High Retention Rate Research Articles

Abstract 3251: QTOLIMOD: A specific TLR9 agonist nanomedicine with high anti-solid tumor activity

Abstract Background Toll-like receptor 9 (TLR9) agonists are extensively studied for cancer treatment, but face challenges in delivery, clearance, and side effects. Our study showed that QTOLIMOD, a 26nt CpG-ODN delivered via QTsomeTM lipid nanoparticle, significantly inhibited tumor growth in MC38-bearing mice (TGI%=99.06%, p<0.001). Here, we report QTOLIMOD's potential for complete tumor rejection, prevention of recurrence, and advantages in safety and immune-cell induction. Methods C57BL/6 mice were subcutaneously inoculated with 1 × 106 MC38 cells. To assess drug tissue distribution, Cy5-labeled naked CpG-ODN or QTOLIMOD were intratumorally injected and in vivo imaging was conducted. ELISA was utilized to determine the levels of cytokines in serum and tumor samples. Once the tumor volume reached an average size of 80-100 mm3, mice were grouped and intratumorally injected with saline, vehicle, or QTOLIMOD. Tumor volume was calculated using the formula: length × width2 × 1/2. Results Following intratumoral injection of QTOLIMOD or naked CpG-ODN, free CpG-ODN were significantly reduced within 24 hours, while QTOLIMOD exhibited extended duration of action up to 7 days. Anatomical examination revealed that a dose of 5 mg/kg naked CpG-ODN caused liver and spleen enlargement in mice, whereas QTOLIMOD at the same dose did not cause the adverse events. Immunohistochemical assay indicated a significant increase in the infiltration of macrophages, dendritic cells, and CD8+ T cells at the tumor site after dosing. IL-10, IFN-γ, and IL-12 were significantly upregulated in the tumor samples, but not in the serum. In a dose escalation experiment, tumor suppression were observed with intratumoral injection of 0.5, 1, 1.5, or 2 mg/kg (every 3 days, 5 doses), resulting in tumor growth inhibition rates ranging from 92.5% to 98.8%. In the QTOLIMOD treated groups, complete tumor rejection was achieved in 4 out of 6 animals in the 0.5 mg/kg group and in all animals in the 1-2 mg/kg groups within 56 days. To investigate the effect of QTOLIMOD on tumor recurrence, cured mice were re-inoculated with MC38 tumor cells at a distant site. All cured mice rejected newly inoculated tumors without additional injection, resulting in 100% survival for up to 60 days. In a dosing frequency experiment, mice were administered with QTOLIMOD at 1 mg/kg once every 3, 5, 7, or 14 days for a total of 5 doses. The results suggested that fortnightly dosing of QTOLIMOD is more effective than more frequent dosing. Conclusions QTOLIMOD exhibits a high intratumoral retention rate, resulting in increased safety, while effectively promoting the expansion and infiltration of immune cells associated with tumors. Moreover, QTOLIMOD demonstrates potent efficacy in inhibiting tumor growth, potentially leading to complete eradication. Furthermore, treatment with QTOLIMOD effectively prevents tumor from recurrence, offering promising long-term effect. Citation Format: Fei Su, Jun Bai, Chen Li, Yujing Wu, Jing Li, Xiaobin Zhao, Yongsheng Yang, Robert J. Lee. QTOLIMOD: A specific TLR9 agonist nanomedicine with high anti-solid tumor activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3251.

Preparation and Study of EPDM Composites with High Volume Resistance Retention Rate

LDPE/ EPDM composites were prepared by mechanical blending method. The effects of two compatibilizers MA/Zn and CPE on the vulcanization properties, mechanical properties, aging resistance and electrical properties of the composites were studied. The results showed that the addition of two kinds of compatibility significantly improved the compatibility of LDPE and EPDM. Compared with CPE, the addition of MA/Zn can improve the properties of the composites better. The mechanical and electrical properties of the composite were improved by the addition of MA/Zn compatibilizer. The volume resistivity of sample L3M2 is the highest at room temperature and 125 ℃, which are 19.8×1013Ω·m and 16.8×1012Ω·m, respectively. Compared with L3, the increase was 26.1% and 25.8%, respectively. The tensile strength is 14.1MPa, which is 90.5% higher than L3.

