A Scoping Review of Dingo and Wild-Living Dog Ecology and Biology in Australia to Inform Parameterisation for Disease Spread Modelling

Background: Dingoes and wild-living dogs in Australia, which include feral domestic dogs and dingo-dog hybrids, play a role as reservoirs of disease. In the case of an exotic disease incursion—such as rabies—these reservoirs could be a threat to the health of humans, domestic animals and other wildlife in Australia. Disease spread models are needed to explore this impact and develop mitigation strategies for responding to an incursion. Our study aim was to describe relevant information from the literature, using a scoping review, on specific topics related to dingo and wild-living dog ecology and biology (topics of interest) in Australia to inform parameterisation of disease spread modelling and identify major research gaps.Methods: A broad electronic search was conducted in five bibliographic databases and grey literature. Two levels of screening and two levels of data extraction were each performed independently by two reviewers. Data extracted included topics of interest investigated, type of population sampled, the presence of lethal control, type of environment, years of collection and GPS coordinates of study sites.Results: From 1666 records captured, the screening process yielded 229 individual studies published between 1862 and 2016. The most frequently reported topics of interest in studies were index of abundance (n = 93) and diet (n = 68). Among the three key parameters in disease spread modelling (i.e., density, contacts and home range), data on density and contacts were identified as major research gaps in the literature due to the small number of recent studies on these topics and the scarcity of quantitative estimates. The research reviewed was mostly located around central Australia and the east coast, including a few studies on density, contacts and home range. Data from these regions could potentially be used to inform parameterisation for disease spread modelling of dingoes and wild-living dogs. However, the number of studies is limited in equatorial and tropical climate zones of northern Australia, which is a high-risk area for a rabies incursion.Conclusions: Research in northern regions of Australia, especially to generate data regarding density, contacts and home ranges, should be prioritised for future research on dingoes and wild-living dogs

The Milky Way Bulge extra-tidal star survey: BH 261 (AL 3)

The Milky Way Bulge extra-tidal star survey (MWBest) is a spectroscopic survey with the goal of identifying stripped globular cluster stars from inner Galaxy clusters. In this way, an indication of the fraction of metal-poor bulge stars that originated from globular clusters can be determined. We observed and analyzed stars in and around BH 261, an understudied globular cluster in the bulge. From seven giants within the tidal radius of the cluster, we measured an average heliocentric radial velocity of = -61 +- 2.6 km/s with a radial velocity dispersion of \sigma = 6.1 +- 1.9 km/s. The large velocity dispersion may have arisen from tidal heating in the cluster's orbit about the Galactic center, or because BH 261 has a high dynamical mass as well as a high mass-to-light ratio. From spectra of five giants, we measure an average metallicity of = -1.1 +- 0.2 dex. We also spectroscopically confirm an RR Lyrae star in BH 261, which yields a distance to the cluster of 7.1 +- 0.4~kpc. Stars with 3D velocities and metallicities consistent with BH 261 reaching to ~0.5 degrees from the cluster are identified. A handful of these stars are also consistent with the spatial distribution of that potential debris from models focussing on the most recent disruption of the cluster.Comment: accepted for publication in The Astronomical Journa

Interventions to promote adherence to antiretroviral therapy in Africa: a network meta-analysis

