Response to Chapter 10 “I Will Treat All My Students with Respect”: The Limits of Good Intentions

Damaged or disabled tissue is life-threatening due to the lack of proper treatment. Many conventional transplantation methods like autograft, iso-graft and allograft are in existence for ages, but they are not sufficient to treat all types of tissue or organ damages. Stem cells, with their unique capabilities like self-renewal and differentiate into various cell types, can be a potential strategy for tissue regeneration. However, the challenges like reproducibility, uncontrolled propagation and differentiation, isolation of specific kinds of cell and tumorigenic nature made these stem cells away from clinical application. Today, various types of stem cells like embryonic, fetal or gestational tissue, mesenchymal and induced-pluripotent stem cells are under investigation for their clinical application. Tissue engineering helps in configuring the stem cells to develop into a desired viable tissue, to use them clinically as a substitute for the conventional method. The use of stem cell-derived Extracellular Vesicles (EVs) is being studied to replace the stem cells, which decreases the immunological complications associated with the direct administration of stem cells. Tissue engineering also investigates various biomaterials to use clinically, either to replace the bones or as a scaffold to support the growth of stemcells/ tissue. Depending upon the need, there are various biomaterials like bio-ceramics, natural and synthetic biodegradable polymers to support replacement or regeneration of tissue. Like the other fields of science, tissue engineering is also incorporating the nanotechnology to develop nano-scaffolds to provide and support the growth of stem cells with an environment mimicking the Extracellular matrix (ECM) of the desired tissue. Tissue engineering is also used in the modulation of the immune system by using patient-specific Mesenchymal Stem Cells (MSCs) and by modifying the physical features of scaffolds that may provoke the immune system. This review describes the use of various stem cells, biomaterials and the impact of nanotechnology in regenerative medicine.

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Fellow Creatures

10.1093/oso/9780198753858.001.0001 ◽

2018 ◽

Cited By ~ 25

Author(s):

Christine M. Korsgaard

Keyword(s):

The Other ◽

Moral Standing ◽

Human Beings ◽

Good For ◽

Treat All ◽

The Right ◽

The Relationship

This book argues that we are obligated to treat all sentient animals as “ends in themselves.” Drawing on a theory of the good derived from Aristotle, it offers an explanation of why animals are the sorts of beings who have a good. Drawing on a revised version of Kant’s argument for the value of humanity, it argues that rationality commits us to claiming the standing of ends in ourselves in two senses. As autonomous beings, we claim to be ends in ourselves when we claim the standing to make laws for ourselves and each other. As beings who have a good, we also claim to be ends in ourselves when we take the things that are good for us to be good absolutely and so worthy of pursuit. The first claim commits us to joining with other autonomous beings in relations of reciprocal moral lawmaking. The second claim commits us to treating the good of every sentient animal as something of absolute importance. The book also argues that human beings are not more important than, superior to, or better off than the other animals. It criticizes the “marginal cases” argument and advances a view of moral standing as attaching to the atemporal subjects of lives. It offers a non-utilitarian account of the relationship between the good and pleasure, and addresses questions about the badness of extinction and about whether we have the right to eat animals, experiment on them, make them work for us, and keep them as pets.

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Incidence of Herpes Zoster in HIV-Infected Patients Undergoing Antiretroviral Therapy: A Systematic Review and Meta-analysis

Journal of Clinical Medicine ◽

10.3390/jcm10112300 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2300

Author(s):

Han-Chang Ku ◽

Yi-Tseng Tsai ◽

Sriyani-Padmalatha Konara-Mudiyanselage ◽

Yi-Lin Wu ◽

Tsung Yu ◽

...

Keyword(s):