Towards a scalable approach to assess speech organization across the psychosis-spectrum -online assessment in conjunction with automated transcription and extraction of speech measures

Automatically extracted measures of speech constitute a promising marker of psychosis as disorganized speech is associated with psychotic symptoms and predictive of psychosis-onset. The potential of speech markers is, however, hampered by (i) lengthy assessments in laboratory settings and (ii) manual transcriptions. We investigated whether a short, scalable data collection (online) and processing (automated transcription) procedure would provide data of sufficient quality to extract previously validated speech measures. To evaluate the fit of our approach for purpose, we assessed speech in relation to psychotic-like experiences in the general population. Participants completed an 8-minute-long speech task online. Sample 1 included measures of psychometric schizotypy and delusional ideation (N = 446). Sample 2 included a low and high psychometric schizotypy group (N = 144). Recordings were transcribed both automatically and manually, and connectivity, semantic, and syntactic speech measures were extracted for both types of transcripts. 73%/86% participants in sample 1/2 completed the experiment. Nineteen out of 25 speech measures were strongly (r > 0.7) and significantly correlated between automated and manual transcripts in both samples. Amongst the 14 connectivity measures, 11 showed a significant relationship with delusional ideation. For the semantic and syntactic measures, On Topic score and the Frequency of personal pronouns were negatively correlated with both schizotypy and delusional ideation. Combined with demographic information, the speech markers could explain 11–14% of the variation of delusional ideation and schizotypy in Sample 1 and could discriminate between high-low schizotypy with high accuracy (0.72−0.70, AUC = 0.78–0.79) in Sample 2. The moderate to high retention rate, strong correlation of speech measures across manual and automated transcripts and sensitivity to psychotic-like experiences provides initial evidence that online collected speech in combination with automatic transcription is a feasible approach to increase accessibility and scalability of speech-based assessment of psychosis.

Nitrogen-Doped Cellulose-Derived Porous Carbon Fibers for High Mass-Loading Aqueous Supercapacitors.

Biomass-based porous carbon with renewability and flexible structure tunability is a promising electrode material for supercapacitors. However, there is a huge gap between experimental research and practical applications. How to maintain good electrochemical performance of high mass-loading electrodes and suppress the self-discharge of supercapacitors is a key issue that urgently needs to be addressed. The structure regulation of electrode materials such as heteroatom doping is a promising optimization strategy for high mass-loading electrodes. In this work, nitrogen-doped cellulose-derived porous carbon fibers (N-CHPCs) were prepared by a facile bio-template method using cotton cellulose as raw material and urea as dopant. The prepared N-CHPCs have high specific surface area, excellent hierarchical porous structure, partial graphitization properties and suitable heteroatom content. The assembled high mass-loading (12.8 mg cm-2; 245 μm) aqueous supercapacitor has excellent electrochemical performance, i. e., low open-circuit voltage attenuation rate (21.39 mV h-1), high voltage retention rate (78.81 %), high specific capacitance (295.8 F g-1 at 0.1 A g-1), excellent area capacitance (3.79 F cm-2 at 0.1 A g-1), excellent cycling stability (97.28 % over 20,000 cycles at 1.0 A g-1). The excellent performance of high mass-loading N-CHPCs is of great significance for their practical applications in advanced aqueous supercapacitors.

Diagnosis and treatment of primary ileal pouch leaks: a 27-year experience at a referral center

