of coronavirus biology and search of putative therapeutic strategies. OBJECTIVE To compare SARS-CoV-2 genome-wide structure and proteins with other coronaviruses, focusing on putative coronavirus-specific or SARS-CoV-2 specific therapeutic designs. METHODS The genome-wide structure of SARS-CoV-2 was compared to that of SARS and other coronaviruses in order to gain insights, doing a literature review through Google searches. RESULTS There are promising therapeutic alternatives. Host cell targets could be modulated to hamper viral replication, but targeting viral proteins directly would be a better therapeutic design, since fewer adverse side effects would be expected. CONCLUSIONS Therapeutic strategies (Figure 1) could include the modulation of host targets (PARPs, kinases) , competition with G-quadruplexes or nucleoside analogs to hamper RDRP. The nicest anti-CoV options include inhibitors of the conserved essential viral proteases and drugs that interfere ribosome slippage at the -1 PRF site.

Novel staging classification of primary mitral regurgitation based on the presence of cardiac damage

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.L Van Wijngaarden ◽  
Y.L Hiemstra ◽  
P Van Der Bijl ◽  
V Delgado ◽  
N Ajmone Marsan ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Kidney Function ◽  
Left Ventricular ◽  
Prognostic Impact ◽  
Cardiac Damage ◽  
Stage 4 ◽  
All Cause Mortality ◽  
Primary Mitral Regurgitation ◽  
Stage 1 ◽  
Staging Classification

Abstract Background The indication for surgery in patients with severe primary mitral regurgitation (MR) is currently based on the presence of symptoms, left ventricular (LV) dilatation and dysfunction, atrial fibrillation and pulmonary hypertension. The aim of this study was to evaluate the prognostic impact of a new staging classification based on cardiac damage including the known risk factors but also including global longitudinal strain (GLS), severe left atrial (LA) dilatation and right ventricular (RV) dysfunction. Methods In total 614 patients who underwent surgery for severe primary MR with available baseline transthoracic echocardiograms were included. Patients were classified according to the extent of cardiac damage (Figure): Stage 0-no cardiac damage, Stage 1-LV damage, Stage 2-LA damage, Stage 3-pulmonary vasculature or tricuspid valve damage and Stage 4-RV damage. Patients were followed for all-cause mortality. Results Based on the proposed classification, 172 (28%) patients were classified as Stage 0, 102 (17%) as Stage 1, 134 (21%) as Stage 2, 135 (22%) as Stage 3 and 71 (11%) as Stage 4. The more advanced the stage, the older the patients were with worse kidney function, more symptoms and higher EuroScore. Kaplan-Meier curve analysis revealed that patients with more advanced stages of cardiac damage had a significantly worse survival (log-rank chi-square 35.2; p<0.001) (Figure). On multivariable analysis, age, male, chronic obstructive pulmonary disease, kidney function, and stage of cardiac damage were independently associated with all-cause mortality. For each stage increase, a 22% higher risk for all-cause mortality was observed (95% CI: 1.064–1.395; p=0.004). Conclusion In patients with severe primary MR, a novel staging classification based on the extent of cardiac damage, may help refining risk stratification, particularly including also GLS, LA dilatation and RV dysfunction in the assessment. Funding Acknowledgement Type of funding source: None

A Description of Middle School Male Singers’ Voice Change and Voice Part Assignment

2021 ◽  
pp. 875512332110182
Author(s):  
Ryan Austin Fisher ◽  
Nancy L. Summitt ◽  
Ellen B. Koziel
Keyword(s):  
Middle School ◽  
Sixth Grade ◽  
Eighth Grade ◽  
Voice Change ◽  
Stage 4 ◽  
Public Middle School ◽  
Middle School Choir ◽  
Choral Programs ◽  
Stage 1 ◽  
The Voice