Systematic Review ◽

Herpes Zoster ◽

Antiretroviral Therapy ◽

Random Effects ◽

Meta Analysis ◽

People Living With Hiv ◽

Funnel Plots ◽

Sex With Men ◽

Treat All ◽

Living With Hiv

The incidence of herpes zoster (HZ) in patients infected with HIV is higher than that of the general population. However, the incidence of HZ in HIV patients receiving antiretroviral therapy (ART) remains unclear. This meta-analysis aimed to estimate the pooled incidence rate and risk factors for HZ in the post-ART era. We identified studies assessing the incidence of HZ in the post-ART era between 1 January 2000 and 28 February 2021, from four databases. Pooled risk ratios were calculated from 11 articles using a random-effects model. The heterogeneity of the included trials was evaluated by visually inspecting funnel plots, performing random-effects meta-regression and using I2 statistics. Of the 2111 studies screened, we identified 11 studies that were eligible for final inclusion in the systematic review and 8 studies that were eligible for a meta-analysis. The pooled incidence of HZ in the post-ART era (after the introduction of ART in 1997) was 2.30 (95% confidence interval (CI): 1.56–3.05) per 100 person years (PYs). The risks of incidence of HZ among people living with HIV included male sex (AOR: 4.35 (95% CI: 054–2.41)), men who have sex with men (AOR: 1.21 (95% CI: −0.76–1.13)), CD4 count < 200 cells/μL (AOR: 11.59 (95% CI: 0.53–4.38)) and not receiving ART (AOR: 2.89 (95% CI: −0.44–2.56)). The incidence of HZ is substantially lower among HIV infected patients receiving ART than those not receiving ART. Initiating ART immediately after diagnosis to treat all HIV-positive individuals is crucial to minimize the disease burden of HZ.

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Gender, Mental Health, and Entry Into Care with Advanced HIV Among People Living with HIV in Cameroon Under a National ‘Treat All’ Policy

AIDS and Behavior ◽

10.1007/s10461-021-03328-3 ◽

2021 ◽

Author(s):

Angela M. Parcesepe ◽

Lindsey M. Filiatreau ◽

Peter Vanes Ebasone ◽

Anastase Dzudie ◽

Rogers Ajeh ◽

...

Keyword(s):

Mental Health ◽

People Living With Hiv ◽

Treat All ◽

Living With Hiv

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Impact of immediate initiation of antiretroviral therapy among men who have sex with men infected with HIV in Chengdu, southwest China: trends analysis, 2008–2018

BMC Public Health ◽

10.1186/s12889-021-10580-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chenyao Wu ◽

Baiyang Zhang ◽

Zhen Dai ◽

Qianwen Zheng ◽

Zhenhua Duan ◽

...

Keyword(s):

Southwest China ◽

Temporal Trends ◽

Interrupted Time Series ◽

Health Information Systems ◽

Hiv Diagnosis ◽

Annual Percent Change ◽

Percent Change ◽

Hiv Epidemic ◽

Sex With Men ◽

Treat All

Abstract Background Given the rampant HIV epidemic among men who have sex with men (MSM) in Chengdu, southwest China, Treat All policy, defined as immediate antiretroviral therapy (ART) initiation after HIV diagnosis, was implemented since 2014. Real-world research evaluating impacts of immediate ART on HIV epidemics is needed to optimize policy-making as national and international guidelines have been lowering ART eligibility threshold. The purpose of this study is to: assess temporal trends of the HIV epidemic and impacts of Treat All policy among MSM; and lay foundation for HIV-related policy evaluation using longitudinal routine data from health information systems. Methods Data used in this study were HIV sentinel seroprevalence, annual reported HIV cases and ART coverage rate among MSM in Chengdu from 2008 to 2018, derived from national HIV/AIDS information system. Temporal trends of the HIV epidemic were described using Joinpoint Regression Program. Interrupted time-series method was deployed to evaluate Treat All policy. Results HIV sentinel seroprevalence rose from 11.20% in 2008 to 17.67% in 2013 and Annual Percent Change (APC) was 8.25% (95% CI − 2.40%, 20.07%), then decreased to 5.17% in 2018 (APC = − 19.63%, 95% CI − 27.54%, − 10.86%). Newly reported HIV cases increased from 168 cases in 2008 to 1232 cases in 2015 (APC = 26.99%, 95% CI 21.32%, 32.93%), and reduced to 1014 cases in 2018 (APC = − 8.80%, 95% CI − 18.45%, 2.01%). ART coverage rate has been climbing from 11.11% in 2008 to 92.29% in 2018 and Average Annual Percent Change was 16.09% (95% CI 11.76%, 20.59%). Results of interrupted time-series models showed that compared to an annual increase of 0.87% during pre-policy period, there was a decline of 3.08% (95% CI − 0.0366%, − 0.0250%) per year of HIV sentinel seroprevalence since 2014; and compared to an annual increase of 116 cases before 2014, there was an annual drop of 158 newly reported HIV cases (95% CI − 194.87%, − 121.69%) during the post-policy period. Conclusions Immediate ART after HIV diagnosis could potentially curb HIV transmission at population level among MSM, along with other strategies. Future assessment of HIV prevention and control policy can be carried out using routinely collected longitudinal data from health information systems.

