Awareness Of Status Research Articles

Residual C-peptide is associated with new and persistent impaired awareness of hypoglycaemia in type 1 diabetes

AimsTo describe the change in impaired awareness of hypoglycaemia (IAH) over time and to identify factors associated with this change in the Dutch Type 1 Diabetes biomarkers cohort (NCT04977635). MethodsA prospective cohort of type 1 diabetes patients, with C-peptide <300 pmol/L, who had completed the Clarke questionnaire, to determine IAH status, at baseline and after 2 years. Changes in awareness status were defined and compares as follows: unchanged normal awareness (NAH) versus unchanged IAH, new IAH versus reversal of IAH. Multivariate logistic regression models were fitted using forward and backward stepwise selection using a 0.10 P-value cut-off, and stepwise backward selection using AIC criteria. ResultsA total of 431 out of 611 participants were included. The baseline prevalence of IAH was 17 % and 20 % after 2 years. The incidence proportion of new IAH and reversal of IAH were, 9.5 % and 31 %, respectively. For every 2.7-fold increase in C-peptide, the odds of IAH decrease by 58 %. A 1-unit increase in BMI over the 2-year follow-up period is associated with a 5.27-fold increase in the odds of reversing IAH. ConclusionsHigher C-peptide levels are protective against new IAH, and an increase in BMI over time is associated with the reversal of IAH.

Efficient Federated Learning With Channel Status Awareness and Devices’ Personal Touch

Efficient Federated Learning With Channel Status Awareness and Devices’ Personal Touch

Abstract 4133830: Uncovering the Gaps: Analyzing Prescribing Patterns of Combination Therapy with SGLT2-inhibitors and GLP-1 Receptor Agonists in Established Atherosclerotic Cardiovascular Disease (ASCVD) and Type 2 Diabetes (T2DM)

Introduction: Combination therapy with SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP1RA) reduces major cardiovascular events (MACE) and improves HbA1c, blood pressure, weight, and renal disease progression. The European Society of Cardiology recommends this therapy for ASCVD and T2DM, independent of HbA1c. This study evaluates prescribing patterns in the Internal Medicine Residency Clinics for patients with ASCVD and T2DM. Aims: To investigate demographic and social determinants of health (SDOH) influencing the prescription of combination therapy versus no therapy in an outpatient population and identify factors affecting prescribing patterns and guideline adherence. Methods: We reviewed 828 electronic records of T2DM and ASCVD patients from March 2024. Patients were grouped into combination therapy (SGLT2i and GLP1RA) and no therapy groups. Data on demographics (Table 1) and SDOH (Table 2) were analyzed. Patients on monotherapy or those who did not complete the SDOH questionnaire were excluded. Descriptive statistics were used to summarize demographics. Welch’s t-test compared continuous variables, and chi-square or Fisher’s exact tests compared categorical variables. Analyses were done with SAS 9.4 with significance at 0.05. Results: Age significantly differed between groups (t = 4.56, p &lt; .05), with older patients less likely to receive therapy. Sex was also significant (p &lt; .05); more females were in the no therapy group. No significant association was found between SDOH and combination therapy (p &gt; .05). Conclusion: Over 90% of patients with T2DM and ASCVD were not on optimal medical therapy to reduce MACE, with nearly half on no medications. This highlights the need for increased awareness and targeted interventions to improve outcomes. Future research will explore insurance status and physician awareness to address prescription discrepancies. Limitations: Patients with a GFR &lt;30 are precluded from SGLT2i usage but were not excluded from this study.

Mixed-methods to explore barriers to the use of food security initiatives in a historically black college and university (HBCU).

