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Background: Close monitoring of vaccination coverage is important for cervical cancer prevention efforts. The study aims to describe the HPV vaccination coverage by dose in girls eligible for HPV vaccination within Sweden’s childhood immunization program and provide an estimate on dose timing compliance. Methods: Vaccination records between 2012 and March 2019 were obtained for girls born in 2000–2006 from the vaccination registers in Sweden. The mid-time population counts for the respective birth cohorts were taken as the denominator. Full-dose coverage and coverage with at least one dose of the vaccine were calculated within the two-dose and three-dose regimen, by region. Dose compliance was calculated within the two-dose regimen. Results: Vaccination coverage with at least one dose of the vaccine was >80% within birth cohorts 2001–2006. Full-dose coverage within a two-dose and three-dose regimen were 73.4% in birth cohorts 2004–2005, and 56.3% in birth cohorts 2000–2001, respectively. Little variation was observed in vaccination coverage between regions. Dose completion was 91.8%, and 72.8% in girls that initiated a two-dose and three-dose regimen, respectively. Among girls receiving a two-dose regimen, 93.0% received the second dose 6–12 months after dose one. Discussion: In conclusion, high levels of HPV vaccination coverage were observed with little variation between regions. Dose timing compliance was particularly high in the two-dose regimen. To fully benefit from the impact of HPV vaccination, it will be important to further push the vaccination coverage and reach the girls that do not or partially engage with HPV vaccination.

• Debate about whether to include the chickenpox vaccine in immunization programs. • No consensus on appropriate timing between chickenpox vaccine doses. • Chickenpox vaccination lead to large decrease in chickenpox over a long period. • The chickenpox vaccine was effective even when varying coverage and waning rates. • Shorter vaccine dosing interval more effective than longer interval. Many countries continue to consider implementing a universal chickenpox vaccine program; however, there is no consensus on the most appropriate and effective timing between vaccine doses. The chickenpox vaccine schedule debate is highlighted in Canada, where there are currently eight different vaccine schedules across the country. The objective of this study was to test the overall effectiveness of chickenpox vaccination, as well as the specific impact of two different vaccine schedules, on chickenpox disease outcomes in Alberta over 75 years. Using an agent-based model of chickenpox disease, we tested the impact of three vaccination scenarios including: baseline (no vaccination), a long dosing interval-Schedule LDI (1st dose – 12 months; 2nd dose – 4-6 years) and a short dosing interval-Schedule SDI (1st dose – 12 months; 2nd dose – 18 months) on chickenpox and shingles disease outcomes. Chickenpox vaccination led to a substantial decrease in chickenpox incidence over 75 years post-vaccine implementation. Compared to Schedule LDI, Schedule SDI resulted in a significantly lower chickenpox incidence, a higher age of chickenpox infection, a lower chickenpox breakthrough rate and a higher shingles incidence rate. Our model findings suggest that the chickenpox vaccine is effective over a long period of time and the dose timing of the vaccine may impact disease outcomes and vaccine effectiveness. However, the effectiveness of the vaccine dose timing is only one consideration for policy-makers who are implementing a chickenpox vaccine program, with others including risk of adverse events, the impact of the schedule on other antigens in a combination vaccine, parental acceptance and the cost associated with different schedules. [ABSTRACT FROM AUTHOR]

Improvest (Zoetis Canada Inc.) immunization provides temporary suppression of ovarian function and estrus in market gilts. The product requires two sequential injections administered at least 4 weeks apart, with full suppression of ovarian function demonstrated 4 to 10 weeks after the second injection. Recent research has shown the importance of closely monitoring the durations between the injections and between the second injection and slaughter. The objective was to determine the effects of dose timing and interval on grow-finish performance, carcass cutting yields, and meat quality of market gilts managed with Improvest when days on feed remained constant. The study consisted of 1,056 market gilts (average starting body weight of 31.7 kg) in 48 pens (22 pigs/pen) with experimental treatments arranged as a 2 × 2 factorial design with main effects of interval between the first and second Improvest injection (D1-D2; 4-week interval or 6-week interval) and time between the second Improvest injection and slaughter [D2-slaughter; weighted average of 34 to 35 days post-second injection (SHORT) or weighted average of 48 to 49 days post-second injection (LONG)]. Pigs were marketed using a similar strategy where the heaviest 3 to 5 pigs from each pen were marketed during study week 12, the next heaviest 3 to 5 pigs from each pen were marketed during study week 14, and the remaining pigs in the pen were marketed during study week 15. Hot carcass weight and optical probe readings (Destron PG-203; Anitech Identification System Inc.) were collected during slaughter. Following slaughter, 288 carcasses (24/treatment for each marketing event; pigs near the population average) were selected for evaluation of carcass cutting yields and meat quality. Data were analyzed with PROC MIXED of SAS, with pen serving as the experimental unit. There were limited interactions between D1-D2 and D2-slaughter, with nonsignificant interactions (P ≥ 0.07) for average daily feed intake (ADFI), average daily gain (ADG), and feed:gain (F:G) ratio during the grow-finish period, hot carcass weight, backfat thickness, or carcass primal weights. Overall, this study illustrated the trade-offs associated with altering the duration of time between D2-slaughter. From a live production standpoint, there were significant differences (P < 0.01) for D2-slaughter for ADFI and F:G ratio, with SHORT having reduced ADFI (2.47 kg versus 2.53 kg) and more efficient F:G (2.69 versus 2.74) compared with LONG (Table 1). From a meat processing standpoint, there were meaningful differences observed in fat deposition for D2- slaughter. In terms of fat quantity, backfat thickness and belly primal weight were affected (P < 0.01) by D2- slaughter (LONG had 0.78 mm greater backfat thickness and 0.15 kg heavier trimmed bellies). In terms of fat quality, iodine value and belly firmness were affected (P < 0.01) by D2-slaughter (LONG had 1.30 units lower iodine value and superior belly flop scores). [ABSTRACT FROM AUTHOR]

