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Objectives To reduce the number of new HIV infections and improve HIV health care outcomes, the social conditions in which people live and work should be assessed. The objective of this study was to describe linkage to HIV medical care by selected demographic characteristics and social determinants of health (SDH) among US adults with HIV at the county level. Methods We used National HIV Surveillance System data from 42 US jurisdictions and data from the American Community Survey to describe differences in linkage to HIV medical care among adults aged ≥18 with HIV infection diagnosed in 2017. We categorized SDH variables into higher or lower levels of poverty (where Results Of 33 204 adults with HIV infection diagnosed in 2017, 78.4% were linked to HIV medical care ≤1 month after diagnosis. Overall, rates of linkage to care were significantly lower among men and women living in counties with higher versus lower poverty (PR = 0.96; 95% CI, 0.94-0.97), with lower versus higher health insurance coverage (PR = 0.93; 95% CI, 0.92-0.94), and with lower versus higher education levels (PR = 0.97; 95% CI, 0.96-0.98). Conclusions Increasing health insurance coverage and addressing economic and educational disparities would likely lead to better HIV care outcomes in these areas.

Microfluidic devices have become a powerful tool for chemical and biologic applications. To control different functional parts on the microchip, valve plays a key role in the device. In conventional methods, physio-mechanical valves are usually used on microfluidic chip. Herein, we reported a chemo-mechanical switchable valve on microfluidic chip by using a thermally responsive block copolymer. The wettability changes of capillary with copolymer modification on inner surface were investigated to verify the function as a valve. Capillaries with modification of poly-(N-isopropylacrylamide-co-hexafluoroisopropyl acrylate) (P(NIPAAm-co-HFIPA)) with a 20% HFIPA was demonstrated capable of control aqueous solution stop or go through. Then short capillaries with copolymer modification were integrated in microchannels as valves. With the temperature changing around lower critical solution temperature (LCST), the integrated chemo-mechanical switchable valve exhibited excellent “OPEN–CLOSE’’ behavior for microflow control. After optimization of the block copolymer sequences and molar ratio, a switching time as low as 20 s was achieved. The developed micro valve was demonstrated effective for flow control on microchip.

BACKGROUND: With significant improvements in the diagnosis and treatment of HIV, the number of people with HIV in the United States steadily increases. Monitoring trends in HIV-related care outcomes is needed to inform programs aimed at reducing new HIV infections in the United States. SETTING: The setting is 33 United States jurisdictions that had mandatory and complete reporting of all levels of CD4 and viral load test results for each year during 2014–2018. METHODS: Estimated annual percentage change and 95% confidence intervals were calculated to assess trends in stage of disease at time of diagnosis, linkage to HIV medical care within 1 month of HIV diagnosis, and viral suppression within 6 months after HIV diagnosis. Differences in percentages were analyzed by sex, age, race/ethnicity, and transmission category for persons with HIV diagnosed from 2014 to 2018. RESULTS: Among 133,477 persons with HIV diagnosed during 2014–2018, the percentage of persons who received a diagnosis classified as stage 0 increased 13.7%, stages 1–2 (early infections) increased 2.9%, stage 3 (AIDS) declined 1.5%, linkage to HIV medical care within 1 month of HIV diagnosis increased 2.3%, and viral suppression within 6 months after HIV diagnosis increased 6.5% per year, on average. Subpopulations and areas that showed the least progress were persons aged 45–54 years, American Indian/Alaska Native persons, Asian persons, Native Hawaiian/other Pacific Islander persons, and rural areas with substantial HIV prevalence, respectively. CONCLUSIONS: New infections will continue to occur unless improvements are made in implementing the Ending the HIV Epidemic: A Plan for America strategies of diagnosing, treating, and preventing HIV infection.

BACKGROUND Among children with HIV infection, opportunistic illness (OI) rates decreased after introduction of highly active antiretroviral therapy (ART) in 1997. We evaluated whether such decreases have continued. METHODS Data from the Centers for Disease Control and Prevention's National HIV Surveillance System for children with HIV living in the US during 1997-2016 was used to enumerate infants experiencing the first OI by birth year and OIs among all children

Objectives To investigate whether hUC-MSCs attenuated severe burn-induced ALI and the effects were based on TSG-6 secreted from hUC-MSCs.Method Rat model was established and evaluated as follows：Anires2005 animal pulmonary function tester for pulmonary function; micro-CT scanner for lung imaging manifestations; Cytokine expression was measured by ELISA assay, both inflammatory cells infiltration and lung injury were assessed by immunohistochemistry assay.Results In vitro, TSG-6 levels in serum from burn group were significantly increased than that of the sham group. In vivo, TSG-6 levels of lung tissues and serum in burn+ hUC-MSCs group were significantly increased than that of in the burn group. Higher parameters of the airway resistance（Ri, Re, etc）were markedly decreased and the disordered lung texture and funicular density shadows were significantly improved after hUC-MSCs administration. Both in lung tissues and serum, increased levels of pro-inflammatory cytokines（TNF-α, IL-1β, IL-6）were remarkably decreased but anti-inflammatory cytokine IL-10 increased after hUC-MSCs administrations (pConclusions Intra-tracheal implantation of hUC-MSCs had been an effective treatment for severe burn-induced ALI via promoting TSG-6 secretion and inhibiting inflammatory reaction in lung tissue.

Background Annual human immunodeficiency virus (HIV) diagnoses in the United States (US) have plateaued since 2013. We assessed whether there is an association between uptake of pre-exposure prophylaxis (PrEP) and decreases in HIV diagnoses. Methods We used 2012–2016 data from the US National HIV Surveillance System to estimate viral suppression (VS) and annual percentage change in diagnosis rate (EAPC) in 33 jurisdictions, and data from a national pharmacy database to estimate PrEP uptake. We used Poisson regression with random effects for state and year to estimate the association between PrEP coverage and EAPC: within jurisdictional quintiles grouped by changes in PrEP coverage, regressing EAPC on time; and among all jurisdictions, regressing EAPC on both time and jurisdictional changes in PrEP coverage with and without accounting for changes in VS. Results From 2012 to 2016, across the 10 states with the greatest increases in PrEP coverage, the EAPC decreased 4.0% (95% confidence interval [CI], −5.2% to −2.9%). On average, across the states and District of Columbia, EAPC for a given year decreased by 1.1% (95% CI, −1.77% to −.49%) for an increase in PrEP coverage of 1 per 100 persons with indications. When controlling for VS, the state-specific EAPC for a given year decreased by 1.3% (95% CI, −2.12% to −.57%) for an increase in PrEP coverage of 1 per 100 persons with indications. Conclusions We found statistically significant associations between jurisdictional increases in PrEP coverage and decreases in EAPC independent of changes in VS, which supports bringing PrEP use to scale in the US to accelerate reductions in HIV infections.

The large volume and weak environmental adaptability of fiber optical frequency combs (OFCs) have become the main obstacles for their applications in various fields. To address these issues, in this study, we present a compact, low-cost f-to-2f interferometer and fiber actuator with a large tuning range and a high control bandwidth for a 200-MHz OFC that is based on a 1.5-μm all-polarization-maintaining fiber mode-locked laser. By employing customized fiber-coupled gradient index lenses, our f-to-2f interferometer is encapsulated in a miniature tube with a diameter of only 4 mm and a length of 40 mm, which substantially reduces the optical section size of the frequency comb as compared to conventional devices. The carrier envelope offset beat with a signal-to-noise ratio of 40 dB is detected in a resolution bandwidth of 360 kHz. In addition, a laboratory-made piezoelectric transducer-driven mechanical actuator for repetition rate regulation exhibited a large tuning range of 106 kHz (corresponding to an effective temperature drift of 53 °C) and a high control bandwidth of approximately 1 kHz. This resulted in a robust repetition rate locking with an Allan deviation of 330 μHz at a gate time of 1 s and a residual integrated timing jitter of 418 fs [3 Hz to 1 MHz] when referenced to a hydrogen maser. Along with reducing the size and improving the environmental adaptability of the OFC, our design can also decrease the power consumption of the system significantly. Our findings provide a new direction to the development of OFCs for various applications.

