Home-based intervention to test and start (HITS) protocol: a cluster-randomized controlled trial to reduce HIV-related mortality in men and HIV incidence in women through increased coverage of HIV treatment.

BACKGROUND: To realize the full benefits of treatment as prevention in many hyperendemic African contexts, there is an urgent need to increase uptake of HIV testing and HIV treatment among men to reduce the rate of HIV transmission to (particularly young) women. This trial aims to evaluate the effect of two interventions - micro-incentives and a tablet-based male-targeted HIV decision support application - on increasing home-based HIV testing and linkage to HIV care among men with the ultimate aim of reducing HIV-related mortality in men and HIV incidence in young women. METHODS/DESIGN: This is a cluster randomized trial of 45 communities (clusters) in a rural area in the uMkhanyakude district of KwaZulu Natal, South Africa (2018-2021). The study is built upon the Africa Health Research Institute (AHRI)'s HIV testing platform, which offers annual home-based rapid HIV testing to individuals aged 15 years and above. In a 2 × 2 factorial design, individuals aged ≥15 years living in the 45 clusters are randomly assigned to one of four arms: i) a financial micro-incentive (food voucher) (n = 8); ii) male-targeted HIV specific decision support (EPIC-HIV) (n = 8); iii) both the micro incentives and male-targeted decision support (n = 8); and iv) standard of care (n = 21). The EPIC-HIV application is developed and delivered via a tablet to encourage HIV testing and linkage to care among men. A mixed method approach is adopted to supplement the randomized control trial and meet the study aims. DISCUSSION: The findings of this trial will provide evidence on the feasibility and causal impact of two interventions - micro-incentives and a male-targeted HIV specific decision support - on uptake of home-based HIV testing, linkage to care, as well as population health outcomes including population viral load, HIV related mortality in men, and HIV incidence in young women (15-30 years of age). TRIAL REGISTRATION: This trial was registered on 28 November 2018 on, identifier https://clinicaltrials.gov/ .

Glycemic Control in US Immigrant and Nonimmigrant Black Youth with Type 1 Diabetes.

Differences in glycemic control based on race have been reported in pediatric populations with type 1 diabetes (T1D). It is unknown if differences exist between pediatric populations within the same race classification. This retrospective study identified all immigrant and nonimmigrant Black youth diagnosed with T1D and treated at Seattle Children's Hospital from 2001 to 2011. Demographic characteristics and hemoglobin A1c (HbA1c) levels at 12, 24, and 36 months post diagnosis were obtained from existing medical records. Immigrant youth had lower mean HbA1c levels at all three time points. The ethnicity effect on mean HbA1c levels approached significance at 36 months. When comparing 12 and 36 months, the time effect was significant; the ethnicity effect approached significance. Clinically important differences may exist in glycemic control between pediatric populations with T1D from the same race classification. Additional work is needed to confirm these findings and determine potential causes.

Transcriptome profiling of human hippocampus dentate gyrus granule cells in mental illness.

This study is, to the best of our knowledge, the first application of whole transcriptome sequencing (RNA-seq) to cells isolated from postmortem human brain by laser capture microdissection. We investigated the transcriptome of dentate gyrus (DG) granule cells in postmortem human hippocampus in 79 subjects with mental illness (schizophrenia, bipolar disorder, major depression) and nonpsychiatric controls. We show that the choice of normalization approach for analysis of RNA-seq data had a strong effect on results; under our experimental conditions a nonstandard normalization method gave superior results. We found evidence of disrupted signaling by miR-182 in mental illness. This was confirmed using a novel method of leveraging microRNA genetic variant information to indicate active targeting. In healthy subjects and those with bipolar disorder, carriers of a high- vs those with a low-expressing genotype of miR-182 had different levels of miR-182 target gene expression, indicating an active role of miR-182 in shaping the DG transcriptome for those subject groups. By contrast, comparing the transcriptome between carriers of different genotypes among subjects with major depression and schizophrenia suggested a loss of DG miR-182 signaling in these conditions.

Bounds for cell entries in contingency tables given marginal totals and decomposable graphs.

Upper and lower bounds on cell counts in cross-classifications of nonnegative counts play important roles in a number of practical problems, including statistical disclosure limitation, computer tomography, mass transportation, cell suppression, and data swapping. Some features of the Frechet bounds are well known, intuitive, and regularly used by those working on disclosure limitation methods, especially those for two-dimensional tables. We previously have described a series of results relating these bounds to theory on loglinear models for cross-classified counts. This paper provides the actual theory and proofs for the special case of decomposable loglinear models and their related independence graphs. It also includes an extension linked to the structure of reducible graphs and a discussion of the relevance of other results linked to nongraphical loglinear models.