The purpose of this study was to describe the voice change and voice part assignment of male middle school choir members. Volunteers ( N = 92) were recruited from three public middle school choral programs (Grades 6-8). Participants were audio-recorded performing simple vocal tasks in order to assess vocal range and asked to share the music they were currently singing in class. Results revealed 23.91% of participants’ voices could be categorized as unchanged, 14.13% as Stage 1, 3.26% as Stage 2, 10.87% as Stage 3, 26.09% as Stage 4, and 21.74% as Stage 5. The majority of sixth-grade participants were classified as unchanged or in Stage 1 of the voice change and the majority of eighth-grade participants were classified in Stages 4 to 5 of the voice change. Of the participants labeled “tenors” in their choir, over 60% were classified as either unchanged voices or in Stage 1 of the voice change.

scholarly journals Temporal changes of quantitative CT findings from 102 patients with COVID-19 in Wuhan, China: A longitudinal study

2021 ◽  
Vol 29 ◽  
pp. 297-309
Author(s):  
Xiaohui Chen ◽  
Wenbo Sun ◽  
Dan Xu ◽  
Jiaojiao Ma ◽  
Feng Xiao ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Early Stage ◽  
Temporal Changes ◽  
Time Interval ◽  
Lesion Area ◽  
Quantitative Ct ◽  
Diagnosis And Prognosis ◽  
Ct Findings ◽  
Stage 4 ◽  
Stage 1

BACKGROUND: Computed tomography (CT) imaging combined with artificial intelligence is important in the diagnosis and prognosis of lung diseases. OBJECTIVE: This study aimed to investigate temporal changes of quantitative CT findings in patients with COVID-19 in three clinic types, including moderate, severe, and non-survivors, and to predict severe cases in the early stage from the results. METHODS: One hundred and two patients with confirmed COVID-19 were included in this study. Based on the time interval between onset of symptoms and the CT scan, four stages were defined in this study: Stage-1 (0 ∼7 days); Stage-2 (8 ∼ 14 days); Stage-3 (15 ∼ 21days); Stage-4 (> 21 days). Eight parameters, the infection volume and percentage of the whole lung in four different Hounsfield (HU) ranges, ((-, -750), [-750, -300), [-300, 50) and [50, +)), were calculated and compared between different groups. RESULTS: The infection volume and percentage of four HU ranges peaked in Stage-2. The highest proportion of HU [-750, 50) was found in the infected regions in non-survivors among three groups. CONCLUSIONS: The findings indicate rapid deterioration in the first week since the onset of symptoms in non-survivors. Higher proportion of HU [-750, 50) in the lesion area might be a potential bio-marker for poor prognosis in patients with COVID-19.

On the use of leading safety indicators in maritime and their feasibility for Maritime Autonomous Surface Ships

2021 ◽  
pp. 1748006X2110276
Author(s):  
Krzysztof Wróbel ◽  
Mateusz Gil ◽  
Przemysław Krata ◽  
Karol Olszewski ◽  
Jakub Montewka
Keyword(s):  
Literature Review ◽  
Current Practice ◽  
Scientific Literature ◽  
Research Effort ◽  
Holistic Approach ◽  
Research Directions ◽  
Safety Critical ◽  
Intact Stability ◽  
Conference Papers ◽  
Operational Aspects

Although the safety of prospective Maritime Autonomous Surface Ships will largely depend on their ability to detect potential hazards and react to them, the contemporary scientific literature lacks the analysis of how to achieve this. This could be achieved through an application of leading safety indicators. The aim of the performed study was to identify the research directions of leading safety indicators in three safety-critical operational aspects of Maritime Autonomous Surface Ships: collision avoidance, intact stability, and communication. To achieve this, literature review is performed, taking into account scientific documents including journal and conference papers. The results indicate that the need for establishing operational leading safety indicators is recognized by numerous scholars, who sometimes make suggestions of what the set of indicators shall consist of. Some leading safety indicators for autonomous vessels are readily identifiable in the scientific literature and used in current practice. However, the research effort is lacking a holistic approach to the issue.

Sign in / Sign up

Export Citation Format

Share Document