Zhangye City is a representative agricultural city in China where agriculture depends heavily on precipitation in the Heihe River Basin; water use for agriculture plays a key role in the sustainable development of total water resources. This study, based on the predicted surface runoff by GCM, uses a CGE model with a water-land resources account, to analyze the impact of climate change on Zhangye City’s economy and agricultural water consumption. The results show that climate change increases surface runoff by 8.84%. The increasing surface runoff contributes most to the total water consumption, increasing by 8.11% accompanied by a small GDP expansion of 0.12%. Relative to the industrial structure, agricultural sectors benefit most. Contrarily, export-oriented industrial sectors see a decrease in benefit, resulting in employment migrating to lower value-added agricultural sectors. From the water types, the consumption for underground and other water also rise by 6.69% and 5.73% respectively, due to the economic scale expansion effect of the agricultural sectors. For varieties of crops, grain crops consume more water because of its greater water intensity. And the land is mostly transferred from economic crops to grain crops. Therefore, the government should pay attention to changes in the consumption propensity of water resources, continue to promote agricultural water-saving measures and the adjustment of agricultural planting structure.

Climate change would pose a direct and severe challenge to China's rice production and self-sufficiency. Here we use Global Trade Analysis Project (GTAP) model to evaluate the impacts of climate change on the self-sufficiency of rice in China due to 2 °C rise in temperature, and further analyze the impact and transmission mechanisms of climate change through market and trade. Our simulation method switches different regional mechanisms in the GTAP model by employing alternative closures and scenarios. Our results suggest that the fluctuation in rice price is much larger than that of rice production. The active regional feedback mechanism has much larger effects than the passive one in assessing climate change impacts. With the passive regional feedback mechanism (Single Regional General Equilibrium, SRGE and Multi-Regional General Equilibrium with China's shock, MRGE_C), China's rice export would decrease by more than 8%, and import would increase by over 5%, which leads to a decrease in rice self-sufficiency by more than 0.06 percentage points. With the active regional feedback mechanism (Multi-Regional General Equilibrium with global shock, MRGE_W), climate change will increase China's rice export by 2.7% as rising rice exports to South Korea overweight the export decrease to other countries, concurrently, China's rice import would decrease by 0.04%, which leads to a slight increase in rice self-sufficiency. As a whole, climate change will not severely threaten China's rice self-sufficiency. By the decomposition analysis, climate change impacts on China's rice self-sufficiency mainly depend on the changes in China's domestic rice production. Interestingly, the source of China's rice import will switch from Vietnam to Pakistan under MRGE_W, which derives from the input structure of paddy rice and rice sectors in different countries.

A navigation scheduling framework for agricultural harvesters (AHs) is proposed, which takes the impacts from both farmer’s demands and dispatch system (DS) into consideration. Farmer’s demands with AHs and the DS are linked in this framework. It benefits farmers and AHs owners by attracting AHs to schedule at rush hours and saving the time of AHs owners with real-time navigation. A hierarchical game approach is proposed based on the formulated framework to effectively navigate AHs to farms that need to harvest (FNHs). And a non-cooperative game is proposed to model the competition between FNHS at the upper level of the hierarchical game. At the lower level, multiple evolutionary games are formulated based on the pricing strategies obtained from the non-cooperative game to evolve AHs’ strategies in choosing FNHs. The simulation results show that the proposed navigation scheduling method is effective in improving both the reliability of the DS and economic profits of AHs owners.

We demonstrate the generation of dark solitons (DSs) in erbium-doped fiber (EDF) laser based on black phosphorus nanoparticles (BPNPs) for the first time. The side-polished fiber deposited with BPNPs is embedded into the laser to enhance the birefringence and nonlinearity of the laser cavity. In the paper, the saturable absorption property of BPNPs with an optical modulation depth of 5.7% and a saturable intensity of 21.7 MW/cm2 are experimentally illustrated. After inserting the BPNPs saturable absorber (SA) into EDF laser, the DSs with repetition rate of 14.68 MHz are obtained at a pump power of 90 mW. Our results prove that the BPNPs are the promising candidate materials for generating DSs in EDF laser.

We report a passively Q-switched all-fiber Yb-doped laser using the structure of step-index multimode fiber and graded-index fiber (SIMF-GIMF) as a new saturable absorber (SA) based on the nonlinear multimode interference (NL-MMI). Through bending the SA to a certain state, we obtain a stable Q-switched laser operation with the shortest pulse duration of 4.37 μs and a corresponding repetition rate of 147.6 kHz with center at 1,039 nm. The maximum average output power and single pulse energy are recorded to be 2.409 mW and 16.3 nJ, respectively. To the best of our knowledge, this paper confirms experimentally for the first time Q-switched laser operation based on SIMF-GIMF SA in all-fiber lasers. In addition, we also observed unstable Q-switched mode-locking operation. All-fiber lasers based on SIMF-GIMF SA are attractive for practical applications and undergo no damage and performance degradation with time.

We experimentally investigate the noise properties of a homemade 586 MHz mode-locked laser (MLL). The variation of the timing jitter versus the harmonic order is measured, which is consistent with the theoretical analyses. The dominant contributions to the timing jitter are detailedly studied by analyzing the phase noises at different harmonic frequencies. For low-order harmonics, the intensity noise and relative-intensity-noise-coupled (RIN-coupled) jitter mainly contribute to the timing jitter, while for high-order harmonics, the amplified spontaneous emission (ASE) noise makes the dominant contribution. Then we find that a higher output ratio has an obvious improvement on reducing the timing jitter and suppressing the phase noise because of the shorter pulse duration and lower net cavity dispersion caused by the higher output ratio. Finally a comparison of the noise performance between the MLL and a commercial signal generator is made, which shows that the optically generated radio-frequency signal (OGRFS) has a lower phase noise at high offset frequencies, however the higher phase noise at low offset frequencies leads to a higher timing jitter than the commercial SG.

