Preferred Option Research Articles

Neither laissez-faire nor prohibition: the khat regulation policy preferences of people who chew khat and local social service providers in Ethiopia

Background This study examines the opinions of khat-chewers and local social service providers about the current regulatory framework for khat and their preferred policy option(s). Methods Interviews were conducted with 102 khat-chewing individuals, five habitual groups, and ten social service providers in Jimma, Ethiopia. Results Most of the participants believe that neither laissez-faire nor prohibition policies are appropriate. Reasons for supporting the reform of the current laissez-faire approach include: worries about the escalating use of khat, concerns about the safety of the khat supply, the adverse effects of khat on the city’s aesthetics and hygiene, and negative impacts on economic security. Reasons for opposing the introduction of a policy of prohibition include: prohibition would be counterproductive, and it would undermine the socioeconomic significance of khat. However, the study participants did suggest several regulatory activities, which can be thematized into primary and secondary preventive strategies. Conclusion The preferred regulatory approaches include addressing the structural causes of (problematic) khat use, empowering khat-chewers with awareness about appropriate use, managing the supply of khat, and restricting the age of users and place of use. These regulations are intended to reduce supply, demand and harm, and they depict the khat problem as a complex system.

The Use of Educational Games to Promote Learning in Geology: Conceptions of Middle and Secondary School Teachers

Studies highlight researchers’ concerns about how science should be taught today. It is recognised that teachers have difficulty involving and motivating students to learn about different complex topics, such as geology. Schools must promote skills development to develop citizens who can be active and informed in society. One way of undertaking this is to use active methodologies such as educational games, in which students play an essential role in developing activities. Games encourage changes in conceptions regarding the relevance of this scientific topic that is often undervalued by students. Games have gained space in recent years in several disciplines, and it is essential that this tool is thought out and planned within a consistent pedagogical proposal. This educational resource is used to increase motivation for learning, as well as enhance and strengthen the effects of learning. An intervention plan can be framed within game-based teaching. Teachers have been underrepresented in the game-based learning literature, with more emphasis on games’ effects. However, the pedagogical issue of games has been particularly relevant in recent decades. The current investigation used a survey given to geology teachers (n = 112) from public and private middle and secondary schools in Portugal. Its purpose was to assess teachers’ perceptions regarding game-based teaching and its potential to promote active learning. Our sample ages ranged from 24 to 64 years (average of 48.9 years old); 81.3% were women and 18.8% were men. The analysis of the results seems to confirm that although they do not always use games to promote learning in geology, most teachers still recognise their potential to motivate, enhance, and reinforce the learning of geological content, with digital games being the preferred option. They emphasise the importance of teacher training in this area and the inclusion of game applications in school textbooks to approach different geology-related themes. Our results seem to indicate some lack of consistency in teachers’ opinions on the impact of games on student learning.

Experimental Analysis of Deep-Sea AUV Based on Multi-Sensor Integrated Navigation and Positioning

The operation of underwater vehicles in deep waters is a very challenging task. The use of AUVs (Autonomous Underwater Vehicles) is the preferred option for underwater exploration activities. They can be autonomously navigated and controlled in real time underwater, which is only possible with precise spatio-temporal information. Navigation and positioning systems based on LBL (Long-Baseline) or USBL (Ultra-Short-Baseline) systems have their own characteristics, so the choice of system is based on the specific application scenario. However, comparative experiments on AUV navigation and positioning under both systems are rarely conducted, especially in the deep sea. This study describes navigation and positioning experiments on AUVs in deep-sea scenarios and compares the accuracy of the USBL and LBL/SINS (Strap-Down Inertial Navigation System)/DVL (Doppler Velocity Log) modes. In practice, the accuracy of the USBL positioning mode is higher when the AUV is within a 60° observation range below the ship; when the AUV is far away from the ship, the positioning accuracy decreases with increasing range and observation angle, i.e., the positioning error reaches 80 m at 4000 m depth. The navigational accuracy inside and outside the datum array is high when using the LBL/SINS/DVL mode; if the AUV is far from the datum array when climbing to the surface, the LBL cannot provide accurate position calibration while the DVL fails, resulting in large deviations in the SINS results. In summary, the use of multi-sensor combination navigation schemes is beneficial, and accurate position information acquisition should be based on the demand and cost, while other factors should also be comprehensively considered; this paper proposes the use of the LBL/SINS/DVL system scheme.

Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer

BackgroundThe optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival (OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC.MethodsIn this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed.ResultsThree hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p = < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49–14.49) and 8.08 months (95% CI, 6.88–9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment.ConclusionOur study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy.

Citizen Preferences and Awareness of Tax Revenue Options: Public Opinion on South Carolina’s “Tax Swap”

Tax complexity makes it challenging for citizens to understand how taxes imposed by state and local governments affect their tax bill. This paper considers citizen awareness and preferences for tax revenue options in the presence of tax features that increase complexity. The researchers mailed a survey questionnaire to a random sample of South Carolina voters measuring their level of knowledge and preferences for school tax funding during the last half of 2021. A sizable majority of respondents report the property tax as their least preferred option to fund school operations when compared to sales tax or commercial property tax, with variation in support by ideology, homeownership, and partisanship. However, respondents are broadly uninformed of current school tax funding mechanisms regardless of college degree attainment, ideology, and other important indicators. Most respondents are not aware of the “tax swap” that replaced residential property tax with a one-cent sales tax to fund South Carolina school operations.

Shock wave lithotripsy in the era of COVID-19.

The objective of the study y was to evaluate factors which can improve shock wave lithotripsy (SWL) results to keep up with COVID-19 pandemic. Between June 2020 and June 2021, patients with radio-opaque or faint radio-opaque upper urinary tract stones, stone attenuation value ≤1200 HU, and stones size <2.5 cm were treated by electrohydraulic SWL. Patients with respiratory tract symptoms elevated temperature, contact with COVID-19 patients, or positive COVID-19 swab 2 weeks preoperatively, skin-to-stone distance >11 cm, and body mass index >30 kg/m2 were excluded from the study. Patients were prospectively enrolled in SWL done at a rate of 40-50 SWs/min under combined ultrasound and fluoroscopy-guided, ramped into high power in the 1st 300 shocks. Success rate and complications were recorded. Five hundred and ninety patients completed the study. The success rate after 1st session was 408/590 patients (69.15%) which was augmented by 2nd session to reach 527/590 patients 89.3%. The success rate was 96.2% at 3 months postoperatively. Most complications were mild (Grade 1 or 2). SWL results improved using slow rate high power from the start of the session under combined fluoroscopy and ultrasound guidance. SWL may be a preferred option during a pandemic.

Recarga artificial mediante pozos secos

Managed aquifer recharge (MAR) is a water management strategy that uses aquifers for the seasonal or inter-annual storage of exceeding surface water. Systems that implement artificial recharge use infiltration ponds or shallow or deep infiltration wells. While articifial recharge through infiltration ponds requires large areas and infiltration through deep wells demands high investment, infiltration through drywells, which inject water to the vadose zone, is often a preferred option because of its low cost and relatively easy implementation. We present results of detailed numerical simulations to assess the operation of a single drywell to implement an artificial recharge system. We demonstrate that depending upon the distribution and property of the geological materials that compose the subsurface, the operation of the well can produce quite different results in terms of effective recharge. We expect that these findings will help design real MAR systems and provide supporting information for decision-makers in charge of approving and financing such water management systems.

Clinicopathological Features and Treatment Outcomes of Male Breast Cancer in Pakistani Population: A 10-Year Retrospective Cross-Sectional Study.

Male breast cancer (MBC) accounts for 1% of global breast cancer cases. On account of its rarity, very few prospective clinical trials have been carried out on MBC. Pakistan has the highest incidence of breast cancer in Asia, but very limited data are available on MBC. The objective is to determine the clinicopathological characteristics and treatment patterns of MBC in Pakistani population. This is a retrospective cross-sectional study. A retrospective cross-sectional study carried out using the cancer database of Shaukat Khanum Memorial Cancer Hospital & Research Center. Men with a histologically proven breast cancer, stage 0 to III disease and requiring surgical intervention were included. The Kaplan-Meier curve and log-rank test were used for survival analysis. Sixty-eight patients with MBC were included with a median age at diagnosis of 55 years. Most patients were stage II (47.1%). Invasive ductal carcinoma (IDC) was the commonest type (89.7%). Estrogen receptor (ER), progesterone receptor (PR), and Her-2 receptor positivity were 92.6%, 86.8%, and 32.4%, respectively. Mastectomy was performed in 95.6% of the cases. Neoadjuvant and adjuvant chemotherapy was administered in 25 (36.8%) and 26 (38.2%) patients, respectively. Fifty-five (80.9%) patients received adjuvant radiotherapy. Most of the patients (89.7%) received tamoxifen. The 5-year overall and disease-free survival was 88.2% and 80.9%, respectively. Patients receiving neoadjuvant chemotherapy had a better overall and disease-free survival (P = .025). Male breast cancer occurs at a relatively earlier age in Pakistani population as compared with Western men. Mastectomy is the preferred surgical option for MBC on account of the advanced disease and delayed presentation. Neoadjuvant chemotherapy has a statistically significant effect on overall and disease-free survival, but in spite of these benefits, it remains underutilized.

