Willingness and preferences for long-acting injectable PrEP among US men who have sex with men: a discrete choice experiment.

INTRODUCTION: Cabotegravir long-acting injectable HIV pre-exposure prophylaxis (LA-PrEP) was shown to be safe and effective in multiple clinical trials. Increasing uptake and persistence among populations with elevated risk for HIV acquisition, especially among men who have sex with men (MSM), is critical to HIV prevention. OBJECTIVE: This analysis aims to understand potential users' preferences for LA-PrEP, with audience segmentation. DESIGN: Willingness to use and preferences for LA-PrEP were measured in HIV-negative, sexually active MSM in the 2020 American Men's Internet Survey. Respondents answered a discrete choice experiment with paired profiles of hypothetical LA-PrEP characteristics with an opt-out option (no LA-PrEP). Conditional and mixed logit models were run; the final model was a dummy-coded mixed logit that interacted with the opt-out. SETTING: US national online sample. RESULTS: Among 2506 MSM respondents, most (75%) indicated a willingness to use LA-PrEP versus daily oral PrEP versus no PrEP. Respondents were averse to side effects and increasing costs and preferred increasing levels of protection. Respondents preferred a 2-hour time to obtain LA-PrEP vs 1 hour, with a strong aversion to 3 hours. Overall, there was an aversion to opting out of LA-PrEP, with variations: those with only one partner, no/other insurance or who were Black, Indigenous or People of Colour were significantly less likely to prefer LA-PrEP, while those who were Hispanic/Latino, college educated and <40 years significantly preferred LA-PrEP. CONCLUSIONS: A large proportion of MSM expressed a preference for LA-PrEP over daily oral pills. Most respondents chose LA-PrEP regardless of cost, clinic time, side effects or protection level; however, preferences varied by sociodemographics. These varied groups likely require tailored intervention strategies to achieve maximum LA-PrEP uptake and persistence.

Quantum Monge-Kantorovich Problem and Transport Distance between Density Matrices.

A quantum version of the Monge-Kantorovich optimal transport problem is analyzed. The transport cost is minimized over the set of all bipartite coupling states ρ^{AB} such that both of its reduced density matrices ρ^{A} and ρ^{B} of dimension N are fixed. We show that, selecting the quantum cost matrix to be proportional to the projector on the antisymmetric subspace, the minimal transport cost leads to a semidistance between ρ^{A} and ρ^{B}, which is bounded from below by the rescaled Bures distance and from above by the root infidelity. In the single-qubit case, we provide a semianalytic expression for the optimal transport cost between any two states and prove that its square root satisfies the triangle inequality and yields an analog of the Wasserstein distance of the order of 2 on the set of density matrices. We introduce an associated measure of proximity of quantum states, called swap fidelity, and discuss its properties and applications in quantum machine learning.

Evaluation of perfusion-driven cell seeding of small diameter engineered tissue vascular grafts with a custom-designed seed-and-culture bioreactor.

Tissue engineering commonly entails combining autologous cell sources with biocompatible scaffolds for the replacement of damaged tissues in the body. Scaffolds provide functional support while also providing an ideal environment for the growth of new tissues until host integration is complete. To expedite tissue development, cells need to be distributed evenly within the scaffold. For scaffolds with a small diameter tubular geometry, like those used for vascular tissue engineering, seeding cells evenly along the luminal surface can be especially challenging. Perfusion-based cell seeding methods have been shown to promote increased uniformity in initial cell distribution onto porous scaffolds for a variety of tissue engineering applications. We investigate the seeding efficiency of a custom-designed perfusion-based seed-and-culture bioreactor through comparisons to a static injection counterpart method and a more traditional drip seeding method. Murine vascular smooth muscle cells were seeded onto porous tubular electrospun polycaprolactone scaffolds, 2 mm in diameter and 30 mm in length, using the three methods, and allowed to rest for 24 hours. Once harvested, scaffolds were evaluated longitudinally and circumferentially to assess the presence of viable cells using alamarBlue and live/dead cell assays and their distribution with immunohistochemistry and scanning electron microscopy. On average, bioreactor-mediated perfusion seeding achieved 35% more luminal surface coverage when compared to static methods. Viability assessment demonstrated that the total number of viable cells achieved across methods was comparable with slight advantage to the bioreactor-mediated perfusion-seeding method. The method described is a simple, low-cost method to consistently obtain even distribution of seeded cells onto the luminal surfaces of small diameter tubular scaffolds.

Examining Changes in Healthy Days After Health Coaching.

