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Introduction: Approval of the first long-acting injectable antiretroviral therapy (LAI ART) medication heralded a new era of HIV treatment. However, the years since approval have been marked by implementation challenges. The "Accelerating Implementation of Multilevel Strategies to Advance Long-Acting Injectable for Underserved Populations (ALAI UP Project)" aims to accelerate the systematic and equitable delivery of LAI ART.
Methods: We coded and analysed implementation barriers according to the Consolidated Framework for Implementation Research (CFIR) domains, desired resources and programme goals from questionnaire short-answer responses by clinics across the United States responding to ALAI UP's solicitation to participate in the project between November 2022 and January 2023.
Results: Thirty-eight clinics responded to ALAI UP's solicitation. The characteristics of LAI ART as an innovation (cost, complexity of procurement, dosing interval, limited eligibility) precipitated and interacted with barriers in other CFIR domains. Barriers included obtaining coverage for the cost of medication (27/38 clinics) (outer setting); need for new workflows and staffing (12/38) and/or systems to support injection scheduling/coordination (16/38), transportation and expanded clinic hours (13/38) (inner setting); and patient (10/38) and provider (7/38) education (individuals). To support implementation, applicants sought: technical assistance to develop protocols and workflows (18/38), specifically strategies to address payor challenges (8/38); additional staff for care coordination and benefits navigation (17/38); opportunities to share experiences with other implementing clinics (12/38); patient-facing materials to educate and increase demand (7/38); and support engaging communities (6/38). Clinics' LAI ART programme goals varied. Most prioritized delivering LAI ART to their most marginalized patients struggling to achieve viral suppression on oral therapy, despite awareness that current US Food and Drug Administration approval is only for virally suppressed patients. The goal for LAI ART reach after 1 year of implementation ranged from ≤10% of patients with HIV on LAI ART (17/38) to ≥50% of patients (2/38).
Conclusions: Diverse clinic types are interested in offering LAI ART and most aspire to use LAI ART to support their most vulnerable patients sustain viral suppression. Dedicated resources centred on equity and relevant to context and population are needed to support implementation. Otherwise, the introduction of LAI ART risks exacerbating, not ameliorating, health disparities.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224578 | PMC |
http://dx.doi.org/10.1002/jia2.26282 | DOI Listing |
Aberration correction is critical for obtaining sharp images but remains a challenging task. Owing to its ability to record both spatial and angular information of light rays, light field imaging is a powerful method to measure and correct optical aberrations. However, current methods need extensive calibrations to obtain prior information about the camera, which is restrictive in real-world applications.
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Institute of Pathology and Parasitology, National Defense Medical Center, Taipei, Taiwan.
Endometrial cancer (EC) diagnosis traditionally relies on tumor morphology and nuclear grade, but personalized therapy demands a deeper understanding of tumor mutational burden (TMB), i.e., a key biomarker for immune checkpoint inhibition and immunotherapy response.
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December 2024
School of Computer Science and Technology, Xi'an Jiaotong University, Xi'an, China.
Open chromatin regions (OCRs) play a crucial role in transcriptional regulation and gene expression. In recent years, there has been a growing interest in using plasma cell-free DNA (cfDNA) sequencing data to detect OCRs. By analyzing the characteristics of cfDNA fragments and their sequencing coverage, researchers can differentiate OCRs from non-OCRs.
View Article and Find Full Text PDFGigascience
January 2024
School of Mathematical Sciences, Peking University, Beijing 100871, China.
Background: In the face of a growing disparity between high-throughput sequence data and low-throughput experimental studies, the emerging field of deep learning stands as a promising alternative. Generally, many data-driven approaches are capable of facilitating fast and accurate predictions of protein functions. Nevertheless, the inherent statistical nature of deep learning techniques may limit their generalization capabilities when applied to novel nonhomologous proteins that diverge significantly from existing ones.
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A search is reported for charge-parity violation in decays, using data collected in proton-proton collisions at recorded by the CMS experiment in 2018. The analysis uses a dedicated data set that corresponds to an integrated luminosity of 41.6 , which consists of about 10 billion events containing a pair of b hadrons, nearly all of which decay to charm hadrons.
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