Effect of Aromatase Inhibitor Letrozole on the Placenta of Adult Albino Rats: A Histopathological, Immunohistochemical, and Biochemical Study.

Letrozole, an aromatase inhibitor, has recently been introduced as the preferred treatment option for ectopic pregnancy. To date, no study has investigated the effect of letrozole alone on placental tissue. The present study aimed to evaluate the effect of different doses of letrozole on the placenta of rats and to clarify the underlying mechanism. Sixty pregnant female rats were equally divided into three groups, namely the control group (GI), low-dose (0.5 mg/Kg/day) letrozole group (GII), which is equivalent to the human daily dose (HED) of 5 mg, and high-dose (1 mg/Kg/day) letrozole group (GIII), equivalent to the HED of 10 mg. Letrozole was administered by oral gavage daily from day 6 to 16 of gestation. Data were analyzed using a one-way analysis of variance followed by Tukey's post hoc test and Chi square test. P<0.05 was considered statistically significant. Compared to the GI and GII groups, high-dose letrozole significantly increased embryonic mortality with a high post-implantation loss rate (P<0.001) and significantly reduced the number of viable fetuses (P<0.001) and placental weight (P<0.001) of pregnant rats. Moreover, it significantly reduced placental estrogen receptor (ER) and progesterone receptor (PR) (P<0.001) and the expression of vascular endothelial growth factor (P<0.001), while increasing the apoptotic index of cleaved caspase-3 (P<0.001). Letrozole inhibited the expression of ER and PR in rat placenta. It interrupted stimulatory vascular signals causing significant apoptosis and placental vascular dysfunction. Letrozole in an equivalent human daily dose of 10 mg caused a high post-implantation loss rate without imposing severe side effects.

Lesão da Placa Plantar: a Importância do Diagnóstico Diferencial

Plantar plate lesions are a common cause of metatarsalgia, a prevalent symptom among the general population and athletes. The plantar plate is a fibrocartilaginous structure located in the plantar side of the feet, that is partly responsible for articular stability. High-impact activities and overuse contribute to plantar plate lesions. The diagnosis is mainly clinical but magnetic resonance imaging and ultrasound can be useful for differential diagnosis. Generally, conservative management, which includes analgesia, shoe adaptation and rehabilitation, is the preferred first treatment option. Surgi¬cal treatment is indicated for severe cases or refractory cases, and post-surgical rehabilitation is mandatory for prognostic optimization.

Prostate cancer management in Southeast Asian countries: a survey of clinical practice patterns.

Prostate cancer (PC) has a serious public health impact, and its incidence is rising due to the aging population. There is limited evidence and consensus to guide the management of PC in Southeast Asia (SEA). We present real-world data on clinical practice patterns in SEA for advanced PC care. A paper-based survey was used to identify clinical practice patterns and obtain consensus among the panelists. The survey included the demographics of the panelists, the use of clinical guidelines, and clinical practice patterns in the management of advanced PC in SEA. Most panelists (81%) voted prostate-specific antigen (PSA) as the most effective test for early PC diagnosis and risk stratification. Nearly 44% of panelists agreed that prostate-specific membrane antigen positron emission tomography-computed tomography imaging for PC diagnostic and staging information aids local and systemic therapy decisions. The majority of the panel preferred abiraterone acetate (67%) or docetaxel (44%) as first-line therapy for symptomatic mCRPC patients. Abiraterone acetate (50%) is preferred over docetaxel as a first-line treatment in metastatic castration-sensitive prostate cancer patients with high-volume disease. However, the panel did not support the use of abiraterone acetate in non-metastatic castration-resistant prostate cancer (nmCRPC) patients. Apalutamide (75%) is the preferred treatment option for patients with nmCRPC. The cost and availability of modern treatments and technologies are important factors influencing therapeutic decisions. All panelists supported the use of generic versions of approved therapies. The survey results reflect real-world management of advanced PC in a SEA country. These findings could be used to guide local clinical practices and highlight the financial challenges of modern healthcare.

