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BackgroundAntiretrovirals (ARVs) are key in the management of HIV. Although no cure exists, ARVs help patients live healthy lives and prevent transmission to others. Adherence to complex regimens is paramount to outcomes and in avoiding the emergence of drug-resistant viruses. The goal of therapy is to reach an undetectable viral load. However, adherence is a common problem, stemming from issues such as mental health, chaotic home situations, and busy work schedules. Mobile health (mHealth) represents a new approach in improving medication adherence, and multiple studies have been performed in this area. ObjectiveThis study aims to review the current implementation of mHealth in the management of HIV among different groups of patients. MethodsWe used PubMed, Academic Search Elite, and 1 journal database with various search terms to review the current implementation of mHealth in HIV care. ResultsTitles and abstracts were screened, and 61 papers were identified and fully reviewed. The literature was divided into lower- and higher-income nations, as defined by the United Nations. A total of 20 studies with quantitative results were identified, with 10 being text- and SMS-based interventions (the majority of these being in lower-income countries) and 8 being smartphone-based apps (primarily in higher-income countries). The majority of these studies determined whether there was an effect on adherence or biochemical parameters (viral load and CD4 count). Various qualitative studies have also been conducted, and many have focused on determining the specific design of interventions that were successful (frequency of messaging, types of messages, etc) as well as priorities for patients with regard to mHealth interventions. ConclusionsThere seems to be a role of mHealth in the management of HIV in lower-income nations; however, the optimal design of an intervention needs to be delineated. In higher-income countries, where the 2 significant risk factors were injection drugs and men who have sex with men, the benefit was less clear, and more research is needed.

Background: While coronavirus disease 2019 (COVID‐19) is no longer a public health emergency, certain patients remain at risk of severe outcomes. To better understand changing risk profiles, we studied the risk factors for patients with and without solid organ transplantation (SOT) through the various waves of the pandemic. Methods: Using the National COVID Cohort Collaborative we studied a cohort of adult patients testing positive for COVID‐19 between January 1, 2020, and May 2, 2022. We separated the data into waves of COVID‐19 as defined by the Centers for Disease Control. In our primary outcome, we used multivariable survival analysis to look at various risk factors for hospitalization in those with and without SOT. Results: A total of 3,570,032 patients were captured. We found an overall risk attenuation of adverse COVID‐19‐associated outcomes over time. In both non‐SOT and SOT populations, diabetes, chronic kidney disease, and congestive heart failure were risk factors for hospitalization. For SOT specifically, longer time periods between transplant and COVID‐19 were protective and age was a risk factor. Notably, asthma was not a risk factor for major adverse renal cardiovascular events, hospitalization, or mortality in either group. Conclusions: Our study provides a longitudinal view of the risks associated with adverse COVID‐related outcomes amongst SOT and non‐SOT patients, and how these risk factors evolved over time. Our work will help inform providers and policymakers to better target high‐risk patients. [ABSTRACT FROM AUTHOR]

Solid organ transplant recipients (SOTR) are at increased risk from COVID-19. Over time, the absolute risk of adverse outcomes after COVID-19 has decreased in both the nonimmunosuppressed/immunocompromised (non-ISC) general population, and amongst SOTR. Using the N3C, we examined the absolute risk of mortality, major adverse renal or cardiac events, and hospitalization after COVID-19 diagnosis amongst non-ISC and SOTR populations over five waves of the pandemic (Wave 1: Ancestral COVID; Wave 2: Alpha; Wave 3: Delta; Wave 4: Omicron; Wave 5: Omicron). Within each wave, we determined the relative risk of each outcome for SOTR versus the non-ISC population based on crude event rates, and then used multivariable cox proportional hazards models and logistic regression to determine the adjusted risk of each outcome based on SOT status. Throughout the pandemic, including during the Omicron wave (Wave 5), SOTR were at greater absolute risk for each outcome than non-ISC patients (p-values all <0.001). The adjusted risk of SOT status for each outcome was relatively stable over time (aHR 1.28-1.61 for mortality; aHR 1.31-1.47 for MACE; aHR 1.72-1.90 for MARCE; aHR 1.75-2.07 for AKI; and aOR 1.53-1.81 for hospitalization). Despite a reduction in the absolute risk of COVID-19 complications, the relative risk for SOTR versus the non-ISC population has not improved. [ABSTRACT FROM AUTHOR]

