Suppression Rate Research Articles

Entropies, level-density parameters and fission probabilities along the triaxially- and axially-symmetric fission paths in 296Lv

We investigate the variation of statistical properties of the fissile nucleus, especially entropy, and nuclear level density, along different fission paths. The calculations were focused on comparing axial and triaxial trajectories leading to fission of 296Lv. We observe that change of shell effects and their suppression rates with deformation can substantially influence fission dynamics. Furthermore, the fission process exhibits iso-entropic behavior at high excitation energies, while pronounced entropy variations are observed at lower energies. We derive a deformation-dependent level density parameter that plays a critical role in estimating the survival probability of a superheavy nucleus. The competition between different fission paths was further studied by employing a master equation approach, thereby demonstrating the critical role of entropy and thermodynamic properties in shaping fission dynamics within multidimensional deformation spaces.

Time to viral load suppression and its predictors among people living with HIV on antiretroviral therapy in Gebi Resu zone, Afar Region, Ethiopia, 2023

ObjectiveThis study aimed to estimate the time to viral load suppression and identify its predictors among HIV patients receiving antiretroviral therapy (ART) in the Gebi Resu zone, Afar Region, Ethiopia, 2023.SettingThe study was conducted at public health facilities in the Gebi Resu zone of the Afar region.Study designThis study is a facility-based, retrospective follow-up study.Study participantsThis study included 298 people living with HIV who were receiving ART services at selected health facilities in the Gebi Resu zone. Data were collected by reviewing patient records using a structured checklist. Bivariate and multivariate Cox regression analyses were conducted to assess the relationship between variables and control for confounders.ResultsThe incidence rate of viral load suppression was 9.46 per 100 person-months. The median time to viral load suppression was 7.7 months, with an interquartile range of 3.8 months (IQR = 6.47–10.27). Patients at clinical stages 3 and 4 [AHR = 0.67, 95%CI (0.47, 0.96)], those who received cotrimoxazole prophylaxis therapy [AHR = 1.47, 95%CI (1.12, 1.92)], and patients with poor drug adherence [AHR = 0.40, 95%CI (0.18, 0.90)] were significantly associated with time to viral load suppression among people on antiretroviral therapy.ConclusionThe time to viral load suppression and the median time to viral load suppression among people living with HIV on ART were shorter than those observed in many developing and developed countries. Clinical stage, cotrimoxazole prophylaxis therapy, and drug adherence were significant predictors of viral load suppression.

Mitochondria-Targeted Icaritin Nanoparticles Induce Immunogenic Cell Death in Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is a highly malignant tumor that is resistant to chemotherapy and immunotherapy. Icaritin (ICT), a traditional Chinese medicine, has been reported as an immunoregulatory agent for treating advanced unresectable HCC. ICT induces mitophagy to cause immunogenic cell death (ICD); however, the poor bioavailability of ICT limits its therapeutic efficacy and clinical use. Therefore, this study aimed to assess the effect of using the poly(2-(N-oxide-N,N-diethylamino) ethyl methacrylate)-b-poly(ε-caprolactone) copolymer (OPDEA-PCL) to encapsulate ICT into nanoparticles (ICT NPs). OPDEA-PCL/ICT NPs colocalized with the mitochondria, promoting the ICD induction effect of ICT in mouse HCC H22 cells. In the H22 subcutaneous tumor model, intravenously injected OPDEA-PCL/ICT NPs quickly accumulated in the tumor and efficiently activated systemic anticancer immunogenicity through their effects on mitophagy. The resulting tumor suppression rate was 60%, which was significantly higher than that of free ICT and poly(ethylene glycol) (PEG)-PCL/ICT NPs. Furthermore, mouse survival was also prolonged by nearly 2-fold with OPDEA-PCL/ICT NPs compared with PBS. In summary, this approach provides valuable insights into improving the immunotherapeutic efficacy of ICT for HCC.

Optimising Paediatric HIV Treatment: Recent Developments and Future Directions.

