Publications by authors named "Cottrell M"

Background: Incomplete adherence to daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) reduces effectiveness. Adherence biomeasures (i.e.

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Background: Little is known about the efficacy of preexposure prophylaxis (PrEP) or what biologic factors may influence HIV transmission in transgender men (TGM). In this study, we sought to explore the effect of testosterone on the vaginal microbiome, cervicovaginal fluid (CVF) tenofovir concentrations, and levels of CVF inflammatory markers in TGM on PrEP.

Methods: Cervicovaginal fluid was collected from 13 TGM (7 using testosterone) and 32 cisgender women (CGW) on PrEP.

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The population-level reductions in HIV incidence attributed to pre-exposure prophylaxis (PrEP) have not been fully realized among sexual, gender, and racial/ethnic minority youth. P3 (Prepared, Protected, emPowered) is a comprehensive mobile application (app) intervention developed to support PrEP adherence through gamification, medication tracking, and social engagement. A randomized controlled trial was conducted with 246 young men who have sex with men (YMSM) and young transgender women who have sex with men (YTWMSM) currently on or planning to begin PrEP.

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Article Synopsis
  • * The study introduces a 3D printed multipurpose prevention technology (MPT) intravaginal ring (IVR) designed to prevent HIV, HSV-2, and unintended pregnancy, utilizing advanced 3D printing techniques and biocompatible materials.
  • * The IVRs demonstrated stable drug release and safety in macaque studies, maintaining effectiveness and tolerability over a 28-day period without causing any significant inflammatory responses.
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Children living with HIV (CLWH) face unique challenges with adherence to antiretroviral therapy. In South Africa, just over a third of children receiving antiretroviral therapy are virally suppressed. Long-acting, subcutaneous implants may improve outcomes in CLWH compared to current daily oral dosing regimens.

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Intravaginal rings (IVRs) represent a well-established, woman-controlled and sustained vaginal drug delivery system suitable for a wide range of applications. Here, we sought to investigate the differences in etonogestrel (ENG) and ethinyl estradiol (EE) release from a 3D-printed IVR utilizing continuous liquid interface production (CLIP™) (referred to as CLIP for low drug loading and CLIP IVRs for high drug loading) and NuvaRing, a commercially available injection molded IVR. We conducted in vitro release studies in simulated vaginal fluid to compare the release of ENG and EE from CLIP IVRs and NuvaRing.

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ObjectiveThis study aimed to explore equity of care for Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians within a Queensland-wide musculoskeletal service.MethodThe service database was analysed between July 2018 and April 2022 across 18 Queensland Health facilities. Representation of Aboriginal and Torres Strait Islander peoples within the service's patient population was first explored.

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Background: Literature reporting positive outcomes from the Good Life with osteoArthritis in Denmark (GLA:D®) program in Australia mainly involves patients attending private physiotherapy services.

Objective: Evaluate the feasibility of implementing GLA:D® in Australian public hospitals.

Design: Implementation study in three metropolitan tertiary public hospitals over six months.

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Background: Previous literature has reported the successful implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program into predominantly private practice settings. There may be unique challenges present within the public hospital setting that influence GLA:D® implementation in public health.

Objective: Explore the attitudes and experiences of service providers directly involved in implementing GLA:D® in Australian public tertiary hospitals.

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Management of obesity requires a multidisciplinary approach including physical activity interventions, which have significant impacts on overall health outcomes. Greater levels of lean muscle mass are significantly associated with improved health and reduced risk of comorbidities and should be preserved where possible when undertaking rapid weight loss. This article reports on the physical and functional outcomes achieved during a 12-week intensive multidisciplinary intervention targeting obesity and evaluates correlations between body composition and functional outcomes.

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Introduction: Management guidelines for low back pain (LBP) recommend exclusion of serious pathology, followed by simple analgesics, superficial heat therapy, early mobilisation and patient education. An audit in a large metropolitan hospital emergency department (ED) revealed high rates of non-recommended medication prescription for LBP (65% of patients prescribed opioids, 17% prescribed benzodiazepines), high inpatient admission rates (20% of ED LBP patients), delayed patient mobilisation (on average 6 hours) and inadequate patient education (48% of patients). This study aims to improve medication prescription for LBP in this ED by implementing an intervention shown previously to improve guideline-based management of LBP in other Australian EDs.

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Long-acting injectable cabotegravir is more effective than daily oral PrEP at preventing HIV transmission due to improved adherence, but requires bi-monthly large-volume intramuscular injections. Subcutaneous (SC) contraceptive implants can be formulated with antiretrovirals for extended-duration HIV PrEP. Islatravir (ISL) is a first-in-class, investigational antiretroviral with pharmacologic properties well-suited for implant delivery.

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Background: During the COVID-19 pandemic, many individuals sought healthcare virtually. Physiotherapy is integral in managing temporomandibular disorders (TMDs); therefore, establishing how key physical tests can be appropriately adapted to telehealth is paramount.

