BACKGROUND Direct-acting antivirals(DAAs)are recommended for the treatment of hepatitis C virus(HCV)infection in patients treated with methadone or buprenorphine.AIM To assess HCV treatment rates in an Opioid Treatmen...BACKGROUND Direct-acting antivirals(DAAs)are recommended for the treatment of hepatitis C virus(HCV)infection in patients treated with methadone or buprenorphine.AIM To assess HCV treatment rates in an Opioid Treatment Program(OTP).METHODS This longitudinal study included 501 patients(81.4%men,median age:45 years;interquartile range:39-50 years)enrolled in an OTP between October 2015 and September 2017.Patients were followed until September 2019.Data on sociodemographics,substance use,HCV infection,human immunodeficiency virus(HIV)infection and laboratory parameters were collected at entry.We analyzed medical records to evaluate HCV treatment.Kaplan-Meier methods and Cox regression models were used to analyze the DAA treatment uptake and to identify treatment predictors.RESULTS Prevalence of HCV and HIV infection was 70%and 34%,respectively.Among anti-HCV-positive(n=336)patients,47.2%,41.3%,and 31.9%used alcohol,cannabis,and cocaine,respectively.HCV-RNA tests were positive in 233(69.3%)patients.Twentyeight patients(8.3%)cleared the infection,and 59/308(19.1%)had received interferon-based treatment regimens before 2015.Among 249 patients eligible,111(44.6%)received DAAs.Treatment rates significantly increased over time from 7.8/100 person-years(p-y)(95%CI:5.0-12.3)in 2015 to 18.9/100 p-y(95%CI:11.7-30.3)in 2019.In a multivariate analysis,patients with HIV co-infection were twice as likely to receive DAAs(HR=1.94,95%CI:1.21-3.12)than patients with HCV mono-infection.Current drug use was an independent risk factor for not receiving treatment against infection(HR=0.48,95%CI:0.29-0.80).CONCLUSION HCV treatment is evolving in patients with HCV-HIV co-infection.Ongoing drug use while in an OTP might negatively impact the readiness to treat infection.展开更多
Background Wound dehiscence is a known complication after anorectal malformations(ARMs) surgery. The aim was to evaluate if a standardized post-posterior sagittal anorectoplasty(PSARP) treatment program decreased woun...Background Wound dehiscence is a known complication after anorectal malformations(ARMs) surgery. The aim was to evaluate if a standardized post-posterior sagittal anorectoplasty(PSARP) treatment program decreased wound dehiscence rates.Methods Wound dehiscence rates within 30 days post-PSARP were compared in a case-control singlecenter study between patients with a standardized post-PSARP treatment 2017–2023, and a cohort with a non-standardized management 2001–2016. The standardized post-PSARP program comprised a minimum of 3 days of: intravenous antibiotics imipenem+cilastatin(with optional subsequent oral amoxicillin+clavulanic acid+metronidazole), fasting after primary PSARP(no stoma), urinary catheter and regular wound cleansing.Results A total of 149 patients(61% males) with various ARM subtypes were included of which 51% were reconstructed with stomas. Overall, wound dehiscence developed in 8 of 59 patients(14%) in the standardized post-PSARP program group versus 28 of 90 patients(31%) in the control group(p=0.014). In primary PSARPs(no stoma, 59% males), wound dehiscence developed in 6 of 33 patients(18%) in the standardized post-PSARP program group versus 17 of 40 patients(43%) in the control group(p=0.026).Conclusion Wound dehiscence rates may be reduced using a standardized post-PSARP treatment program.展开更多
The global commitment to providing antiretroviral therapy （ART） to people living with human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS） in low-income countries has raised hope that the inc...The global commitment to providing antiretroviral therapy （ART） to people living with human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS） in low-income countries has raised hope that the increasing momentum in the fight against the worldwide HIV/AIDS pandemic will be sufficient to control it. However, improved availability of subsidized antiretroviral （ARV） treatments in low-income .countries raises complex ethical issues. In many resource-constrained countries the number of individuals infected with HIV in need of treatment far exceeds the supply of ARV medication. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria. Healthcare systems and funding in low-income countries are limited, requiring a step-by-step approach to scaling- up programs to reach their stated aims.展开更多
Water-Decision Support System (DSS) tools enhance decision-makings towards improved water supply in a given region. The rigours of manual design of the conventional water treatment plants are easily eliminated with th...Water-Decision Support System (DSS) tools enhance decision-makings towards improved water supply in a given region. The rigours of manual design of the conventional water treatment plants are easily eliminated with the use of softwares as in the case of DSS. Therefore, this paper focuses on the development of a Water-DSS for design of treatment plant in Karkala Town, Udupi District of India. A four-decade population projection was made using the baseline data of 1971 till date. The manual computation for water demand, unit operations and adjoining facilities was carried out and later coded in C-programming language for development of a DSS for easier design and process selection. Data validation was done and results from the two approaches were compared. With the C-programming technique, a decision support tool for design and process selection of drinking water treatment plant using conventional method has been developed and named Water-DSS1. The designed tool is simple, accurate, flexible, efficient and universal, easily adaptable to any similar conventional treatment plant. Water-DSS1 is thus recommended for general use in ultimately alleviating water supply challenges.展开更多
Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are?largely dysfunctional, major b...Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are?largely dysfunctional, major barriers to achieving this goal remain. While treatments with antiretroviral drugs (ART) are the focal point of HIV management, it is increasingly recognized that ART alone will not be sufficient to adequately deal with the lifelong consequences of the disease. In addition, the current global economic downturn will continue to impact on funding for HIV care and support, making the search for sustainable solutions more urgent. This article reviews the current evidence base on the impact of community-based programs on HIV/AIDS treatment and general health outcomes, as well as their contribution to ensuring sustained care for HIV-positive people. Our findings suggest that these programs overall have a positive impact on various dimensions of HIV treatment and care, and make a significant contribution to health and HIV outcomes. The authors argue that better use of community platforms for HIV treatment and care programs could be critical for attaining desired goals and should be prioritized at all levels of program design, implementation, and monitoring and evaluation.展开更多
Length of stay in treatment is thought to be the best predictors for long-term recovery from substance use disorders. The objective of this study was to examine the relationship between participation in mind-body-spir...Length of stay in treatment is thought to be the best predictors for long-term recovery from substance use disorders. The objective of this study was to examine the relationship between participation in mind-body-spirit (MBS) therapeutic programs and length of stay in a residential treatment facility. A retrospective analysis of data from 1719 subjects who were admitted to a 30-day residential program for substance use disorders (SUD) was conducted. Subjects participated in MBS programs that included yoga, acupuncture and meditation. We examined the effects of subject participation in MBS programs for subjects who left against staff advice (ASA) and those who successfully completed the residential program. A higher percentage of subjects with severe heroin use disorder left ASA compared with subjects with severe alcohol use disorder (16% vs. 9%, respectively). Most subjects from both substance groups who failed to complete the 30-day treatment program, left within the first two weeks of stay (59% of alcohol group and 75% of heroin group);however, again, the percentage of heroin users leaving during the first two weeks was significantly greater compared with that of alcohol subjects. We found a highly significant, positive correlation (r = 0.56, p < 0.01) and a statistically significant increase in LOS for all subjects, regardless of the substance type, and the number of MBS program sessions attended showing an association between MBS participation and increased LOS. These data support the inclusion of MBS programs as part of a comprehensive treatment strategy for SUD in combination with traditional counseling to help develop a sustainable long-term recovery.展开更多
Prostate cancer is a common malignant tumor of the urinary system in men,and the incidence and detection rate of prostate cancer have been rising significantly in recent years.Androgens play an important role in the o...Prostate cancer is a common malignant tumor of the urinary system in men,and the incidence and detection rate of prostate cancer have been rising significantly in recent years.Androgens play an important role in the occurrence and development of prostate cancer,so hormone deprivation therapy has become an essential means of prostate cancer treatment.Abiraterone acetate is a therapeutic agent for prostate cancer by inhibiting the enzyme activity of CYP17,thereby blocking androgen biosynthesis.In this paper,we present a review of the current mechanism of action of abiraterone acetate for prostate cancer treatment,research progress,and its side effects and limitations.It is expected to provide help for further research on the treatment of prostate cancer.展开更多
Compared with the traditional rigid plastic/rigid viscoplastic(RP/RVP) FEM(based on iteration solution),RP/RVP FEM based on linear programming (LP) has some remarkable advantages,such as it's free of convergence...Compared with the traditional rigid plastic/rigid viscoplastic(RP/RVP) FEM(based on iteration solution),RP/RVP FEM based on linear programming (LP) has some remarkable advantages,such as it's free of convergence problem and its convenience in contact,rigid zone,and friction force treatment.The numerical model of RP/RVP FEM based on LP for axisymmetrical metal forming simulation is studied,and some related key factors and its treatment methods in formulation of constraint condition are proposed.Some solution examples are provided to validate its accuracy and efficiency.展开更多