Background Delayed wound healing remains a common but challenging problem in patients with acute or chronic wound following accidental scald burn injury. However, the systematic and detailed evaluation of the scald burn injury, including second-degree deep scald (SDDS) and third-degree scald (TDS), is still unclear. The present study aims to analyze the wound-healing speed, the formation of granulation tissue, and the healing quality after cutaneous damage. Methods In order to assess SDDS and TDS, the models of SDDS and TDS were established using a scald instrument in C57BL/6 mice. Furthermore, an excisional wound was administered on the dorsal surface in mice (Cut group). The wound-healing rate was first analyzed at days 0, 3, 5, 7, 15 and 27, with the Cut group as a control. Then, on the full-thickness wounds, hematoxylin and eosin (H&E) staining, Masson staining, Sirius red staining, Victoria blue staining and immunohistochemistry were performed to examine re-epithelialization, the formation of granulation tissue, vascularization, inflammatory infiltration and the healing quality at different time points in the Cut, SDDS and TDS groups. Results The presented data revealed that the wound-healing rate was higher in the Cut group, when compared with the SDDS and TDS groups. H&E staining showed that re-epithelialization, formation of granulation tissue and inflammatory infiltration were greater in the Cut group, when compared with the SDDS and TDS groups. Immunohistochemistry revealed that the number of CD31, vascular endothelial growth factor A, transforming growth factor-β and α-smooth muscle actin reached preferential peak in the Cut group, when compared with other groups. In addition, Masson staining, Sirius red staining, Victoria blue staining, Gordon-Sweets staining and stress analysis indicated that the ratio of collagen I to III, reticular fibers, failure stress, Young’s modulus and failure length in the SDDS group were similar to those in the normal group, suggesting that healing quality was better in the SDDS group, when compared with the Cut and TDS groups. Conclusion Overall, the investigators first administered a comprehensive analysis in the Cut, SDDS and TDS groups through in vivo experiments, which further proved that the obstacle of the formation of granulation tissue leads to delayed wound healing after scald burn injury in mice.

Background Epidermal stem cells (EpSCs) that reside in cutaneous hair follicles and the basal layer of the epidermis are indispensable for wound healing and skin homeostasis. Little is known about the effects of photochemical activation on EpSC differentiation, proliferation and migration during wound healing. The present study aimed to determine the effects of photodynamic therapy (PDT) on wound healing in vivo and in vitro. Methods We created mouse full-thickness skin resection models and applied 5-aminolevulinic acid (ALA) for PDT to the wound beds. Wound healing was analysed by gross evaluation and haematoxylin–eosin staining in vivo. In cultured EpSCs, protein expression was measured using flow cytometry and immunohistochemistry. Cell migration was examined using a scratch model; apoptosis and differentiation were measured using flow cytometry. Results PDT accelerated wound closure by enhancing EpSC differentiation, proliferation and migration, thereby promoting re-epithelialization and angiogenesis. PDT inhibited inflammatory infiltration and expression of proinflammatory cytokines, whereas the secretion of growth factors was greater than in other groups. The proportion of transient amplifying cells was significantly greater in vivo and in vitro in the PDT groups. EpSC migration was markedly enhanced after ALA-induced PDT. Conclusions Topical ALA-induced PDT stimulates wound healing by enhancing re-epithelialization, promoting angiogenesis as well as modulating skin homeostasis. This work provides a preliminary theoretical foundation for the clinical administration of topical ALA-induced PDT in skin wound healing.

Infrared sensing technology can be well used for night observation, which is becoming an important measure for battlefield reconnaissance. It is a powerful way to implement precision strikes and situational awareness by improving the ability of target recognition based on infrared images. For the problem of infrared image recognition, the Light Gradient Boosting Machine (LightGBM) is employed to select the outline descriptors extracted based on the elliptic Fourier series (EFS), which is combined with sparse representation-based classification (SRC) to achieve target recognition. First, based on the target outlines in the infrared image, the multi-order outline descriptors are extracted to characterize the essential characteristics of the target to be recognized. Then, the LightGBM feature selection algorithm is used to screen the multi-order outline descriptors to reduce redundancy and improve the pertinence of features. Finally, the selected outline descriptors are classified based on SRC. The method effectively improves the effectiveness of the final features through the feature selection of LightGBM and reduces the computational complexity of classification at the same time, which is beneficial to improve the overall recognition performance. The mid-wave infrared (MWIR) dataset of various targets is employed to carry out verification experiments for the proposed method under three different conditions of original samples, noisy samples, and partially occluded samples. By comparing the proposed method with several types of existing infrared target recognition methods, the results show that the proposed method can achieve better performance.

Objective Although some studies have reported a higher incidence of HIV infection among non–US-born people than among US-born people, national data on this topic are scarce. We compared the epidemiology of HIV infection between US-born and non–US-born residents of the United States and examined the characteristics of non–US-born people with diagnosed HIV infection by region of birth (ROB). Methods We used a cross-sectional study design to produce national, population-based data describing HIV infection among US-born and non–US-born people. We analyzed National HIV Surveillance System data for people with HIV infection diagnosed during 2010-2017 and reported to the Centers for Disease Control and Prevention (CDC). We compared data on demographic characteristics, transmission risk category, and stage 3 infection (AIDS) classification within 3 months of HIV diagnosis, by nativity and ROB. Results During 2010-2017, 328 317 children and adult US residents were diagnosed with HIV infection and were reported to CDC: 214 973 (65.5%) were US-born, 50 301 (15.3%) were non–US-born, and 63 043 (19.2%) were missing data on country of birth. After adjusting for missing country of birth, 266 147 (81.1%) people were US-born and 62 170 (18.9%) were non–US-born. This group accounted for 15 928 of 65 645 (24.2%) HIV diagnoses among girls and women and 46 242 of 262 672 (17.6%) HIV diagnoses among boys and men. A larger percentage of non–US-born people than US-born people had stage 3 infection (AIDS) at HIV diagnosis (31.2% vs 23.9%). Among non–US-born people with HIV diagnoses, 19 876 (39.5%) resided in the South. Conclusions Characterizing non–US-born people with HIV infection is essential for developing effective HIV interventions, particularly in areas with large immigrant populations.

Background Autologous platelet-rich plasma (PRP) has been suggested to be effective for wound healing. However, evidence for its use in patients with acute and chronic wounds remains insufficient. The aims of this study were to comprehensively examine the effectiveness, synergy and possible mechanism of PRP-mediated improvement of acute skin wound repair. Methods Full-thickness wounds were made on the back of C57/BL6 mice. PRP or saline solution as a control was administered to the wound area. Wound healing rate, local inflammation, angiogenesis, re-epithelialization and collagen deposition were measured at days 3, 5, 7 and 14 after skin injury. The biological character of epidermal stem cells (ESCs), which reflect the potential for re-epithelialization, was further evaluated in vitro and in vivo. Results PRP strongly improved skin wound healing, which was associated with regulation of local inflammation, enhancement of angiogenesis and re-epithelialization. PRP treatment significantly reduced the production of inflammatory cytokines interleukin-17A and interleukin-1β. An increase in the local vessel intensity and enhancement of re-epithelialization were also observed in animals with PRP administration and were associated with enhanced secretion of growth factors such as vascular endothelial growth factor and insulin-like growth factor-1. Moreover, PRP treatment ameliorated the survival and activated the migration and proliferation of primary cultured ESCs, and these effects were accompanied by the differentiation of ESCs into adult cells following the changes of CD49f and keratin 10 and keratin 14. Conclusion PRP improved skin wound healing by modulating inflammation and increasing angiogenesis and re-epithelialization. However, the underlying regulatory mechanism needs to be investigated in the future. Our data provide a preliminary theoretical foundation for the clinical administration of PRP in wound healing and skin regeneration.

Explosions always lead to serious public health, social, and economic problems. We investigated the epidemiology, outcomes, and costs of burn patients caused by explosion accident in Southwest China to explore more effective prevention and treatment strategies. This retrospective study included 497 inpatients with burns during explosion accident admitted to the Institute of Burn Research of Army Medical University from 2002 to 2016. A total of 497 cases (77.78% males) were found, accounting for 2.37% of the total burn patients. The average age was 34.38 ± 15.02 years. The most common etiology was gas explosions (51.51%). Most of the cases were caused by work-related activities. The average TBSA was 31.30 ± 28.32%. The median length of stay (LOS) was 31 days. The LOS was correlated with TBSA, full-thickness burns, older age, number of operations and outcome. The major factors determining the cost were larger TBSA, full-thickness burns, and higher cure rate. The mortality was 6.44%. Larger TBSA and older age were the most important risk factors for the mortality. This study suggested that special attention should be paid to prevent burns during explosion accident in adult males with occupational exposure. In the future, more effective and practical strategies for preventing and treating burns during explosion accident based on related risk factors should be implemented.