Introduction: Basal insulin should be injected at the same time each day, but people with diabetes sometimes mistime their injections. It is not known whether irregular daily dose timing affects diabetes-related factors. We report here our evaluation of the effects of deviations from a regular dosing schedule on glycemic control and hypoglycemia on patients treated with long-acting insulin (insulin glargine U100). We also consider the effects of ultra-long-acting insulin (insulin degludec) in this context. Methods: Nineteen individuals with type 1 diabetes and 58 with type 2 diabetes were enrolled. Demographic data on all participants were retrieved from their medical records. Variation in dose timing was determined as the difference between the time of the earliest mistimed dose and the time of the latest mistimed dose, for each participant, over a 2-week period. All participants completed the Summary of Diabetes Self-Care Activities questionnaire, Problem Areas in Diabetes scale and 5-Item World Health Organization Well-being Index. Glargine U100 was switched to degludec in those individuals with type 2 diabetes who achieved inadequate glycemic control or suffered from frequent hypoglycemic episodes or who required two injections per day, and changes in hemoglobin A1c level and frequency of hypoglycemic episodes during the 12-week period were compared. Results: A greater difference in dose timing was related to a higher frequency of hypoglycemic episodes and overweight in persons with type 2 diabetes. Smoking, drinking and living alone were independently associated with a greater difference in dose timing. Insulin degludec decreased the frequency of hypoglycemia and improved glycemic control in participants whose dose mistiming was >120 min. Conclusion: Fixed dose timing should be employed for basal insulin, as a larger difference in dose timing worsens diabetes-related factors. Insulin degludec improved glycemic control and lowered the hypoglycemia rate in persons with more irregular dose timing. [ABSTRACT FROM AUTHOR]

Background: Close monitoring of vaccination coverage is important for cervical cancer prevention efforts. The study aims to describe the HPV vaccination coverage by dose in girls eligible for HPV vaccination within Sweden's childhood immunization program and provide an estimate on dose timing compliance., Methods: Vaccination records between 2012 and March 2019 were obtained for girls born in 2000-2006 from the vaccination registers in Sweden. The mid-time population counts for the respective birth cohorts were taken as the denominator. Full-dose coverage and coverage with at least one dose of the vaccine were calculated within the two-dose and three-dose regimen, by region. Dose compliance was calculated within the two-dose regimen., Results: Vaccination coverage with at least one dose of the vaccine was >80% within birth cohorts 2001-2006. Full-dose coverage within a two-dose and three-dose regimen were 73.4% in birth cohorts 2004-2005, and 56.3% in birth cohorts 2000-2001, respectively. Little variation was observed in vaccination coverage between regions. Dose completion was 91.8%, and 72.8% in girls that initiated a two-dose and three-dose regimen, respectively. Among girls receiving a two-dose regimen, 93.0% received the second dose 6-12 months after dose one., Discussion: In conclusion, high levels of HPV vaccination coverage were observed with little variation between regions. Dose timing compliance was particularly high in the two-dose regimen. To fully benefit from the impact of HPV vaccination, it will be important to further push the vaccination coverage and reach the girls that do not or partially engage with HPV vaccination., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The study was funded by Merck and Co., LLC. KS has received unrestricted research grants for other studies on HPV-vaccination in Sweden. SH and CV are employees of Merck and Co., LLC. CK was previously an employee of the study Sponsor., (© 2023 Published by Elsevier Inc.)

