High Initial Rate Research Articles

507. Trajectories of Newly Initiated Pre-Exposure Prophylaxis (PrEP) Use among Priority Populations with Unmet Needs for PrEP in the USA

Abstract Background PrEP is an important strategy in HIV-1 prevention, yet disparities persist in its uptake across diverse demographic groups. This study aims to identify priority populations with unmet PrEP needs and to describe new PrEP prescription initiation patterns in these groups.Figure 1.Trajectories for Number of Individuals Who Newly Initiated PrEP between 2019 and 2023 by Priority Groups in the United States*APC from 2019 to 2023. HIV–1 risk factors on record in the claims dataset were a group of ICD-based diagnosis and CPT codes that were highly recommended for PrEP use by providers, including any diagnoses of any sexually transmitted diseases (A50-64), contact with and exposure to communicable diseases (Z20.6, Z20.2, Z20.828, Z20.9), high-risk sexual behavior (Z72.51-Z72.53), other hazardous exposures (Z77.21, Z77.9), contact with hypodermic needle (W46.0, W46.1), long-term prophylaxis (Z79.899), HIV prevention counseling (99401-99404), and HIV screening procedures (86689, 86701-86703, 87389, 87534-87538, G0432-G0435). Female PG1: Females without recorded HIV-1 risk factors; Female PG2: Females with recorded HIV-1 risk factors; Male PG1: Males without recorded HIV-1 risk factors; Male PG2: (1) Males with recorded HIV-1 risk factors and had Medicaid coverage; (2) Males with recorded HIV-1 risk factors, with commercial insurance (including ∼23% assistance programs, Medicare, and other mixed/missing on plan coverage) and residing in Black (non-Hispanic) or Hispanic neighborhoods; Male PG3: Males with any recorded HIV-1 risk factors, with commercial insurance (including ∼23% assistance programs, Medicare, and other mixed/missing on plan coverage) and residing in White (Non-Hispanic White, and with ∼24% in non-Hispanic Asian or other mixed/missing) neighborhoods. APC, annual percent change; CPT, Current Procedural Terminology; ICD; International Classification of Diseases; PG, priority group; PrEP, pre-exposure prophylaxis. Methods Data on PrEP prescriptions and new HIV-1 diagnoses (2019–2023) were obtained from an IQVIA claims database. PrEP-to-Need Ratio (PNR; number of individuals using PrEP in a year divided by new HIV diagnoses in the previous year) was calculated for subpopulations defined by five PNR-associated factors: sex, insurance, recorded HIV-1 risk factors (identified by diagnosis or procedure codes), ‘Ending the HIV Epidemic’ jurisdictions, and neighborhood race/ethnicity composition. Lower PNR indicates higher unmet need. Using cluster analysis, subpopulations with similar 2019 PNR values were classified into five population priority groups (PGs). Trends of newly initiated PrEP prescriptions and its annual percent change (APC) were assessed by PG, and PNR values for PGs in 2019 and 2023 were compared.Figure 2.PrEP-to-Need Ratio in 2019 and 2023 by Priority Groups in the United StatesLower PNR indicates higher unmet need.PG, priority group; PNR, PrEP-to-Need Ratio; PrEP, pre-exposure prophylaxis. Results A large proportion of newly initiated PrEP users in both 2019 (53% of 93,344) and 2023 (43% of 125,819) were males with HIV-1 risk factors, using commercial insurance, and residing in White dominant neighborhoods; this group had a marginal increase in PrEP initiation (APC 2%; Male PG3, Figure 1) and the lowest unmet needs (Figure 2). Other males with HIV-1 risk factors (Male PG2; those commercially insured residing in Black/Hispanic neighborhoods or those on Medicaid across all neighborhoods) had a moderate increase in PrEP initiation (APC 11%) and higher unmet needs. Females and males without recorded HIV-1 risk factors showed the highest PrEP initiation increase (Female PG1, APC 30%, and Male PG1, APC 19%), but retained the most substantial unmet needs from 2019 to 2023. Conclusion This study identified individuals without known HIV-1 risk factors and with a high rate of new PrEP initiation; this highlights an ongoing unmet need for PrEP in this population. Individuals on Medicaid or residing in Black/Hispanic communities would benefit from increased PrEP uptake to address disparities in HIV prevention. These findings emphasize the need to ensure equitable PrEP access across diverse populations in the real world. Disclosures Li Tao, MD, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Juan Yang, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Joshua Gruber, PhD MPH, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Chris Nguyen, PharmD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Woodie Zachry, RPh, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company)