It is estimated that approximately 200 million people globally are infected with the hepatitis C virus and that roughly half of these people live in Asia. Without treatment, it is estimated that roughly twenty percent...It is estimated that approximately 200 million people globally are infected with the hepatitis C virus and that roughly half of these people live in Asia. Without treatment, it is estimated that roughly twenty percent of those infected with hepatitis C virus progress to chronic liver disease, then subsequently, end-stage liver disease. Thus, access to hepatitis C testing and subsequent care and treatment of chronic hepatitis C infection are essential to address the global burden of disease. In the United States, the Center for Disease Control and Prevention estimates that 60% of new cases of hepatitis infection are due to injection drug use. Opioid Treatment Programs (OTP’s) dispense methadone and buprenorphine under specific federal regulations to injection drug users diagnosed with opioid dependence. OTPs are developing comprehensive care and treatment model programs that integrate general medical and infectious disease-related medical care with substance abuse and mental health services. Integrating hepatitis care services and treatment in the substance abuse treatment settings foster access to care for patients with hepatitis C infection, many who otherwise would not receive needed care and treatment. This may serve as a national model for highly cost-efficient healthcare that has a measurable outcome of improved public health with reduced hepatitis C prevalence.展开更多
In this paper, mathematical models and FEA formulation for implementing heat treatment process simulation were given out. The various coupling effects were treated. The object-oriented methodology of developing heat t...In this paper, mathematical models and FEA formulation for implementing heat treatment process simulation were given out. The various coupling effects were treated. The object-oriented methodology of developing heat treatment simulation was explored. The framework of simulating programs was outlined. The main C++ classes were developed, some important member functions were implemented. The present research work shows that using object-oriented method can greatly reduce the amount of coding. The programs are clear in conception, easy to test, modify and expand. By using the methodology introduced in this paper, one heat treatment process three dimensional simulation tool was developed.展开更多
基金Supported by the Ministry of Science,Innovation and Universities,CarlosⅢHealth Institute(ISCⅢ),European Fund for Regional Development(FEDER),Network for Cooperative Research in Health(RETICS),Spain(No.RD16/0017/0003,PI17/00174,INT19/00026,CD19/00019)the Ministry of Health,National Plan on Drugs(PNSD),Spain(No.2018/020)+4 种基金the European Commission(806996-JUSTSO-JUST2017-AG-DRUG)the Gilead Fellowship Program,Gilead Sciences(No.GLD17/187)the Ministry of Education,Spain(No.PRX18/00245)the Agency for Management of University and Research Grants,Government of Catalonia(No.2017SGR316)and the Municipal Institute of Personal。
文摘BACKGROUND Direct-acting antivirals(DAAs)are recommended for the treatment of hepatitis C virus(HCV)infection in patients treated with methadone or buprenorphine.AIM To assess HCV treatment rates in an Opioid Treatment Program(OTP).METHODS This longitudinal study included 501 patients(81.4%men,median age:45 years;interquartile range:39-50 years)enrolled in an OTP between October 2015 and September 2017.Patients were followed until September 2019.Data on sociodemographics,substance use,HCV infection,human immunodeficiency virus(HIV)infection and laboratory parameters were collected at entry.We analyzed medical records to evaluate HCV treatment.Kaplan-Meier methods and Cox regression models were used to analyze the DAA treatment uptake and to identify treatment predictors.RESULTS Prevalence of HCV and HIV infection was 70%and 34%,respectively.Among anti-HCV-positive(n=336)patients,47.2%,41.3%,and 31.9%used alcohol,cannabis,and cocaine,respectively.HCV-RNA tests were positive in 233(69.3%)patients.Twentyeight patients(8.3%)cleared the infection,and 59/308(19.1%)had received interferon-based treatment regimens before 2015.Among 249 patients eligible,111(44.6%)received DAAs.Treatment rates significantly increased over time from 7.8/100 person-years(p-y)(95%CI:5.0-12.3)in 2015 to 18.9/100 p-y(95%CI:11.7-30.3)in 2019.In a multivariate analysis,patients with HIV co-infection were twice as likely to receive DAAs(HR=1.94,95%CI:1.21-3.12)than patients with HCV mono-infection.Current drug use was an independent risk factor for not receiving treatment against infection(HR=0.48,95%CI:0.29-0.80).CONCLUSION HCV treatment is evolving in patients with HCV-HIV co-infection.Ongoing drug use while in an OTP might negatively impact the readiness to treat infection.