Treatment options for children living with HIV have historically been less effective, less practical and more difficult to implement compared with those for adults, as the research and development of new drugs for children has lagged behind. Significant progress has been achieved in response to the paediatric HIV epidemic over the last decade. Several optimised paediatric antiretroviral formulations are currently available or in development, including fixed-dose combination tablets containing a complete World Health Organization-recommended regimen. Despite these advancements, virological suppression rates in children are generally lower than in adults. Even when oral fixed-dose combinations with the optimal target profiles are developed, for some children virological suppression is not achievable for reasons such as adherence challenges, intolerance, toxicity and genotypic resistance. New safe, effective, well-tolerated antiretroviral agents from existing and novel classes, as well as innovative administration strategies are essential. To achieve the UNAIDS target of virological suppression in 95% of children receiving antiretroviral therapy, concerted efforts are required. This includes identifying priority drugs in line with latest developments, focusing drug development studies on these priorities, ensuring a timely technical knowledge transfer between originator and generic companies, accelerating regulatory approvals and facilitating procurement and implementation in countries. Success in these efforts depends on collaboration among all stakeholders, including communities, researchers, pharmaceutical companies, guideline and policymakers, governments, funders, regulators and healthcare providers. This review outlines which paediatric antiretroviral therapies are currently available, those which are under development and the future directions of paediatric HIV treatment.

Influence of trains meeting on the ventilation performance of equipment compartment with independent air duct in high-speed train: numerical and experimental study

AbstractDuring the train meeting events, train equipment compartments are exposed to the worst pressure changes, potentially affecting the ventilation performance of equipment, particularly for electrical facilities equipped with independent air ducts. In this paper, a two-step method is used for numerical computation: (1) obtaining the temporal and spatial transient node data of the flow field sections during the train-passing simulation and (2) using the data as the input data for the equipment compartment simulation. In addition, this paper also compares the difference in equipment ventilation between the single-train and train-passing scenarios in real vehicle tests. The results indicate that the primary factors influencing ventilation effectiveness are the aerodynamic compression and deceleration of airflow induced by the other train’s nose, as well as the instability of the external flow field in the wake of the other train. During train crossing, the air is forced into the air duct, with a maximum ratio of the airflow in-duct to the airflow out-duct reaching 3.2. The average mass flow falls below the rated mass flow for the converter. Compared to the rated air volume of converter, the maximum suppression rates obtained from testing and simulation are – 24.5% and – 16.8%, respectively. Compared to the single-train operation, the maximum suppression rates obtained from testing and simulation are – 15% and – 18%, respectively. These findings provide valuable insights into the design and operation of high-speed trains.

Precise Preparation of Supramolecular Spherical Nucleic Acids for Nucleolin-Targeted Gene Delivery.

Molecular spherical nucleic acids (m-SNAs) are a second generation of spherical nucleic acids (SNAs), which are of significance in potential application of targeted delivery of nucleic acids or gene regulation due to their defined molecular structures. Nevertheless, m-SNAs typically involve a single DNA sequence which greatly limits its functions as either targeting purpose or gene regulation. In response, we proposed here a third generation, supramolecular spherical nucleic acids (Supra-SNAs) with two different sequences to achieve both above-mentioned functions. Specifically, we constructed a series of supramolecular self-assembly structures by coupling a cell membrane receptor (i.e., nucleolin)-recognizing aptamer (AS1411)-modified adamantine as targeting probe and human epithelial growth factor receptor 2 (HER2) antisense-functionalized β-cyclodextrin to specifically inhibit the overexpression of HER2 proteins for gene regulations. In comparison to the m-SNA precursors, such Supra-SNA structures exhibited enhanced levels of resistance to nuclease degradation, cellular uptake, gene regulation capabilities and tumor retention capacity. We demonstrated that Supra-SNAs exhibited optimal cell suppression rates and cell apoptosis via a phosphatidylinositol 3-kinase/protein kinase B signaling pathway. The well-defined molecular structures provide an attractive platform for investigating interrelationship between structure and property at the molecular level.

