Publications by authors named "Koss C"

Article Synopsis
  • The review highlights the potential of long-acting preexposure prophylaxis (LA-PrEP), specifically cabotegravir (CAB-LA) and lenacapavir, to reduce HIV incidence in the U.S.
  • It notes that while CAB-LA is approved in many countries, its availability is mainly limited to U.S. implementation studies, with obstacles like insurance issues impacting access.
  • To maximize LA-PrEP's effectiveness, there's a pressing need for equitable access, improved healthcare delivery systems, and targeted efforts to address disparities in HIV care and prevention.
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Article Synopsis
  • A study aimed to enhance HIV prevention by providing participants in Uganda and Kenya with options for daily pills or long-acting injectable medication, allowing them to switch methods based on personal preference.
  • The research involved 1,534 individuals at risk for HIV who previously participated in trials, with 984 agreeing to continue in the extension phase of the study.
  • Results showed that the intervention group experienced a higher mean coverage of biomedical prevention (69.7%) compared to those receiving standard care, suggesting a potential benefit in offering treatment choices.
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Article Synopsis
  • Long-acting cabotegravir (CAB-LA) is effective for preventing HIV, but there have been instances of delayed diagnoses and resistance to integrase inhibitors in trials.
  • A case study involving a 23-year-old gender-nonbinary individual showed that after a brief interruption in CAB-LA, HIV became detectable with an INSTI resistance mutation only identified through a sensitive research assay.
  • The findings highlight the need for faster HIV testing and access to CAB-LA, even without insurance, to improve early detection and reduce the risk of resistance.
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Background: Injectable cabotegravir (CAB)/rilpivirine (RPV) is the only combination long-acting (LA) antiretroviral regimen approved for HIV. RPV may not be effective among individuals with non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance, which has >10% prevalence in many countries. Lenacapavir (LEN) is an LA capsid inhibitor given every 6 months, but has not been studied in combination with other LA agents.

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Background: Pregnant and postpartum women in Sub-Saharan Africa are at high risk of HIV acquisition. We evaluated a person-centered dynamic choice intervention for HIV prevention (DCP) among women attending antenatal and postnatal care.

Setting: Rural Kenya and Uganda.

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Discrimination performance in perceptual choice tasks is known to reflect both sensory discriminability and nonsensory response bias. In the framework of signal detection theory, these aspects of discrimination performance are quantified through separate measures, sensitivity (d') for sensory discriminability and decision criterion (c) for response bias. However, it is unknown how response bias (i.

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Objective: HIV prevention service delivery models that offer product choices, and the option to change preferences over time, may increase prevention coverage. Outpatient departments in sub-Saharan Africa diagnose a high proportion of new HIV infections, but are an understudied entry point to biomedical prevention.

Design: Individually randomized trial of dynamic choice HIV prevention (DCP) intervention vs.

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Introduction: Person-centred HIV prevention delivery models that offer structured choices in product, testing and visit location may increase coverage. However, data are lacking on the actual uptake of choices among persons at risk of HIV in southern Africa. In an ongoing randomized study (SEARCH; NCT04810650) in rural East Africa, we evaluated the uptake of choices made when offered in a person-centred, dynamic choice model for HIV prevention.

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Article Synopsis
  • Researchers looked at a specific type of leukemia in kids, called KMT2Ar acute lymphoblastic leukemia (ALL), which has a low chance of recovery.
  • They tested 1,116 approved medicines and found that some can help fight this cancer by blocking certain cell processes.
  • When used on some patients who didn't respond to other treatments, 90% showed improvement, and this approach is now being tested in a new trial for infants with leukemia.
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Pre-exposure prophylaxis (PrEP) implementation is underway across sub-Saharan Africa. However, little is known about health care providers' experiences with PrEP provision in generalized epidemic settings, particularly outside of selected risk groups. In this study (NCT01864603), universal access to PrEP was offered to adolescents and adults at elevated risk during population-level HIV testing in rural Kenya and Uganda.

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Purpose Of Review: Cabotegravir is a potent integrase strand transfer inhibitor (INSTI) recently approved as a long-acting injectable formulation for HIV prevention (CAB-LA). We summarize what is known about cabotegravir pharmacokinetics, activity, and emergence of resistance from in vitro, macaque and clinical studies, and we evaluate the risk of resistance from CAB-LA with on-time injections and after CAB-LA discontinuation.

Recent Findings: The accumulation of multiple INSTI mutations is required for high-level cabotegravir resistance, and the same mutation combinations may cause cross-resistance to dolutegravir, which is widely used for first-line antiretroviral therapy in low- and middle-income countries.

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Background: Social network analysis can elucidate tuberculosis transmission dynamics outside the home and may inform novel network-based case-finding strategies.

Methods: We assessed the association between social network characteristics and prevalent tuberculosis infection among residents (aged ≥15 years) of 9 rural communities in Eastern Uganda. Social contacts named during a census were used to create community-specific nonhousehold social networks.

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Is the pursuit of interdisciplinary or innovative research beneficial or detrimental for the impact of early career researchers? We focus on young scholars as they represent an understudied population who have yet to secure a place within academia. Which effects promise higher scientific recognition (i.e.