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Adherence to antiretroviral medications is usually expressed in terms of the proportion of doses taken. However, the timing of doses taken may also be an important dimension to overall adherence. Little is known about whether patients who mistime doses are also more likely to skip doses. Using data from the completed Adherence for Life randomized controlled trial, we created visual and statistical models to capture and analyze dose timing data collected longitudinally with electronic drug monitors (EDM). From scatter plots depicting dose time versus calendar date, we identified dominant patterns of dose taking and calculated key features [slope of line over calendar date; residual mean standard error (RMSE)]. Each was assessed for its ability to categorize subjects with 'sub-optimal' (<95 % of doses taken) using area under the receiver operating characteristic (AROC) curve analysis. Sixty eight subjects contributed EDM data, with ~300 to 400 observations/subject. While regression line slopes did not predict 'sub-optimal' adherence (AROC 0.51, 95 % CI 0.26-0.75), the variability in dose timing (RMSE) was strongly predictive (AROC 0.79, 95 % CI 0.62-0.97). Compared with the lowest quartile of RMSE (minimal dose time variability), each successive quartile roughly doubled the odds of 'sub-optimal' adherence (OR 2.1, 95 % CI 1.3-3.4). Patterns of dose timing and mistiming are strongly related to overall adherence behavior. Notably, individuals who skip doses are more likely to mistime doses, with the degree of risk positively correlated with the extent of dose timing variability. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate which administration timing of valsartan provides satisfactory blood pressure (BP) control, once daily in the morning, once daily in the evening, or twice daily in total 160 mg. Hypertensive patients with mild-to-moderate diabetic nephropathy were enrolled, but those with more than three anti-hypertensive agents, renal insufficiency (serum creatinine ≥≥ 3 mg// dL), or hepatic insufficiency were excluded. They were randomized to receive valsartan 160mg once daily in the morning, valsartan 160 mg once daily in the evening, or valsartan 80 mg twice daily for 12 weeks according to a three-period crossover design. Office blood pressure (OBP), home blood pressure (HBP) self-measured by patients, and urinary albumin excretion adjusted by creatinine excretion (UAE) were measured every 12 weeks. In 34 patients, (male: 18, mean age: 57.5 ±± 10.3), valsartan with ether all administration timing demonstrated significant reductions in OBP and HBP compared to baseline: valsartan 160 mg once daily in the morning: −−12.2//−−9.5 mmHg (p < 0.01); valsartan 160 mg once daily in the evening: −−14.2//−−10.3 mmHg (p < 0.01); valsartan 80 mg twice daily: −−15.0//−−10.2 mmHg (p < 0.01) There was no statistically significant differences in a decrease in OBP and HBP, and reduction of UAE among three administration timing. In conclusion, these data indicate that the efficacy on BP-lowering does not depend on administration timing of valsartan in patients with diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Little is known about the importance of dose timing to successful antiretroviral therapy (ART). In a cohort comprised of Chinese HIV/AIDS patients, we measured adherence among subjects for 6 months using three methods in parallel: self-report using a visual analog scale (SR-VAS), pill count, and electronic drug monitors (EDM). We calculated two adherence metrics using the EDM data. The first metric used the proportion of doses taken; the second metric credited doses as adherent only if taken within a 1-h window of a pre-specified dose time (EDM ‘proportion taken within dose time’). Of the adherence measures, EDM had the strongest associations with viral suppression. Of the two EDM metrics, incorporating dose timing had a stronger association with viral suppression. We conclude that dose timing is also an important determinant of successful ART, and should be considered as an additional dimension to overall adherence. [ABSTRACT FROM AUTHOR]

The article focuses on the importance of adhering to antiretroviral medication in order to achieve HIV viral suppression. In line with this, information using various tools such as clinical, social-behavioral, demographic and virologic set ups have been gathered. It has also been found through this inquiry that consistency and high adherence associated with optimal interdose intervals are required in long-term viral suppression. Furthermore, development and transmission of resistant variants should then be prevented.

The objective of the study was to compare compliance with and the hypocholesterolaemic effect of lovastatin given once daily as a morning or an evening dose. Twenty-four out-patients with familial hypercholesterolaemia were randomly assigned to receive placebo first, then lovastatin 20 mg, to be taken once daily for 4 weeks, either with the breakfast or evening meal, in a single-blind fashion. Drug compliance was assessed by pill counts and continuous electronic monitoring. Two compliance parameters were evaluated, consumption, defined as percentage of prescribed doses taken, and time compliance, the percentage of total dosing events recorded within defined intervals (6.00-10.00 h, and 17.00-21.00 h), for the morning and evening regimes. Both regimes satisfactorily reduced the total and LDL-cholesterol concentrations, and there was no significant difference in the extent of the reductions. Pill counts overestimated compliance, as revealed by the monitoring method. The times of actual consumption of doses by the patients often differed from that prescribed, predominantly in patients who were told to take the evening dose. Partial time compliance may have confounded the efficacy of the drugs. Electronic compliance monitoring appears to be particularly useful in chronopharmacological studies. [ABSTRACT FROM AUTHOR]