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Epoxyeicosatrienoic acids (EETs) are active metabolites of arachidonic acid that are inactivated by soluble epoxide hydrolase enzyme (sEH) to dihydroxyeicosatrienoic acid. EETs are known to render cardioprotection against ischemia reperfusion (IR) injury by maintaining mitochondrial function. We investigated the effect of a novel sEH inhibitor (sEHi) in limiting IR injury. Mouse hearts were perfused in Langendorff mode for 40 min and subjected to 20 min of global no-flow ischemia followed by 40 min of reperfusion. Hearts were perfused with 0.0, 0.1, 1.0 and 10.0 µmol-[L.sup.-1] of the sEHi N-(2chloro-4-methanesulfonyl-benzyl)-6-(2,2,2-trifluoro-ethoxy)-nicotinamide (BI00611953). Inhibition of sEH by BI00611953 significantly improved postischemic left-ventricular-developed pressure and reduced infarct size following IR compared with control hearts, and similar to hearts perfused with 11,12-EETs (1 µmol*[L.sup.-1]) and sE[H.sup.-/-] mice. Perfusion with the putative EET receptor antagonist 14,15-epoxyeicosa-5(Z)-enoic acid (14,15-EEZE, 10 µmol*[L.sup.-1),] or the plasma membrane [K.sub.ATP] channels (pm[K.sub.ATP)] inhibitor (glibenclamide, 10 µmol*[L.sup.-1)] abolished the improved recovery by BI00611953 (1 µmol*[L.sup.-1]). Mechanistic studies in H9c2 cells demonstrated that BI0611953 decreased ROS generation, caspase-3 activity, proteasome activity, increased HIF-1[varies] DNA binding, and delayed the loss of mitochondrial membrane potential (Δ[Ψ.sub.m]) caused by anoxia-reoxygenation. Together, our data demonstrate that the novel sEHi BI00611953, a nicotinamide-based compound, provides significant cardioprotection against ischemia reperfusion injury. Key words: epoxyeicosatrienoic acid, soluble epoxide hydrolase, ischemia-reperfusion, pm[K.sub.ATP] channels and sEH inhibitors. Les acides epoxyeicosatrienoiques (EET) sont des metabolites actifs de l'acide arachidonique qui sont inactives par l'epoxyde hydrolase soluble (sEH) en acide dihydroxyeicosatrienoi'que. Les EET sont connus pour conferer une cardioprotection contre les dommages causes par l'ischemie reperfusion (IR) en maintenant la fonction mitochondriale. Nous avons examine l'effet d'un nouvel inhibiteur de la sEH (sEHi) sur le controle du dommage cause par l'IR. Des coeurs de souris ont ete perfuses dans le systeme de Langendorff pendant 40 min et soumis a une ischemie statique globale de 20 min, suivie d'une reperfusion de 40 min. Les coeurs ont ete perfuses avec le sEHi, le BI00611953 (N-(2-chloro-4-methanesulfonyl-benzyl)-6(2,2,2-trifluoro-ethoxy)-nicotinamide) (0, 0,1, 1,0, et 10,0 µmol*[L.sup.-1]). L'inhibition de la sEH par le BI00611953 ameliorait significativement la pression ventriculaire gauche post-ischemique et reduisait la taille de l'infarctus apres l'IR comparativement aux coeurs controles et similairement aux coeurs perfuses avec des 11,12-EET (1 µmol*[L.sup.-1]) et aux souris sE[H.sup.-/-]. La perfusion avec un antagoniste presume du recepteur des EET, l'acide 14,15-epoxyei'cosa-5(Z)-enoi'que (14,15-EEZE, 10 µmol*[L.sup.-1]), ou avec un inhibiteur des canaux KATP de la membrane plasmique (pm[K.sub.ATP)] (glibenclamide, 10 µmol*[L.sup.-1]) supprimait l'amelioration de la recuperation induite par le BI00611593. Des etudes mecanistiques realisees chez les cellules H9c2 ont demontre que le BI00611593 diminuait la generation d'ERO, la caspase-3 et l'activite du proteasome, augmentait la liaison du HIF-1 a l'ADN, et retardait la perte de potentiel membranaire mitochondrial (Δ[Ψ.sub.m]) causee par l'anoxie-reoxygenation. L'ensemble de ces donnees demontre que ce nouvel sEHi, le BI00611953, un compose a base de nicotinamide, confere une cardioprotection significative contre les dommages causes par l' ischemie reperfusion Mots-cles : acide epoxyei'cosatrienoi'que, epoxyde hydrolase soluble, ischemie-reperfusion, canaux pm[K.sub.ATP,] inhibiteurs de la sEH., Introduction Epoxyeicosatrienoic acids (EETs) are cytochrome P450 (CYP) epoxygenase metabolites of arachidonic acid (AA); potent intracellular lipid signaling molecules that exist as 4 regioisomeric metabolites: 5,6-, 8,9-, 11,12-, and 14,15-EETs [...]

Chemical oxidation of alpha-tocopherol(TOH) with the structurally similar nonnatural phenols (CH(sub 3))alpha-TOH and (COOH)alpha-TOH with NOSbF(sub 6) in CH(sub 3)CN at 233 K is a straightforward method for preparing the phenoxonium cations in high concentrations in solution in accordance with heterogeneous electrochemical electrolysis procedures. Direct oxidation of vitamin E in a lipophilic membrane could result in the formation of both alpha-TOH(super +.) and alpha-TO(super +), depending on the delectric properties of the medium.