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Current treatments fail to modify the underlying pathophysiology and disease progression of chronic obstructive pulmonary disease (COPD), necessitating alternative therapies. Here, we show that COPD subjects have increased IL-36γ and decreased IL-36 receptor antagonist (IL-36Ra) in bronchoalveolar and nasal fluid compared with control subjects. IL-36γ is derived from small airway epithelial cells (SAEC) and is further induced by a viral mimetic, whereas IL-36Ra is derived from macrophages.

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Background: Approaches that allow easy access to pre-exposure prophylaxis (PrEP), such as over-the-counter provision at pharmacies, could facilitate risk-informed PrEP use and lead to lower HIV incidence, but their cost-effectiveness is unknown. We aimed to evaluate conditions under which risk-informed PrEP use is cost-effective.

Methods: We applied a mathematical model of HIV transmission to simulate 3000 setting-scenarios reflecting a range of epidemiological characteristics of communities in sub-Saharan Africa.

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Introduction: Premonitory urges in Tourette disorder are often linked to altered somatosensory processing, which might include deficits in metacognition. We explored tactile and visual metacognitive ability in people with Tourette disorder and healthy control participants.

Methods: Patients with Tourrete disorder and healthy control participants completed a tactile and a visual metacognitive task.

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Next-generation sequencing (NGS) has revolutionized genomics, decreasing sequencing costs and allowing researchers to draw correlations between diseases and DNA or RNA changes. Technical advances have enabled the analysis of RNA expression changes between single cells within a heterogeneous population, known as single-cell RNA-seq (scRNA-seq). Despite resolving transcriptomes of cellular subpopulations, scRNA-seq has not replaced RNA-seq, due to higher costs and longer hands-on time.

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Article Synopsis
  • * Research shows that TNF inhibits the development and functioning of M2 macrophages, which are important for tissue repair, by using advanced techniques like RNA sequencing and signaling pathway analysis.
  • * The study reveals that TNF impacts M2 macrophage gene expression through specific signaling pathways, particularly highlighting JNK signaling as a crucial factor, suggesting that TNF’s role is more nuanced than simply suppressing all M2 macrophage activity.
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The Sustainable East Africa Research in Community Health (SEARCH), a universal test and treat (UTT) trial, implemented 'Streamlined Care'-a multicomponent strategy including rapid linkage to care and antiretroviral therapy (ART) start, 3-monthly refills, viral load counseling, and accessible, patient-centered care provision. To understand patient and provider experiences of Streamlined Care to inform future care innovations, we conducted in-depth interviews with patients ( = 18) and providers ( = 28) at baseline (2014) and follow-up (2015) ( = 17 patients;  = 21 providers). Audio recordings were transcribed, translated, and deductively and inductively coded.

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Introduction: Antiretroviral-based HIV prevention, including pre-exposure prophylaxis (PrEP), is expanding in generalized epidemic settings, but additional prevention options are needed for individuals with periodic, high-risk sexual exposures. Non-occupational post-exposure prophylaxis (PEP) is recommended in global guidelines. However, in Africa, awareness of and access to PEP for sexual exposures are limited.

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We can make exquisitely precise movements without the apparent need for conscious monitoring. But can we monitor the low-level movement parameters when prompted? And what are the mechanisms that allow us to monitor our movements? To answer these questions, we designed a semivirtual ball throwing task. On each trial, participants first threw a virtual ball by moving their arm (with or without visual feedback, or replayed from a previous trial) and then made a two-alternative forced choice on the resulting ball trajectory.

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Tenofovir disoproxil fumarate (TDF) in combination with emtricitabine (FTC) is the backbone for both human immunodeficiency virus (HIV) treatment and pre-exposure prophylaxis (PrEP) worldwide. Tenofovir alafenamide (TAF) with FTC is increasingly used in HIV treatment and was recently approved for PrEP among men-who-have-sex-with-men. TDF and TAF are both metabolized into tenofovir (TFV).

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Background: Oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but data are limited on HIV incidence among PrEP users in generalized epidemic settings, particularly outside of selected risk groups. We performed a population-based PrEP study in rural Kenya and Uganda and sought to evaluate both changes in HIV incidence and clinical and virologic outcomes following seroconversion on PrEP.

Methods And Findings: During population-level HIV testing of individuals ≥15 years in 16 communities in the Sustainable East Africa Research in Community Health (SEARCH) study (NCT01864603), we offered universal access to PrEP with enhanced counseling for persons at elevated HIV risk (based on serodifferent partnership, machine learning-based risk score, or self-identified HIV risk).

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IL-36, which belongs to the IL-1 superfamily, is increasingly linked to neutrophilic inflammation. Here, we combined in vivo and in vitro approaches using primary mouse and human cells, as well as, acute and chronic mouse models of lung inflammation to provide mechanistic insight into the intercellular signaling pathways and mechanisms through which IL-36 promotes lung inflammation. IL-36 receptor deficient mice exposed to cigarette smoke or cigarette smoke and H1N1 influenza virus had attenuated lung inflammation compared with wild-type controls.

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