Objective Nicorandil exerts a protective effect against coronary microvascular dysfunction in acute myocardial infarction (AMI) patients. However, the mechanism and effect of nicorandil in hyperhomocysteinemia (HHcy) AMI patients remain unclear. Methods C57/BL6 mice with mild to moderate HHcy and human coronary artery endothelial cells (HCAECs) cotreated with HHcy (1 mmol/L) for 24 h and hypoxia for 6 h were selected as models. Small animal ultrasound detection was used to compare cardiac function. CD31 immunofluorescence staining and tomato lectin staining were used to assess the number of microcirculation changes in vivo. MTT, tube formation and western blotting assays were used to evaluate the effect of nicorandil on HCAECs and the PI3K/Akt/eNOS pathway. Results The results showed that nicorandil improved cell viability and p-PI3K/PI3K, p-Akt/Akt, and p-eNOS/eNOS expression in the vitro HHcy and hypoxia models. The beneficial effects of nicorandil on HCAECs could be inhibited by the phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002 and the nitric oxide synthase (NOS) inhibitor L-NAME. In vivo, nicorandil improved the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) in the post-HHcy + MI model, and the levels of CD31 and tomato lectin expression were higher in the nicorandil treatment group. The effectiveness of nicorandil was inhibited in the PI3K and L-NAME groups. Conclusion The results suggest that nicorandil improves Hcy-induced coronary microvascular dysfunction through the PI3K/Akt/eNOS signalling pathway.

Background Restenosis is a serious problem in patients who have undergone percutaneous transluminal angioplasty. Endothelial injury resulting from surgery can lead to endothelial dysfunction and neointimal formation by inducing aberrant proliferation and migration of vascular smooth muscle cells. Exosomes secreted by mesenchymal stem cells have been a hot topic in cardioprotective research. However, to date, exosomes derived from mesenchymal stem cells (MSC-Exo) have rarely been reported in association with restenosis after artery injury. The aim of this study was to investigate whether MSC-Exo inhibit neointimal hyperplasia in a rat model of carotid artery balloon-induced injury and, if so, to explore the underlying mechanisms. Methods Characterization of MSC-Exo immunophenotypes was performed by electron microscopy, nanoparticle tracking analysis and western blot assays. To investigate whether MSC-Exo inhibited neointimal hyperplasia, rats were intravenously injected with normal saline or MSC-Exo after carotid artery balloon-induced injury. Haematoxylin-eosin staining was performed to examine the intimal and media areas. Evans blue dye staining was performed to examine re-endothelialization. Moreover, immunohistochemistry and immunofluorescence were performed to examine the expression of CD31, vWF and α-SMA. To further investigate the involvement of MSC-Exo-induced re-endothelialization, the underlying mechanisms were studied by cell counting kit-8, cell scratch, immunofluorescence and western blot assays. Results Our data showed that MSC-Exo were ingested by endothelial cells and that systemic injection of MSC-Exo suppressed neointimal hyperplasia after artery injury. The Evans blue staining results showed that MSC-Exo could accelerate re-endothelialization compared to the saline group. The immunofluorescence and immunohistochemistry results showed that MSC-Exo upregulated the expression of CD31 and vWF but downregulated the expression of α-SMA. Furthermore, MSC-Exo mechanistically facilitated proliferation and migration by activating the Erk1/2 signalling pathway. The western blot results showed that MSC-Exo upregulated the expression of PCNA, Cyclin D1, Vimentin, MMP2 and MMP9 compared to that in the control group. Interestingly, an Erk1/2 inhibitor reversed the expression of the above proteins. Conclusion Our data suggest that MSC-Exo can inhibit neointimal hyperplasia after carotid artery injury by accelerating re-endothelialization, which is accompanied by activation of the Erk1/2 signalling pathway. Importantly, our study provides a novel cell-free approach for the treatment of restenosis diseases after intervention.

Mycobacterium tuberculosis (Mtb), a typical intracellular parasite that cause tuberculosis (TB), which rank the top infectious killer for human death. Pathogenic mycobacterium has evolved numerous strategies to favor their intracellular survival including a unique lipid-rich cell wall component and granuloma formation during early infection [1]. Phthiocerol dimycocerosate (PDIM) is a critical virulence factor of mycobacteria including Mycobacterium marinum (Mm), which manipulate host immune responses and granuloma induction and facilitate immune evasion [2-7], but the mechanisms are still remains questionable. We used an AACT/SILAC-based quantitative proteomic approach to determine PDIM-responded proteome profiles during Mm early infection. A major difference was the high abundance of galectin3 (Gal-3) in WT Mm-infected cells and not with PDIM-deficient. Gal-3 induction by PDIM-replete bacteria was primarily via Toll-like receptor 2, and also engaged TGF-β non-classical pathway. Elevated Gal-3 in macrophages prevented the turnover and translocation of NF-κB to effectively modulate the profile of inflammatory cytokines. Silencing of Gal-3 effectively relieved tissue damage induced in mice by PDIM-expressing Mm. We found upregulated Gal-3 in the serum and BALF of confirmed clinical tuberculosis cases, while decreased significantly after effective chemotherapy. Our findings demonstrated that upregulated Gal-3 not only plays an important role in regulating host immune response and granuloma formation in vivo, but also that target-Gal-3 therapy is a promising anti-tuberculosis strategy in the future. Funding Statement: This work was supported in part by the National Natural Science Foundation of China (Grant Nos. 31772709 and 31572485 to D.W), the new faculty startup research fund of China Three Gorges University (KJ2014B023 to D.W), Health Commission of Hubei Province in China (WJ2019H528 to D.W; WJ2019F080 to D.L), and in part by the intramural research program of NIAID, NIH (Bethesda MD, USA). Z.L was supported by grants from the China’s 13th Five Year Programs for the prevention and cure of great infectious diseases (2017ZX10201301-005) and Open Fund of Shanghai Key Laboratory of Tuberculosis (2018kf03). XY.Fan is the recipient of National Natural Science Foundation of China (31771004). Declaration of Interests: The authors declare no competing financial interests. Ethics Approval Statement: The case-control study of TB was reviewed and approved by the Ethics Committee of the Third People’s Hospital of Yichang (2017008H). Written informed consent was obtained from all participants. The animal experiments were reviewed and approved by the Animal Care and Use Committee of China Three Gorges University (2017010M).

Tuberous scleroses complex (TSC) is a rare neurocutaneous syndrome and has autosomal dominant inheritance. However, larger family with TSC is very rare. Here, we report the first five generations family with TSC from China, and localize the pathogenic gene. A boy with TSC and epilepsy underwent preoperative evaluation and epileptic surgery. His TSC family history was gotten, and the clinical data of a Chinese family with TSC were collected in 2016. Complete exons sequencing was performed in the proband and his parents, and whole exons sequence of TSC was performed in the other family members. The family showed autosomal dominant inheritance, and it was the largest reported family with TSC. In this pedigree, there were 14 patients in 5 generations, but only 1 case with epilepsy in them. All of examined patients had TSC 1 gene exon 15 c.1846delG p.A616Pfs*13 mutation. In conclusion, TSC patients with TSC 1 deletion presented mild neurological symptom and rendered larger family.