PURPOSE: To describe changes in health-related quality of life (HRQOL) related to variation in demographic characteristics, program goals, and program participation, among health coaching program participants. DESIGN: A retrospective observational study of a health coaching program. SETTING AND PARTICIPANTS: A total of 2169 adults enrolled in an individually purchased or employer-sponsored health plan from a large health and well-being company, who participated in a health coaching program between January 2016 and April 2017. INTERVENTION: The health coaching program used evidence-based behavior change strategies to encourage skill development, self-monitoring, and goal setting/achievement. Health coaching program modalities included online and telephonic coaching sessions. MEASURES: Demographic characteristics (gender, age, race, income), goal categories (weight management, fitness, nutrition, stress management, other), program modality (online, telephonic, both), engagement level (low, medium, high), and Healthy Days, a validated HRQOL measure developed by the Centers for Disease Control and Prevention. ANALYSIS: t Tests, mixed analysis of variance (ANOVA). RESULTS: There were significant ( P < .05) reductions in average total unhealthy days (UHDs) across all goal categories. Mixed ANOVAs identified a significant main effect for time, for all demographic characteristics ( P values < .05), and a significant effect for program modality ( P < .0001), time ( P < .0001), and interaction effects, between program modality and time, on average UHD ( P = .01). CONCLUSION: Our findings indicate significant reductions in UHD, following 6 months of health coaching, and support the use of HRQOL measures, which are known to be highly correlated with traditional measures of health, to evaluate health coaching programs.

Impact of a Temporary NRT Enhancement in a State Quitline and Web-Based Program.

PURPOSE: To examine the impact of a nicotine replacement therapy (NRT) enhancement on quit outcomes. DESIGN: Observational study using an intent to treat as treated analysis. SETTING: Not available. PARTICIPANTS: A total of 4022 Idaho tobacco users aged ≥18 years who received services from the Idaho Tobacco Quitline or Idaho's web-based program. INTERVENTION: One-call phone or web-based participants were sent a single 4- or 8-week NRT shipment. Multiple-call participants were sent NRT in a single 4-week shipment or two 4-week shipments (second shipment sent only to those completing a second coaching call). MEASURES: North American Quitline Consortium recommended Minimal Data Set items collected at registration and follow-up. Thirty-day point prevalence quit rates were assessed at 7-month follow-up. ANALYSIS: Multiple logistic regression models were used to examine the effects of program type and amount of NRT sent to participants while controlling for demographic and tobacco use characteristics. RESULTS: Abstinence rates were significantly higher among 8-week versus 4-week NRT recipients (42.5% vs 33.3%). The effect was only significant between multiple-call program participants who received both 4-week NRT shipments versus only the first of 2 possible 4-week shipments (51.1% vs 31.1%). Costs per quit were lowest among web-based participants who received 4 weeks of NRT (US$183 per quit) and highest among multiple-call participants who received only 1 of 2 possible NRT shipments (US$557 per quit). CONCLUSION: To better balance cost with clinical effectiveness, funders of state-based tobacco cessation services may want to consider (1) allowing tobacco users to choose between phone- and web-based programs while (2) limiting longer NRT benefits only to multiple-call program participants.

Systematic review and meta-analysis of Internet interventions for smoking cessation among adults.

BACKGROUND: The aim of this systematic review was to determine the effectiveness of Internet interventions in promoting smoking cessation among adult tobacco users relative to other forms of intervention recommended in treatment guidelines. METHODS: This review followed Cochrane Collaboration guidelines for systematic reviews. Combinations of "Internet," "web-based," and "smoking cessation intervention" and related keywords were used in both automated and manual searches. We included randomized trials published from January 1990 through to April 2015. A modified version of the Cochrane risk of bias assessment tool was used. We calculated risk ratios (RRs) for each study. Meta-analysis was conducted using random-effects method to pool RRs. Presentation of results follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS: Forty randomized trials involving 98,530 participants were included. Most trials had a low risk of bias in most domains. Pooled results comparing Internet interventions to assessment-only/waitlist control were significant (RR 1.60, 95% confidence interval [CI] 1.15-2.21, I (2)=51.7%; four studies). Pooled results of largely static Internet interventions compared to print materials were not significant (RR 0.83, 95% CI 0.63-1.10, I (2)=0%; two studies), whereas comparisons of interactive Internet interventions to print materials were significant (RR 2.10, 95% CI 1.25-3.52, I (2)=41.6%; two studies). No significant effects were observed in pooled results of Internet interventions compared to face-to-face counseling (RR 1.35, 95% CI 0.97-1.87, I (2)=0%; four studies) or to telephone counseling (RR 0.95, 95% CI 0.79-1.13, I (2)=0%; two studies). The majority of trials compared different Internet interventions; pooled results from 15 such trials (24 comparisons) found a significant effect in favor of experimental Internet interventions (RR 1.16, 95% CI 1.03-1.31, I (2)=76.7%). CONCLUSION: Internet interventions are superior to other broad reach cessation interventions (ie, print materials), equivalent to other currently recommended treatment modes (telephone and in-person counseling), and they have an important role to play in the arsenal of tobacco-dependence treatments.