To assess students' use and perception of the initiatives to tackle food insecurity (FI) in a Texas historically black college and university (HBCU). HBCU students > 18 years (288 students). A mixed-methods approach involving an online survey, focus group discussions and key informant interviews were conducted among the students and major stakeholders to evaluate the prevalence of FI, and gain insights into the challenges to accessing, utilizing and effectively implementing food security (FS) initiatives. FI affected 63.5% of the participants. The awareness and utilization of the food pantry were 27.9% and 8.1% respectively while for the meal share programs, awareness and utilization were 30.1% and 15.0%, respectively. A significant association was found between FI and the place of residence (p = 0.027). Binary logistic regression model showed that students' school year was a predictor of food pantry awareness (p < 0.05), residence and FI status were predictors of the meal share program utilization (p < 0.05). Five themes, including poor awareness and visibility of campus resources, bureaucratic process and logistics, insufficient funds, personnel and other resources to run the initiatives, ineffective communication, and stigma due to location emerged as the main barriers to the use of the resources. This study emphasizes the necessity for HBCUs to address these hurdles in order to successfully help students in need with FI resources.

Awareness of Disease Incurability Moderates the Association between Patients' Health Status and Their Treatment Preferences.

With advancing illness, some patients with heart failure (HF) opt to receive life-extending treatments despite their high costs, while others choose to forgo these treatments, emphasizing cost containment. We examined the association between patients' health status and their preferences for treatment cost containment versus life extension and whether their patients' awareness of disease incurability moderated this association. In a prospective cohort of patients (N = 231) with advanced HF in Singapore, we assessed patients' awareness of disease incurability, health status, and treatment preferences every 4 mo for up to 4 y (up to 13 surveys). Using random effects multinomial logistic regression models, we assessed whether patients' awareness of disease incurability moderated the association between their health status and treatment preferences. About half of the patients in our study lacked awareness of HF's incurability. Results from regression analyses showed that patients with better health status, as indicated by lower distress scores (odds ratio [OR] [95% confidence interval {CI}]: 0.862 [0.754, 0.985]) and greater physical well-being (1.12 [1.03, 1.21]); and who lacked awareness of their disease's incurability were more likely to prefer higher cost containment/minimal life extension treatments compared with lower cost containment/maximal life extension. This study underscores the significance of patients' awareness in disease incurability in shaping the relationship between their health status and treatment preferences. Our findings emphasize the need to incorporate illness education during goals-of-care conversations with patients and the importance of revisiting these conversations frequently to accommodate changing treatment preferences. The health status of patients with advanced heart failure was associated with their treatment preferences.Patients whose health status improved and who lacked awareness of their disease's incurability were more likely to prefer higher cost containment/minimal life extension treatments.

Questionnaire Survey on Stockpiling Medicines for Disasters in Pharmacies in Gifu City in Anticipation of Nankai Trough Earthquake.

In recent years, Japan has experienced a series of earthquakes and torrential rain disasters in various regions, and in Gifu City, there is concern about the possibility ofNankai Trough earthquakes in the near future. However, pharmacists' awareness of disaster preparedness and status of drug stockpiles in pharmacies are not clearly outlined. A survey on disaster prevention and stockpiling was conducted in 286 pharmacies in Gifu City. Data were collected from August to the end of October 2022. A simple aggregate was used in the study. The response rate was 66.8% (191 pharmacies). Among them, 9.9% (19 pharmacies) had stockpiles of medicines for disasters, in which 33.3% of the medicines needed in the early stages of a disaster were above the average overall stockpiling rate. In addition, 2.1% (4 pharmacies) selected medicines according to national or prefectural manuals, and 96.3% (184 pharmacies) preferred to have the "national or local government" bear the cost of stockpiling. This study allowed us to understand the stockpiling situation of pharmacies in Gifu City in event of a disaster such as the Nankai Trough earthquake, which is likely to occur in the future. Based on these results, it is necessary to consider measures for disaster stockpiling.

Oral health status, self-perceptions, and risk awareness among young adult users of electronic cigarettes in Pakistan.