The setup of nonlinear pulse compression with hollow-core photonic crystal fiber (HC-PCF) is demonstrated. In our experiment, the HC-PCF is just put in the air with no extra gas fill. The spectrum is effectively broadened to more than 60 nm by delivering the ultrashort laser in the HC-PCF and compressing the pulse with Gires–Tournois interferometer-type dispersion mirrors. The initial pulse duration of 279 fs has been shortened to 36 fs with $20\mu \text{J}$ of pulse energy, which corresponds to a peak power of about 556 MW. To our best knowledge, it is the highest peak power obtained from the solid-state laser at the wavelength around $1~\mu \text{m}$ by using Kagome-type HC-PCF without extra gas fill. With precise dispersion compensation and higher input pulse energy, even shorter pulse width and higher peak power can be obtained.

Acid rain in China is mainly caused by man-made SO2 emission. In order to reduce SO2 emission, "Environmental Protection Tax Law of People's Republic of China" has been implemented on January 1, 2018. This study, based on environmental CGE model, analyses the impact of different ratio of environmental tax revenue refunded to consumption tax on China's economy and further decomposes sectors' SO2 emissions reduction into output scale effect, process emission effect, intermediate input substitution effect, energy substitution effect and imported-domestic energy substitution effect. Results show that environmental tax can effectively reduce SO2 emission, and not always hurt the economy. With the tax refund ratio rising, GDP appears an upward trend in varying degrees (−0.25%–0.21%), and SO2 emission reduction shows a downward trend (−3.81%∼-3.28%). A critical point of tax refund ratio is found to locate at 59.5%, which represents the maximum amount of SO2 emission reduction without sacrificing economy. For the SO2 emission reduction, sectors' combustion emission reduction of oilgas and coal play a leading role. After specific decomposition, the energy substitution effect dominates the SO2 emission reduction. Further, emission reductions of SO2 mainly focus on high pollution sectors such as power, building materials manufacturing and paper. Factors driving emission changes in sectors may differ substantially. Therefore, the environmental tax does not necessarily hurt the economy, and can effectively curb high pollution sectors' SO2 emission, stimulating the demand for clean energy like gas and upgrading energy structure.

A hybrid high energy femtosecond laser system based on Yb:YAG single crystal fiber amplifier is experimentally studied. Due to the low nonlinearity and high gain of the Yb:YAG single crystal fiber, laser pulses with high energy of 146 μJ at the repetition of 100KHz are obtained. The beam quality of 1.233 in the horizontal direction and 1.239 in the vertical direction is detected. After compression, pulses with the duration of 859 fs and energy as high as 63.5 μJ are achieved at 100 kHz repetition rate in a compact size, this compact and simple laser system will find various applications in ultrafast laser micro-machining.

We demonstrate a hundred micro-Joules level femtosecond laser system based on a compact and simple two-stage Yb:YAG single crystal fiber chirped pulse amplification system which delivers compressed power of 15.57 W, pulse width of 715 fs. The different amplification performance with different input seed power is experimentally studied. A maximum direct amplified power output of 44 W at 100 kHz is obtained for an input seed power of 12 W. To the best of our knowledge, this is the highest average power of femtosecond laser based on single crystal fiber at hundred micro-Joules energy level.

Data from CDC's National HIV Surveillance System (NHSS)* are used to monitor progress toward achieving national goals set forth in the Division of HIV/AIDS Prevention's Strategic Plan (1) and other federal directives† for human immunodeficiency virus (HIV) testing, care, and treatment outcomes and HIV-related disparities in the United States. Recent data indicate that Hispanics or Latinos§ are disproportionately affected by HIV infection. Hispanics or Latinos living with diagnosed HIV infection have lower levels of care and viral suppression than do non-Hispanic whites but higher levels than those reported among blacks or African Americans (2). The annual rate of diagnosis of HIV infection among Hispanics or Latinos is three times that of non-Hispanic whites (3), and a recent study found increases in incidence of HIV infection among Hispanic or Latino men who have sex with men (4). Among persons with HIV infection diagnosed through 2013 who were alive at year-end 2014, 70.2% of Hispanics or Latinos received any HIV medical care compared with 76.1% of non-Hispanic whites (2). CDC used NHSS data to describe HIV care outcomes among Hispanics or Latinos. Among male Hispanics or Latinos with HIV infection diagnosed in 2015, fewer males with infection attributed to heterosexual contact (34.6%) had their infection diagnosed at an early stage (stage 1 = 12.0%, stage 2 = 22.6%) than males with infection attributed to male-to-male sexual contact (60.9%: stage 1 = 25.2%, stage 2 = 35.7%). The percentage of Hispanics or Latinos linked to care after diagnosis of HIV infection increased with increasing age; females aged 45-54 years with infection attributed to injection drug use (IDU) accounted for the lowest percentage (61.4%) of persons linked to care. Among Hispanics or Latinos living with HIV infection, care and viral suppression were lower among selected age groups of Hispanic or Latino males with HIV infection attributed to IDU than among males with infection attributed to male-to-male sexual contact and male-to-male sexual contact and IDU. Intensified efforts to develop and implement effective interventions and public health strategies that increase engagement in care and viral suppression among Hispanics or Latinos (3,5), particularly those who inject drugs, are needed to achieve national HIV prevention goals.

Background Through amplifying inflammatory cascades, IL-17A produced by γδ T cells potently attracts neutrophils to the site of injury for exacerbating ischemic tissue damage. Our goal was to identify the precise role of γδ T cell subsets in ischemic brain tissue damage of stroke. Methods In a model of experimental stroke, we analyzed the functions of Vγ1 and Vγ4 T cells on γδ T cell-mediated ischemic brain tissue damage of stroke. Results We identified that, in stroke, Vγ4 T cells are essential for γδ T cell-mediated ischemic brain tissue damage through providing an early source of IL-17A. Both CCL20 and IL-1β/IL-23 are deeply involved in Vγ4 T cell-mediated amplification of inflammatory responses: CCL20 might promote Vγ4 T cells recruit to infract hemisphere, and IL-1β/IL-23 powerfully enhance IL-17A production mediated by the infiltrating Vγ4 T cells. Moreover, Vγ4 T cell-derived IL-17A enhances both CCL20 and IL-1β, and conversely, CCL20 and IL-1β further enhance both recruitment and IL-17A production of IL-17A-positive cells, in a classic positive feedback loop. Conclusion Our data suggest that in the setting of ischemic stroke, Vγ4 T cell-derived IL-17A, CCL20 and IL-1β/IL-23 in infract hemisphere coordinately to amplify inflammatory cascades and exacerbate ischemic tissue damage.