Precise Preparation of Supramolecular Spherical Nucleic Acids for Nucleolin‐Targeted Gene Delivery

AbstractMolecular spherical nucleic acids (m‐SNAs) are a second generation of spherical nucleic acids (SNAs), which are of significance in potential application of targeted delivery of nucleic acids or gene regulation due to their defined molecular structures. Nevertheless, m‐SNAs typically involve a single DNA sequence which greatly limits its functions as either targeting purpose or gene regulation. In response, we proposed here a third generation, supramolecular spherical nucleic acids (Supra‐SNAs) with two different sequences to achieve both above‐mentioned functions. Specifically, we constructed a series of supramolecular self‐assembly structures by coupling a cell membrane receptor (i.e., nucleolin)‐recognizing aptamer (AS1411)‐modified adamantine as targeting probe and human epithelial growth factor receptor 2 (HER2) antisense‐functionalized β‐cyclodextrin to specifically inhibit the overexpression of HER2 proteins for gene regulations. In comparison to the m‐SNA precursors, such Supra‐SNA structures exhibited enhanced levels of resistance to nuclease degradation, cellular uptake, gene regulation capabilities and tumor retention capacity. We demonstrated that Supra‐SNAs exhibited optimal cell suppression rates and cell apoptosis via a phosphatidylinositol 3‐kinase/protein kinase B signaling pathway. The well‐defined molecular structures provide an attractive platform for investigating interrelationship between structure and property at the molecular level.

Active phase and amplitude temperature control method for cryostat: A case in the thermodynamic temperature international comparison system

Achieving highly stable temperature control is essential for cryostats. However, the cryocooler used in cryostats, such as the pulse tube cryocooler, produces regular sinusoidal temperature fluctuations due to its inherent working principles. To establish a highly stable temperature environment, an active phase and amplitude control method for suppressing temperature fluctuation is proposed in this paper, by which the optimal phase and amplitude can be predicted in theory. To validate this approach, a thermal response model was developed based on experiments conducted in the thermodynamic temperature international comparison cryostat at approximately 3.7 K. Based on this model, we conducted both single-stage and multi-stage active temperature control experiments. The results demonstrate that the temperature control effect is the best when the active temperature control current is added at the second cold head, the fluctuation of the comparison copper block from 3.3mK to 0.166mK with 94.9 % suppression rate. The multi-stage joint temperature control reduced the temperature fluctuation with an attenuation rate of 95.4 %. These findings offer significant potential for improving temperature stability in future thermodynamic temperature comparison experiments.

A cascade of care for diabetes in people living with HIV in a tertiary care center in Mexico City

Background Diabetes affects 4.5% of people living with HIV in Mexico. This study aims to describe the diabetes cascade of care (DMC) in people with HIV in a tertiary center in Mexico City. Methods We conducted a single-center review of people with HIV aged over 18, using medical records of active people enrolled at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) HIV Clinic (HIVC). Our analysis focused on their last visit to describe the DMC, aiming to identify gaps in control goals. We included people who had a consultation within the 12 months preceding May 2020. Results Out of the 2072 active people, medical records were available for 2050 (98.9%). Among these, 326 people (15.9%) had fasting glucose (FG) abnormalities, of which 133 (40.7%) had diabetes. The prevalence of diabetes among people with HIV was of 6.4% (133/2050). Regarding the DMC, the following proportions of people achieved control goals: 133/133 (100%) received medical care in the last 12 months, 123/123 (100%) had blood pressure (BP) <140/90 mmHg, 73/132 (55.3%) had LDL cholesterol (c-LDL) <100 mg/dl, 63/132 (47.7%) had FG <130 mg/dl, 50/116 (43.1%) had glycosylated hemoglobin (HbA1c) <7%. ABC goals (HbA1c <7%, c-LDL <100 mg/dl, BP <140/90 mmHg) were met in 28/109 (25.6%) people. 126/133 (94%) people with HIV achieved HIV-viral load <50 copies/mL. Conclusions Despite the high rate of viral suppression among people with HIV and diabetes, significant challenges remain in achieving comprehensive diabetes control. These findings highlight the need for targeted interventions to improve metabolic outcomes and the overall management of diabetes in people with HIV.