The impact of COVID-19 pandemic on sleep duration and mental health among middle school students: a 3-year cross-sectional survey

BackgroundSince the outbreak of COVID-19 in late 2019, and until the Chinese government downgraded the pandemic control measures to Category B management in January 2023, various epidemic prevention measures were implemented across regions based on the local spread of the virus. Correspondingly, educational formats shifted between online and offline teaching according to the pandemic situation. Changes in daily life and teaching methods, along with the high initial mortality rate of COVID-19, have had varying degrees of negative impact on the mental health (MH) of adolescents.PurposesThis study aimed to explore the impact of the COVID-19 pandemic status on the sleep duration (SD) and MH of adolescents, investigate the relationship between SD and MH in middle school students, and evaluate the protective effect of SD on MH.MethodsUsing a convenient sampling method, 6 junior high schools and 3 senior high schools in Guiyang City, China, were selected. Random samples from two classes per grade in each school were chosen for the survey. The study was conducted annually for three consecutive years using the Mental Health Inventory of Middle-school students (MMHI-60) scale and a self-designed questionnaire. Data were analyzed using IBM SPSS version 26.0 software, employing ANOVA, cross-tabulation, and generalized linear models to examine the relationship between SD and MH scores.ResultsThe SD and MH scores of middle school students in 2021, 2022, and 2023 were 436.41 ± 71.21 min/day, 423.69 ± 61.71 min/day, and 445.26 ± 65.04 min/day (F = 41.44, p < 0.001), 1.72 ± 0.63, 1.87 ± 0.73, and 1.79 ± 0.67 (F = 18.31, p < 0.001). The SD compliance rates were 34.1%, 23.9%, and 33.2%, and the MH problem detection rates were 27.9%, 36.4%, and 33.4%, respectively; there is a significant correlation between SD and MH scores among middle school students (P < 0.001); the protective effects of SD compliance on MH were 1.859 times, 2.156 times, and 1.516 times higher than those of SD non-compliance (all p < 0.001).ConclusionMeeting the SD standard is a protective factor for adolescent MH. The COVID-19 pandemic and its control measures have had a severe and long-term negative impact on both SD and MH in middle school students, with differences observed between genders and academic levels. The greater the severity of the pandemic and the stricter the control measures, the more significant the negative impact on SD and MH etc.

Barriers and drivers to exclusive breastfeeding in Kyrgyzstan: a qualitative study with mothers and health workers

BackgroundThe WHO/UNICEF global nutrition target for exclusive breastfeeding for six months is at least 70% of infants by 2030. However, global prevalence rates are 48% with variations between countries and within regions. Kyrgyzstan has consistently high early breastfeeding initiation rates, yet exclusive breastfeeding for six months is 46%. This qualitative study addressed two research questions: (1) What are the barriers and drivers for mothers to exclusive breastfeeding in the first six months? (2) What are the barriers and drivers for health workers in primary care facilities to supporting exclusive breastfeeding in the first six months?MethodsThe study took place from April to June 2023 in five sites (mix of urban and rural). Ten focus group discussions with 40 primary care health workers and 20 in-depth interviews with mothers of a child currently aged 6–12 months who initiated breastfeeding with this child were conducted. Mothers were purposively selected to represent four groups of infant feeding practices in the first six months: (1) exclusive breastfeeding, (2) breastfeeding alongside other fluids/solids, (3) breastfeeding alongside infant formula, (4) breastfeeding followed by switching to formula only. The Capability-Opportunity-Motivation-Behaviour (COM-B) model was the underpinning theoretical framework. Data were analysed using the Framework approach.ResultsThe study uncovered important misperceptions amongst mothers who were not exclusively breastfeeding (groups 2–4). These existed alongside a perceived inability to resolve physical challenges of breastfeeding and social pressure to supplement breastmilk with fluids/solids or formula. Half of all mothers felt uncomfortable breastfeeding in public. Health workers were recommending and supporting women with exclusive breastfeeding during multiple antenatal and postnatal interactions during the initial six months. They were knowledgeable and motivated to do this. Moreover, they felt well supported with training, resources, and legislation with just a few mentioning workplace time or space challenges. Very few doctors appeared to currently be meeting with formula industry representatives.ConclusionsThis theory-informed qualitative study focusing on mother and health worker perspectives provided important insights into the individual and contextual barriers and drivers to exclusive breastfeeding for the first six months in Kyrgyzstan. These insights have informed recommendations for tailored interventions for both groups.