Background: Adherence to antiretroviral therapy (ART) is necessary for the improvement of the health of patients and for public health. We sought to determine the comparative effectiveness of different interventions for improving ART adherence in HIV-infected people living in Africa. Methods: We searched for randomised trials of interventions to promote antiretroviral adherence within adults in Africa. We searched AMED, CINAHL, Embase, Medline (via PubMed), and ClinicalTrials.gov from inception to Oct 31, 2014, with the terms “HIV”, “ART”, “adherence”, and “Africa”. We created a network of the interventions by pooling the published and individual patients\u27 data for comparable treatments and comparing them across the individual interventions with Bayesian network meta-analyses. The primary outcome was adherence defined as the proportion of patients meeting trial defined criteria; the secondary endpoint was viral suppression. Findings: We obtained data for 14 randomised controlled trials, with 7110 patients. Interventions included daily and weekly short message service (SMS; text message) messaging, calendars, peer supporters, alarms, counselling, and basic and enhanced standard of care (SOC). Compared with SOC, we found distinguishable improvement in self-reported adherence with enhanced SOC (odds ratio [OR] 1·46, 95% credibility interval [CrI] 1·06–1·98), weekly SMS messages (1·65, 1·25–2·18), counselling and SMS combined (2·07, 1·22–3·53), and treatment supporters (1·83, 1·36–2·45). We found no compelling evidence for the remaining interventions. Results were similar when using viral suppression as an outcome, although the network contained less evidence than that for adherence. Treatment supporters with enhanced SOC (1·46, 1·09–1·97) and weekly SMS messages (1·55, 1·01–2·38) were significantly better than basic SOC. Interpretation: Several recommendations for improving adherence are unsupported by the available evidence. These findings can inform future intervention choices for improving ART adherence in low-income settings. Funding: None

Daily and Nondaily Oral Preexposure Prophylaxis in Men and Transgender Women Who Have Sex With Men: The Human Immunodeficiency Virus Prevention Trials Network 067/ADAPT Study

Background: Nondaily dosing of oral preexposure prophylaxis (PrEP) may provide equivalent coverage of sex events compared with daily dosing. Methods: At-risk men and transgender women who have sex with men were randomly assigned to 1 of 3 dosing regimens: 1 tablet daily, 1 tablet twice weekly with a postsex dose (time-driven), or 1 tablet before and after sex (event-driven), and were followed for coverage of sex events with pre- and postsex dosing measured by weekly self-report, drug concentrations, and electronic drug monitoring. Results: From July 2012 to May 2014, 357 participants were randomized. In Bangkok, the coverage of sex events was 85% for the daily arm compared with 84% for the time-driven arm (P = .79) and 74% for the event-driven arm (P = .02). In Harlem, coverage was 66%, 47% (P = .01), and 52% (P = .01) for these groups. In Bangkok, PrEP medication concentrations in blood were consistent with use of ≥2 tablets per week in >95% of visits when sex was reported in the prior week, while in Harlem, such medication concentrations occurred in 48.5% in the daily arm, 30.9% in the time-driven arm, and 16.7% in the event-driven arm (P < .0001). Creatinine elevations were more common in the daily arm (P = .050), although they were not dose limiting. Conclusions: Daily dosing recommendations increased coverage and protective drug concentrations in the Harlem cohort, while daily and nondaily regimens led to comparably favorable outcomes in Bangkok, where participants had higher levels of education and employment

Improving Antiretroviral Therapy Adherence in Resource-Limited Settings at Scale: a Discussion of Interventions and Recommendations

INTRODUCTION: Successful population-level antiretroviral therapy (ART) adherence will be necessary to realize both the clinical and prevention benefits of antiretroviral scale-up and, ultimately, the end of AIDS. Although many people living with HIV are adhering well, others struggle and most are likely to experience challenges in adherence that may threaten virologic suppression at some point during lifelong therapy. Despite the importance of ART adherence, supportive interventions have generally not been implemented at scale. The objective of this review is to summarize the recommendations of clinical, research, and public health experts for scalable ART adherence interventions in resource-limited settings. METHODS: In July 2015, the Bill and Melinda Gates Foundation convened a meeting to discuss the most promising ART adherence interventions for use at scale in resource-limited settings. This article summarizes that discussion with recent updates. It is not a systematic review, but rather provides practical considerations for programme implementation based on evidence from individual studies, systematic reviews, meta-analyses, and the World Health Organization Consolidated Guidelines for HIV, which include evidence from randomized controlled trials in low- and middle-income countries. Interventions are categorized broadly as education and counselling; information and communication technology-enhanced solutions; healthcare delivery restructuring; and economic incentives and social protection interventions. Each category is discussed, including descriptions of interventions, current evidence for effectiveness, and what appears promising for the near future. Approaches to intervention implementation and impact assessment are then described. RESULTS AND DISCUSSION: The evidence base is promising for currently available, effective, and scalable ART adherence interventions for resource-limited settings. Numerous interventions build on existing health care infrastructure and leverage available resources. Those most widely studied and implemented to date involve peer counselling, adherence clubs, and short message service (SMS). Many additional interventions could have an important impact on ART adherence with further development, including standardized counselling through multi-media technology, electronic dose monitoring, decentralized and differentiated models of care, and livelihood interventions. Optimal targeting and tailoring of interventions will require improved adherence measurement. CONCLUSION: The opportunity exists today to address and resolve many of the challenges to effective ART adherence, so that they do not limit the potential of ART to help bring about the end of AIDS

