Chronic HBV Infection and Community‐Based Services for High‐Risk Asians and Pacific Islanders

Chronic hepatitis B (HBV) infection is a significant cause of morbidity and mortality in the U.S., and results in considerable health disparities for Asians and Pacific Islander Americans (APIs). There are still multiple knowledge gaps regarding HBV in APIs, including information on factors associated with HBV infection and immunity in foreign‐born APIs. Particularly in Philadelphia, the epidemiological landscape of chronic HBV infection in high‐risk API communities remains largely unknown, making it difficult to develop appropriately targeted interventions. Community‐based screening and linkage to care can play an important role in improving low HBV diagnosis rates and generating a more complete understanding of HBV infection in high‐risk ethnic communities. However, there are no recommended strategies for addressing HBV infection at the community level, which has limited the success of community‐based programs throughout the U.S. This project used a mixed‐methods approach to: determine the factors associated with HBV infection and protection (immunity) among APIs in Philadelphia who participated in community‐based screening; and to understand the processes, challenges and strategies for conducting enhanced community‐based screening and linkage to care. The study included quantitative analysis of survey and seroprevalence data from 2,047 foreign‐born and 2nd generation APIs residing in Philadelphia; and qualitative analysis of narratives, focus groups and interviews from two sites that conducted enhanced community‐based HBV programming. Controlling for all other variables (at p<0.5), infected individuals in the sample tended to be male, between the ages of 18‐29, disclosed that they had been previously tested for HBV, had a high school diploma or less, and had either a family member with HBV or HCC, or lived with an infected person; protected individuals in the sample tended to be between the ages of 18‐29 and born in Korea; susceptible individuals tended to be over age 55, with no family history of HBV, no previous HBV test, and born in a country with no (or a limited) national HBV vaccine program. Not controlling for other variables, being born in China was significantly associated with being linked to care. Results of the qualitative analysis revealed that having a diverse community stakeholder committee was important to the success of enhanced community‐based HBV programming. Including stakeholders in all planning stages, and offering ongoing opportunities for training and relationship development helped maintain stakeholder engagement. Limited time, funding, HBV knowledge, bi‐lingual resources, and a lack of language capable free health clinics served as challenges to HBV screening, vaccination and linkage to care. Service integration, advanced planning, and having an understanding of community needs were identified strategies to improve programmatic outcomes. Identified challenges with data collection included length of the survey instrument, as well as limited staff time and training needs. The results of this project can be used to guide future community‐based interventions in Philadelphia and around the U.S., to successfully improve HBV‐related screening, vaccination and linkage to care for high‐risk and infected API communities.Dr.P.H., Community Health and Prevention -- Drexel University, 201

Needs of Individuals Living With Hepatitis Delta Virus and Their Caregivers, 2016-2019.

INTRODUCTION: Hepatitis delta virus (HDV) is a serious coinfection of the hepatitis B virus (HBV) that is estimated to affect between 48 to 72 million people worldwide. Data are limited on the informational needs of people living with HDV. The Hepatitis B Foundation, a US-based nonprofit organization that provides support to people living with HBV and HDV, receives emails (queries) as part of a helpline, a service to provide information, resources, and support to people affected by HBV and HDV. METHODS: Query content was analyzed to assess the impact of HDV at the individual level. A total of 65 HDV-related queries from 17 countries were received from October 2016 to January 2019, and all were analyzed for this study. RESULTS: Thematic analysis of queries indicated 4 dominant themes. Three were related to a need for information about 1) the disease and prevention of it, 2) disease symptoms and outcomes, and 3) treatment options. The fourth theme was related to barriers and quality of life. Individuals requested information on treatment options, medication access, diagnostic test interpretation, and clinical trials. CONCLUSION: Our study highlights the needs and lived experience of patients with HDV and summarizes critical information gaps. Findings can inform health care providers, public health professionals, and the pharmaceutical and biotechnology industries about the informational needs and lived experiences of individuals living with HDV and help create future HDV-related educational resources, care, and clinical trials