基金Lund University,SwedenSwedish Regional Research Funding(ALF 2022-0215)Region SkåneSkåne University Hospital’s Funding(SUS Fonder och Stiftelser)
文摘Background Wound dehiscence is a known complication after anorectal malformations(ARMs) surgery. The aim was to evaluate if a standardized post-posterior sagittal anorectoplasty(PSARP) treatment program decreased wound dehiscence rates.Methods Wound dehiscence rates within 30 days post-PSARP were compared in a case-control singlecenter study between patients with a standardized post-PSARP treatment 2017–2023, and a cohort with a non-standardized management 2001–2016. The standardized post-PSARP program comprised a minimum of 3 days of: intravenous antibiotics imipenem+cilastatin(with optional subsequent oral amoxicillin+clavulanic acid+metronidazole), fasting after primary PSARP(no stoma), urinary catheter and regular wound cleansing.Results A total of 149 patients(61% males) with various ARM subtypes were included of which 51% were reconstructed with stomas. Overall, wound dehiscence developed in 8 of 59 patients(14%) in the standardized post-PSARP program group versus 28 of 90 patients(31%) in the control group(p=0.014). In primary PSARPs(no stoma, 59% males), wound dehiscence developed in 6 of 33 patients(18%) in the standardized post-PSARP program group versus 17 of 40 patients(43%) in the control group(p=0.026).Conclusion Wound dehiscence rates may be reduced using a standardized post-PSARP treatment program.
文摘The global commitment to providing antiretroviral therapy （ART） to people living with human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS） in low-income countries has raised hope that the increasing momentum in the fight against the worldwide HIV/AIDS pandemic will be sufficient to control it. However, improved availability of subsidized antiretroviral （ARV） treatments in low-income .countries raises complex ethical issues. In many resource-constrained countries the number of individuals infected with HIV in need of treatment far exceeds the supply of ARV medication. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria. Healthcare systems and funding in low-income countries are limited, requiring a step-by-step approach to scaling- up programs to reach their stated aims.
文摘Water-Decision Support System (DSS) tools enhance decision-makings towards improved water supply in a given region. The rigours of manual design of the conventional water treatment plants are easily eliminated with the use of softwares as in the case of DSS. Therefore, this paper focuses on the development of a Water-DSS for design of treatment plant in Karkala Town, Udupi District of India. A four-decade population projection was made using the baseline data of 1971 till date. The manual computation for water demand, unit operations and adjoining facilities was carried out and later coded in C-programming language for development of a DSS for easier design and process selection. Data validation was done and results from the two approaches were compared. With the C-programming technique, a decision support tool for design and process selection of drinking water treatment plant using conventional method has been developed and named Water-DSS1. The designed tool is simple, accurate, flexible, efficient and universal, easily adaptable to any similar conventional treatment plant. Water-DSS1 is thus recommended for general use in ultimately alleviating water supply challenges.
文摘Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are?largely dysfunctional, major barriers to achieving this goal remain. While treatments with antiretroviral drugs (ART) are the focal point of HIV management, it is increasingly recognized that ART alone will not be sufficient to adequately deal with the lifelong consequences of the disease. In addition, the current global economic downturn will continue to impact on funding for HIV care and support, making the search for sustainable solutions more urgent. This article reviews the current evidence base on the impact of community-based programs on HIV/AIDS treatment and general health outcomes, as well as their contribution to ensuring sustained care for HIV-positive people. Our findings suggest that these programs overall have a positive impact on various dimensions of HIV treatment and care, and make a significant contribution to health and HIV outcomes. The authors argue that better use of community platforms for HIV treatment and care programs could be critical for attaining desired goals and should be prioritized at all levels of program design, implementation, and monitoring and evaluation.