Model-Based Methods to Translate Adolescent Medicine Trials Network for HIV/AIDS Interventions Findings Into Policy Recommendations: Rationale and Protocol for a Modeling Core (ATN 161)

BACKGROUND: The United States Centers for Disease Control and Prevention estimates that approximately 60,000 US youth are living with HIV. US youth living with HIV (YLWH) have poorer outcomes compared with adults, including lower rates of diagnosis, engagement, retention, and virologic suppression. With Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) support, new trials of youth-centered interventions to improve retention in care and medication adherence among YLWH are underway. OBJECTIVE: This study aimed to use a computer simulation model, the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Adolescent Model, to evaluate selected ongoing and forthcoming ATN interventions to improve viral load suppression among YLWH and to define the benchmarks for uptake, effectiveness, durability of effect, and cost that will make these interventions clinically beneficial and cost-effective. METHODS: This protocol, ATN 161, establishes the ATN Modeling Core. The Modeling Core leverages extensive data-already collected by successfully completed National Institutes of Health-supported studies-to develop novel approaches for modeling critical components of HIV disease and care in YLWH. As new data emerge from ongoing ATN trials during the award period about the effectiveness of novel interventions, the CEPAC-Adolescent simulation model will serve as a flexible tool to project their long-term clinical impact and cost-effectiveness. The Modeling Core will derive model input parameters and create a model structure that reflects key aspects of HIV acquisition, progression, and treatment in YLWH. The ATN Modeling Core Steering Committee, with guidance from ATN leadership and scientific experts, will select and prioritize specific model-based analyses as well as provide feedback on derivation of model input parameters and model assumptions. Project-specific teams will help frame research questions for model-based analyses as well as provide feedback regarding project-specific inputs, results, sensitivity analyses, and policy conclusions. RESULTS: This project was funded as of September 2017. CONCLUSIONS: The ATN Modeling Core will provide critical information to guide the scale-up of ATN interventions and the translation of ATN data into policy recommendations for YLWH in the United States

Could a rabies incursion spread in the northern Australian dingo population? Development of a spatial stochastic simulation model.

Australia, home to the iconic dingo, is currently free from canine rabies. However northern Australia, including Indigenous communities with large free-roaming domestic dog populations, is at increased risk of rabies incursion from nearby Indonesia. We developed a novel agent-based stochastic spatial rabies spread model to evaluate the potential spread of rabies within the dingo population of the Northern Peninsula Area (NPA) region of northern Australia. The model incorporated spatio-temporal features specific to this host-environment system, including landscape heterogeneity, demographic fluctuations, dispersal movements and dingo ecological parameters-such as home range size and density-derived from NPA field studies. Rabies spread between dingo packs in nearly 60% of simulations. In such situations rabies would affect a median of 22 dingoes (approximately 14% of the population; 2.5-97.5 percentiles: 2-101 dingoes) within the study area which covered 1,131 km2, and spread 0.52 km/week for 191 days. Larger outbreaks occurred in scenarios in which an incursion was introduced during the dry season (vs. wet season), and close to communities (vs. areas with high risk of interaction between dingoes and hunting community dogs). Sensitivity analyses revealed that home range size and duration of infectious clinical period contributed most to the variance of outputs. Although conditions in the NPA would most likely not support a sustained propagation of the disease in the dingo population, due to the predicted number of infected dingoes following a rabies incursion and the proximity of Indigenous communities to dingo habitat, we conclude that the risk for human transmission could be substantial

