Medication Adherence and Health Status in HIV Positive Patients in Akwa Ibom State, Nigeria

Purpose: To assess medication adherence and health status in ambulatory HIV positive patients in Akwa Ibom State, Nigeria.Methods: The 7-item Adherence to Refills and Medication Scale (ARMS-7) was used to assess medication adherence among 500 HIV positive patients in three secondary health facilities in Akwa Ibom State, Nigeria. A single-item question (measuring self-rated health) and depression (CESD-R) questionnaire were also used to evaluate the patients. Recent CD4 count and viral load were obtained from the patients’ folders. The association between independent and dependent variables was evaluated using logistic regression analysis.Results: Only 56 (11.7%) respondents reported 100% adherence to their medications; 190 (39.7%) rated their health as being ‘very good’ and 51 (10.7%) reported being depressed. Respondents who were single were more likely to be nonadherent (aOR = 2.665, 95% CI = 1.336 - 5.318; p = 0.005), and the nonadherent patients were more likely to have lower CD4 cell counts (aOR = 0.998, CI = 0.996 – 0.999; p = 0.007). Those who rated their health as ‘fair’ or ‘poor’ were more likely to be nonadherent (aOR= 11.380, CI = 1.527 – 84.785; p=0.018) and depressed (aOR = 2.748, CI = 1.469 – 5.141; p = 0.002). Patients who were unemployed were more likely to rate their health as fair/poor (aOR = 1.890, CI = 1.197 – 2.985; p=0.006).Conclusion: This work has shown that even though most of the HIV positive patients perceive their health as being very good, their adherence to medications was poor which is directly related to their unemployment status. Intervention to improve adherence directed at socio-economic status of the individual patient is recommended. Keywords: Medication adherence; Depression; Self-rated health; Nigeri

Race affects SVR12 in a large and ethnically diverse hepatitis C-infected patient population following treatment with direct-acting antivirals: Analysis of a single-center Department of Veterans Affairs cohort.

Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. HCV cure has been linked to improved patient outcomes. In the era of direct-acting antivirals (DAAs), HCV cure has become the goal, as defined by sustained virological response 12 weeks (SVR12) after completion of therapy. Historically, African-Americans have had lower SVR12 rates compared to White people in the interferon era, which had been attributed to the high prevalence of non-CC interleukin 28B (IL28B) type. Less is known about the association between race/ethnicity and SVR12 in DAA-treated era. The aim of the study is to evaluate the predictors of SVR12 in a diverse, single-center Veterans Affairs population. We conducted a retrospective study of patients undergoing HCV therapy with DAAs from 2014 to 2016 at the VA Greater Los Angeles Healthcare System. We performed a multivariable logistic regression analysis to determine predictors of SVR12, adjusting for age, HCV genotype, DAA regimen and duration, human immunodeficiency virus (HIV) status, fibrosis, nonalcoholic fatty liver disease (NAFLD) fibrosis score, homelessness, mental health, and adherence. Our cohort included 1068 patients, out of which 401 (37.5%) were White people and 400 (37.5%) were African-American. Genotype 1 was the most common genotype (83.9%, N = 896). In the adjusted models, race/ethnicity and the presence of fibrosis were statistically significant predictors of non-SVR. African-Americans had 57% lower odds for reaching SVR12 (adj.OR = 0.43, 95% CI = 1.5-4.1) compared to White people. Advanced fibrosis (adj.OR = 0.40, 95% CI = 0.26-0.68) was also a significant predictor of non-SVR. In a single-center VA population on DAAs, African-Americans were less likely than White people to reach SVR12 when adjusting for covariates

Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol: statistical analysis plan for a prospective, multicenter, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

BACKGROUND: Observational research suggests that combined therapy with Vitamin C, thiamine and hydrocortisone may reduce mortality in patients with septic shock. METHODS AND DESIGN: The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) trial is a multicenter, double-blind, adaptive sample size, randomized, placebo-controlled trial designed to test the efficacy of combination therapy with vitamin C (1.5 g), thiamine (100 mg), and hydrocortisone (50 mg) given every 6 h for up to 16 doses in patients with respiratory or circulatory dysfunction (or both) resulting from sepsis. The primary outcome is ventilator- and vasopressor-free days with mortality as the key secondary outcome. Recruitment began in August 2018 and is ongoing; 501 participants have been enrolled to date, with a planned maximum sample size of 2000. The Data and Safety Monitoring Board reviewed interim results at N = 200, 300, 400 and 500, and has recommended continuing recruitment. The next interim analysis will occur when N = 1000. This update presents the statistical analysis plan. Specifically, we provide definitions for key treatment and outcome variables, and for intent-to-treat, per-protocol, and safety analysis datasets. We describe the planned descriptive analyses, the main analysis of the primary end point, our approach to secondary and exploratory analyses, and handling of missing data. Our goal is to provide enough detail that our approach could be replicated by an independent study group, thereby enhancing the transparency of the study. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03509350. Registered on 26 April 2018

COPI mediates recycling of an exocytic SNARE by recognition of a ubiquitin sorting signal

The COPI coat forms transport vesicles from the Golgi complex and plays a poorly defined role in endocytic trafficking. Here we show that COPI binds K63-linked polyubiquitin and this interaction is crucial for trafficking of a ubiquitinated yeast SNARE (Snc1). Snc1 is a v-SNARE that drives fusion of exocytic vesicles with the plasma membrane, and then recycles through the endocytic pathway to the Golgi for reuse in exocytosis. Removal of ubiquitin from Snc1, or deletion of a β’-COP subunit propeller domain that binds K63-linked polyubiquitin, disrupts Snc1 recycling causing aberrant accumulation in internal compartments. Moreover, replacement of the β’-COP propeller domain with unrelated ubiquitin-binding domains restores Snc1 recycling. These results indicate that ubiquitination, a modification well known to target membrane proteins to the lysosome or vacuole for degradation, can also function as recycling signal to sort a SNARE into COPI vesicles in a non-degradative pathway