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Understanding the Reasons for Deferring ART Among Patients Diagnosed Under the Same-Day-ART Policy in Johannesburg, South Africa

AIDS and Behavior ◽

10.1007/s10461-021-03171-6 ◽

2021 ◽

Author(s):

Dorina Onoya ◽

Tembeka Sineke ◽

Idah Mokhele ◽

Jacob Bor ◽

Matthew P. Fox ◽

...

Keyword(s):

South Africa ◽

Hiv Testing ◽

Self Report ◽

Hiv Diagnosis ◽

Adjusted Risk ◽

Art Initiation ◽

Art Policy ◽

Universal Test And Treat ◽

Post Test ◽

Treat All

AbstractWe aimed to examine the correlates of antiretroviral therapy (ART) deferral to inform ART demand creation and retention interventions for patients diagnosed with HIV during the Universal Test and Treat (UTT) policy in South Africa. We conducted a cohort study enrolling newly diagnosed HIV-positive adults (≥ 18 years), at four primary healthcare clinics in Johannesburg between October 2017 and August 2018. Patients were interviewed immediately after HIV diagnosis, and ART initiation was determined through medical record review up to six-months post-test. ART deferral was defined as not starting ART six months after HIV diagnosis. Participants who were not on ART six-months post-test were traced and interviewed telephonically to determine reasons for ART deferral. Modified Poisson regression was used to evaluate correlates of six-months ART deferral. We adjusted for baseline demographic and clinical factors. We present crude and adjusted risk ratios (aRR) associated with ART deferral. Overall, 99/652 (15.2%) had deferred ART by six months, 20.5% men and 12.2% women. Baseline predictors of ART deferral were older age at diagnosis (adjusted risk ratio (aRR) 1.5 for 30–39.9 vs 18–29.9 years, 95% confidence intervals (CI): 1.0–2.2), disclosure of intentions to test for HIV (aRR 2.2 non-disclosure vs disclosure to a partner/spouse, 95% CI: 1.4–3.6) and HIV testing history (aRR 1.7 for > 12 months vs < 12 months/no prior test, 95% CI: 1.0–2.8). Additionally, having a primary house in another country (aRR 2.1 vs current house, 95% CI: 1.4–3.1) and testing alone (RR 4.6 vs partner/spouse support, 95% CI: 1.2–18.3) predicted ART deferral among men. Among the 43/99 six-months interviews, women (71.4%) were more likely to self-report ART initiation than men (RR 0.4, 95% CI: 0.2–0.8) and participants who relocated within SA (RR 2.1 vs not relocated, 95% CI: 1.2–3.5) were more likely to still not be on ART. Under the treat-all ART policy, nearly 15.2% of study participants deferred ART initiation up to six months after the HIV diagnosis. Our analysis highlighted the need to pay particular attention to patients who show little social preparation for HIV testing and mobile populations.

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Avoid a ???treat all??? strategy for aciclovir

Inpharma Weekly ◽

10.2165/00128413-199409350-00016 ◽

1994 ◽

Vol &NA; (935) ◽

pp. 8

Author(s):

&NA;

Keyword(s):

Treat All

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A New Computationally Efficient Model for Tempering in Multi-Tracks Laser Hardening

ASME 2009 International Manufacturing Science and Engineering Conference, Volume 2 ◽

10.1115/msec2009-84093 ◽

2009 ◽

Cited By ~ 3

Author(s):

Alessandro Fortunato ◽

Leonardo Orazi ◽

Giovanni Tani

Keyword(s):

Process Parameters ◽

Laser Power ◽

Laser Scanning ◽

Original Model ◽

Laser Hardening ◽

Computationally Efficient ◽

Laser Process ◽

Treat All ◽

Tempering Time ◽

Experimental Comparisons

The bottleneck in laser hardening principally occurs when large surfaces have to be treated because this process situation leads to multi-tracks laser scanning in order to treat all the component surface. Unfortunately, multi-tracks laser trajectories generate an unwanted tempering effect that depends on the overlapping of two close trajectories. To reduce the softening effects, a simulator capable to optimize the process parameters such as laser power and speed, number and types of trajectories, could sensibly increase the applicability of the process. In this paper an original model for the tempering is presented. By introducing a tempering time factor for the martensitic transformation, the hardness reduction can be predicted according to any laser process parameters, material and geometry. Experimental comparisons will be presented to prove the accuracy of the model.

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