The use of electronic cigarettes (ECs) has surged globally, particularly among young individuals. This study aimed to assess the perceptions of vaping-related oral health risks, clinical oral health status, and self-perceived dental and periodontal conditions among young adult users of ECs in Pakistan. A cross-sectional study was conducted from June 2023 to March 2024, recruiting 142 young users of ECs. Intraoral examinations assessed Decayed, Missing, and Filled Teeth (DMFT) index, Oral Hygiene Index Simplified (OHI-S), Gingival Bleeding Index (GBI), Plaque Index (PI), and dental stain. Data on sociodemographic characteristics, oral health behaviors, vaping habits, and perceptions of impact of vaping on oral health were gathered through a self-administered questionnaire. Associations between EC use and various oral health variables were analyzed using the chi-squared and Fisher's exact tests. Mean DMFT was 5.66 (SD=2.20). Poor oral hygiene (29.6%) and severe dental staining were prevalent. Most participants (76.1%) brushed once daily, while only 34.5% attended regular dental check-ups. Gingival bleeding and plaque accumulation were observed in 47.2% and 35.3% of participants. Around 66% reported daily EC use, with 80.3% initiating vaping before the age of 18 years. Most common reason for vaping was perception that ECs are safer than traditional smoking (31.7%). Participants' perceptions of vaping-related oral health risks were relatively low, with 45% associating vaping with tooth decay, 48% with gum disease, and 58.5% with tooth staining. Tooth brushing frequency, vaping frequency (per day), and time since vaping started, were significantly associated with oral clinical indicators (p<0.05). The education level was the only variable significantly associated with vaping-related risk perception (p<0.05). The study reveals that oral health awareness among young vapers is low, with many starting EC use at a young age and exhibiting poor oral health behaviors. Misconceptions about the safety of ECs compared to conventional cigarettes may contribute to increased vaping.

An international survey of optometric management of stroke survivors

Objectives A survey was conducted to describe the current status of optometric awareness and involvement regarding post-stroke management as literature suggests that visual impairment often goes undiagnosed and unmanaged in stroke survivors. Materials and methods A questionnaire was developed by the researchers, pilot tested by 5 other optometric researchers and 15 optometrists and modified based on the feedback. Practicing optometrists were invited to complete the anonymous online survey through optometric organizations in Canada, Hong Kong, India, UK, and US. Results Results showed that the majority of optometrists (61%) see 1–5 post-stroke patients per month, although 15% report seeing none. In all cases, optometrists referred stroke patients to other health care professionals more often than receiving incoming referrals from them. About 21% of all respondents were already fully involved in post-stroke vision care and 57% were interested in being more involved. Limiting factors to seeing more post-stroke patients included resources (29.8%), funding (25.8%), awareness (25.1%), and interest (9.8%). There was consensus among respondents in all countries that optometrists should be members of post-stroke care teams. Conclusion Optometrists are well suited to provide post-stroke visual rehabilitation but are often not included in care teams for these patients. As a result, the visual management of post-stroke patients often is unaddressed.

HIV Outcomes Among Women Living With HIV Who Experienced Early Sexual Violence Across Four Sub-Saharan African Countries.

Early experiences of sexual violence may influence HIV care and treatment outcomes among women living with HIV (WLHIV). We examined whether self-report by WLHIV of being forced into their first sexual experience was associated with awareness of HIV-positive status, being on antiretroviral therapy (ART) and being virologically suppressed. We conducted a secondary analysis using nationally representative, cross-sectional Population-based HIV Impact Assessment surveys from Lesotho, Malawi, Zambia, and Zimbabwe conducted from 2015 through 2017. Adjusted logistic regression models with survey weights and Taylor series linearization were used to measure the association between forced first sex and 3 HIV outcomes: (1) knowledge of HIV status among all WLHIV, (2) being on ART among WLHIV with known status, and (3) virological suppression among WLHIV on ART. Among WLHIV, 13.9% reported forced first sex. Odds of knowledge of HIV status were not different for WLHIV with forced first sex compared with those without (adjusted odds ratio [aOR], 1.17; 95% CI: 0.95 to 1.45). Women living with HIV with forced first sex had significantly lower odds of being on ART (aOR 0.74, 95% CI: 0.57 to 0.96) but did not have lower odds of virological suppression (aOR 1.06, 95% CI: 0.80 to 1.42) compared with WLHIV without forced first sex. While high proportions of WLHIV were on ART, report of nonconsensual first sex was associated with a lower likelihood of being on ART which may suggest that early life trauma could influence long-term health outcomes.