Optimal topological simplification of discrete functions on surfaces

We solve the problem of minimizing the number of critical points among all functions on a surface within a prescribed distance {\delta} from a given input function. The result is achieved by establishing a connection between discrete Morse theory and persistent homology. Our method completely removes homological noise with persistence less than 2{\delta}, constructively proving the tightness of a lower bound on the number of critical points given by the stability theorem of persistent homology in dimension two for any input function. We also show that an optimal solution can be computed in linear time after persistence pairs have been computed.Comment: 27 pages, 8 figure

An Arena for Model Building in the Cohen-Glashow Very Special Relativity

The Cohen-Glashow Very Special Relativity (VSR) algebra [arXiv:hep-ph/0601236] is defined as the part of the Lorentz algebra which upon addition of CP or T invariance enhances to the full Lorentz group, plus the space-time translations. We show that noncommutative space-time, in particular noncommutative Moyal plane, with light-like noncommutativity provides a robust mathematical setting for quantum field theories which are VSR invariant and hence set the stage for building VSR invariant particle physics models. In our setting the VSR invariant theories are specified with a single deformation parameter, the noncommutativity scale \Lambda_{NC}. Preliminary analysis with the available data leads to \Lambda_{NC}\gtrsim 1-10 TeV. This note is prepared for the Proceedings of the G27 Mathematical Physics Conference, Yerevan 2008, and is based on arXiv:0806.3699[hep-th].Comment: Presented by M.M.Sh-J. in the G27 Mathematical Physics Conference, Yerevan 2008 as the 4th Weyl Prize Ceremony Tal

The Importance of Triple Panel Testing for Hepatitis B and the Burden of Isolated Anti-Hepatitis B Core Antibodies Within a Community Sample

Within the United States (US), 2.4 million individuals are living with chronic hepatitis B, but less than 20% are diagnosed. Isolated anti-hepatitis B core (iAHBc) antibodies indicate serology in an individual that is positive for anti-HBc antibodies, while negative for surface antigen (HBsAg) and surface antibodies (anti-HBs). A result of iAHBc could indicate a chronic occult bloodstream infection, necessitating further testing. This study assesses the prevalence and risk factors associated with anti-HBc and iAHBc within community high-risk screening in Greater Philadelphia. Participants (n = 177) were screened for HBsAg, anti-HBs, and anti-HBc during community screening events in 2022. Chi-square tables and Firth logistic regression were used to describe the data and to assess the odds of iAHBc. The findings indicate that there was an iAHBc prevalence of 7.3% (n = 13) within our study. The odds of anti-HBc were increased for immigrants from the Western Pacific (4.5%) and Africa (11.9%). Individuals born in Africa had 7.93 greater odds for iAHBc than those born in the Americas, and these odds are multiplied by 1.01 for every 1-year increase in age. Our data show a high burden of iAHBc within high-risk and often hard-to-reach communities. Triple panel screening should be incorporated into all HBV screening programs, in accordance with current Centers for Disease Control and Prevention (CDC) universal screening recommendations, to ensure a comprehensive picture of the disease burden and reduce the risk of missing people with occult hepatitis B and those at risk for viral reactivation or liver complications

Geometrical origin of the *-product in the Fedosov formalism

The construction of the *-product proposed by Fedosov is implemented in terms of the theory of fibre bundles. The geometrical origin of the Weyl algebra and the Weyl bundle is shown. Several properties of the product in the Weyl algebra are proved. Symplectic and abelian connections in the Weyl algebra bundle are introduced. Relations between them and the symplectic connection on a phase space M are established. Elements of differential symplectic geometry are included. Examples of the Fedosov formalism in quantum mechanics are given.Comment: LaTeX, 39 page

Common concerns, barriers to care, and the lived experience of individuals with hepatitis B: a qualitative study.