Ileal pouch-anal anastomosis (IPAA) is considered the preferred restorative surgical procedure for patients with ulcerative colitis and familial adenomatous polyposis requiring proctocolectomy. Unfortunately, postoperative leaks remain a complication with potentially significant ramifications. This study aimed to provide a comprehensive description of the evaluation, management, and outcomes of leaks after primary IPAA procedures. Between 1995 and 2022, a total of 4058 primary IPAA procedures were performed at Cleveland Clinic. From a prospectively maintained pouch registry, we retrospectively reviewed the data of 237 patients who presented to the pouch center for management. Of these, 114 (3%) had undergone the index IPAA procedure at our clinic (de novo cases), whereas 123 patients had their index IPAA performed elsewhere. Data were missing for 43 patients, resulting in a final cohort of 194 patients. Our cohort had an average age of 41 years (range, 16-76) at the time of leak diagnosis. Overall, 55.2% were males, average body mass index was 24.4kg/m2, and pain was the most prevalent presenting symptom (61.8%), followed by fever (34%). Leaks were confirmed through diagnostic testing in 141 cases, whereas 27.3% were detected intraoperatively. The most common initial diagnoses were pelvic abscess (47.4%) and enteric fistulas (26.8%), including cutaneous (9.8%), vaginal (7.2%), and bladder fistulas (3.1%). By location, leaks occurred at the tip of the "J" (52.6%), at the pouch-anal anastomotic site (35%), and in the body of the pouch (12.4%). A nonoperative management approach was initially attempted in 49.5% of cases, including antibiotic therapy, drainage, endoclip, and endo-sponge, with a success rate of 18.5%. Surgery was eventually required in 81.4% of patients, including (1) sutured or stapled pouch repair (52.5%), with diversion performed in 87.9% of these cases either before or during the salvage surgery; (2) pouch excision with neo-IPAA (22.7%), including 9 patients from the first group; and (3) pouch disconnection, repair, and reanastomosis (9.3%). Pouch failure occurred in 8.4%, with either pouch excision (11.1%) or permanent diversion (4.5%). Ultimately, 12.4% of patients (24 of 194) required permanent diversion, with all necessitating pouch excision. In the 30-day follow-up after salvage surgery, short-term complications arose in 38.7% of patients. The most common complications observed were ileus, pelvic abscess/sepsis, and fever. Leaks after primary IPAA procedures represent an infrequent, yet challenging, complication. Despite attempts at nonoperative management, the success rate is limited. Salvage surgery is associated with a high pouch retention rate, underscoring its importance in the management of post-IPAA leaks.

Preparation and chemical properties of microencapsulation developed with mulberry anthocyanins and silk fibroin

Anthocyanins, as natural pigments with bright color and non-toxic side effect, are widely used in the agricultural products processing field. In the present research, mulberry anthocyanin microcapsules were prepared with silk fibroin and gum arabic as wall materials for the possible application in cosmetics industry. Anthocyanin microcapsule encapsulation efficiency was up to 95.71% in the condition of silk fibroin: gum arabic at 2:1, wall-core ratio of 7.5:1 and solid content at 15%. Microcapsules improved the thermal stability and pH stability of mulberry anthocyanins with higher retention rates. Besides, scanning electron microscopy (SEM), X-ray diffraction (XRD), differential scanning calorimetry (DSC), and fourier transform infrared (FTIR) were applied to analyze the surface morphology, structure, crystallinity and thermal properties of mulberry anthocyanin microcapsules. The results indicated that anthocyanins were embedded in the capsules with crystalline structures, good encapsulation and enhanced thermal stability.

Health insurance financing and patient retention in care at diabetics and hypertension clinics in Dar es Salaam and Pwani regions, Tanzania. A cohort study.

Hypertension and diabetes are chronic conditions that cause major morbidity and mortality worldwide. Whether health insurance financing is associated with improved retention in chronic care in Tanzania, is unknown. Our study establishes the effect of health insurance on retention and the determinants for retention in care among patients attending diabetes and hypertension clinics. We used a Cohort design to study participants enrolled in a cluster-randomized trial of integrated management of HIV, diabetes, and hypertension compared with standard vertical care in the INTE-AFRICA trial. Fifteen health facilities in Dar es Salam and Pwani regions were enrolled, with 1716 participants. Our sample size had 95% power to detect a 50% to 60% retention difference between the insured and uninsured groups (95% CI). We compared proportions using χ2 tests and obtained prevalence and rate ratios by Generalised Linear Models. We studied 1716 participants for 1612.3 Person-years (PY). At the study's end, 1351 persons were alive and retained in care. Among the insured participants (26.0%), females accounted for 65.9%. Middle-aged adults contributed 58.8% of insured participants. We observed high retention rates (retention incidence rate IR: 83.80/100 PY; 95% CI (79.40-88.40)). There was no difference in retention among insured and uninsured patients (adjusted rate ratio aRR: 1.00; 95% CI, 0.94-1.06). Being middle-aged or senior-aged adults compared to young adults, having diabetes alone or hypertension alone compared to both conditions, having the comorbidity of diabetes or hypertension with HIV compared to a single condition, and attending health centres and hospitals compared to dispensaries were significantly associated with retention in care. This study showed no effect of health insurance on retention in diabetic and hypertension care clinics. However, age, medical diagnosis, morbidity, and type of health facility attended were associated with retention in care.