Generations, permanent income and housing tenure choice: A multinomial logit model approach

This paper examines how generational cohorts influence households’ choices regarding housing tenure and considers the diverse preferences and socio-economic factors that shape decisions—using survey data on 425 families in Ho Chi Minh City, Vietnam. The data is analyzed using a multinomial logit model. The results indicate that generation significantly positively affects housing tenure choice, such that, unlike older cohorts, younger generations are more inclined to rent houses as their preferred housing option. Furthermore, permanent income plays a significant role in shaping housing tenure choices. On the other hand, social-economic variables, namely education, gender of references, family structures, and area of residence, were significant in influencing housing tenure decisions. This finding highlights the importance of housing policies prioritizing affordable and accessible rental options in large cities.

Financing strategies for a textile and apparel remanufacturing supply chain with the delay in disbursement subsidies

The remanufacturing of end-of-use textile and apparel (T&A) products can reduce greenhouse gas emissions, and remanufacturing by third-party remanufacturers (TPRs) is one of the most common remanufacturing models. Governments have incentivized companies to remanufacture discarded T&A products and subsidize them by enacting diverse policies, but these subsidies often lag behind upfront investments, and several TPRs in this industry often confront financial constraints and need to seek financing. Along this line, we have established a T&A remanufacturing supply chain that includes a well-funded Original Equipment Manufacturer (OEM), which manufactures and sells new T&A products, and a capital-constrained TPR, which is licensed by the OEM to remanufactures end-of-use T&A products. OEM financing and subsidy-based confirmation financing, are considered on top of the benchmark model without financing to the TPR. The results of the research show that initial operating capital level and unit remanufacturing cost are two key factors influencing the choice of TPR financing. When the initial operating capital shortfall is small, it is more advantageous for the TPR to cut down production accordingly by maxing out her in-house capital rather than to obtain loan from a well-funded OEM or bank. When TPR's unit remanufacturing cost is low, it is advisable for TPR to secure a loan from the bank (OEM) under moderate (low) capital shortfall. When the unit remanufacturing cost of TPR is moderate, OEM financing becomes a preferable option for the TPR if its capital shortfall is relatively large.

Autonomous Design of a Green Sea-Cleaner Boat

This paper addresses the urgent global issue of marine pollution, with a focus on the inadequacies of traditional cleanup methods and the promising potential of an autonomous green sea-cleaner boat. The study presents a sea-cleaner boat design with reduced wake-wash, integrated with an autonomous system using visual equipment and LiDAR sensors for precise navigation and debris identification. Parametric studies of catamaran hull configurations show that the Flat-Outside Model exhibits the lowest wave elevation, indicating reduced hydrodynamic force and wake-wash, making it an environmentally preferable option. Additionally, the sea-cleaner boat employs LiDAR for obstacle detection and a camera with a Convolutional Neural Network for efficient debris identification and collection, enhancing operational safety and efficiency. Overall, the autonomous green sea-cleaner boat represents a significant advancement in maritime environmental conservation.

Critical aspects in dissolution testing of nanomaterials in the oro-gastrointestinal tract: the relevance of juice composition for hazard identification and grouping.

The dissolution of a nanomaterial (NM) in an in vitro simulant of the oro-gastrointestinal (OGI) tract is an important predictor of its biodurability in vivo. The cascade addition of simulated digestive juices (saliva, stomach and intestine), including inorganic/organic biomacromolecules and digestive enzymes (complete composition, referred to as "Type 1 formulation"), strives for realistic representation of chemical composition of the OGI tract. However, the data robustness requires consideration of analytical feasibility, such as the use of simplified media. Here we present a systematic analysis of the effects exerted by different digestive juice formulations on the dissolution% (or half-life values) of benchmark NMs (e.g., zinc oxide, titanium dioxide, barium sulfate, and silicon dioxide). The digestive juices were progressively simplified by removal of components such as organic molecules, enzymes, and inorganic molecules (Type 2, 3 and 4). The results indicate that the "Type 1 formulation" augments the dissolution via sequestration of ions by measurable factors compared to formulations without enzymes (i.e., Type 3 and 4). Type 1 formulation is thus regarded as a preferable option for predicting NM biodurability for hazard assessment. However, for grouping purposes, the relative similarity among diverse nanoforms (NFs) of a NM is decisive. Two similarity algorithms were applied, and additional case studies comprising NFs and non NFs of the same substance were included. The results support the grouping decision by simplified formulation (Type 3) as a robust method for screening and grouping purposes.