Health Behavior Frameworks Describing HPV Vaccine Uptake in Adults: A Scoping Review

Human papillomavirus (HPV) is the most prevalent sexually transmitted disease in the United States, and it has been shown to cause a number of different cancers, namely cervical. Fortunately, there is a highly efficacious vaccine that is available to adolescents and adults up to age 45. Vaccination rates in adults have increased over the years but are still low, especially in men. There is a need to understand HPV vaccine-seeking behaviors in adults to better address their concerns, beliefs, and barriers. The purpose of this scoping review is to provide a synthesis of the current literature on health behavior frameworks that have been used to describe HPV vaccine uptake in adults. This review also covers the socioeconomic barriers of adults getting the vaccine. For this review, 33 articles were found and included. The theory of planned behavior, health belief model, and social cognitive theory were the most commonly seen frameworks in the literature. Theoretical constructs that significantly predicted HPV vaccine behavior across the included studies were social norms, attitudes, perceived behavioral control, perceived benefits, perceived susceptibility, perceived severity, perceived barriers, and self-efficacy. Major socioeconomic factors that were described were provider recommendation, knowledge, age, gender, race, awareness, and marital status. This information is critical for public health efforts to better target the adult population with HPV vaccine information and awareness. It is also necessary for providers to better understand patients and their potential barriers to getting the HPV vaccine.

Characterising impaired awareness of hypoglycaemia and associated risks through HypoA-Q: findings from a T1D Exchange cohort.

We aimed to: (1) externally validate the five-item Hypoglycaemia Awareness Questionnaire (HypoA-Q) impaired awareness subscale (HypoA-Q IA); (2) examine how impaired awareness of hypoglycaemia (IAH) relates to the risk of severe hypoglycaemia and level 2 hypoglycaemia; and (3) identify factors associated with IAH. Nationwide survey of T1D Exchange registrants was conducted to collect data on demographics, 6 month severe-hypoglycaemia history, hypoglycaemia awareness status (via HypoA-Q IA, the Gold instrument and the Clarke instrument) and continuous glucose monitor (CGM) measures. The Clarke hypoglycaemia awareness factor (Clarke-HAF) was calculated to exclude severe-hypoglycaemia history items. Analyses included Cronbach's α, Spearman correlations and logistic regression. Valid survey responses were collected from N=1580 adults with type 1 diabetes (median age, 44 years; 52% female participants; median HbA1c, 48 mmol/mol [6.5%]). Of these, 94% of participants were using CGMs and 69% were using hybrid closed-loop (HCL) systems; 30% had at least one severe-hypoglycaemia episode in the past 6 months. The HypoA-Q IA had satisfactory internal reliability (α=0.79) and construct validity. Higher HypoA-Q IA scores were independently associated with greater risk of severe hypoglycaemia (p<0.001), performing comparably to the Gold instrument and the Clarke-HAF instrument. HypoA-Q IA-determined IAH was independently associated with 88% higher odds of developing severe hypoglycaemia (p<0.001) and twofold higher odds for spending ≥1% of time in level 2 hypoglycaemia (p=0.011). Higher age and longer diabetes duration were associated with higher IAH risk (p<0.001). CGM and HCL use was associated with lower IAH risk (p<0.001). The HypoA-Q IA is a brief, valid and reliable tool for assessing IAH in today's technology-oriented era. IAH was independently associated with severe hypoglycaemia and level 2 hypoglycaemia in a cohort with high prevalence of advanced diabetes technology use and HbA1c within the recommended range. CGM and HCL use was related to lower IAH risk.