Anthropogenic activities have had diversiform impacts on the surrounding river and environments. A study on the surface water of the Lhasa River Basin was undertaken to assess its hydrogeochemical characteristics under the influence of anthropogenic activities. A total of 16 samples collected from the Lhasa River were analyzed for pH, electric conductivity (EC), oxidation-reduction potential (ORP), total dissolved solids (TDS), major cations (K+, Na+, Ca2+, and Mg2+), major anions (Cl&minus, SO42&minus, HCO3&minus, and NO3&minus, ), and trace metals. The pH of the analyzed water samples varied from 6.40 to 9.10, indicating alkaline in nature. The EC values varied from 77.3 to 213 &mu, s/cm while the TDS values varied from 73.37 to 217.55 mg/L. HCO3&minus, and SO42&minus, are the dominant anions while Ca2+ and Na+ are the dominant cations in the river water. The concentration of alkaline earth metals (Ca2+ + Mg2+) exceed the alkali metals (Na+ + K+) and HCO3&minus, dominates over SO42&minus, + Cl&minus, concentrations in the majority of the surface water samples. Ca2+-Mg2+-HCO3&minus, and Ca2+-Mg2+-Cl&minus, are the dominant hydrogeochemical facies in the surface water of the area. The water chemistry is mainly controlled by rock weathering with secondary contribution from anthropogenic sources. The content of trace elements in the Lhasa River is low, basically at the natural background value. The high content of individual elements is mainly due to the mineral resource exploitation and geothermal resources in the basin. Countermeasures and attention should be payed to these aspects, such as the construction of water conservancy facilities, urban economic development, the development of mining activities, and sewage and wastewater discharge, so as to protect the water quality and sustainable development of the Lhasa River Basin.

Background In 2017, 19% of new HIV diagnoses in the United States were in women. HIV acquisition can be prevented with pre-exposure prophylaxis, and HIV transmission with viral suppression. HIV viral suppression is achieved by linking women to care and supporting adherence to antiretroviral medications. The national HIV prevention goal for viral suppression is 80%. Setting United States. Methods We analyzed data reported by 40 US jurisdictions to the Centers for Disease Control and Prevention's National HIV Surveillance System to determine the number and rate of HIV diagnoses per 100,000 women in 2016. We also determined the percentages of women with diagnosed HIV who were linked to care within 1 and 3 months, received HIV care, were retained in HIV care, and were virally suppressed in 2015. Findings were stratified by demographic characteristics and HIV transmission category. Results In 2016, 6407 women were diagnosed with HIV. Black women had a rate of 783.7 per 100,000, Hispanic/Latino women 182.7, and white women 43.6. In 2015, 190,735 women were living with diagnosed HIV. Viral suppression increased with age, ranging from 46.5% among women aged 13-24 years to 62.3% among women aged ≥45 years. Black women had the lowest rate of viral suppression (55.5%). No age group of women achieved 80% viral suppression. Conclusions Pre-exposure prophylaxis implementation for women at high risk for HIV infection can help to decrease new infections. Women living with HIV would benefit from interventions that support linkage to HIV care and antiretroviral medication adherence to increase viral suppression.

As an inflammatory factor, IL‐25 has been studied in variouscancers, but it is rarely reported in cancer chemotherapy resistance. Major vault protein (MVP), as a gene associated with lung multidrug resistance, is associated with multiple chemotherapy resistances of lung cancer. However, the relationship between IL‐25 and MVP in lung cancer cells has not been studied. In this study, we found that both IL‐25 and MVP were elevated expressed in cisplatin‐resistant lung adenocarcinoma cell line (A549/CDDP). Silencing of IL‐25 resulted in down‐regulation of MVP expression and reduced cisplatin tolerance of A549/CDDP cells. Overexpression of IL‐25 resulted in increase of MVP expression and the cisplatin tolerance in A549 cells. In addition, we found that the extracellular IL‐25 could stimulate the expression of MVP and activate the NF‐κB signaling pathway. Further, animal models also confirmed that IL‐25 reduced the sensitivity of xenografts to chemotherapy. Taken together, we believe that the up‐regulation of IL‐25 induces MVP expression contributing to chemotherapy resistances of lung cancer cells. Our findings suggest that interference the expression of IL‐25 might be potential treatment strategies for the clinical reversing the chemotherapy resistance.

Light-emitting electrochemical cell of bithiazole-based material was fabricated by solution processing rendered high external quantum efficiency over 12.8% and luminance of 1.8 104 cd m−2.

We demonstrate an all-fiber mode locked laser based on hybrid structure of multimode fiber saturable absorber (SA) that can realize both conventional soliton and stretched-pulse states. Stable 16.44 MHz conventional soliton pulses are achieved by injecting 80 mW threshold pump power. By increasing the incident pump power to 420 mW, the laser evolves from soliton operation into stretched-pulse mode locking state. 310 fs stretched-pulse are obtained with the same repetition rate as the soliton pulses. The center wavelength and its 3 dB spectrum bandwidth are 1603 nm and 14.2 nm, respectively. For the first time, we experimentally confirm transition between conventional soliton and stretched-pulse in 1.5 μm mode-locked fiber laser by introducing multimode optical fiber SA. Moreover, the maximum single pulse energy of nearly 1 nJ is achieved. Such all-fiber mode-locked lasers based on hybrid structure of multimode fiber are attractive for practical applications without damage and the limitation of life time.

The first prospective trial for resective surgery combined with corpus callosotomy (CCT) was performed to investigate the outcomes of the combined surgery in children with Lennox-Gastaut syndrome (LGS) without focal lesion on brain MRI.This study enrolled 68 children with LGS and without focal lesion on brain MRI, of which 25 received medicine (medicine group) and 43 underwent surgery (surgery group), including 20 with exclusively resective surgery (exclusively resection subgroup) and 23 with resective surgery combined with CCT (combined CCT subgroup). All patients were followed for 3-5 years.Significant differences in seizure control were observed between the medicine group and the exclusively resection subgroup and combined CCT subgroup at the 1-year, 3-year, and 5-year follow-ups. There was a trend that the children with resection combined with CCT had better seizure control than those with exclusively resection at the three follow-ups, but this could not be verified by the statistical method used. Furthermore, significant differences were not observed in seizure control between children with different MRI findings, age at surgery, or pathology in the surgery group. The percentage of long-term seizure-free did not remain as high as the percentage of early stage seizure-free at 1-year follow-up. However, the children with combined CCT surgery demonstrated more postoperative improvement than the children with resective surgery alone based on the mean QOL score (10.78 vs. 5.75, p = 0.0152) and full-scale IQ (7.91 vs. 4.55, p = 0.0446).Resective surgery combined with CCT can provide favorable seizure control and obvious improvements in QOL and IQ in children with LGS. This combined approach can be performed in carefully selected LGS children without focal lesions and can localize the epileptogenic zone following a comprehensive preoperative evaluation.

Purpose The HIV care continuum is used to monitor success in HIV diagnosis and treatment among persons living with HIV in the United States. Significant differences exist along the HIV care continuum between subpopulations of people living with HIV; however, differences that may exist between residents of rural and nonrural areas have not been reported. Methods We analyzed the Centers for Disease Control and Prevention's National HIV Surveillance System data on adults and adolescents (≥13 years) with HIV diagnosed in 28 jurisdictions with complete reporting of HIV-related lab results. Lab data were used to assess linkage to care (≥1 CD4 or viral load test ≤3 months of diagnosis), retention in care (≥2 CD4 and/or viral load tests ≥3 months apart), and viral suppression (viral load

Introduction Using National HIV surveillance system data, we estimated life expectancy and average years of life lost (AYLL) among persons diagnosed with HIV infection during 2008-2011. Methods Population-based surveillance data, restricted to persons with diagnosed HIV infection aged 13 years or older, from all 50 states and Washington, D.C. were used to estimate life expectancy after HIV diagnosis using the life table method. Generated estimates were compared with life expectancy in the general population in the same calendar year to calculate AYLL. Life expectancy and AYLL were also estimated for subgroups by age, sex, and race/ethnicity. Results The overall life expectancy after HIV diagnosis in the United States increased by 3.43 years from 25.43 (95% CI: 25.37 to 25.49) in 2008 to 28.86 (95% CI: 28.80 to 28.92) in 2011. Improvements were observed irrespective of sex, race/ethnicity, transmission category, and stage of disease at diagnosis, though the extent of improvement varied by different characteristics. Based on the life expectancy in the general population, in 2010, the AYLL were 12.8 years for males and 16.5 years for females. By race/ethnicity, on average, blacks (13.3 years) and whites (13.4 years) had fewer AYLL than Hispanics/Latinos (14.7). Conclusions Despite improvements in life expectancy among people diagnosed with an HIV infection during 2008-2011, disparities by sex and by race/ethnicity persist. Targeted efforts should continue to further reduce disparities and improve life expectancy after HIV diagnosis.