Effects of Paecilomyces lilacinus and Bacillus pumilus on stem nematode and rhizosphere bacterial communities of sweet potato

Stem nematode (Ditylenchus destructor Thorne) is considered one of the most economically devastating species affecting sweet potato production. Biocontrol offers a sustainable strategy for nematode control. This study conducted a pot experiment to evaluate the biocontrol efficacy of Paecilomyces lilacinus CS-Z and Bacillus pumilus Y-26 against the stem nematode, as well as to examine their influence on the bacterial communities in the sweet potato rhizosphere. The findings indicated that B.pumilus Y-26 and P.lilacinus CS-Z exhibited respective suppression rates of 82.9% and 85.1% against the stem nematode, while also stimulating sweet potato plant growth. Both high-throughput sequencing and Biolog analysis revealed distinct impacts of the treatments on the bacterial communities. At the phylum level, B.pumilus Y-26 enhanced the abundance of Actinobacteria but reduced the abundance of Cyanobacteria, with P.lilacinus CS-Z exhibiting similar effects. Additionally, the treatment with B.pumilus Y-26 resulted in increased abundances of Crossiella, Gaiella, Bacillus, and Streptomyces at the genus level, while the treatment with P.lilacinus CS-Z showed increased abundances of Crossiella and Streptomyces. In contrast, the abundance of Pseudarthrobacter was reduced in the treatment with B.pumilus Y-26. Conversely, the application of the nematicide fosthiazate exhibited minor influence on the bacterial community. The findings indicated that the application of P.lilacinus CS-Z and B.pumilus Y-26 led to an increase in the relative abundances of beneficial microorganisms, including Gaiella, Bacillus, and Streptomyces, in the rhizosphere soil. In conclusion, P.lilacinus CS-Z and B.pumilus Y-26 demonstrated their potential as environmentally friendly biocontrol agents for managing stem nematode disease of sweet potato.

Trojan-Horse Strategy Targeting the Gut-Liver Axis Modulates Gut Microbiome and Reshapes Microenvironment for Orthotopic Hepatocellular Carcinoma Therapy.

Reversing the hepatic inflammatory and immunosuppressive microenvironment caused by gut microbiota-derived lipopolysaccharides (LPS), accumulating to the liver through the gut-liver axis, is crucial for suppressing hepatocellular carcinoma (HCC) and metastasis. However, synergistically manipulating LPS-induced inflammation and gut microbiota remains a daunting task. Herein, a Trojan-horse strategy is proposed using an oral dextran-carbenoxolone (DEX-CBX) conjugate, which combines prebiotic and glycyrrhetinic acid (GA) homologs, to targeted delivery GA to HCC through the gut-liver axis for simultaneous modulation of hepatic inflammation and gut microbiota. In the orthotopic HCC model, a 95-45% reduction in the relative abundances of LPS-associated microbiota is observed, especially Helicobacter, caused by DEX-CBX treatment over phosphate-buffered saline (PBS) treatment. Notably, a dramatic increase (37-fold over PBS) in the abundance of Akkermansia, which is known to strengthen systemic immune response, is detected. Furthermore, DEX-CBX significantly increased natural killer T cells (5.7-fold) and CD8+ T cells (3.9-fold) as well as decreased M2 macrophages (59% reduction) over PBS treatment, resulting in a tumor suppression rate of 85.4%. DEX-CBX is anticipated to offer a novel strategy to precisely modulate hepatic inflammation and the gut microbiota to address both the symptoms and root causes of LPS-induced immunosuppression in HCC.

Backward motion suppression in space-constrained piezoelectric pipeline robots

In response to the current challenges of detecting micro pipelines, a micro pipeline robot based on the principle of piezoelectric inertia stick-slip drive was proposed in this paper, which can be effectively applied to the detection and maintenance of micro pipelines. However, during the analysis of the robot's displacement trajectory, it was observed that using inertial drive could cause the backward motion of the robot. This may adversely affect the accuracy and stability of the robot's operation within the micro pipelines. Therefore, a novel control method is derived from the original pipeline robot structure. By affixing piezoelectric sheets to the driving feet of the robot to adjust their deformation and subsequently employing collaborative control of piezoelectric sheets and piezoelectric stacks to regulate friction between the driving feet and the pipe wall, the backward motion of the robot was effectively mitigated. Compared to existing backward motion suppression methods, the approach proposed in this paper has a minimal impact on the actuator's size, allowing for flexible adaptation to various space-constrained applications, while also offering the advantage of a simple control strategy. After determining the structure and working principle, deformation analysis of the driving foot and dynamic simulation analysis of the driving system were conducted. These analyses provide insights into the relationship between mechanical and electrical parameters and output performance within the driving system, thereby validating the feasibility of the control method. Subsequently, a prototype was fabricated, and its output performance was tested. Results demonstrate that this control method can effectively suppress inertial backward motion, achieving a suppression rate close to 100 %. This research presents a novel idea and methodology for mitigating the backward motion of piezoelectric inertial stick-slip actuators with driving foot structures.