High-temperature oxidation resistance of SiCf/SiC composites annealed and cladded with LaMgAl11O19/Yb2Si2O7 thermal/environmental barrier coatings

SiCf/SiC composites were annealed at 1300 °C for 5 h in argon and then fully cladded by LaMgAl11O19/Yb2Si2O7 (LMA/YbDS) thermal/environmental barrier coatings (T/EBCs). The annealed and coated system, directly-coated one and non-coated composites were isothermally oxidized at 1350 °C for 300 h. The oxidation resistance was estimated by strength retention rates. Compared to serious strength degradation in the non-coated composites, high strength retention rates were obtained for the coated ones, indicating LMA/YbDS provided effective protection for SiCf/SiC. Additionally, the annealed and coated system had higher strength retention rates than directly-coated one, resulting from weakened interfacial bonding strength between SiC matrix and fibers.

Dual effect of organic/inorganic artificial protective layer to construct high-performance zinc metal anode

Owing to their high specific capacity, low cost, environmental friendliness and safety, aqueous zinc ion batteries (AZIBs) have been one of the most popular battery systems. Nevertheless, dendrite growth, corrosion, hydrogen evolution and passivation on the anode side can seriously affect the lifetime of AZIBs. In view of this, this work constructs a protective layer compounded from inorganic (titanium silicate molecular sieve, TS) and organic (polyacrylonitrile, PAN) materials to realize the high-performance and dendrite-free zinc anode (Zn@PAN-TS). The cyano group in PAN has a coordination effect with zinc ions, which facilitates the transport of zinc ions. The porous TS can regulate the zinc ion flux through ion-confinement effect. Thus, the PAN-TS composite protective layer provides fast and orderly ion transport channels that modulate the uniform deposition of zinc through dual effect. Moreover, the experimental results show that the Zn@PAN-TS 50:1 anode has the best electrochemical performance. The corresponding MnO2 full cell maintained a high discharge capacity of 217.2 mAh·g−1 with a high retention rate of 81.1 % after 500 cycles at 0.3 A·g−1. This strategy offers fresh insight into constructing multifunctional hybrid interface for dendrite-free AZIBs.

Dual-stage polyporate framework with redox mediator for high loading lithium sulfur batteries

Realizing a high sulfur loading cathode is a necessary measure for assembling a high actual energy density lithium sulfur battery, which requires consideration of conductivity, reaction interface, confinement of lithium polysulfide, and redox kinetics. Herein, a pomegranate-inspired dual-stage porous graphene foam with large cavity skeletons and submicron small cavity carriers is obtained by combining the bubble-template and the flash-freezing ice-template. Furthermore, the redox mediator of poly (1-aminoanthraquinone) is electropolymerized onto it to obtain a sulfur host with high specific surface area and strong confinement capability. The nanosized sulfur deposition behavior and the rich electronic relay capability of the sulfur host are analyzed by the independent gradient model combined with in-situ Raman spectroscopy. Besides, a few of electro-depolymerization products of poly (1-aminoanthraquinone) are confirmed to be able to migrate to the anode surface to stabilize lithium deposition. With these merits, the assembled lithium sulfur batteries exhibit a discharge capacity of 1214 mAh g−1 and a high capacity retention rate of 75.1 % after 800 cycles at a sulfur loading of 10.0 mg cm−2, and provide an excellent areal capacity of 17.5 mAh cm−2 (867 mAh g−1) even at an ultra-high sulfur loading of 20.1 mg cm−2.

Bimodal Block Molecule with Ether‐Type and Hydroxyl‐Type Oxygen Stabilizes Zn Anode in Super‐Dilute Electrolyte

AbstractDiluted electrolyte promises a further decrease of the battery cost for intrinsically safe aqueous zinc ion batteries (ZIBs). However, the parasitic side reactions between abundant water molecules and Zn metal induce serious dendrite growth and anode corrosion, leading to the rapid failure of the ZIBs. In this work, a conceptual design of a bimodal block molecule that features double types of oxygen into polyethylene glycol is proposed, which serves as an effective bifunctional mixing agent (MA) in the super‐dilute electrolyte (≈0.23 m). The ether‐type oxygen can effectively modulate the solvation structure of the Zn2+ and break the hydrogen bond network of the electrolyte, thereby inhibiting the H2 production reaction. Furthermore, the terminal hydroxyl‐type oxygen shows preferential adsorption on the Zn metal (101) plane, guiding the oriented growth of Zn (002) facets parallel to the Zn metal surface and inhibiting the dendrite growth. Consequently, the Zn||Zn symmetrical cells show highly stable reversibility (1400 h at 1 mA cm−2), and the Zn||V2O5 full cells show exceptional cycling stability for 1500 cycles at 1 A g−1, with a high capacity retention rate of 82%. This work provides an insightful design of super‐dilute electrolytes for the stable operation of metal electrodes in aqueous batteries.