We present a new high-efficiency divided chirp-pulse amplification (DCPA) system based on an actively controlled quasi-all-fiber structure. As a proof-of-principle experiment, a two-channel amplification system composed of single-mode ytterbium doped fiber is constructed. The experimental results show that the degree of linear polarization of similar to 93% is maintained after recombination and the system efficiency is up to similar to 95%. In addition, the beam quality (M-2 factor) is around 1.2. Moreover, the system can operate stably for a long time without performance degradation. Compared with the traditional spatial DCPA, this system exhibits some advantages, such as improved spatial adjustment, high stability, compact size, and low cost. It is demonstrated that this work paves the way to design a quasi-all-fiber high-performance pulsed laser system. Refereed/Peer-reviewed

Aims: To prospectively study the surgical outcomes of unilateral anterior temporal lobectomy (ATL) in patients with intractable bilateral temporal lobe epilepsy (TLE) as well as two-staged contralateral hippocampal stimulation in patients after failed unilateral ATL. Methods: Eighteen carefully selected patients with bilateral TLE underwent unilateral ATL. Five cases with failed ATL underwent two-staged contralateral hippocampal stimulation. Seizure control and changes in intelligence quotient (IQ), memory quotient, and quality of life (QOL) were analyzed 2-5 years after treatment. Results: In the patients with unilateral ATL, the percentages seizure free were 55.6% (10/18), 50.0% (9/18), and 44.4% (4/9) at the 1-, 2-, and 5-year follow-up visits, respectively. There were significant difference in seizure control between the patients with unilateral ATL and the 12 cases in the medication group. Significant differences were also found in changes in the patients' QOL and full-scale IQ at the 2-year follow-up between the surgical and medication groups. Five patients who underwent contralateral hippocampal stimulation after failed unilateral ATL experienced 80-100% seizure reductions, and 80% were seizure free 1 year after hippocampal stimulation. Conclusion: Unilateral ATL provides good seizure control and does not cause serious memory or IQ injury in carefully selected patients with true bilateral TLE. Contralateral hippocampal stimulation is a useful approach for patients who experience unilateral ATL failure.

Comparative analyses of the characteristics of persons living with HIV infection (PLWH) in the United States (US) captured in surveillance and other observational databases are few. To explore potential joint data use to guide HIV treatment and prevention in the US, we examined three CDC-funded data sources in 2012: the HIV Outpatient Study (HOPS), a multisite longitudinal cohort; the Medical Monitoring Project (MMP), a probability sample of PLWH receiving medical care; and the National HIV Surveillance System (NHSS), a surveillance system of all PLWH. Overall, data from 1,697 HOPS, 4,901 MMP, and 865,102 NHSS PLWH were analyzed. Compared with the MMP population, HOPS participants were more likely to be older, non-Hispanic/Latino white, not using injection drugs, insured, diagnosed with HIV before 2009, prescribed antiretroviral therapy, and to have most recent CD4+ T-lymphocyte cell count ≥500 cells/mm3 and most recent viral load test

Perfect linkage of dual frequency combs based on all polarization-maintaining femtosecond fiber lasers is demonstrated. By employing two independent tracking feedback controlling circuits, the repetition frequency ( $f_{r}$ ) and the carrier-envelope offset frequency ( $f_{ceo}$ ) of the slave frequency comb track the master’s $f_{r}$ and $f_{ceo}$ , respectively. The correlation coefficients of the dual $f_{r}$ ’s and the dual $f_{ceo}$ ’s are up to 0.99 and 0.98, which indicate an ideal linkage between the dual frequency combs. To the best of our knowledge, this is the first report about linkage of dual frequency combs.

A two-color visible frequency comb system based on a 1.5-μm all-polarization-maintaining (PM) fiber femtosecond laser was developed. This configuration relies on the implementation of three amplifiers, seeded by a single master oscillator. With the repetition rate (fr) of the oscillator locked to a reference frequency of 200 MHz, the output of the first amplifier was used to generate the feedback signal and achieve simultaneous phase lock of the carrier envelop offset frequency (fceo). The remaining two independently configurable amplifiers followed by highly nonlinear fibers and MgO-doped periodically poled lithium niobite crystals were used to produce visible comb lights at 543 and 633 nm (in air), respectively. By referencing to a hydrogen maser, the Allan deviations of fr and fceo at a gate time of 1 s are 438 μHz and 63 mHz, respectively. The spectral bandwidths of the 543- and 633-nm comb lights are 0.157 and 0.174 nm, respectively, and the single-mode powers of these comb lights are higher than 1 μW. The multiple-branch all-PM fiber-based visible frequency comb system exhibiting a narrow spectrum and a high single-mode power will facilitate the development of optical clocks and wavelength standard calibrations.

In 2016, black women with HIV infection attributed to heterosexual contact accounted for 47% of all women living with diagnosed HIV, and 41% of deaths that occurred among women with diagnosed HIV in the USA that year. Social determinants of health have been found to be associated with mortality risk among people with HIV. We analyzed the role social determinants of health may have on risk of mortality among black women with HIV attributed to heterosexual contact. Data from the Center for Disease Control and Prevention’s National HIV Surveillance System were merged at the county level with three social determinants of health (SDH) variables from the U.S. Census Bureau’s American Community Survey for black women aged ≥ 18 years with HIV infection attributed to heterosexual contact that had been diagnosed by 2011. SDH variables were categorized into four empirically derived quartiles, with the highest quartile in each category serving as the reference variable. For black women whose deaths occurred during 2012–2016, mortality rate ratios (MRR) were calculated using age-stratified multivariate logistic regressions to evaluate associations between SDH variables and all-cause mortality risk. Risk of mortality was lower for black women aged 18–34 years and 35–54 years who lived in counties with the lowest quartile of poverty (adjusted mortality rate ratio aMRR = 0.56, 95% confidence interval CI [0.39–0.83], and aMRR = 0.67, 95% CI [0.58–0.78], respectively) compared to those who lived in counties with the highest quartile of poverty (reference group). Compared to black women who lived in counties with the highest quartile of health insurance coverage (reference group), the mortality risk was lower for black women aged 18–34 years and black women aged 35–54 who lived in counties with the lowest 2 quartiles of health insurance coverage. Unemployment status was not associated with mortality risk. This ecological analysis found poverty and lack of health insurance to be predictors of mortality, suggesting a need for increased prevention, care, and policy efforts targeting black women with HIV who live in environments characterized by increased poverty and lack of health insurance.

We theoretically and numerically investigate the effects of high-order dispersion (HOD) on microcavity solitons, both in time and frequency domain with an extended normalized Lugiato-Lefever equation (LLE). The observed temporal drift of bright and dark solitons is shown to originate from high-odd-order dispersion, while the sign determines the direction of soliton movement and the amplitude decides the drift speed. HOD can also be introduced to stabilize the breathing bright and dark cavity solitons. In spectral domain, the nonlinear symmetry breaking is mainly introduced by third-order dispersion, whereas both third- and fourth-order dispersion can introduce dispersive wave accompanied by soliton tail oscillation. This work could give insight for exploring detailed intracavity pulse dynamics and spectral characteristics of Kerr combs influenced by HOD, as well as provide a viable route to delicate control of Kerr comb generation through tailoring the dispersion parameters.

