For years, a discussion has persevered on the benefits and drawbacks of antibody discovery using animal immunization versus in vitro selection from non-animal-derived recombinant repertoires using display technologies. While it has been argued that using recombinant display libraries can reduce animal consumption, we hold that the number of animals used in immunization campaigns is dwarfed by the number sacrificed during preclinical studies. Thus, improving quality control of antibodies before entering in vivo studies will have a larger impact on animal consumption. Both animal immunization and recombinant repertoires present unique advantages for discovering antibodies that are fit for purpose. Furthermore, we anticipate that machine learning will play a significant role within discovery workflows, refining current antibody discovery practices.
To describe the social network characteristics of pregnant women with opioid use disorder (OUD) and explore how changes in social relationships during pregnancy may influence substance use behaviors.

Between 2017 and 2018, we conducted an exploratory pilot study among 50 pregnant women with OUD. Participants completed a detailed social network inventory to describe the behaviors (e.g. substance-using), social support characteristics (e.g. financial, emotional, informational) and roles (e.g. family member, friend) of network members. The primary outcome was a self-reported decrease in substance use during pregnancy. Pearson correlations were used to test for associations between covariates reflecting different aspects of participants' social networks and decreased substance use during pregnancy.

Most participants (84.0 %) decreased substance use during pregnancy and stated that pregnancy motivated them to engage in treatment (94.0 %). Participants had a median of 8 (IQR 4-18) network members with differing proportions of those who did and did not use substances. Pregnancy prompted participants to significantly increase contact with (26.4 % vs. 5.0 %), have increased support from (35.7 % vs. 7.5 %), and a have a feeling of increased closeness with (26.1 % vs. 3.3 %) network members who did not use substances. However, decreased substance use during pregnancy was most strongly (negatively) associated with the proportion of network members who used substances and provided informational support (r=-0.25, p = 0.08) and a feeling of closeness (r=-0.26, p = 0.08).

Our findings indicate that pregnancy has a profound influence on women's substance use behaviors and that changes in social relationships due to pregnancy may influence substance use.
Our findings indicate that pregnancy has a profound influence on women's substance use behaviors and that changes in social relationships due to pregnancy may influence substance use.
Management of chronic pain is an essential aspect of HIV primary care. Previous literature in the general population has elucidated racial disparities in the evaluation and treatment of pain. This study examined racial/ethnic differences in patient satisfaction and barriers to pain management among a cohort of PWH receiving LTOT.

Patient-reported survey and EMR data were compared between non-white (n = 135; 81.3 %) and white (n = 31; 18.7 %) patients in a cohort of 166 PWH receiving LTOT in two clinics in Atlanta and Boston. Quantile and linear regression were used to evaluate the association between race and pain management outcomes 1) satisfaction with pain management (0-10) and 2) patient-related barriers to pain management, including patient perceptions of pain medications, fatalism, and communication about pain. Models were adjusted for sex, age, clinical site, and baseline general health.

Non-white participants were noted to receive chronic opioids for a shorter mean duration of time than white participants (6.0 versus 11.0 years, p < 0.001) and lower mean morphine equivalent daily dose (MEDD) than white participants (28.1 versus 66.9 mg, p < 0.001). In adjusted analyses, there was no significant difference in satisfaction with pain management among non-white and white participants (p = 0.101). There was no significant difference in barriers to pain management in unadjusted (p = 0.335) nor adjusted models (p = 0.397).

While non-white PWH were noted to have received lower doses of chronic opioids and for shorter duration than white PWH, satisfaction with pain management was similar. Patient-related barriers to pain management were similar among non-white and white PWH.
While non-white PWH were noted to have received lower doses of chronic opioids and for shorter duration than white PWH, satisfaction with pain management was similar. Patient-related barriers to pain management were similar among non-white and white PWH.
Women with histories of opioid misuse face drug-related stigma, which can be amplified during pregnancy. While women are often blamed for their drug use and urged to change, the social contexts that create and reinforce stigma are largely unchallenged. Drawing on a multidimensional model of stigma, we examine how stigma manifested across women's pregnancy journeys to shape access and quality of care.

We triangulate in-depth interviews with 28 women with histories of opioid misuse who were pregnant or recently gave birth and 18 healthcare providers in Ohio. Thematic analysis examined how stigma operates across contexts of care.

Providers represented physicians, nurses, social workers, counselors, and healthcare administrators. Among 28 women, average age was 30 (range 22-41) and 79 % were White. Most women used prenatal medication-assisted treatment (MAT), including Suboxone (n = 19) or methadone (n = 8), and 15 were pregnant. https://www.selleckchem.com/products/mrtx849.html Evidence of stigma emerged across healthcare contexts. Structural stigma encoded barriers to care in insurance practices and punitive drug treatment, while enacted stigma manifested as mistreatment and judgment from providers. Unpredictability of an infant diagnosis of neonatal abstinence syndrome (NAS), even when women were "doing everything right" by using MAT, perpetuated anticipated stigma from fear of loss of custody and internalized stigma among women who felt guilty about the diagnosis. Providers recognized the harmful effects of these stigmas and many actively addressed it.