Objectives: To establish the validity and reliability of telehealth (specifically videoconferencing) assessments against in-person assessments on a battery of TMD physical tests.

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The prevention of HIV and unintended pregnancies is a public health priority. Multi-purpose prevention technologies capable of long-acting HIV and pregnancy prevention are desirable for women. Here, we utilized a preclinical macaque model to evaluate the pharmacokinetics of biodegradable ε-polycaprolactone implants delivering the antiretroviral islatravir (ISL) and the contraceptive etonogestrel (ENG).

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Background: The efficacy of daily oral pre-exposure prophylaxis (PrEP) in preventing HIV transmission among people who inject drugs (PWID) was demonstrated over a decade ago. However, only a few studies among PWID have since measured PrEP adherence using laboratory markers.

Methods: In this trial, we randomized recently injecting PWID in Kyiv, Ukraine, to receive daily oral TDF/FTC with or without SMS reminders.

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Virologic suppression with antiretroviral therapy (ART) has significantly improved health outcomes for people living with HIV, yet challenges related to chronic inflammation in the central nervous system (CNS)-known as Neuro-HIV- persist. As primary targets for HIV-1 with the ability to survey and populate the CNS and interact with myeloid cells to co-ordinate neuroinflammation, CD4 T cells are pivotal in Neuro-HIV. Despite their importance, our understanding of CD4 T cell distribution in virus-targeted CNS tissues, their response to infection, and potential recovery following initiation of ART remain limited.

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Article Synopsis
  • The review assesses the cost-effectiveness of telehealth for outpatient musculoskeletal physiotherapy, noting that while its effectiveness is supported, economic impact requires further study.
  • Eleven studies highlight that telehealth generally produces similar health outcomes to in-person care and is often less expensive due to reduced travel and fewer face-to-face appointments.
  • The conclusion suggests telehealth is both effective and more economical for public patients, but additional research is needed on its impact for private or non-government physiotherapy providers.
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Aim: To establish the prevalence of positional head deformations (PHDs) within a neonatal unit (NU) setting, and to evaluate the subsequent impact that PHDs have on NU graduates and their families.

Methods: A prospective audit was conducted over a six-week period within a tertiary NU (Brisbane, Australia). Eligible babies were measured weekly using a craniometer where presence, type and severity of PHD were determined.

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  • The study aimed to assess how vaginal microbiota impacts the levels of antiretroviral drugs in women with HIV initiating hormonal contraception.
  • Results showed a significant decrease in lamivudine concentrations after starting contraception, particularly in those using the levonorgestrel implant, but no marked change observed in the DMPA group.
  • The findings suggest that starting hormonal contraception does not increase the risk of HIV shedding in the genital area, ensuring that ART efficacy remains intact for women using DMPA or levonorgestrel implants, though further investigation into the link between vaginal bacteria and drug concentrations is needed.
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A priori use of mathematical modeling and simulation to predict outcomes from incomplete adherence or reduced frequency dosing strategies may mitigate the risk of clinical trial failure with HIV pre-exposure prophylaxis regimens. We developed a semi-physiologic population pharmacokinetic model for two antiretrovirals and their active intracellular metabolites in three mucosal tissues using pharmacokinetic data from a phase I, dose-ranging study. Healthy female volunteers were given a single oral dose of tenofovir disoproxil fumarate (150, 300, or 600 mg) or emtricitabine (100, 200, or 400 mg).

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Article Synopsis
  • Only condoms effectively prevent both HIV and unplanned pregnancies, but user acceptability and partner cooperation can reduce their effectiveness.
  • Researchers developed a novel injectable implant that combines antiretroviral drugs (like dolutegravir and cabotegravir) with hormonal contraceptives (etonogestrel and medroxyprogesterone acetate) for multipurpose prevention.
  • Studies in mice showed that this implant is safe and well-tolerated, maintaining effective drug concentrations for 90 days after administration, indicating its potential as an effective preventive method.
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Introduction And Methods: To understand the relationship between immunovirological factors and antiretroviral (ARV) drug levels in lymph nodes (LN) in HIV therapy, we analyzed drug levels in twenty-one SIV-infected rhesus macaques subcutaneously treated with daily tenofovir (TFV) and emtricitabine (FTC) for three months.

Results: The intracellular active drug-metabolite (IADM) levels (TFV-dp and FTC-tp) in lymph node mononuclear cells (LNMC) were significantly lower than in peripheral blood mononuclear cells (PBMC) (P≤0.005).

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Virologic suppression with antiretroviral therapy (ART) has significantly improved health outcomes for people living with HIV, yet challenges related to chronic inflammation in the central nervous system (CNS) - known as Neuro-HIV- persist. As primary targets for HIV-1 with the ability to survey and populate the CNS and interact with myeloid cells to co-ordinate neuroinflammation, CD4 T cells are pivotal in Neuro-HIV. Despite their importance, our understanding of CD4 T cell distribution in virus-targeted CNS tissues, their response to infection, and potential recovery following initiation of ART remain limited.

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