A systematic review of the financial issues of higher education institutions (HEIs) and possible strategies to cope with them

The field of higher education has not only been for elites since the last three decades. It has also included the general masses in it. That’s why the transformation of the socio-economic status and general awareness in the present age owes to higher education. On the other hand, challenges have also emerged and set conditions on the path to sustainability. Thus, higher education has faced problems, especially financial problems. These issues further give birth to some other issues. This study is an attempt to understand the issues caused by financial issues. The study also aimed to propose strategies to deal with these issues. Based on the systematic literature review, the problems have been categorized as lack of internet, digitalization, and online teaching; underdeveloped infrastructure for STEAM; lack of priorities; and quality issues. These findings create hurdles in achieving the quality of HEIs. To cope with these issues, clear policy and setting priorities were proposed as the top most important strategies to bring about quality and achieve HEIs’ organizational objectives. It can be concluded that HEIs need appropriate strategic and financial managers and administrators who can align their strategy with the vision and mission of the institutions.

Perceptions of preschoolers and parents on forest pollution

IntroductionAn examination of preschool children’s perceptions and attitudes towards the environment and forests has recently been conducted. However, little research has focused on preschool children’s and their parents’ perceptions of clean and dirty forests. Investigating these perceptions is essential to increase children’s interest in and sensitivity to the environment, thereby fostering their development as responsible individuals who protect the natural world.MethodsThis study aimed to address this knowledge gap by examining the perceptions of clean and dirty forests held by 40 5–6-year-old students and 40 parents, randomly selected from two preschools: one attended by children from high socioeconomic families and the other by children from low socioeconomic families, in a Mediterranean coastal city in southwestern Turkey. A semi-structured questionnaire was used to collect sociodemographic information and perceptions of clean and dirty forests. Additionally, drawing sheets were distributed to the students to illustrate their concepts of clean and dirty forests.ResultsThe results indicated that individuals with higher educational levels had more complex and conscious perceptions of clean forests. Children considered abstract concepts, such as supernatural forces and fossil fuels, while parents focused on awareness and conservation status. Conversely, parents and children with lower levels of education tended to concentrate on more concrete and everyday factors, such as litter and natural disasters. Individuals with higher socioeconomic status generally associated forest cleanliness with conscious behaviors and conservation, whereas those with lower socioeconomic status linked it more with polluting factors.DiscussionThis investigation provides valuable insights into the management and control of local forests by incorporating the perspectives of children and their parents, promoting responsible and sustainable tourism practices.

Probing an LSTM-PPO-Based reinforcement learning algorithm to solve dynamic job shop scheduling problem

With the growth of personalized demand and the continuous improvement in social productivity, the large-scale and few-variety centralized production model is gradually transitioning towards a personalized model of small batches and multiple varieties, which makes the manufacturing process of the job shop increasingly complex. Furthermore, disruptive events such as machinery failures and rush orders in the job shop increase the uncertainty and variability of the production environment. Traditional scheduling methods are usually based on fixed rules and heuristic algorithms, which are difficult to adapt to constantly changing production environments and demands. This may lead to inaccurate scheduling decisions and hinder the optimal allocation of job shop resources. To solve the dynamic job shop scheduling problem (JSP) more effectively, this paper proposes a Reinforcement Learning (RL) optimization algorithm integrating long short-term memory (LSTM) neural network and proximal policy optimization (PPO). It can dynamically adjust scheduling strategies according to the changing production environment, achieving comprehensive status awareness of the job shop environment to make optimal scheduling decisions. First, a state-aware network framework based on LSTM-PPO is proposed to achieve real-time perception of job shop state changes. Then, the state and action space of the job shop are described within the context of the state-aware network framework. Finally, an experimental environment is established to verify the algorithm’s effectiveness. Training the LSTM-PPO algorithm makes it feasible to achieve better performance than other scheduling methods. By comparing the initial planning time with the actual completion time of the rescheduling decision under different dynamic disturbances, the efficiency of the proposed algorithm is verified for the dynamic JSP.

Is Bangladesh’s people aware of “diabetes mellitus: the disease of prosperity” health care management?