We recommend harm reduction approaches to address the multiplicity of stigmas that women navigate in opioid misuse and pregnancy to improve healthcare experiences.
We recommend harm reduction approaches to address the multiplicity of stigmas that women navigate in opioid misuse and pregnancy to improve healthcare experiences.
For years, a discussion has persevered on the benefits and drawbacks of antibody discovery using animal immunization versus in vitro selection from non-animal-derived recombinant repertoires using display technologies. While it has been argued that using recombinant display libraries can reduce animal consumption, we hold that the number of animals used in immunization campaigns is dwarfed by the number sacrificed during preclinical studies. Thus, improving quality control of antibodies before entering in vivo studies will have a larger impact on animal consumption. Both animal immunization and recombinant repertoires present unique advantages for discovering antibodies that are fit for purpose. Furthermore, we anticipate that machine learning will play a significant role within discovery workflows, refining current antibody discovery practices. To describe the social network characteristics of pregnant women with opioid use disorder (OUD) and explore how changes in social relationships during pregnancy may influence substance use behaviors. Between 2017 and 2018, we conducted an exploratory pilot study among 50 pregnant women with OUD. Participants completed a detailed social network inventory to describe the behaviors (e.g. substance-using), social support characteristics (e.g. financial, emotional, informational) and roles (e.g. family member, friend) of network members. The primary outcome was a self-reported decrease in substance use during pregnancy. Pearson correlations were used to test for associations between covariates reflecting different aspects of participants' social networks and decreased substance use during pregnancy. Most participants (84.0 %) decreased substance use during pregnancy and stated that pregnancy motivated them to engage in treatment (94.0 %). Participants had a median of 8 (IQR 4-18) network members with differing proportions of those who did and did not use substances. Pregnancy prompted participants to significantly increase contact with (26.4 % vs. 5.0 %), have increased support from (35.7 % vs. 7.5 %), and a have a feeling of increased closeness with (26.1 % vs. 3.3 %) network members who did not use substances. However, decreased substance use during pregnancy was most strongly (negatively) associated with the proportion of network members who used substances and provided informational support (r=-0.25, p = 0.08) and a feeling of closeness (r=-0.26, p = 0.08). Our findings indicate that pregnancy has a profound influence on women's substance use behaviors and that changes in social relationships due to pregnancy may influence substance use. Our findings indicate that pregnancy has a profound influence on women's substance use behaviors and that changes in social relationships due to pregnancy may influence substance use. Management of chronic pain is an essential aspect of HIV primary care. Previous literature in the general population has elucidated racial disparities in the evaluation and treatment of pain. This study examined racial/ethnic differences in patient satisfaction and barriers to pain management among a cohort of PWH receiving LTOT. Patient-reported survey and EMR data were compared between non-white (n = 135; 81.3 %) and white (n = 31; 18.7 %) patients in a cohort of 166 PWH receiving LTOT in two clinics in Atlanta and Boston. Quantile and linear regression were used to evaluate the association between race and pain management outcomes 1) satisfaction with pain management (0-10) and 2) patient-related barriers to pain management, including patient perceptions of pain medications, fatalism, and communication about pain. Models were adjusted for sex, age, clinical site, and baseline general health. Non-white participants were noted to receive chronic opioids for a shorter mean duration of time than white participants (6.0 versus 11.0 years, p < 0.001) and lower mean morphine equivalent daily dose (MEDD) than white participants (28.1 versus 66.9 mg, p < 0.001). In adjusted analyses, there was no significant difference in satisfaction with pain management among non-white and white participants (p = 0.101). There was no significant difference in barriers to pain management in unadjusted (p = 0.335) nor adjusted models (p = 0.397). While non-white PWH were noted to have received lower doses of chronic opioids and for shorter duration than white PWH, satisfaction with pain management was similar. Patient-related barriers to pain management were similar among non-white and white PWH. While non-white PWH were noted to have received lower doses of chronic opioids and for shorter duration than white PWH, satisfaction with pain management was similar. Patient-related barriers to pain management were similar among non-white and white PWH. Women with histories of opioid misuse face drug-related stigma, which can be amplified during pregnancy. While women are often blamed for their drug use and urged to change, the social contexts that create and reinforce stigma are largely unchallenged. Drawing on a multidimensional model of stigma, we examine how stigma manifested across women's pregnancy journeys to shape access and quality of care. We triangulate in-depth interviews with 28 women with histories of opioid misuse who were pregnant or recently gave birth and 18 healthcare providers in Ohio. Thematic analysis examined how stigma operates across contexts of care. Providers represented physicians, nurses, social workers, counselors, and healthcare administrators. Among 28 women, average age was 30 (range 22-41) and 79 % were White. Most women used prenatal medication-assisted treatment (MAT), including Suboxone (n = 19) or methadone (n = 8), and 15 were pregnant. https://www.selleckchem.com/products/mrtx849.html Evidence of stigma emerged across healthcare contexts. Structural stigma encoded barriers to care in insurance practices and punitive drug treatment, while enacted stigma manifested as mistreatment and judgment from providers. Unpredictability of an infant diagnosis of neonatal abstinence syndrome (NAS), even when women were "doing everything right" by using MAT, perpetuated anticipated stigma from fear of loss of custody and internalized stigma among women who felt guilty about the diagnosis. Providers recognized the harmful effects of these stigmas and many actively addressed it. We recommend harm reduction approaches to address the multiplicity of stigmas that women navigate in opioid misuse and pregnancy to improve healthcare experiences. We recommend harm reduction approaches to address the multiplicity of stigmas that women navigate in opioid misuse and pregnancy to improve healthcare experiences.
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