High stakes and low bars: How international recognition shapes the conduct of civil wars

When rebel groups engage incumbent governments in war for control of the state, questions of international recognition arise. International recognition determines which combatants can draw on state assets, receive overt military aid, and borrow as sovereigns—all of which can have profound consequences for the military balance during civil war. How do third-party states and international organizations determine whom to treat as a state's official government during civil war? Data from the sixty-one center-seeking wars initiated from 1945 to 2014 indicate that military victory is not a prerequisite for recognition. Instead, states generally rely on a simple test: control of the capital city. Seizing the capital does not foreshadow military victory. Civil wars often continue for many years after rebels take control and receive recognition. While geopolitical and economic motives outweigh the capital control test in a small number of important cases, combatants appear to anticipate that holding the capital will be sufficient for recognition. This expectation generates perverse incentives. In effect, the international community rewards combatants for capturing or holding, by any means necessary, an area with high concentrations of critical infrastructure and civilians. In the majority of cases where rebels contest the capital, more than half of its infrastructure is damaged or the majority of civilians are displaced (or both), likely fueling long-term state weakness

Neuroprotection in a Novel Mouse Model of Multiple Sclerosis

The authors acknowledge the support of the Barts and the London Charity, the Multiple Sclerosis Society of Great Britain and Northern Ireland, the National Multiple Sclerosis Society, USA, notably the National Centre for the Replacement, Refinement & Reduction of Animals in Research, and the Wellcome Trust (grant no. 092539 to ZA). The siRNA was provided by Quark Pharmaceuticals. The funders and Quark Pharmaceuticals had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Pre-Impact Thermophysical Properties and the Yarkovsky Effect of NASA DART Target (65803) Didymos

The NASA DART (Double Asteroid Redirection Test) spacecraft impacted the secondary body of the binary asteroid (65803) Didymos on 2022 September 26and altered its orbit about the primary body. Before the DART impact, we performed visible and mid-infrared observations to constrain the pre-impact thermophysical properties of the Didymos system and to model its Yarkovsky effect. Analysis of the photometric phase curve derives a Bond albedo of 0.07 ± 0.01, and a thermophysical analysis of the mid-infrared observations derives a thermal inertia of 320 ± 70 J m-2 K-1 s-1/2 and a thermal roughness of 40° ± 3° RMS (root-mean-square) slope. These properties are compatible with the ranges derived for other S-type near-Earth asteroids. Model-to-measurement comparisons of the Yarkovsky orbital drift for Didymos derives a bulk density of 2750 ± 350 kg m-3, which agrees with other independent measures based on the binary mutual orbit. This bulk density indicates that Didymos is spinning at or near its critical spin-limit at which self-gravity balances equatorial centrifugal forces. Furthermore, comparisons with the post-impact infrared observations presented in Rivkin et al. (2023) indicate no change in the thermal inertia of the Didymos system following the DART impact. Finally, orbital temperature simulations indicate that sub-surface water ice is stable over geologic timescales in the polar regions if present. These findings will be investigated in more detail by the upcoming ESA Hera mission.<br/

Expanding the Diversity of Mycobacteriophages: Insights into Genome Architecture and Evolution

Mycobacteriophages are viruses that infect mycobacterial hosts such as Mycobacterium smegmatis and Mycobacterium tuberculosis. All mycobacteriophages characterized to date are dsDNA tailed phages, and have either siphoviral or myoviral morphotypes. However, their genetic diversity is considerable, and although sixty-two genomes have been sequenced and comparatively analyzed, these likely represent only a small portion of the diversity of the mycobacteriophage population at large. Here we report the isolation, sequencing and comparative genomic analysis of 18 new mycobacteriophages isolated from geographically distinct locations within the United States. Although no clear correlation between location and genome type can be discerned, these genomes expand our knowledge of mycobacteriophage diversity and enhance our understanding of the roles of mobile elements in viral evolution. Expansion of the number of mycobacteriophages grouped within Cluster A provides insights into the basis of immune specificity in these temperate phages, and we also describe a novel example of apparent immunity theft. The isolation and genomic analysis of bacteriophages by freshman college students provides an example of an authentic research experience for novice scientists

Genetic Background Can Result in a Marked or Minimal Effect of Gene Knockout (GPR55 and CB2 Receptor) in Experimental Autoimmune Encephalomyelitis Models of Multiple Sclerosis

PMCID: PMC379391

Electrospun amplified fiber optics

A lot of research is focused on all-optical signal processing, aiming to obtain effective alternatives to existing data transmission platforms. Amplification of light in fiber optics, such as in Erbium-doped fiber amplifiers, is especially important for an efficient signal transmission. However, the complex fabrication methods, involving high-temperature processes performed in highly pure environment, slow down the fabrication and make amplified components expensive with respect to an ideal, high-throughput and room temperature production. Here, we report on near infrared polymer fiber amplifiers, working over a band of about 20 nm. The fibers are cheap, spun with a process entirely carried out at room temperature, and show amplified spontaneous emission with good gain coefficients as well as low optical losses (a few cm^-1). The amplification process is favoured by the high fiber quality and low self-absorption. The found performance metrics promise to be suitable for short-distance operation, and the large variety of commercially-available doping dyes might allow for effective multi-wavelength operation by electrospun amplified fiber optics.Comment: 27 pages, 8 figure