Introduction: Diabetes mellitus is an increasing threat to the world, which is also considered a “disease of prosperity”. The manifest of demographic changes, cultural transition, modernization, and population aging, etc. make it a “developing countries problem”. The incidence of type 2 diabetes mellitus is increasing so rapidly and it is estimated by 2030 this number will almost double. Around 387 million people have diabetes which is equal to 8.3% people. It is projected that there will be a 42% increase in the number of individuals with diabetes, from 51 to 72 million in the developed countries and a 170% increase, from 84 to 228 million, in the developing countries. Diabetes mellitus is a chronic disease once thought to be uncommon in Bangladesh, but now it has emerged as an important public health problem. About 3.6 million people are affected throughout the country. In Bangladesh around 4% of adults aged 25 years or more have type 2 diabetes mellitus, and 80 lakh people in Bangladesh suffer from diabetes. It causes 6.4 percent of total deaths in the country. Awareness of diabetes is not up to the mark due to health education about diabetes, announcement, and an overall lack of awareness of the disease and its effectiveness makes it more complicated to manage. Objectives: This study aimed to assess the knowledge and awareness status on health care management of type 2 diabetes mellitus in Bangladesh. Methods: This is a cross-sectional study followed by descriptive methods and mixed methods in design among Dhaka and Manikgonj districts. Results: Findings reveal that a very significant relationship exists between compliances and complications. Compliances are influenced by various factors like sex, education, occupation, treatment facilities, etc. But who follow the proper compliances face fewer complications? Also, in addition to anti-diabetic medication and another method of compliance to an herbal method which was familiar to diabetic patients. Most compliance the respondents preferred are diet, exercise, weight control over the medication. Conclusion: Overall, a positive outcome was that the patients of type 2 diabetics who maintained proper compliance faced fewer complications than those who didn’t follow them properly.

Military System Culture Archetype and Humanistic Thinking-In Sunzibingfa, Focusing on the Practical Will of Military System and Strengthening of Discipline

Regardless of the time and space differences between eastern and western countries before and after their origin, the improvement of military systems and solutions to problems all reflect the practical will of national defense strategic responsibility and tactics. From the anthropological point of view, no matter the development of the xianqin civilization and the victory or defeat of the war history, the establishment, development and changes of the system and discipline are discussed as the boundary and module of historical dialectics. This is a myth of the victory of the country&amp;apos;s social and political diplomacy, a basic sanction of the security strategy, and a specific matter for the interpretation of the structural and institutional principles. Then, as a cultural prototype, can the other appearance and symbolic significance of this military system, as the AI social language view in the 21st century, become another status and security awareness of dominating the world? The positive answer to this is that as an individual country, its multiple roles are sufficient to enhance political strategies, diplomatic security, social tranquility and individual spirit of challenge. This issue actually plays a role as the boundary and module of the historical dialectics of military system through the changing process of the history of the times before discussing the concept and essence of a liberal democratic society.

ASSESSMENT OF JAPANESE ENCEPHALITIS VACCINATION STATUS IN TRIBAL AREAS OF THE MAYURBHANJ DISTRICT OF ODISHA – A COMMUNITY-BASED CROSS-SECTIONAL STUDY

Objectives: Japanese encephalitis (JE) is a vector-borne viral disease that primarily infects swines, equids, and humans. Outbreaks of JE-acute encephalitis syndrome were reported from September to November 2012 and 9th September to 2nd December 2016 in Malkangiri district, Odisha. Due to the paucity of studies on JE transmission, causation, and prevention in tribal areas, the present study was undertaken to assess the JE vaccination status of children between 12 and 36 months in the Mayurbhanj district and to determine the association between sociodemographic characteristics of study participants with JE vaccination status. Methods: To estimate the JE vaccination coverage, a cluster sampling method was adopted to conduct survey in the Mayurbhanj district of Odisha by selecting 45 clusters. Twenty children aged 12–36 months were selected from each cluster, and their mothers were interviewed about JE vaccination. House-to-house survey was conducted in selected villages. Mothers were interviewed about the knowledge on JE vaccination. Results: A total of 900 children were surveyed, of which a majority were born in government hospitals. The association between the literacy status of mothers and awareness regarding JE is found to be statistically significant. Furthermore, it was found that the association between vaccination coverage and area of residence of the beneficiaries in relation to session sites is statistically significant. Conclusion and Recommendation: The association of maternal literacy status with JE vaccination coverage was not significant, whereas the association with the awareness regarding JE was statistically significant. Four key messages of immunization should be delivered to every mother during vaccination.