文摘Length of stay in treatment is thought to be the best predictors for long-term recovery from substance use disorders. The objective of this study was to examine the relationship between participation in mind-body-spirit (MBS) therapeutic programs and length of stay in a residential treatment facility. A retrospective analysis of data from 1719 subjects who were admitted to a 30-day residential program for substance use disorders (SUD) was conducted. Subjects participated in MBS programs that included yoga, acupuncture and meditation. We examined the effects of subject participation in MBS programs for subjects who left against staff advice (ASA) and those who successfully completed the residential program. A higher percentage of subjects with severe heroin use disorder left ASA compared with subjects with severe alcohol use disorder (16% vs. 9%, respectively). Most subjects from both substance groups who failed to complete the 30-day treatment program, left within the first two weeks of stay (59% of alcohol group and 75% of heroin group);however, again, the percentage of heroin users leaving during the first two weeks was significantly greater compared with that of alcohol subjects. We found a highly significant, positive correlation (r = 0.56, p < 0.01) and a statistically significant increase in LOS for all subjects, regardless of the substance type, and the number of MBS program sessions attended showing an association between MBS participation and increased LOS. These data support the inclusion of MBS programs as part of a comprehensive treatment strategy for SUD in combination with traditional counseling to help develop a sustainable long-term recovery.
文摘Prostate cancer is a common malignant tumor of the urinary system in men,and the incidence and detection rate of prostate cancer have been rising significantly in recent years.Androgens play an important role in the occurrence and development of prostate cancer,so hormone deprivation therapy has become an essential means of prostate cancer treatment.Abiraterone acetate is a therapeutic agent for prostate cancer by inhibiting the enzyme activity of CYP17,thereby blocking androgen biosynthesis.In this paper,we present a review of the current mechanism of action of abiraterone acetate for prostate cancer treatment,research progress,and its side effects and limitations.It is expected to provide help for further research on the treatment of prostate cancer.
文摘Compared with the traditional rigid plastic/rigid viscoplastic(RP/RVP) FEM(based on iteration solution),RP/RVP FEM based on linear programming (LP) has some remarkable advantages,such as it's free of convergence problem and its convenience in contact,rigid zone,and friction force treatment.The numerical model of RP/RVP FEM based on LP for axisymmetrical metal forming simulation is studied,and some related key factors and its treatment methods in formulation of constraint condition are proposed.Some solution examples are provided to validate its accuracy and efficiency.
文摘It is estimated that approximately 200 million people globally are infected with the hepatitis C virus and that roughly half of these people live in Asia. Without treatment, it is estimated that roughly twenty percent of those infected with hepatitis C virus progress to chronic liver disease, then subsequently, end-stage liver disease. Thus, access to hepatitis C testing and subsequent care and treatment of chronic hepatitis C infection are essential to address the global burden of disease. In the United States, the Center for Disease Control and Prevention estimates that 60% of new cases of hepatitis infection are due to injection drug use. Opioid Treatment Programs (OTP’s) dispense methadone and buprenorphine under specific federal regulations to injection drug users diagnosed with opioid dependence. OTPs are developing comprehensive care and treatment model programs that integrate general medical and infectious disease-related medical care with substance abuse and mental health services. Integrating hepatitis care services and treatment in the substance abuse treatment settings foster access to care for patients with hepatitis C infection, many who otherwise would not receive needed care and treatment. This may serve as a national model for highly cost-efficient healthcare that has a measurable outcome of improved public health with reduced hepatitis C prevalence.
文摘In this paper, mathematical models and FEA formulation for implementing heat treatment process simulation were given out. The various coupling effects were treated. The object-oriented methodology of developing heat treatment simulation was explored. The framework of simulating programs was outlined. The main C++ classes were developed, some important member functions were implemented. The present research work shows that using object-oriented method can greatly reduce the amount of coding. The programs are clear in conception, easy to test, modify and expand. By using the methodology introduced in this paper, one heat treatment process three dimensional simulation tool was developed.
