Search

BackgroundInjectable cabotegravir was superior to daily oral tenofovir disoproxil fumarate plus emtricitabine for HIV prevention in two clinical trials. Both trials had the primary aim of establishing the HIV prevention efficacy of long-acting injectable cabotegravir pre-exposure prophylaxis (PrEP) compared with tenofovir disoproxil fumarate plus emtricitabine daily oral PrEP. Long-acting PrEP was associated with diagnostic delays and integrase strand-transfer inhibitor (INSTI) resistance. This report presents findings from the first unblinded year of the HIV Prevention Trials Network (HPTN) 083 study.MethodsThe HPTN 083 randomised controlled trial enrolled HIV-uninfected cisgender men and transgender women at elevated HIV risk who have sex with men, from 43 clinical research sites in Africa, Asia, Latin America, and the USA. Inclusion criteria included: a negative HIV serological test at the screening and study entry, undetectable HIV RNA levels within 14 days of study entry, age 18 years or older, overall good health as determined by clinical and laboratory evaluations, and a creatinine clearance of 60 mL/min or higher. Participants were randomly allocated to receive long-acting injectable cabotegravir or daily oral tenofovir disoproxil fumarate plus emtricitabine PrEP. After study unblinding, participants remained on their original regimen awaiting an extension study. HIV infections were characterised retrospectively at a central laboratory. Here we report the secondary analysis of efficacy and safety for the first unblinded year. The primary outcome was incident HIV infection. Efficacy analyses were done on the modified intention-to-treat population using a Cox regression model. Adverse events were compared across treatment groups and time periods (blinded vs unblinded). This trial is registered with ClinicalTrials.gov, NCT02720094.FindingsOf the 4488 participants who contributed person-time to the blinded analysis, 3290 contributed person-time to the first unblinded year analysis between May 15, 2020, and May 14, 2021. Updated HIV incidence in the blinded phase was 0·41 per 100 person-years for long-acting injectable cabotegravir PrEP and 1·29 per 100 person-years for daily oral tenofovir disoproxil fumarate plus emtricitabine PrEP (hazard ratio [HR] 0·31 [95% CI 0·17-0·58], p=0·0003). HIV incidence in the first unblinded year was 0·82 per 100 person-years for long-acting PrEP and 2·27 per 100 person-years for daily oral PrEP (HR 0·35 [0·18-0·69], p=0·002). Adherence to both study products decreased after study unblinding. Additional infections in the long-acting PrEP group included two with on-time injections; three with one or more delayed injections; two detected with long-acting PrEP reinitiation; and 11 more than 6 months after their last injection. Infection within 6 months of cabotegravir exposure was associated with diagnostic delays and INSTI resistance. Adverse events were generally consistent with previous reports; incident hypertension in the long-acting PrEP group requires further investigation.InterpretationLong-acting injectable cabotegravir PrEP retained high efficacy for HIV prevention in men and transgender women who have sex with men during the first year of open-label follow-up, with a near-identical HR for HIV risk reduction between long-acting injectable cabotegravir and daily oral tenofovir disoproxil fumarate plus emtricitabine PrEP during the first year after unblinding compared with the blinded period. Extended follow-up further defined the risk period for diagnostic delays and emergence of INSTI resistance.FundingDivision of AIDS at the National Institute of Allergy and Infectious Diseases, ViiV Healthcare, and Gilead Sciences.

The worldwide need for environmental preservation and robust economic development has garnered significant interest from scholars and politicians. This study examines the influence of green finance and environmental protection tax on Vietnam’s financial sustainability and the transition towards a green economyas an emerging economy. The study obtained data from the Central Bank of Vietnam and World Bank Indicators covering 2012 to 2022. The authors used the Ordinary Least Squares approach to examine the associations between the variables. The analysis and examination of the data used Stata 19 software. The findings show a favourable correlation between green finance and environmental tax on sustainable development goalswith all control variables. These results have prompted authorities to focus on green finance and environmental issues in the progress towards the country’s green economy and sustainable development.