48-week viral suppression rates in people with HIV starting long-acting CAB/RPV with initial viremia.

We previously demonstrated at the Ward 86 HIV clinic in San Francisco that long-acting cabotegravir/rilpivirine (LA-CAB/RPV) can rapidly lead to viral suppression (VS) in people with HIV (PWH) with viremia due to adherence challenges. We now evaluate VS durability in this population. We conducted a retrospective cohort study of PWH who started LA-CAB/RPV with viremia (HIV RNA viral load [VL]≥50 copies/mL) before December 2022. Our primary outcome was VS (VL<50 copies/mL) with LA-CAB/RPV persistence (not discontinued or late by >14 days) at 48 weeks, using the closest VL to 48+/-8 weeks. We also describe viral failure (VF), defined as <2-log VL decline at 4 weeks or VL≥200 copies/mL after initial VS with emergent CAB- or RPV-associated resistance mutations; and overall 48-week VS including those switched to alternative ART. Fifty nine PWH initiated LA-CAB/RPV with viremia and were included in analysis; 49% had CD4<200 cells/µL and median baseline VL was 42,900 copies/mL (Q1-Q3 5,272-139,038). At 48 weeks, 47 met the primary outcome of VS with LA-CAB/RPV persistence (80%; 95%CI 67-89%). Five had VF with resistance (three with RPV-associated mutations, two with CAB and RPV-associated mutations) and one was lost-to-follow-up. At week 48, two of those with VF were suppressed on alternative regimens (lenacapavir+BIC/TAF/FTC and CAB+lenacapavir). Overall week 48 VS on either LA-CAB/RPV or alternative ART was 92% (54/59). In PWH initiating LA-CAB/RPV with initial viremia, 48-week VS (<50 copies/mL) was 92%. Long-acting ART can be an important tool for improving VS among patients who face adherence challenges to oral ART.

A Qualitative Study of Transportation-Related Barriers to HIV Care in South Carolina.

Addressing structural barriers to care for people living with human immunodeficiency virus (HIV) in the southern United States is critical to increase rates of viral suppression and to reduce existing HIV disparities. This qualitative study aimed to describe transportation-related barriers experienced by people living with HIV in South Carolina, understand perceived effects of transportation vulnerability on HIV care, and explore strategies used by individuals to overcome transportation-related challenges. We conducted semistructured interviews with 20 people living with HIV from South Carolina who were either reengaging in HIV care after a prolonged absence (>9 months) or in care but with a detectable viral load (ie, >200 copies/mL). All people living with HIV reported transportation vulnerability. A deductive/inductive approach was used to identify transportation-related barriers perceived to negatively affect HIV care. We also identified strategies and resources described by people living with HIV as helpful in addressing transportation challenges. Participants described a range of transportation-related barriers to HIV care, including lack of access to reliable, safe, and affordable transportation, as well as stigma due to HIV and socioeconomic statuses. These barriers were reported to negatively affect engagement in care and worsen both physical and mental health. Participants indicated flexible clinic policies and instrumental support from family and friends were useful in overcoming barriers. This study offers insight for the development of transportation interventions to improve equitable access to HIV care for people living with HIV in South Carolina. It also calls attention to the ways in which transportation vulnerability, HIV-related stigma, and disability status intersect to create unique challenges for some people living with HIV.

