1,721,021 research outputs found
Shift in disparities in Hepatitis C treatment from interferon to DAA era: A population-based cohort study
No full textWe evaluated the shift in the characteristics of people who received interferon-based hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV or HIV, or reported cases of hepatitis B and active tuberculosis in BC from 1990 to 2013 linked to medical visits, hospitalization, cancer, prescription drugs and mortality data. This analysis included all patients who filled at least one prescription for HCV treatment until 31 July 2015. HCV treatments were classified as older interferon-based treatments including pegylated interferon/ribavirin (PegIFN/RBV) with/without boceprevir or telaprevir, DAAs with RBV or PegIFN/RBV, and newer interferon-free DAAs. Of 11 886 people treated for HCV between 2000 and 2015, 1164 (9.8%) received interferon-free DAAs (ledipasvir/sofosbuvir: n=1075; 92.4%), while 452 (3.8%) received a combination of DAAs and RBV or PegIFN/RBV. Compared to those receiving interferon-based treatment, people with HIV co-infection (adjusted odds ratio [aOR]: 2.96, 95% CI: 2.31-3.81), cirrhosis (aOR: 1.77, 95% CI: 1.45-2.15), decompensated cirrhosis (aOR: 1.72, 95% CI: 1.31-2.28), diabetes (aOR: 1.30, 95% CI: 1.10-1.54), a history of injection drug use (aOR: 1.34, 95% CI: 1.09-1.65) and opioid substitution therapy (aOR: 1.30, 95% CI: 1.01-1.67) were more likely to receive interferon-free DAAs. Socio-economically marginalized individuals were significantly less likely (most deprived vs most privileged: aOR: 0.71, 95% CI: 0.58-0.87) to receive DAAs. In conclusion, there is a shift in prescription of new HCV treatments to previously excluded groups (eg HIV-co-infected), although gaps remain for the socio-economically marginalized populations
TRENDS, PREDICTORS AND OUTCOMES ASSOCIATED WITH UNSTRUCTURED TREATMENT INTERRUPTIONS AMONG HIV-POSITIVE INDIVIDUALS ON ANTIRETROVIRAL THERAPY IN CANADA
Full text linkBackground
The expanded use of combination antiretroviral therapy (cART) has dramatically enhanced the quality of care and life expectancy of HIV-positive individuals. However, incomplete adherence and treatment interruptions (TIs) due to treatment fatigue, side effects and cART toxicities have emerged as major challenges to the full realization of the therapeutic promise of cART. Despite the relatively high frequency of TIs, their determinants and outcomes are still not well-characterized.
Methods
Trends, predictors and consequences of treatment interruption (TI) and resumption in two study populations were estimated. First, the Longitudinal Investigations into Supportive and Ancillary health services (LISA) is a cross-sectional study of hard-to-reach individuals on cART in British Columbia. Between 2007 and 2010, 1000 participants were interviewed about sociodemographic and clinical factors. Using pharmacy recording, TIs were defined as a patient-initiated interruption in treatment of at least 90 days during the 12 months preceding or following the study interview. Multivariable logistic regression was used to identify factors associated with treatment interruption. The second study, the Canadian Observational Cohort (CANOC) collaboration, is composed of treatment-naïve HIV-positive individuals who initiated cART between 2000-2011. TIs were defined as interruptions in cART for a period of at least 90 days. Cox proportional hazards regression was used to identify determinants and consequences of cART interruption and resumption.
Results
Of 768 participants included in the LISA study, 15% had a TI recorded during the study window. In multivariable analysis, TIs were significantly associated with current illicit drug use (adjusted odds ratio (aOR): 1.68, 95% confidence interval [CI]: 1.05-2.68); <95% adherence in the first year of treatment (aOR: 2.68, 95% CI: 1.67-4.12); living with more than one person (aOR: 1.95; 95% CI: 1.22-3.14) or on the street (aOR: 5.08, 95% CI: 1.72-14.99) compared to living alone; poor perception of overall health (aOR: 1.64 95% CI: 1.05-2.55); being unemployed (aOR: 2.22, 95% CI: 1.16-4.23); and younger age at interview (aOR: 0.57, 95% CI: 0.44-0.75, per 10 year increment).
A total of 7,633 CANOC participants initiating cART between 2000 and 2011, of whom 1,860 (24.5%) had at least one TI ≥90 days. The prevalence of TI in the first calendar year of cART decreased by half over the study period. Predictors of a first TI were female sex (adjusted hazard ratio (aHR): 1.59, 95% CI: 1.33-1.92), Aboriginal ancestry (aHR: 1.67, 1.27-2.20), a history of injecting drug use (aHR: 1.43, CI: 1.09-1.89), hepatitis C antibody seropositivity (aHR: 2.17, CI: 1.68-2.79), a baseline CD4 cell count above 350 cells/mm3 versus less than 200 cells/mm3 (aHR: 1.46, CI: 1.17-1.81) and use of zidovudine versus tenofovir in the initial cART regimen (aHR: 2.47, CI: 1.92-3.20). Factors protective against TI were older age (aHR: 0.79, CI: 0.73-0.87), higher HIV plasma viral load (log10) (aHR: 0.87, CI: 0.78-0.97) and residence in Ontario (aHR: 0.55, CI: 0.43-0.70) or Quebec (aHR: 0.42, CI: 0.31-0.57) versus British Columbia (BC). Factors predicting resumption of treatment after a first TI included male sex, residence in BC, older age, more recent cART initiation and a CD4 cell count <200 cells/mm3 at cART initiation (all p<0.05). TIs were associated with increased risk of mortality (aHR: 1.79, CI: (1.49-2.16)) after adjusting for socio-demographic and clinical factors.
Conclusions
Despite significant improvements in cART since its advent and the decreasing prevalence of TIs, gaps in treatment remain relatively common. As cART is propagated at increasing levels globally, and the impetus to provide treatment earlier in the course of HIV infection for individual and public health benefits gains momentum, ensuring continuity of treatment becomes even more vital. Strategies to support continuous HIV treatment are needed to maximize the benefits of cART
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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