The synthesis and crystal structure of a phenoxonium cation of a vitamin E alpha-tocopherol model compound are reported. Phenoxonium cations are usually unstable, and therefore, non-nucleophilic [[B[(C6F5).sub.4].sup.-] and [(CB11H6Br6).sup.-] anions are used in the crystallization of the phenoxonium cations, whose high stability is imparted by the chromanol structure and the degree of methylation around the phenolic aromatic ring.

α-Tocopherol (α-TOH), the main oil component making up vitamin E, and its nonnatural solid 6-hydroxy-2,2,5,7,8-pentamethylchroman and 6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid structurally related analogues were oxidized quantitatively with 2 tool equiv of NO+SbF6- in CH3CN at 233 K to form phenoxonium cations (α-TO+SbF6-) in a chemically reversible two-electron/ one-proton process. Solution-phase infrared spectroscopy, 1H and 13C NMR spectroscopy, and corresponding theoretical calculations of the spectroscopic data using density-based and wave-function-based models support the identity of the remarkably stable phenoxonium cations. The presence of an oxygen atom in the para position to the hydroxyl group and the chromanol ring structure appear to be important factors in stabilization of the phenoxonium ions, which raises the interesting possibility that the cations play a crucial role in the mode of action of vitamin E in biological systems. Although the phenoxonium cations are reactive toward nucleophiles such as water, they may be moderately stable in the hydrophobic (lipophilic) environment where vitamin E is known to occur naturally. [ABSTRACT FROM AUTHOR]

The article presents information related to a study which has demonstrated that the chromanol structure impart stability on the phenoxonium cation. The study has shown that phenolic methyl groups also impart stability on the phenoxonium cation. It has also been discussed that the chromanol structure is crucial to vitamin E's role as an antioxidant.

Postacute sequelae after the coronavirus disease (COVID) of 2019 (PASC) is increasingly recognized, although data on solid organ transplant (SOT) recipients (SOTRs) are limited. Using the National COVID Cohort Collaborative, we performed 1:1 propensity score matching (PSM) of all adult SOTR and nonimmunosuppressed/immunocompromised (ISC) patients with acute COVID infection (August 1, 2021 to January 13, 2023) for a subsequent PASC diagnosis using International Classification of Diseases, 10th Revision, Clinical Modification codes. Multivariable logistic regression was used to examine not only the association of SOT status with PASC, but also other patient factors after stratifying by SOT status. Prior to PSM, there were 8769 SOT and 1 576 769 non-ISC patients with acute COVID infection. After PSM, 8756 SOTR and 8756 non-ISC patients were included; 2.2% of SOTR (n = 192) and 1.4% (n = 122) of non-ISC patients developed PASC (P value < .001). In the overall matched cohort, SOT was independently associated with PASC (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.09-2.01). Among SOTR, COVID infection severity (aOR, 11.6; 95% CI, 3.93-30.0 for severe vs mild disease), older age (aOR, 1.02; 95% CI, 1.01-1.03 per year), and mycophenolate mofetil use (aOR, 2.04; 95% CI, 1.38-3.05) were each independently associated with PASC. In non-ISC patients, only depression (aOR, 1.96; 95% CI, 1.24-3.07) and COVID infection severity were. In conclusion, PASC occurs more commonly in SOTR than in non-ISC patients, with differences in risk profiles based on SOT status., Competing Interests: Declaration of competing interest The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation., (Copyright © 2024 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: Machine learning (ML) will have a large impact on medicine and accessibility is important. This study's model was used to explore various concepts including how varying features of a model impacted behavior., Materials and Methods: This study built an ML model that classified chest X-rays as normal or abnormal by using ResNet50 as a base with transfer learning. A contrast enhancement mechanism was implemented to improve performance. After training with a dataset of publicly available chest radiographs, performance metrics were determined with a test set. The ResNet50 base was substituted with deeper architectures (ResNet101/152) and visualization methods used to help determine patterns of inference., Results: Performance metrics were an accuracy of 79%, recall 69%, precision 96%, and area under the curve of 0.9023. Accuracy improved to 82% and recall to 74% with contrast enhancement. When visualization methods were applied and the ratio of pixels used for inference measured, deeper architectures resulted in the model using larger portions of the image for inference as compared to ResNet50., Discussion: The model performed on par with many existing models despite consumer-grade hardware and smaller datasets. Individual models vary thus a single model's explainability may not be generalizable. Therefore, this study varied architecture and studied patterns of inference. With deeper ResNet architectures, the machine used larger portions of the image to make decisions., Conclusion: An example using a custom model showed that AI (Artificial Intelligence) can be accessible on consumer-grade hardware, and it also demonstrated an example of studying themes of ML explainability by varying ResNet architectures., Competing Interests: The author has no competing interests to declare., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

[This corrects the article DOI: 10.2196/14739.]., (©Stephen B Lee, Joanne Valerius. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 15.09.2020.)

We correlated antibiotic consumption measured by point prevalence survey with defined daily doses (DDD) across multiple hospitals. Point prevalence survey had a higher correlation (1) with monthly DDDs than annual DDDs, (2) in nonsurgical versus surgical wards, and (3) on high- versus low-utilization wards. Findings may be hospital specific due to hospital differences.