Altered homeostasis and dysfunction of dendritic epidermal T cells (DETCs) contribute to abnormal diabetic wound healing. IL-15 plays important roles in survival and activation of T lymphocytes. Recently, reduction of epidermal IL-15 has been reported as an important mechanism for abnormal DETC homeostasis in streptozotocin -induced diabetic animals. However, the role of IL-15 in impaired diabetic wound healing remains unknown. Here, we found that, through rescuing the insufficient activation of DETCs, IL-15 increased IGF-1 production by DETCs and thereby promoted diabetic skin wound repair. Regulation of IGF-1 in DETCs by IL-15 was partly dependent on the mTOR pathway. In addition, expression of IL-15 and IGF-1 were positively correlated in wounded epidermis. Together, our data indicated that IL-15 enhanced IGF-1 production by DETCs to promoting diabetic wound repair, suggesting IL-15 as a potential therapeutic agent for managing diabetic wound healing.

Purpose We estimated female and male incident AIDS diagnosis rates (IARs) among people who inject drugs (PWID) in U.S. metropolitan statistical areas (MSAs) over time to assess whether declines in IARs varied by sex after combination antiretroviral therapy (cART) dissemination. Methods We compared IARs and 95% confidence intervals for female and male PWID in 95 of the most populous MSAs. To stabilize estimates, we aggregated data across three-year periods, selecting a period immediately preceding cART (1993–1995) and the most recent after the introduction of cART for which data were available (2005–2007). We assessed disparities by comparing IAR 95% confidence intervals for overlap, female-to-male risk ratios, and disparity change scores. Results IARs declined an average of 58% for female PWID and 67% for male PWID between the pre-cART and cART periods. Among female PWID, IARs were significantly lower in the later period relative to the pre-cART period in 48% of MSAs. Among male PWID, IARs were significantly lower over time in 86% of MSAs. Conclusions IARs among female PWID in large U.S. MSAs have declined more slowly than among male PWID. This suggests a need for increased targeting of prevention and treatment programs and for research on MSA level conditions that may drive differences in declining AIDS rates among female and male PWID.

A spectro-temporal filtering method is proposed to increase the contrast ratio of chirped pulses. The advantages of this method include easy cascading, high transmission, and it can also be used in the high-energy chirped pulse amplifier (CPA) system. The effectiveness of the proposed method was experimentally verified by operating the spectro-temporal filtering method on a Ti:sapphire CPA system and then measuring the contrast ratio of pulse based on optical Kerr gate effect(OKG). The measuring result demonstrated that, after passing through one-stage spectro-temporal filtering system with transmittance up to 70%, the contrast ratio of the pulse was improved by an order of magnitude.

Recently, modifying TiO2 to develop visible-light-driven photocatalysts via doping with nonmetal elements, metals and semiconductors has attracted much attention. In this study, a facile and reproducible sol–gel method was utilized for the first time to codope nonmetal (P), metal (Ag) and narrow band gap semiconductors (Ag2O and Ag3PO4) in TiO2 to prepare a P/Ag/Ag2O/Ag3PO4/TiO2 composite photocatalyst for developing a novel visible-light-driven photocatalyst. The crystal structure, morphology and optical properties of P/Ag/Ag2O/Ag3PO4/TiO2 were systemically characterized, and the photocatalytic abilities were evaluated under simulated solar light, in comparison with pure TiO2 and Ag/Ag2O/TiO2 photocatalysts. The results indicated that the P/Ag/Ag2O/Ag3PO4/TiO2 composite photocatalyst exhibited a strong absorption band in the visible light region, a small band gap (about 2.2 eV) and extremely high separation efficiency of photo-excited electron–hole pairs, which could account for its enhanced photocatalytic performance. The degradation ratio of rhodamine B (Rh B) by P/Ag/Ag2O/Ag3PO4/TiO2 reached 97.1% after 60 min under simulated solar light with only 13 mW cm−2 light intensity, while just 26.6% and 66.7% of Rh B were degraded by the as-prepared TiO2 and Ag/Ag2O/TiO2 photocatalysts, respectively. Furthermore, the radical trapping experiments implied that photo-generated holes and O2˙− radicals in the P/Ag/Ag2O/Ag3PO4/TiO2 composite photocatalyst were the major active species for Rh B degradation. Metallic Ag could effectively trap the photo-generated electrons from Ag3PO4 and Ag2O to reduce the possibility of decomposing Ag3PO4 and Ag2O, resulting in an improved stability of the P/Ag/Ag2O/Ag3PO4/TiO2 composite with high photocatalytic ability.

A group of nine states in the Southern United States, hereafter referred to as the targeted states, has experienced particularly high HIV diagnosis and case fatality rates. To provide additional information about the HIV burden in this region, we used CDC HIV surveillance data to examine characteristics of individuals diagnosed with HIV in the targeted states (2011), 5-year HIV and AIDS survival, and deaths among persons living with HIV (2010). We used multivariable analyses to explore the influence of residing in the targeted states at diagnosis on deaths among persons living with HIV after adjustment for demographics and transmission risk. In 2011, the targeted states had a higher HIV diagnosis rate (24.5/100,000 population) than the US overall (18.0/100,000) and higher proportions than other regions of individuals diagnosed with HIV who were black, female, younger, and living in suburban and rural areas. Furthermore, the targeted states had lower HIV and AIDS survival proportions (0.85, 0.73, respectively) than the US overall (0.86, 0.77, respectively) and the highest death rate among persons living with HIV of any US region. Regional differences in demographics and transmission risk did not explain the higher death rate among persons living with HIV in the targeted states indicating that other factors contribute to this disparity. Differences in characteristics and outcomes of individuals with HIV in the targeted states are critical to consider when creating strategies to address HIV in the region, as are other factors identified in previous research to be prominent in the region including poverty and stigma.

Aims To compare outcomes of anterior corpus callosotomy (CCT) with anti-epileptic drugs (AEDs) treatment in school-aged children with Lennox–Gastaut syndrome (LGS). Methods Sixty school-aged children with LGS were prospectively enrolled and divided into either the medicine or surgery group according the choice of the patients' caregivers. Cases in the medicine group were treated with multiple rational AEDs and patients in the surgery group underwent anterior CCT. Seizure control at 1–5 years after enrollment and changes of intelligence quotient (IQ) and quality of life (QOL) from pre-treatment to the 2-year follow-up were compared between the two groups. Results The percentages of patients who were totally seizure-free in the surgery group were 17.4% at the 1-year follow-up, 13.0% at the 2-year follow-up and 8.7% at the 5-year follow up, and the data for patients in the medicine group were 2.9%, 5.9% and 2.9%, respectively. Significant differences were found in total seizure control between the two groups at 1, 2, and 5-year follow-up (personal χ 2 test). Significant differences were found in mean changes of IQ and overall QOL between the medicine and surgery groups at the 2-year follow-up, showing positive results for the surgery group, but these changes were not related to postoperative outcomes of seizure control ( t -test). Conclusion Anterior CCT is a promising treatment for school-aged children with LGS, and can present marked seizure control and improvement in QOL and IQ, all of which were significantly better than the effects of treatment with multiple AEDs.