Constructing flame retardant microspheres for safe and stable poly (ethylene oxide) based All-Solid-State batteries at high voltage

The development of all-solid-state polymer electrolytes (ASSPE) based on poly (ethylene oxide) (PEO) is facing a series of challenges, such as poor ionic conductivity, low Li+ transference number, flammability, and the limited electrochemical windows of 4 V. Herein, we report our recent effort to meet these challenges by introducing flame retardant microspheres (TH) into PEO-based ASSPE to form stable solid cathode electrolyte interface (CEI) films and enhance safety performance. TH is constructed by reacting tetrabromobisphenol A (TBBA) with hexachlorocyclotriphosphazene (HCCP). With the presence of only 5 wt% TH, the LiNi0.8Mn0.1Co0.1O2 (NCM811)//Li cell achieves a high capacity retention rate of 77.61 % after 100 cycles at the cutoff voltage of 4.3 V and 0.5C, and achieves a capacity retention of 75.7 % at the voltage range of 3–4.5 V after 50 cycles at 0.5C. In addition, the PEO-based ASSPE with TH (TH-PEO/PE) shows excellent flame retardancy, which endows the NCM811//Li pouch cell with good resistance to fire and mechanical abuse. This simple process is compatible with the existing production lines in the battery industry, which exhibits enormous promise in manufacturing commercialized all-solid-state lithium metal batteries (ASSLMBs) with high energy density and safety capabilities.

Dose-Related Visual Outcomes in the Treatment of Choroidal Melanoma with Stereotactic Radiotherapy

Introduction: Stereotactic radiotherapy (SRT) in the treatment of choroidal melanoma (CM) may be indicated if the tumour is located close to the optic nerve or is unsuitable for a radiotherapeutic plaque. It is thought that the rate of visual decline and ocular sequelae with SRT is influenced by dose and location of radiation in relation to important visual structures. This study therefore aimed to look at these prognoses with respect to localisation and dose of radiation when treatment of CM with SRT occurs. Methods: A retrospective data analysis was conducted on all patients at Dunedin Hospital (DH) from August 2001 to May 2017 who were followed up for 4 years. SRT consisted of 50 Gy divided into five fractions over 5 days to tumours, with 2-mm treatment margins. The primary outcome measure was retention of functional vision – better than hand movements (HMs) within the treated eye. Secondary outcome measures included time to non-functional vision (HM or less) in relation to location, dose and tumour thickness, the presence of radiation retinopathy, local and metastatic tumour progression, enucleation, and disease-specific mortality. Results: Seventy-five patients were identified in this study. Follow-up was incomplete in 10 patients, and 4 patients became deceased within the 4-year study period. Twenty-nine patients (48%) retained visual acuity (VA) better than HMs in the treated eye at 4 years, and thirty-two (52%) of patients did not. Calculated dose to the optic nerve and macula and proximity of the tumour to the optic nerve and macula were not statistically determinative of vision outcomes, although presenting VA was. Fifty-six per cent of patients developed radiation retinopathy involving the macula. The local progression, metastatic progression and enucleation rates were 4.6%, 6%, and 12.3%, representing 3, 4, and 8 patients, respectively. Conclusion: This study demonstrates that approximately half of patients treated with SRT can expect to maintain functional vision better than HM at 4 years. The rate of visual decline and final vision outcome are independent of location of the tumour in relation to the optic nerve and macula. While it affirms that SRT achieves high rates of local tumour control and eye retention, preservation of functional VA remains an unpredictable endpoint for individual cases and highlights the therapeutic challenge of this treatment modality.