Enhancing Antiretroviral Therapy Initiation for Hospitalized and Recently Discharged People Living With HIV in Johannesburg, South Africa.

Despite increased antiretroviral therapy (ART) access in South Africa, HIV testing and ART initiation are suboptimal in hospital settings. Key gaps include in-hospital case finding, ART initiation support, and primary health care (PHC) facility linkage after discharge. We identified weaknesses in hospital processes by comparing them with PHC HIV services and developed a quality improvement model for implementation in 5 Johannesburg hospitals. We introduced dedicated teams of HIV testing counselors for structured case finding and ART-trained nurses and linkage officers to provide in-hospital or post-discharge ART initiation and support to strengthen PHC facility linkage. Monitoring data (May 2020-March 2021) was used to measure initiation rates. Over 11 months, despite COVID-19 pandemic-related disruptions, our model achieved 74% (5,201/7,025) ART linkage within 28 days post-discharge and 87% (6,087/7,025) overall, including all initiations (i.e., all newly diagnosed, known not on ART and reinitiating individuals). The 2 highest-performing hospitals achieved 97% (2,096/2,170) linkage overall, demonstrating the potential of implementing this quality improvement model with fidelity. Over half (58%, 4,092/7,025) of patients initiated ART within 7 days, with 39% (2,748) initiating on the same day. Women and men achieved similar initiation rates (3,010/4,015, 75%; 2,186/3,003, 73%, respectively). Combining rapid (<7 days) in-hospital ART initiation with 28-day post-discharge follow-up supported high ART initiation rates. Using the model mitigated initiation gaps for men and older people, engaging stakeholders supported implementation, and using a team-based approach founded on clear roles and responsibilities improved service delivery. This model achieved above-average ART linkage rates in a large hospitalized population. We recommend considering introducing this model or adaptations of it to hospitals across South Africa and similar settings where hospital-to-PHC ART service gaps are identified to optimize case finding, ART initiation, and post-discharge linkage support.

Creating a doula support program for pregnant teens using human-centered design.

Pregnant teens experience suboptimal outcomes during pregnancy, birth, and postpartum, which can adversely impact their health and that of their children. Human-centered design (HCD) is an approach to solving complex problems that prioritizes the lived experiences of those who would be served by the new program or intervention. Recognizing the utility of HCD to the creation of successful health interventions, we describe the application of these methods to create a comprehensive doula program to support pregnant teens. We followed the three phases of HCD. The inspiration phase allowed for the collection of information about the needs and preferences of teen parents. During the ideation phase these ideas were processed and developed into potential solutions. Lastly during the implementation phase we created a pilot doula support program, Beyond the Bump. Beyond the Bump served 12 participants who had positive birth outcomes, including low rates of cesarean section deliveries and high rates of breastfeeding initiation. The doulas and program participants had positive impressions of the program. Beyond the Bump may serve as a model for others aiming to incorporate lived experiences of patients into the design of new interventions.

Hydroxychloroquine in combination with platinum doublet chemotherapy as first-line treatment for extensive-stage small cell lung cancer (Study 15): A randomised phase II multicentre trial.

Most patients with small-cell lung cancer (SCLC) present with extensive-stage (ES) disease and have a poor prognosis despite achieving high initial response rates to platinum-based doublet chemotherapy. This study evaluated whether adding hydroxychloroquine (HCQ) to chemotherapy could improve outcomes. This was a randomised multicentre phase II trial. Eligible patients had untreated ES-SCLC, a performance status 0-2 and measurable disease. Patients were randomly assigned (1:1 ratio) to HCQ (400mg orally twice daily) plus carboplatin-gemcitabine or carboplatin-etoposide alone. Chemotherapy was administered for up to six cycles, with HCQ given concurrently and then as single agent for up to 30 months. Primary endpoint was PFS, aiming for a hazard ratio (HR) of 0.70. 72 patients were randomised (36 HCQ+chemotherapy and 36 chemotherapy alone). Median HCQ treatment duration was 4.4 months. HCQ did not improve PFS (HR 1·12 95%CI 0·69-1.84; p=0·64), with a median of 5.7 months (HCQ+chemotherapy) versus 6.2 months (chemotherapy). The corresponding median OS were 8.9 and 10.2 months (HR 0.83, 95%CI 0.48-1.45, p=0.52). Fewer patients in the HCQ arm completed four cycles of chemotherapy due to adverse events (64% vs. 81%). Grade ≥3 adverse events were higher in the HCQ+chemotherapy arm (83.3% vs. 27.8%), primarily anaemia, neutropenia, and thrombocytopenia, partly due to the initially higher gemcitabine dose used CONCLUSIONS: Combining HCQ with platinum doublet chemotherapy did not improve PFS or OS outcomes for ES-SCLC, resulting in more patients stopping chemotherapy due to increased adverse events. When considered alongside other randomised studies of HCQ in cancer, the evidence collectively indicates a limited role for HCQ as a therapeutic option.