Dingo Density Estimates and Movements in Equatorial Australia: Spatially Explicit Mark–Resight Models

Australia is currently free of canine rabies. Spatio-ecological knowledge about dingoes in northern Australia is currently a gap that impedes the application of disease spread models and our understanding of the potential transmission of rabies, in the event of an incursion. We therefore conducted a one-year camera trap survey to monitor a dingo population in equatorial northern Australia. The population is contiguous with remote Indigenous communities containing free-roaming dogs, which potentially interact with dingoes. Based on the camera trap data, we derived dingo density and home range size estimates using maximum-likelihood, spatially explicit, mark&ndash;resight models, described dingo movements and evaluated spatial correlation and temporal overlap in activities between dingoes and community dogs. Dingo density estimates varied from 0.135 animals/km2 (95% CI = 0.127&ndash;0.144) during the dry season to 0.147 animals/km2 (95% CI = 0.135&ndash;0.159) during the wet season. The 95% bivariate Normal home range sizes were highly variable throughout the year (7.95&ndash;29.40 km2). Spatial use and daily activity patterns of dingoes and free-roaming community dogs, grouped over ~3 month periods, showed substantial temporal activity overlap and spatial correlation, highlighting the potential risk of disease transmission at the wild&ndash;domestic interface in an area of biosecurity risk in equatorial northern Australia. Our results have utility for improving preparedness against a potential rabies incursion

Ancillary service needs among persons new to HIV care and the relationship between needs and late presentation to care.

Ancillary service needs likely influence time to diagnosis and presentation for HIV care. The effect of both met and unmet needs on late presentation to HIV care is not well understood. We used baseline data from 348 people with HIV (PWH) with no prior HIV care who enrolled in iENGAGE (a randomized controlled trial (RCT) of an intervention to support retention in care) at one of four HIV clinics in the US. A standardized baseline questionnaire collected information on ancillary service needs, and whether each need was presently unmet. We examined covariates known to be associated with disease stage at presentation to care and their association with needs. We subsequently assessed the relationship of needs with CD4 accounting for those other covariates by estimating prevalence ratios (PR) using inverse probability weights. Most patients enrolling in the RCT were male (79%) and the majority were Black (62%); median age was 34 years. Prevalence of any reported individual need was 69%. One-third of the sample had a baseline CD4 cell count <200, 42% between 200 and 499 and 27% ≥500. There was no statistically significant association between need or unmet need and baseline CD4. In general, psychiatric health and SU issues (depression, anxiety, and drug use) were consistently associated with higher prevalence of need (met and unmet). Additionally, the Black race was associated with higher basic resource needs (housing: PR 1.67, 95%CI 1.08–2.59; transportation: PR 1.65, 95% CI 1.12–2.45). Ancillary service needs (met and unmet) were common among patients new to HIV care and impacted vulnerable subgroups. However, we found no evidence that reporting a specific individual need, whether met or unmet, was associated with a timely presentation to HIV care. The impact of needs on subsequent steps of the HIV care continuum will be examined with longitudinal data

A Brief and Informationally Rich Naming System for Oligosaccharide Motifs of Heteroxylans Found in Plant Cell Walls

The one-letter code system proposed here is a simple method to accurately describe structurally diverse oligosaccharides derived from heteroxylans. Substitutions or `molecular decoration(s)' of main-chain D-xylosyl moieties are designated by unique letters. Hence, an oligosaccharide is described by a series of single letters, beginning with the non- reducing D-xylosyl unit. Superscripted numbers are used to indicate the linkage position(s) of main-chain substitution(s) and, where necessary, superscripted lowercase letter(s) indicate the nature of non- glycosidic groups (e. g., methyl, acetyl, or phenolic derivative moieties) that can be present on the substituents. Although relatively simple and practical to use, this abbreviated system lends itself to the naming of a large number of different combinations of structural building blocks and substituents. In its present state, this system is, therefore, adequate to name and differentiate all currently known complex oligosaccharides derived from heteroxylans and is sufficiently flexible to accommodate new structures as they become available.status: publishe