Artificial LiF‐Rich Interface Enabled by In situ Electrochemical Fluorination for Stable Lithium‐Metal Batteries

AbstractLithium (Li)‐metal batteries are promising next‐generation energy storage systems. One drawback of uncontrollable electrolyte degradation is the ability to form a fragile and nonuniform solid electrolyte interface (SEI). In this study, we propose the use of a fluorinated carbon nanotube (CNT) macrofilm (CMF) on Li metal as a hybrid anode, which can regulate the redox state at the anode/electrolyte interface. Due to the favorable reaction energy between the plated Li and fluorinated CNTs, the metal can be fluorinated directly to a LiF‐rich SEI during the charging process, leading to a high Young's modulus (~2.0 GPa) and fast ionic transfer (~2.59×10−7 S cm−1). The obtained SEI can guide the homogeneous plating/stripping of Li during electrochemical processes while suppressing dendrite growth. In particular, the hybrid of endowed full cells with substantially enhanced cyclability allows for high capacity retention (~99.3 %) and remarkable rate capacity. This work can extend fluorination technology into a platform to control artificial SEI formation in Li‐metal batteries, increasing the stability and long‐term performance of the resulting material.

Novel Uses of Methadone Under the "72-Hour Rule" to Facilitate Transitions of Care and Low-Dose Buprenorphine Induction in an Outpatient Bridge Clinic.

Federal regulations restrict methadone for opioid use disorder (OUD) treatment to licensed opioid treatment programs (OTPs). However, providers in other settings can administer methadone for opioid withdrawal under the "72-hour rule" while linking to further care. Prior work has demonstrated that methadone initiation in a low-barrier bridge clinic is associated with high OTP linkage and 1-month retention rates. We describe 2 other novel applications of the 72-hour rule in which methadone withdrawal management facilitated linkage to inpatient hospitalization and outpatient buprenorphine induction. Patient 1 was a 46-year-old woman with OUD complicated by serious injection-related infections. Severe opioid withdrawal limited her ability to tolerate emergency department wait times and receive inpatient care. We administered methadone for opioid withdrawal in an outpatient bridge clinic immediately before emergency department referral; this enabled hospital admission for intravenous antibiotics and anticoagulation. Patient 2 was a 36-year-old man with OUD desiring buprenorphine treatment. He had been unable to complete traditional buprenorphine induction without experiencing precipitated withdrawal. Thus, we recommended a low-dose buprenorphine induction overlapping with a full opioid agonist. Given the patient's preference to stop using fentanyl immediately, he received 72 hours of methadone for withdrawal treatment during the induction phase and successfully transitioned to buprenorphine without significant concomitant fentanyl use. In addition to facilitating OTP linkage, on-demand 72-hour methadone administration for opioid withdrawal can reduce barriers to acute medical care and buprenorphine treatment.

A feasibility (pilot) mixed methods study of an innovative non-pharmacological breath-based yoga and social-emotional intervention program in an at-risk youth sample in London, Canada

BackgroundVarious service provision models for youth at risk of homelessness have been researched and implemented, including access to housing and physical and mental health resources. However, even with these interventions, we remain unaware of how best to manage symptoms of depression and anxiety and the rate of drug use in these populations primarily because of a lack of feasibility data.MethodsThis paper presents the results of a mixed-methods study in London, Canada, that examined the feasibility of implementing a biopsychosocial intervention, SKY Schools, in at-risk youth aged between 16 and 25 (n = 49). The study also recorded qualitative responses about the program’s usefulness from the perspective of the service users. The SKY Schools intervention consisted of social-emotional learning combined with Sudarshan Kriya Yoga, a standardized yoga-based breathing exercise routine. The intervention program was divided into two phases: an active learning phase and a reinforcement phase. The following feasibility outcome measures were collected: (1) the number of potential participants approached per month, (2) number (proportion) who were successfully screened, (3) the proportion of screened participants who enrolled, (4) the rate of retention in the study, (5) rate of adherence to study protocol, (6) proportion of planned ratings that were completed, (7) intervention cost per case, (8) completeness of final data for analysis, (9) length of time to collect all data, (10) quality of all collected data, (11) determining if partnering community organizations were willing to conduct the study as per study protocol, (12) determining if there were any capacity issues with partners providing intervention and investigators being able to perform the tasks that they were committed to doing, (13) determining if there were any problems of entering the data into a computer, (14) preliminary data about the safety of the intervention, and (15) preliminary estimate of treatment effects.ResultsAll feasibility outcome measures were collectible. In the city of London, Canada it was feasible to conduct a pilot study in this population of youth at risk of homelessness. Foremost among the findings was a high retention rate (61.2%) and overall positive qualitative feedback with a number of potential suggestions to improve the delivery and quality of the intervention. However, we had a significantly low recruitment rate (0.27 participants per week) suggesting that multiple sites will be needed to achieve an adequate sample size for a subsequent definitive trial.ConclusionsFuture researchers may consider the findings of this feasibility study when designing a randomized control trial to further assess the efficacy and tolerability of SKY Schools.Trial registrationTrial registration: Clinicaltrials.gov, identifier NCT02749240. Registered April 22, 2016, https://clinicaltrials.gov/ct2/show/NCT02749240.