High Absorption and Elasticity of a Novel Transgenic Silk with Egg Case Silk Protein from Nephila clavata.

Spider silk is part of a special class of natural protein fibers that have high strength and toughness: these materials have excellent comprehensive properties that are not found in other natural fibers (including silk) or most synthetic fibers. Spider egg case filaments have good hardness, can resist water, can protect spider eggs from external threats, have a significantly high initial modulus and high moisture absorption rate, and are expected to be used as a new generation of environmentally friendly natural polymer fibers and biomaterials. However, spiders are predatory and difficult to rear in large numbers, and it is also difficult to obtain spider egg case filaments in large quantities. Silkworms and spiders have a similar spinning system, and the use of transgenic technology in silkworms can obtain stable and high-yield exogenous gene proteins for a long time, representing an ideal bioreactor for the production of spider silk. In this study, the eukaryotic bioreactor and piggyBac transposon system were employed to recombinantly introduce the egg case silk protein of Nephila clavata (Nc-CYSP1) into the silkworm in the silkworm heavy-chain expression system. The results revealed that the silk glands produced a new type of transgenic silk with a significantly high initial modulus and high moisture absorption. In summary, this study provides an experimental reference for future research on the large-scale production and application of spider egg case filamentous protein, with great application prospects in the development of new environmentally friendly materials.

Highly Pathogenic H5N1 Influenza A Virus (IAV) in Blue-Winged Teal in the Mississippi Flyway Is Following the Historic Seasonal Pattern of Low-Pathogenicity IAV in Ducks.

Highly pathogenic H5N1 (HP H5N1) influenza A virus (IAV) has been detected annually in North American ducks since its introduction during 2021, but it is unknown if this virus will follow the same seasonal and geographic patterns that have been observed with low-pathogenicity (LP) IAV in this reservoir. We monitored blue-winged teal in the Mississippi flyway prior to the detection of HP H5N1 and during two post-introduction migration cycles from spring 2022 to spring 2024, testing birds for infection and antibodies to IAV nucleoprotein (NP), hemagglutinin subtype H5, and neuraminidase subtype N1. Antigens representing clade 2.3.4.4b HP H5 and LP North American H5 were used for hemagglutination inhibition (HI) and virus neutralization (VN) tests for H5 antibodies. Virologic results were consistent with historic seasonal and geographic patterns reported for LP IAV with peak infections occurring in pre-migration staging areas in Minnesota during fall 2022. However, the high prevalence of the H5 subtype was exceptional compared to historic prevalence estimates at this same site and for the Mississippi flyway. HP H5N1 was detected on wintering areas in Louisiana and Texas during the fall of that same year and this was followed by an increase in estimated antibody prevalence to NP, H5, and N1 with no HP H5N1 detections during the wintering or spring migration periods of 2022/2023. HP H5N1 was not detected in Minnesota during fall 2023 but was detected from a single bird in Louisiana. However, a similar increase in antibody prevalence was observed during the winter and spring period of 2023 and 2024. Over the two migration cycles, there was a temporal shift in observed prevalence and relative titers against the H5 antigens with a higher proportion of ducks testing positive to the 2.3.4.4b H5 antigen and higher relative titer to that antigen compared to the representative LP North American H5 antigen. The seasonal and geographic patterns observed appear to be driven by population immunity during the migration cycle. Results support an initial high infection rate of HP H5N1 in blue-winged teal in the Mississippi flyway followed by a high prevalence of antibodies to NP, H5, and N1. Although prevalence was much reduced in the second migration cycle following introduction, it is not known if this pattern will persist in the longer term or affect historic patterns of subtype diversity in this reservoir.