Unravelling potential reaction intermediates during catalytic pyrolysis of polypropylene with microscopy and spectroscopy.

While plastics-to-plastics recycling via melting and re-extrusion is often the preferred option due to a relatively low CO2 footprint, this technique requires a highly sorted waste stream and plastic properties can often not be maintained. Obtaining aromatics, such as benzene, toluene, and xylene (BTX), via catalytic pyrolysis of polyolefins, such as polypropylene and polyethylene, offers another attractive recycling technology. In this process, a discarded crude oil refinery catalyst (ECAT) was previously shown to lower the unwanted formation of deactivating coke species compared to a fresh crude oil refinery catalyst (FCC-cat), while yielding 20 wt% aromatics from polypropylene. In this work, we study the underlying reaction mechanism for this chemical recycling process over the fresh and used refinery catalyst as well as a model system, not containing any zeolite material, using a combination of microscopy and spectroscopy. More specifically, by using in situ fluorescence microscopy, in situ infrared spectroscopy, in situ ultraviolet-visible spectroscopy as well as ex situ solid-state nuclear magnetic resonance, we observe highly fluorescent methylated aromatic intermediates that differ for the three catalyst materials under study both in their fluorescence, IR, UV-vis, and NMR spectroscopy features. This detailed micro-spectroscopic comparison informs which potential reaction intermediates lead to increased coke formation. Our results suggests that a next generation of catalyst materials for this process would profit from a higher accessibility and a milder acidity compared to an FCC-cat and shows the great potential of using ECAT to reduce coking and obtain a BTX stream, which could be become the chemical building blocks for the manufacturing of e.g., plastics and coating materials.

Consumer-driven evaluation of Ecoplas as a sustainable flexible packaging in Jakarta

400 million tons of plastic waste pollute the environment every year, and then 8 million tons of plastic waste have ended up in the ocean. Flexible plastic waste accounts for 76% of plastic waste entering the environment in Indonesia. Ecoplas have been developed in Jakarta, as starch-based biodegradable packaging. This study aims to 1) determine the ranking of Ecoplas compared to PP, r-PP, and Oxo-biodegradable; 2) Identify criteria that affect the path of Ecoplas packaging into sustainable packaging. Data collection was conducted through a questionnaire involving 96 consumers of flexible packaging in Jakarta, taken by convenience sampling. In this study, Ecoplas packaging was evaluated using PROMETHEE II to generate rankings, and Rainbow-PROMETHEE to review criteria affecting packaging sustainability. The results show that PP packaging (0.1168) remains the most preferred option for flexible packaging, followed by Oxo-biodegradable (0,0020), Ecoplas (-0,0113), and r-PP (-0,1076). Ecoplas have good criteria on willingness to purchase (Ec), consumers' environmental preferences (En), property preference (T1), packaging safety preference (T3), and consumer knowledge of post-consumer (S2). Aspects of criteria that need to be improved by Ecoplas i.e. awareness of alternative packaging usage (S1) and accessibility (S3 &amp; S4), and packaging durability preference (S2). Ecoplas is promising to be an alternative to flexible packaging, as shown by the good evaluation and willingness of consumers to purchase it as eco-friendly packaging. However, Ecoplas packaging needs to improve the level of packaging properties and accessibility level for consumers to find it easily.