Providing Prenatal Care in a Student Run Free Clinic

Background: Prenatal care is a cornerstone of maternal and child health. This paper describes the creation of a free prenatal clinic for uninsured families following recognition of a significant disparity in birth outcomes in Alachua County, Florida including: the development of essential community re- source collaborations, clinical operations in a dual aim patient care-medical education site, preliminary outcomes after one year of clinical operation, identified challenges, and next steps for our growing program.
 Methods: A retrospective chart review of all sixteen patients enrolled with the student run free prenatal clinic in its first year of clinical operation. Analysis included assessment of the prenatal care course using descriptive statistics. Specific dimensions assessed include timing of transition of care to a traditional obstetrics clinic, clinical findings and diagnoses identified at the prenatal clinic, and birth out- comes during the study period and report findings as descriptive statistics.
 Results: The clinic has demonstrated the ability to identify and treat numerous pathologies which may impact maternal-fetal morbidity and mortality. The clinic has seen very high rates of patient retention and has demonstrated successful transition of patients to higher levels of care when indicated. Finally, the clinical model provides an uncommon opportunity for medical and physician assistant students to care for patients throughout the first 32 weeks of pregnancy and receive additional training in point-of-care ultrasound, diagnostics, and medical decision making.
 Conclusion: While the small sample size limits the ability to assess the effectiveness of the prenatal clinic intervention, there are numerous promising features based on preliminary results.

Norwegian population-based study of effectiveness of vagus nerve stimulation in patients with developmental and epileptic encephalopathies.

Evaluate the long-term efficacy of vagus nerve stimulation (VNS) in patients with developmental and epileptic encephalopathies (DEE) compared with epilepsy patients without intellectual disability (ID). Long-term outcomes from a Norwegian VNS quality registry are reported in 105 patients with DEEs (Lennox-Gastaut syndrome [LGS] n = 62; Dravet n = 16; Rett n = 9; other syndromes n = 18) were compared with 212 epilepsy patients without ID, with median follow-up of 88 and 72 months, respectively. Total seizure reduction was evaluated at 6, 12, 24, 36, and 60 months. Effect on different seizure types was evaluated at baseline and last observation carried forward (LOCF). Median monthly seizure frequency at LOCF was reduced by 42.2% (p < 0.001) in patients with DEE and by 55.8% (p < 0.001) in patients without ID. In DEE patients, ≥50% seizure reduction at 6 and 24 months were 17.1% and 37.1%, respectively, and 33.5% and 48.6% for patients without ID. Seizure reduction ≥75% at 60 months occurred in 14.3% of DEE patients and 23.1% of patients without ID. Highest median reduction was for atonic seizures, most notably 64.6% for LGS patients. A better effect was seen at 2 years among DEE patients with unchanged medication compared with those with changed medication (54.5% vs. 35.6% responders, p = 0.078). More DEE patients were reported to have greater improvement in ictal or postictal severity (43.8% vs. 28.3%, p = 0.006) and alertness (62.9% vs. 31.6%, p < 0.001) than patients without ID. For both groups, use of the magnet reduced seizure severity. Hoarseness was the most common adverse effect in both groups. In addition, DEE patients were frequently reported to have sleep disturbance, general discomfort, or abdominal problems. Our data indicate that VNS is very effective for atonic seizures. Patients without ID had best overall seizure reduction, however, patients with DEE had higher retention rates probably due to other positive effects. DEE refers to a group of patients with severe epilepsy and intellectual disability. Many of these patients have restricted lifestyles with frequent seizures. VNS is a treatment option for patients who do not respond well to medicines, either because of insufficient effect or serious adverse effects. Our study shows that VNS is well tolerated in this patient group and leads to a reduction in all seizure types, most notably for seizures leading to fall. Many patients experience other positive effects like shorter and milder seizures, as well as improvement in alertness.