A novel mouse model recapitulating the MMR-defective SCLC subtype uncovers an actionable sensitivity to immune checkpoint blockade

PurposeSmall cell lung cancer (SCLC) has an extremely poor prognosis. Despite high initial response rates to chemotherapy and modest survival improvements with the addition of immune checkpoint inhibitors (ICI), almost all patients experience relapse and fatal outcomes. Recent genomic insights uncovered extensive molecular heterogeneity in addition to the almost uniform loss of RB1 and TRP53. Additionally, defective DNA mismatch repair (MMR) has recently been described in some SCLC cases. Here, we generated a novel SCLC mouse model capturing MMR deficiency and assessed immunotherapy responses.MethodsWe developed an MMR-deficient genetically engineered mouse model (GEMM) of SCLC by introducing a conditional Msh2 gene, crucial for maintaining MMR integrity, into the standard Rb1fl/fl;Trp53fl/fl (RP) model. Genomic characteristics and preclinical therapy responses were evaluated by focusing on overall survival and whole exome sequencing (WES) analyses.ResultsMMR-defective SCLC tumors (Rb1fl/fl;Trp53fl/fl;Msh2fl/fl (RPM)) developed later than tumors in MMR-proficient mice. However, the time from tumor manifestation to death of the affected animals was substantially shortened (median survival 55 days in RP vs. 46.5 days in RPM), indicating increased aggressiveness of MMR-defective tumors. RPM tumors exhibited MMR deficiency, high tumor mutational burden (TMB), and an elevated load of candidate neoantigens, compared to RP lesions (p = 0.0106), suggesting increased immunogenicity. Importantly, the overall survival of RPM animals was significantly improved when exposed to ICI.ConclusionWe propose a novel RPM mouse model as a suitable system to mimic MMR-defective SCLC and tumors with high TMB. We provide in vivo evidence that Msh2 deficiency enhances ICI sensitivity. These findings could contribute to stratifying SCLC patients to immunotherapy, thereby improving treatment outcomes.

Predicting the long-term effects of electronic cigarette use on population health: a systematic review of modelling studies

ObjectiveTo systematically review and synthesise the findings of modelling studies on the population impacts of e-cigarette use and to identify potential gaps requiring future investigation.Data source and study selectionFour databases...

ERK signaling promotes resistance to TRK kinase inhibition in NTRK fusion-driven glioma mouse models

Pediatric-type high-grade gliomas frequently harbor gene fusions involving receptor tyrosine kinase genes, including neurotrophic tyrosine kinase receptor (NTRK) fusions. Clinically, these tumors show high initial response rates to tyrosine kinase inhibition but ultimately recur due to the accumulation of additional resistance-conferring mutations. Here, we develop a series of genetically engineered mouse models of treatment-naive and -experienced NTRK1/2/3 fusion-driven gliomas. All tested NTRK fusions are oncogenic invivo. The NTRK variant, N-terminal fusion partners, and resistance-associated point mutations all influence tumor histology and aggressiveness. Additional tumor suppressor losses greatly enhance tumor aggressiveness. Treatment with TRK kinase inhibitors significantly extends the survival of NTRK fusion-driven glioma mice, but fails to fully eradicate tumors, leading to recurrence upon treatment discontinuation. Finally, we show that ERK activation promotes resistance to TRK kinase inhibition and identify MEK inhibition as a potential combination therapy. These models will be invaluable tools to study therapy resistance of NTRK fusion tumors.

PPP3CB overexpression mediates EGFR TKI resistance in lung tumors via calcineurin/MEK/ERK signaling.

Despite initial high response rates to first-line EGFR TKI, all non-small-cell lung cancer (NSCLC) with EGFR-activating mutation will ultimately develop resistance to treatment. Identification of resistance mechanisms is critical to adapt treatment and improve patient outcomes. Here, we show that a PPP3CB transcript that encodes full-length catalytic subunit 2B of calcineurin accumulates in EGFR-mutant NSCLC cells with acquired resistance against different EGFR TKIs and in post-progression biopsies of NSCLC patients treated with EGFR TKIs. Neutralization of PPP3CB by siRNA or inactivation of calcineurin by cyclosporin A induces apoptosis in resistant cells treated with EGFR TKIs. Mechanistically, EGFR TKIs increase the cytosolic level of calcium and trigger activation of a calcineurin/MEK/ERK pathway that prevents apoptosis. Combining EGFR, calcineurin, and MEK inhibitors overcomes resistance to EGFR TKI in both in vitro and in vivo models. Our results identify PPP3CB overexpression as a new mechanism of acquired resistance to EGFR TKIs, and provide a promising therapeutic approach for NSCLC patients that progress under TKI treatment.