A Modified Xception Deep Learning Model for Automatic Sorting of Olives Based on Ripening Stages

Olive fruits at different ripening stages give rise to various table olive products and oil qualities. Therefore, developing an efficient method for recognizing and sorting olive fruits based on their ripening stages can greatly facilitate post-harvest processing. This study introduces an automatic computer vision system that utilizes deep learning technology to classify the ‘Roghani’ Iranian olive cultivar into five ripening stages using color images. The developed model employs convolutional neural networks (CNN) and transfer learning based on the Xception architecture and ImageNet weights as the base network. The model was modified by adding some well-known CNN layers to the last layer. To minimize overfitting and enhance model generality, data augmentation techniques were employed. By considering different optimizers and two image sizes, four final candidate models were generated. These models were then compared in terms of loss and accuracy on the test dataset, classification performance (classification report and confusion matrix), and generality. All four candidates exhibited high accuracies ranging from 86.93% to 93.46% and comparable classification performance. In all models, at least one class was recognized with 100% accuracy. However, by taking into account the risk of overfitting in addition to the network stability, two models were discarded. Finally, a model with an image size of 224 × 224 and an SGD optimizer, which had a loss of 1.23 and an accuracy of 86.93%, was selected as the preferred option. The results of this study offer robust tools for automatic olive sorting systems, simplifying the differentiation of olives at various ripening levels for different post-harvest products.

Assessment of treatment outcomes for HIV Positives transitioned from Tenofovir/Lamivudine/Efavirenz to Tenofovir/Lamivudine/Dolutegravir in a Nigerian Tertiary Hospital

Objective: Dolutegravir, an integrase inhibitor replaced nevirapine or efavirenz (both NRTIs) in a fixed dose combination with Tenofovir/Lamivudine, as the preferred first-line option for the prevention and treatment of HIV infection. This study aimed to assess the treatment outcomes of the new Tenofovir/Lamivudine/Dolutegravir (TLD) regimen at the Federal Medical Centre Abeokuta. Methods: This retrospective study used data drawn from the treatment register of patients who transitioned from Tenofovir/Lamivudine/Efavirenz (TLE) to TLD. Data were analyzed using SPSS v23. Descriptive statistics were used to describe categorical and continuous variables. Statistically significant independent variables in univariate analyses were included in the multivariate model. The level of significance was set at p&lt;0.05. Results: The 358 cases reviewed showed a mean age of 44.29 ± 11.5 years. The majority (267; 74.6%) were females. Viral load suppression (≤1000 copies/ml) was achieved in 313 (87.4%) while on TLE but increased to 339 (94.7%) when transitioned to TLD. Also, 36.3% had a high CD4 count while on TLE, this increased to 67.3%. The mean CD4 counts (428.59±251.85) while using TLE increased exponentially when transitioned to TLD (634.89±244.72) (t-31.601; p-value- 0.001). Before the transition, 90.5% of respondents were at WHO stage 1 compared to 92.5% after the transition to TDF/3TC/DTG. Conclusion: Treatment outcome was greatly improved in terms of virologic, immunologic and clinical parameters among patients who transitioned from TDF/3TC/EFV to TDF/3TC/DTG. The outcome of this work supports and encourages the use of TDF/3TC/DTG as the preferred first-line regimen in HIV treatment for the patient’s maximum clinical benefit.

Comparison of low dose cytosine arabinoside, azacitidine and azacitidine venetoclax combination treatment as remission induction in elderly acute myeloid leukemia patients

Aims: Low-intensity therapies are widely preferred in the treatment of advanced age, fragile acute myeloid leukemia (AML) patients. In this study, we aimed to compare hematological recovery rates after first cycle chemotherapy and overall survival for advanced aged AML patients treated with azacitidine (AZA) or low dose cytosine arabinoside (LDCA) or venetoclax (Ven) with AZA combination.&#x0D; Methods: Ninety-one patients were retrospectively analyzed. &#x0D; Results: Forty-one patients treated with LDCA, 30 patients treated with AZA and 20 patients treated with AZA+Ven were included in the study. Patients who received these three treatments and who achieved response and did not receive any other treatment during the follow-up period were included in the study. Median age at diagnosis was 70. The percentage of patients who achieved neutrophil recovery after the first cycle was 27%, 73% and 50% of the patients treated with LDCA, AZA and AZA+Ven respectively. The rate of patients who achieved platelet recovery was 60%, 80%, 70% respectively. Erythrocyte transfusion independency was 54% for LDCA patients, 73% for AZA patients and 60% for combination therapy. Overall survival was longer in patients receiving AZA+Ven than other treatment groups while grade 3-4 infections were more common in the first cycle of the treatment.&#x0D; Conclusion: According to our study, patients treated with AZA had better platelet and neutrophil recovery rates with also longer overall survival than patients treated with LDCA, but total overall survival was superior in AZA+Ven combination. Hypomethylating agents with venetoclax is a preferable treatment option in elderly AML patients.