The effects of HIV self-testing on HIV incidence and awareness of status among men who have sex with men in the United States: Insights from a novel compartmental model

BackgroundThe OraQuick In-Home HIV self-test represents a fast, inexpensive, and convenient method for users to assess their HIV status. If integrated thoughtfully into existing testing practices, accompanied by efficient pathways to formal diagnosis, self-testing could enhance both HIV awareness and reduce HIV incidence. However, currently available self-tests are less sensitive, particularly for recent infection, when compared to gold-standard laboratory tests. It is important to understand the impact if some portion of standard testing is replaced by self-tests. We used a compartmental model to evaluate the effects of self-testing in diverse scenarios among gay, bisexual and other men who have sex with men (MSM) in the United States for the period 2020–2030, and to understand which scenarios maximize the advantages of self-testing. MethodsWe introduced a novel 4-compartment model for HIV self-testing. We employed the model under different screening rates, self-test proportions, and delays to diagnosis for those identified through self-tests to determine the potential effects of self-testing on HIV incidence and awareness of status when applied to the US MSM population. We studied scenarios in which self-tests supplement laboratory-based tests, with no replacement, and scenarios in which some replacement occurs. We also examined how future improvements in self-test sensitivity may affect our results. ResultsWhen HIV self-tests are supplemental rather than substitutes for laboratory-based testing, self-testing can decrease HIV incidence among MSM in the US by up to 10 % and increase awareness of status among MSM from 85 % to 91 % over a 10-year period, provided linkage to care and formal diagnosis occur promptly following a positive self-test (90 days or less). As self-tests replace a higher percentage laboratory-based testing algorithms, increases in overall testing rates were necessary to ensure reductions in HIV incidence. However, such needed increases were relatively small (under 10 % for prompt engagement in care and moderate levels of replacement). Improvements in self-test sensitivity and/or decreases in the detection period may further reduce any necessary increases in overall testing by up to 40 %. ConclusionsIf properly utilized, self-testing can provide significant long-term reductions to HIV incidence and improve awareness of HIV status. Ensuring that self-testing increases overall testing and that formal diagnosis and engagement in care occur promptly following a positive self-test are necessary to maximize the benefits of self-testing. Future improvements in self-test sensitivity and reductions in the detection period would further reduce HIV incidence and the potential risks associated with replacing laboratory tests with self-tests.

Status of Awareness and Use of Real-World Data and Real-World Evidence in the Domestic Drug Approval Process: Insights from the Survey Study

Status of Awareness and Use of Real-World Data and Real-World Evidence in the Domestic Drug Approval Process: Insights from the Survey Study

Overcoming Dataset Bias: A Deep Learning Approach to Improve Cross-Cultural Image Classification

The difficulties and strategies concerning cross-ethnic image categorization are discussed throughout this report based on deep learning techniques for preventing model bias towards specific ethnic groups. In this part of the project, we continued our discussion of the theory and practice of bias in training datasets and how it impacts the model in the case of emotion recognition and facial analysis using simulations. Three real-time scenarios were explored: public security applications, health status evaluations, education performance, and awareness, all of which must include culturally sensitive data to maximize performance. Some of the issues we defined include the data bias problem, the problem that different cultures exhibit different levels of emotions, and technical concerns such as the limitations of machine learning algorithms, among others that we have described in the paper. Some solutions we provided include data augmentation, real-time learning, and ethical concerns such as using machine learning in making decisions. In doing so, we propose solutions that include building models that are not only precise but also culturally sensitive to avoid prejudice in applications, ranging from credit scoring to complaints handling.