BACKGROUND: An estimated between 257 and 292 million people live with chronic HBV globally. While much is known about the causes, and epidemiology of HBV, little is understood about the quality of life and impact of HBV on those living with the infection. METHODS: A random sample of HBV-related email queries sent to the Hepatitis B Foundation, a U.S.-based non-profit organization, over a 12-month period in 2018-2019 were retrieved, tabulated, and analyzed qualitatively to highlight information needs and explore the experiences of people living with HBV and their families and loved ones. Codebook development was informed by the literature and through line-by-line reading of a sub-sample of queries. Data analysis was facilitated by NVivo12 software. Data were coded independently by two members of the research team and intercoder reliability was assessed to assure coding accuracy throughout the coding phase. RESULTS: A total of 338 queries from people around the globe were identified and analyzed. The analysis revealed three thematic groups: 1) health-specific challenges associated with diagnosis and treatment, 2) emotional needs related to experiences with HBV stigma, discrimination, fear, social isolation, and distress and 3) informational needs related to HBV prevention and transmission, and interpretation of laboratory tests. CONCLUSIONS: People living with HBV are in need of information to manage their disease and prevent its spread. Analysis of queries uncovered significant misconceptions about HBV transmission and treatment. Additionally, the emotional and psychological impact of an HBV diagnosis on those living with the infection is significant. There is a clear need for patient and community education to expand knowledge and awareness of HBV globally to achieve 2030 WHO HBV elimination goals

Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia

The prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV/HDV prevalence and facilitate linkage to care. Participants completed a demographic HBV/HDV risk factor survey and were screened for HBV and reflexively for HDV if positive for HBV surface antigen or isolated core antibody. Fisher\u27s exact tests and regression were used to understand relationships between risks and HBV blood markers. Of the 498 participants, 126 (25.3%) did not have hepatitis B immunity, 52.6% had been vaccinated against HBV, and 17.9% had recovered from a past infection. Eleven (2.2%) participants tested positive for isolated HBV core antibody, 10 (2.0%) for HBV surface antigen, and one (0.2%) for HDV antibody. History of incarceration was associated with current HBV infection, while transactional sex and experience of homelessness were predictive of previous exposure. This study found high rates of current and past HBV infection, and a 10% HBV/HDV co-infection rate. Despite availability of vaccine, one quarter of participants remained vulnerable to infection. Findings demonstrate the need to improve low-threshold HBV/HDV screening, vaccination, and linkage to care among PWUD. The study also identified gaps in the HBV/HDV care cascade, including lack of point-of-care diagnostics and lack of support for HROs to provide HBV services

Daratumumab monotherapy for patients with intermediate-risk or high-risk smoldering multiple myeloma: a randomized, open-label, multicenter, phase 2 study (CENTAURUS)

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Innovation Inducement Prizes: Connecting Research to Policy

Innovation inducement prizes have been used for centuries. In the United States, a recent federal policy change—the America COMPETES Reauthorization Act of 2010—clarified and simplified a path by which all federal agencies can offer innovation inducement prizes, thus intensifying interest in how government agencies can most effectively design and apply such prizes. This paper aims to review and synthesize the academic literature on innovation inducement prizes, to clarify what has been learned that is relevant to current policy discussions, and to highlight unresolved questions that would be fruitful areas for future academic research and policy experimentation. Relative to the existing literature, this paper aims to bridge two gaps. First, I synthesize the academic literature in this area with an eye toward drawing lessons for the types of innovation inducement prizes under consideration by federal agencies under the America COMPETES Reauthorization Act. Second, I discuss the problem of how to evaluate the success or failure of innovation inducement prizes, arguing that careful empirical evaluations of innovation inducement prizes are needed in order to provide guidance to federal agencies (and others) on how to most effectively apply and design innovation inducement prizes.National Institute on Aging (Grant Number: T32-AG000186