Midterm clinical and radiological outcomes of arthrogryposis-associated clubfoot treated with the Ponseti method: a retrospective observational study and comprehensive literature review

BackgroundThe treatment results of the Ponseti method for arthrogrypotic clubfoot have been described in only a few case series. Further evaluations are necessary.MethodsChildren from two German paediatric orthopaedic hospitals with arthrogryposis-associated clubfoot treated with the Ponseti method between 2004 and 2011 and who were at least five years of age at their last follow-up were retrospectively evaluated. The endpoints were the clinical foot position, necessary surgeries during the follow-up period and radiological constellations. A comprehensive literature review was conducted after a systematic literature search.ResultsSeventeen patients (47% with amyoplasia [AP] and 53% with distal arthrogryposis [DA]) met the inclusion criteria. Thirty-one feet were evaluated. The period between the treatment start and the last follow-up examination covered 8.9 ± 2.5 years. After the last cast removal within the initial Ponseti cast series, 74% of the clinical results were good to excellent. However, the clinical outcomes in the patients with AP were significantly worse. Overall, in 23 feet (74%), at least one major surgery at the age of 2.9 ± 2.2 years was necessary during the clinical course. Major surgeries were much more frequent on the feet of the patients with AP than with DA. Lateral X-rays showed normal age-appropriate radiological angles in 4% of the feet, hindfoot equinus in 19%, under-corrected hindfoot in 44%, under-corrected clubfoot in 26% and rocker bottom deformity in 7%. The radiological residual deformities in AP were much more severe than in DA (p = 0.042). Most of the studies reviewed (11 case series, 144 patients) reported high initial clinical correction rates, followed by high recurrence rates and the need for further surgeries.ConclusionAbout a quarter of the arthrogrypotic patients benefited from the Ponseti therapy without further major surgery. However, the clinically observed high initial correction rate after Ponseti therapy of arthrogrypotic clubfoot was not accompanied by a correction of the bony foot position in the X-rays. The feet of the patients with DA had better outcomes than those of the patients with AP. Therefore, in outcome studies, a clear distinction between patients with AP and those with DA is necessary.

High stable PtZnLa/Beta catalyst with low Pt loading for propane dehydrogenation

A high stable and active Pt-Zn-La/Beta catalyst with 0.1 wt% Pt loading was studied for catalyzing propane dehydrogenation (PDH) in this work, which is constructed by anchoring La and Zn species onto silanol nests of Beta zeolite at first and then loading Pt on the resultant material after calcination. It is found that the Beta zeolite with the Si/Al ratio of 9.75 is more appropriate than the one with higher Si/Al ratio to be used as the support after the dealumination. And that anchoring La and Zn species prior to Pt onto the silanol nests are quite important. In Pt0.1Zn0.4La0.4/Beta catalyst, La significantly dispersed and stabilized Pt1Zn1 ensembles on the zeolite surface while Zn isolated the Pt atoms and therefore the catalyst is much active, highly selective and catalytic stable. With this catalytic structure, the catalyst provided a high initial propylene formation rate of 113.8 molC3H6·gPt−1·h−1 with extremely low deactivation constant of 0.0149 h−1 and a high propylene selectivity of 98 % at 600 °C.

Contribution of root and soil properties on soil infiltration capacity of gramineous and leguminous forages during root decomposition