Lithiophilic and Eco-Friendly Nano-Se Seeds Unlock Dendrite-Free and Anode-Free Li-Metal Batteries.

A 3D host design for lithium (Li)-metal anodes can effectively accommodate volume changes and suppress Li dendrite growth; nonetheless, its practical applicability in energy-dense Li-metal batteries (LMBs) is plagued by excessive Li loading. Herein, we introduced eco- and human-friendly Se seeds into 3D carbon cloth (CC) to create a robust host for efficient Li deposition/stripping. The highly lithiophilic nano-Se endowed the Se-decorated CC (Se@CC) with perfect Li wettability for instantaneous Li infusion. At an optimal Li loading of 17 mg, the electrode delivered an unprecedentedly long life span of 5400 h with low overpotentials <36 mV at 1 mA cm-2/1 mAh cm-2 and 1500 h at 5 mA cm-2/5 mAh cm-2. Furthermore, the uniform Se distribution and strong Li-Se binding allowed for further reduction in Li loading to 2 mg via direct Li electrodeposition. The corresponding LiNi0.8Co0.1Mn0.1O2 (NCM811)-based full cell afforded a high capacity retention rate of 74.67% over 300 cycles at a low N/P ratio of 8.64. Finally, the initial anode-free LMB using a NCM811 cathode and a Se@CC anode current collector demonstrated a high electrode-level specific energy of 531 Wh kg-1 and consistently high CEs >99.7% over 200 cycles. This work highlights a high-performance host design with excellent tunability for practical high-energy-density LMBs.

Long-term efficacy, safety, and cumulative retention rate of antitumor necrosis factor-alpha treatment for patients with Behcet's uveitis: A systematic review and meta-analysis.

This study aims to evaluate the long-term efficacy, safety, and cumulative retention rate of antitumor necrosis factor-alpha (anti-TNF-α) therapy for patients with Behcet's uveitis (BU) using meta-analysis. We searched the Web of Science and PubMed databases for eligible studies up to December 1, 2022. The quality of each identified study was assessed using the Joanna Briggs Institute's case series literature quality assessment tool. Statistical analysis was conducted using Stata 16.0 software with a random-effects model. Twelve studies comprising 1156 patients with BU were included in our analysis. We found that 85.0% of patients achieved ocular inflammation remission after receiving anti-TNF-α treatment, with a 95% confidence interval (CI) ranging from 78.7% to 90.5%. Additionally, 77.4% (95% CI: 57.5%-92.5%) experienced an improvement in visual acuity (VA). Moreover, the pooled dose reduction of glucocorticoids (GCs) was 11.08 mg (95% CI: -13.34 mg to -8.83 mg). Throughout the follow-up period, the cumulative retention rate of the medication was 67.3% (95% CI: 53.7%-79.6%). Serious adverse events occurred in 5.8% (95% CI: 3.1%-8.9%) of cases, with the three most common types being severe infusion or injection reactions (2.7%; 95% CI: 0.8%-5.4%), tuberculosis (1.3%; 95% CI: 0.0%-3.9%), and bacterial pneumonia (1.3%; 95% CI: 0.1%-3.4%). Subgroup analysis revealed that ocular inflammation remission rates were 89.3% (95% CI: 81.2%-95.5%) for adalimumab treatment and 83.7% (95% CI: 75.3%-90.8%) for infliximab treatment. The drug retention rate after adalimumab therapy was 70.3% (95% CI: 62.0%-78.0%) compared to 66.4% (95% CI: 48.6%-82.2%) for infliximab treatment. Furthermore, the incidence of severe infusion or injection reactions was 2.2% (95% CI: 0.1%-5.8%) following adalimumab treatment and 3.5% (95% CI: 0.7%-7.7%) following infliximab treatment. Anti-TNF-α therapy represents an effective treatment for BU patients with favorable safety profile and high drug retention rate and a potential advantage of adalimumab over infliximab in terms of ocular inflammation remission, drug retention, and the incidence of severe infusion or injection reactions.