Clinical efficacy and safety of new compound single tablet antiviral drugs in the treatment of HIV/AIDS

AimsGenvoya, Biktarvy and Dovato are novel single-tablet antiretroviral therapy(ART). The aim of this study is to explore the therapeutic effects of these novel drugs on HIV/AIDS. Main methodsThis retrospective cohort study, conducted at a single center, included a total of 200 HIV-treated patients who transitioned to these new antiretroviral drugs from July 2021 to August 2023. Data were extracted from electronic medical records at Ditan Hospital. The Genvoya group comprised 22 patients, and all subsequent switches in this group were to Biktarvy. The primary HAART group consisted of 178 patients initially treated with a first-line triple Highly Active Antiretroviral Therapy (HAART) regimen during the same period. This group was further subdivided into HAART+Dovato, HAART+Biktarvy, and HAART+Genvoya groups based on the switching regimen. The primary outcomes focused on changes in viral load and immune efficacy, while secondary safety indicators included blood/liver function, lipid parameters, renal function, blood glucose, blood uric acid, etc. Key findingsThe viral suppression rate was 100 % after the drug change treatment, and CD4+ T cell counts increased significantly across all four groups. Over the 6-month treatment period, there were increases in creatinine (Cr), low-density lipoprotein (LDL), high-density lipoprotein (HDL), erythrocyte count, and glomerular filtration rate (eGFR). Conversely, Alanine transaminase (ALT), Aspartate aminotransferase (AST), C-reactive protein (CRP), albumin (ALB), and blood glucose (Glu) levels decreased. SignificanceGenvoya, Biktarvy and Dovato are recommended for the treatment of HIV/AIDS and have a good safety profile.

Eight-year efficacy and safety of tenofovir alafenamide for treatment of chronic hepatitis B virus infection: Final results from two randomised phase 3 trials.

In two phase 3 studies, tenofovir alafenamide (TAF) showed non-inferior efficacy versus tenofovir disoproxil fumarate (TDF), with more favourable renal and bone safety in patients with chronic hepatitis B (CHB). Here, we report the studies' final 8-year results. CHB patients (hepatitis B e antigen [HBeAg]-negative and HBeAg-positive) were randomised (2:1) to double-blind TAF 25 mg/day or TDF 300 mg/day for up to 3 years, followed by open-label (OL) TAF through year 8. Virological, biochemical, serological and fibrosis responses, and safety, including bone and renal parameters, were evaluated. Resistance to TAF was assessed annually by deep sequencing of polymerase/reverse transcriptase and by phenotyping. Among 1298 patients randomised to double-blind TAF (n = 866) or double-blind TDF (n = 432), 775 in the TAF group and 382 in the TDF group received OL TAF, including 180 and 202 who switched from TDF to TAF at year 2 (TDF2y → TAF6y) or year 3 (TDF3y → TAF5y), respectively. At year 8, among patients in the TAF8y, TDF2y → TAF6y and TDF3y → TAF5y groups, 69%, 66% and 73% (missing-equals-failure analysis) and 95%, 94% and 97% (missing-equals-excluded) of patients, respectively, achieved HBV DNA <29 IU/mL. Estimated glomerular filtration rate (Cockcroft-Gault method; eGFRCG) and hip/spine bone mineral density (BMD) remained stable in patients receiving double-blind/OL TAF, with only small declines at year 8. Decreases in eGFRCG and hip/spine BMD observed during double-blind TDF improved after switching to OL TAF. No patients developed resistance to TAF. Long-term TAF treatment exhibited favourable safety and tolerability with high rates of viral suppression and no development of resistance. gov numbers NCT01940341 and NCT01940471.

Globular Antifreeze Protein-Inspired Nanoparticle-Based Large-Scale T-Cell Cryoprotection System for Lymphoma Immunotherapy.

Large-scale biosafe T-cell cryopreservation is required to bring T-cell therapies to the market, but it remains challenging due to the cytotoxicity of common cryoprotectants [e.g., dimethyl sulfoxide (DMSO)] and unavoidable ice injuries to cells. Herein, inspired by natural globular antifreeze proteins, we establish a biocompatible zwitterionic magnetic nanoparticle (ZMNP)-based cryoprotection system, achieving large-scale cryopreservation of T cells for lymphoma immunotherapy. ZMNPs could form a globular hydration shell to inhibit water molecule aggregation as well as ice growth, and the surficial hydration strength-antifreeze performance relationship of ZMNPs was investigated. During the thawing process, ZMNPs possessed a magnetic field-mediated nanowarming property that enabled rapid heating and also facilitated easy magnetic separation for cell recovery. These combined effects resulted in a high post-thaw viability (>80%) of large-scale T-cell cryopreservation (20 mL). Notably, post-thaw T cells exhibited similar transcript profiles to fresh cells, while up- or downregulation of 1050 genes was found in the DMSO group. In a mouse E.G7-OVA lymphoma model, ZMNP-system-cryopreserved T cells achieved a tumor suppression rate of 77.5%, twice as high as the DMSO group. This work holds great promise for the application of advanced cryopreservation techniques in the development of therapeutic cellular products.

Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study.

Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain. This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education. The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered "No" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019. After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively. These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.

Cost-effectiveness of an interactive voice response system for improving retention in care and adherence to antiretroviral therapy among young adults in Uganda

BackgroundNew interventions aimed at increasing access to and adherence to antiretroviral therapy among young people living with the human immunodeficiency virus (YPLHIV) are needed. This study assessed the cost-effectiveness of the call-for-life interaction voice response tool compared to that of the standard of care (SOC) for promoting treatment adherence and retention in care among YPLHIV in Western Uganda.This cost-effectiveness study used data from a randomized controlled trial and a decision-analytic Markov model to estimate the long-term outcomes and costs of the Call for Life-Interactive Voice Response (CFL-IVR) tool and the usual care from the Ugandan public payer perspective. The model was parameterized using primary data and the literature and adopted a 1-year Markov cycle. The main outcomes were mean annual costs, disability-adjusted life-years (DALYs), and the incremental cost-effectiveness ratio (ICER) in form of cost per DALY averted. The CLF-IVR was deemed cost-effective if the ICER was between 1% and 51% of Uganda’s gross domestic product. We conducted deterministic and probabilistic sensitivity analyses to assess the effect of adjusting parameter values on cost-effectiveness estimates. All costs were reported in 2021 US dollars, and a discount rate of 3% was applied to both costs and outcomes.ResultsThe base case analysis showed that, from the Ugandan public payer perspective, the CLF-IVR led to more mean annual costs ($359 vs. $280) and averted more mean annual DALYs (15.78 vs. 11.09) than the SOC, leading to an ICER of $17 per DALY averted. The base-case results did not change significantly in the deterministic and probabilistic sensitivity analyses. The cost-effectiveness estimates were more responsive to uncertainties surrounding ART duration, viral load suppression rates, and discount rates.ConclusionThe CLF-IVR may be a cost-effective intervention for promoting treatment adherence and retention in care among YPLHIV in Uganda and other low-income settings. Once implemented, similar interventions may lead to greater returns in encouraging adherence to ART and retention in care among YPLHIV and other vulnerable groups, and eventually favorable clinical outcomes.Trial registrationNCT04718974 Registry: clinical Trials.gov https://ichgcp.net/nl/clinical-trials-registry/NCT04718974 (20 Jan 2021).

Experimental and molecular dynamics simulation of the synergistic mechanism of short-chain fluorocarbon surfactant and electrolyte on inhibiting coal dust pollution

This paper investigated the synergistic mechanism of short-chain fluorocarbon surfactant and electrolyte on inhibiting coal dust pollution via the experimental and molecular dynamics simulations Findings illustrated that the synergistic application of short-chain fluorocarbon and electrolyte achieves better dust suppression performance when compares with the individual application of FS-50 and FS-3100, the maximum suppression rates for FS-50 and FS-3100 after the addition of electrolytes are 94.48 % and 93.94 %, respectively. The addition of electrolyte reduces the diffusion coefficient of suppressants, and its effect on FS-3100 is much higher than on FS-50. The maximum particle size achieved by FS-50 reaches 304–344 μm, while only 238–269 μm and 269–306 μm are acquired by FS-3100. The smaller negative potential and the larger difference in EPE indicate that the addition of NaCl promotes the adsorption of H2O molecules by surfactants. Compared to FS-3100, FS-50 has a lower negative potential and a larger EPE difference, suggesting that FS-50 exhibits stronger reactivity and better ability of absorb ion hydrates and H2O molecules, and hence has superior agglomeration effect. The addition of NaCl also promotes the generation of more sodium hydrate ions and hydrated chloride ions, which enhances the ability of FS-3100 to absorb H2O. Compares with FS-50, due to special curved spatial configuration and the synergistic effect with electrolytes, FS-3100 could restrict the desorption of large numbers of H2O molecules more effectively, and therefore exhibiting better wettability.