Soil properties are generally altered during root decomposition, which impacts soil water infiltration. Gramineous and leguminous plants present distinct root properties, but it remains unclear whether the root or soil properties are primarily responsible for the soil infiltration capability during root decomposition. To identifythe differences in the contributions of root and soil properties to soil infiltration capability between these two species during root decomposition, a potted plant in situ decomposition experiment was conducted using Bothriochloa. ischaemum (Gramineae) and Lespedeza. davurica (Leguminosae) during three root decomposition times (the 90th, 270th and 450th day). The results revealed that all the root properties (root length, root volume, average root diameter and root biomass) gradually decreased during root decomposition, especially the root length (RL) and root volume (RV) of L. davurica in 0–40 cm soil layer, with reductions of 55.35% and 58.73% at the 450th day compared with the 90th day. The reverse was true for the soil porosity and mean weight diameter of the soil aggregates. Compared to B. ischaemum, L. davurica presented relatively high initial infiltration rate (IIR), steady infiltration rate (SIR), and average infiltration rate (AIR) values at three root decomposition times. A great increase in the soil infiltration rate was observed for both species at the late decomposition stage (450th day), especially for L. davurica, with increases of 38.32%, 267.7%, and 137.1% in IIR, SIR, and AIR. The GLM analysis results revealed that root properties had a greater contribution to the soil infiltration capability. The key factors controlling the soil water infiltration process have been quantified as RL and RV. The present study indicates that leguminous forage presented greater soil infiltration capability during root decomposition. A great decrease in RL and RV within the upper soil layers increased the soil porosity and facilitated the formation of soil aggregates, thereby promoting water flow and ultimately improving the soil infiltration capability.

Zero-Intrarenal Pressure Percutaneous Nephrolithotomy for One-Stage Treatment of Non-Acute Infectious Calculous Pyonephrosis: A Strategy to Avert Sepsis.

Purpose: To evaluate the efficacy and safety of a novel zero-intrarenal pressure (IRP) percutaneous nephrolithotomy (PCNL) technique for one-stage treatment of non-acute infectious calculous pyonephrosis. Patients and Methods: This retrospective study analyzed 12 patients (4 males, 8 females; mean age 56.4 years) who underwent zero-IRP PCNL. The technique utilized a double-sheath vacuum suction system, with the outer sheath allowing for gravity irrigation and the inner sheath facilitating continuous suction. Keeping the height of gravity perfusion at the level of the kidney inherently prevented high IRP and achieved zero-IRP PCNL, even when stone fragments obstructed the suction channel. Results: The procedure demonstrated a high initial stone-free rate of 75%, improving to 91.7% after 1 month. The average operative time was 50.7 minutes. The mean hemoglobin drop was 6.1 g/L, managed without transfusions. Complications were minimal, with low-grade fever in two patients. No significant intraoperative or postoperative complications, such as sepsis, were noted. Conclusions: The zero-IRP PCNL technique, characterized by its double-sheath vacuum suction system and zero-pressure gravity perfusion, shows promise in safely and effectively managing non-acute infectious calculous pyonephrosis. Preliminary results are encouraging, but further research with larger sample sizes is essential for broader clinical validation.

Impact of Hepatitis B Virus Point-of-care DNA Viral Load Testing Compared With Laboratory-based Standard-of-care Approaches on Uptake of HBV Viral Load Testing, Treatment, and Turnaround Times: A Systematic Review and Meta-analysis.

Point-of-care (PoC) hepatitis B virus (HBV) DNA viral load (VL) assays represent an alternative to laboratory-based standard-of-care (SoC) VL assays to accelerate diagnosis and treatment. We evaluated the impact of using PoC versus SoC approaches on the uptake of VL testing, treatment, and turnaround times from testing to treatment across the HBV care cascade. We searched 5 databases, 6 conference websites, and contacted manufacturers for unpublished reports, for articles with or without a comparator (SoC VL testing), and had data on the uptake of VL testing, treatment, or turnaround times between hepatitis B surface antigen (HBsAg) testing, VL testing, and treatment in the cascade. We performed a random-effects meta-analysis on rates of VL testing and treatment initiation. Six studies, composing 9 arms, were included. Three PoC arms reported less than 1 day between screening for HBsAg positivity and VL testing, and the other one (2 arms) reported it between 7 and 11 days. Five arms reported the time to available VL test results (<1 day). Three studies reported 1-8 days between VL testing results and treatment initiation. Two studies reported the turnaround times between a positive HBsAg screening and treatment initiation (the same day and 27 days). Overall, 84.1% of those with HBsAg positivity were tested for DNA VL and 88.3% of eligible people initiated treatment. HBV PoC DNA testing appears to be associated with a turnaround time of <1 day for receipt of VL results and appears associated with high rates of DNA testing and initiation of treatment among those eligible. PROSPERO CRD42023398440.

