Retention in care and survival rates in comorbid conditions in persons living with HIV

More than one million people suffer from human immunodeficiency virus (HIV) infections in the United States. Recently, HIV treatments have been developing and improving steadily. Seeing this, persons living with HIV (PLWH) now live longer, but they can also have more chances to experience comorbid conditions. As a result, this dissertation study has two aims. Aim 1 is a longitudinal retrospective cross-sectional study to investigate the relationships of retention in care measurements, association with symptom burden and retention in care, and association between disease control and retention in care between PLWH with diabetes (DM). Aim 2 is a longitudinal retrospective comparison study to compare the chronic kidney disease (CKD) occurrences between PLWH and PLWH+DM from 2006 through 2015, and to compare the survival rates differences among PLWH, PLWH+DM, and PLWH+DM with CKD. In Aim 1, a total of 798 samples who had PLWH+DM in 2015 participated in this study. Most of the retention in care in PLWH+DM measurements were significantly correlated (p < 0.05). As to disease control, only CD4 cell count had relationships with retention in care measurements in all age groups, and hemoglobin A1c (HbA1c) level only occurred as a significant relationship with younger adults living with HIV with DM (YALWH+DM). Having the additional burden of some symptoms negatively affects retention in care in older adults living with HIV with DM (OALWH+DM). In Aim 2, a total of 10,063 samples had HIV infections in study. With having more comorbid conditions as well as increasing age at initial clinic visit, mortality rates increased. The mean survival time was 19.689 years (95% CI: 19.572-19.806). Having DM with PLWH, the mortality rates were three times higher than PLWH-only, and as for patients having DM with CKD in PLWH, the mortality rate was three times higher than PLWH+DM. According to the study, retention in care in PLWH+DM affects disease control and symptom burden (fatigue, sadness, memory loss) negatively in regard to the retention in care in OALWH+DM. Moreover, comorbid conditions have negative association with length of survival. Based on these findings, this study will contribute to the knowledge of comorbid conditions in PLWH as it applies to nursing practice, research, and policy.Nursin

Unidirectional scattering with spatial homogeneity using photonic time disorder

The temporal degree of freedom in photonics has been a recent research hotspot due to its analogy with spatial axes, causality, and open-system characteristics. In particular, the temporal analogues of photonic crystals have stimulated the design of momentum gaps and their extension to topological and non-Hermitian photonics. Although recent studies have also revealed the effect of broken discrete time-translational symmetry in view of the temporal analogy of spatial Anderson localization, the broad intermediate regime between time order and time uncorrelated disorder has not been examined. Here we investigate the inverse design of photonic time disorder to achieve optical functionalities in spatially homogeneous platforms. By developing the structure factor and order metric using causal Green's functions for the domain of time disorder, we demonstrate engineered time scatterer, which provides unidirectional scattering with controlled scattering amplitudes. We also reveal that the order-to-disorder transition in the time domain allows for the manipulation of scattering bandwidths, which inspires resonance-free temporal colour filtering. Our work will pave the way for advancing optical functionalities without spatial patterning.Comment: 22 pages, 4 figure

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma

Objectives As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population. Methods Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed. Results Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction. Conclusion Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES

Imaging findings for intravascular large B-cell lymphoma of the liver

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal diffuse large B-cell lymphoma that most commonly involves the central nervous system and skin. To our knowledge, no state-of-the art imaging findings have been reported for hepatic IVLBCL in the English literature. We report the first case of hepatic involvement of IVLBCL along with a literature review