Entropy enhancement drived high initial Coulombic efficiency and capacity integrated SnS2 nanosheets for lithium-ion batteries

Layer SnS2 has been garnered significant attention for next-generation lithium-ion batteries (LIBs), due to its abundant resources and high theoretical capacity. However, the low initial Coulombic efficiency, large volume expansion and structural degradation have significantly hindered its application in LIBs. Herein, the layer Sn0.7(MoFeCoNiV)0.3S2 nanosheets (HE3-SnS2) grown on the conductive substrate carbon cloth (CC) is synthesized by one-step hydrothermal method. Multiple elements doping strategy not only increases the conformational entropy which will improve the structural stability of during cycling, but also enlarges the interlayer spacing which benefits for lithium-ion transfer. As a result, the additive-free integrated CC@HE3-SnS2 electrode achieves a high reversible specific capacity of 1204.9 mAh g−1 with a high initial Coulombic efficiency of 94.7 % at 1C, and maintains 1011.4 mAh g−1 after 100 cycles. Specifically, the CC@HE3-SnS2 anode exhibits excellent rate capability of 670.8 mAh g−1 at 10C. Moreover, the full cell based on CC@HE3-SnS2 anode and commercial LiCoO2 cathode displays a stable capacity retention of 862.7 mAh g−1 after 100 cycles at 1C. The entropy-stabilized SnS2-based anode with high initial Coulombic efficiency and rate capability has a competitive candidate for LIBs.

Factors influencing pregnancy loss between days 30 and 70 in a single cattle herd: A comprehensive analysis of sire, cow, and other contributing factors

This retrospective study utilized a mixed-effects logistic model analysis to investigate variables associated with the probability of pregnancy loss (PL) between days 30 and 70 in a dataset comprising 9507 pregnancies from a single cattle herd over 10 years. The model incorporated fixed-effect variables including cow breed (Holstein, Crossbred, and Brown Swiss), parity (1st, 2nd, 3rd, and 4th or more), insemination seasons, insemination number (≤3 vs >3), estrus nature (spontaneous vs synchronized), postpartum problems, sire breed (Holstein, Fleckvieh, Brown Swiss, and Montbéliarde), zygote genotypic (pure vs crossbred), days in milk (DIM) at insemination, actual 305-day milk yield, and sire conception rate. Additionally, random effects included sire (n = 129), cow (n = 3463), and production years (n = 10). The results revealed that cows inseminated with Brown Swiss sires or sires with lower initial conception rates had higher PL rates. Biparous cows, cows with lower 305-day milk yield, cows inseminated later in DIM, cows receiving the 4th or subsequent insemination, and cows inseminated during winter or autumn had lower PL rates. The estrus type and zygote genotype did not significantly impact PL. The random effects of cow, sire, and production years were estimated at 0.230, 0.054, and 0.112, respectively. In conclusion, the study findings suggested that improving management practices for high-yielding cows, cows in early lactation stages, and cows exposed to thermal stress conditions, along with utilizing Brown Swiss cows and sires with high initial conception rates per insemination, could potentially decrease overall PL rates on the farm. Nonetheless, the results did not support the use of Crossbred cows, sires from different breeds, or specific sires to mitigate PL rates on the farm.

Prevalence of psychiatric comorbidities and treatment initiation in African American pediatric patients with vitiligo: A retrospective, single-center, case-control study

BackgroundVitiligo may impact psychosocial development, especially among African American pediatric patients, given heightened visibility and increasing rates of anxiety and depression in this subpopulation. ObjectiveEvaluate psychiatric comorbidities and treatment initiation in African American pediatric patients. Methods327 African American pediatric patients with vitiligo were each matched to three patients without vitiligo by age, race, and sex in this case-control study. Prevalence of psychiatric conditions and subsequent initiation of pharmaco- and/or psycho-therapy were analyzed. ResultsCompared to controls, pediatric African American patients with vitiligo were significantly more likely to be diagnosed with depression (p<0.001) disruptive behavior disorders (DBDs) (p<0.001), eating disorders (EDs) (p=0.013), generalized anxiety disorder (GAD) (p<0.001), substance abuse (SA) (p=0.011), and suicidal ideation (SI) (p=0.005). Patients with depression, DBDs, and EDs had higher initiation rates (76.5%, 82.1%, and 100%, respectively) for psychiatric treatment compared to those with GAD and SA (55.3% and 61.5%). Nearly 15% of patients did not initiate treatment for SI. LimitationsThis retrospective study has a limited sample size in a single institution and does not explore psychiatric treatment efficacy. ConclusionsBetter understanding of associated psychological comorbidities and impacts on African American children of vitiligo may improve quality of life and dermatologic outcomes for these individuals.