The aim of this paper is to examine how a shock in the oil industry affects firms' debt funding obligations using credit default swaps in different segments of the oil industry's value chain. In particular, it focuses on two types of shocks suffered by upstream, integrated and downstream firms in the industry, namely (1) endogenous shocks resulting from oil-market shocks, and (2) exogenous shocks resulting from the recent financial crisis and the Covid-19 pandemic. Using a wide data set ranging from 2007 to 2020, this paper measures the dynamic relationships between the CDS spreads of oil-related firms, US dollar exchange rates, and crude oil prices at different sectors of the oil-industry value chain, namely, upstream, integrated and downstream. Overall results show that the upstream firms have suffered the largest impacts during the COVID-19 crisis, when experiencing shocks from USD rates or oil prices. Integrated firms have suffered the second-largest effects, however, and interestingly, no significant impacts from shocks are observed on CDS spreads for downstream firms. Keywords: CDS Spread, Oil, Corporate Funding, Upstream. Downstream, 1. INTRODUCTION Post the 1990s, the world has seen a further increase in debt-issuance activities by the corporate sector in financial markets not only due to the diversity of the [...]

This paper presents the development and psychometric properties of an interpersonal problem-solving inventory for Vietnamese elementary school students (IPSI). The IPSI consists of five subscales: Positive problem-solving behavior; Negative problem-solving behavior; Rational problem-solving behavior; Impulsive behavior; and Avoidance behavior. The scale was administered to a total sample that consists of 730 Vietnamese fifth grade students (age 10-14, M = 10.70, SD = 0.56). Multiple psychometric analyses were utilized including classical test theory (CTT), exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Reliability of IPSI was reported by calculating internal consistency. Findings showed that the IPSI has adequate internal consistency (Cronbach's [alpha] = 0.90; McDonald's [omega] = 0.82). The EFA findings suggested that the IPSI has two-factor structure. The CFA findings indicated that the IPSI has the theory-driven five-factor structure that has the adequate fitness indices (X[superscript 2]/df = 1.369, p < 0.001; GFI: 0.930; TLI: 0.926; CFI: 0.871; RMSEA: 0.032; SRMR: 0.046). These findings suggest that the IPSI is a well-functioning scale with good psychometric properties. Recommendations and weak points of the scale are discussed. Future research and possible improvements are proposed.

Laparoscopic donor nephrectomy (LDN) is increasingly popular because of its advantages over open surgery. Chyle leak after donor nephrectomy is a rare but potentially lethal complication if not treated appropriately. We describe a case of a 43-year-old female patient with no remarkable history who presented a chyle leak on day 2 after right transperitoneal LDN. Since conservative treatment failed, the patient underwent magnetic resonance imaging (MRI) and intranodal lipiodol lymphangiography, which confirmed the chyle leak from the right lumbar lymph trunk into the right renal fossa. The chyle leak was percutaneously embolized twice, on postoperative day (POD) 5 and POD 10, by a mixture of N-butyl-2-cyanoacrylate and lipiodol. The drainage fluid decreased significantly after the second embolization. The subhepatic drainage tube was withdrawn on POD 14, and the patient was discharged on POD 17. MRI lymphangiography and intranodal lipiodol lymphangiography effectively identified the chyle leak point. Percutaneous embolization seems to be a safe, effective method for treating high-output chyle leaks.

Early neurological deterioration (END) is progressive neurological deterioration with an increase in NIHSS score of 2 points or more in the first 72 hours from the onset of acute ischemic stroke. END increases the risk of poor clinical outcomes at day 90 of ischemic stroke. We will study the frequency, predictors, and outcomes of patients with END in a case-control study at a comprehensive stroke centre in Vietnam. of the design is a descriptive observational study, longitudinal follow-up of patients with minor stroke hospitalized at the Stroke Center of Bach Mai Hospital from December 1, 2023, to December 1, 2024. Minor stroke patients characterized by NIHSS score ≤ 5 hospitalized within 24 hours of symptom onset will be recruited. The estimated END rate is about 30%, relative accuracy ε = 0.11, 95% reliability, expected 5% of patients lost data or follow-up, and an estimated sample size of 779 patients. This study will help determine the END rate in patients with minor stroke and related factors, thereby building a prognostic model for END. Our study determined the END rate in patients with minor stroke in Vietnam and also proposed risk factors for minor stroke management and treatment.

This study employed novel extraction methods with natural deep eutectic solvents (NADES) to extract bioactive compounds and proteins from Bacopa monnieri leaves. The conditional influence of ultrasonic-assisted extraction (UAE), microwave-assisted extraction (MAE), and enzymatic-assisted extraction (EAE) on the recovery efficiency of phenolics, proteins, flavonoids, and terpenoids was evaluated. The conditions of UAE were 50 mL/g LSR, 600W of ultrasonic power, and 30% water content with 40°C for 1 min to obtain the highest bioactive compounds and protein contents. The conditions of MAE were 40 mL/g LSR, 400W of microwave power with 30% water content for 3 min to reach the highest contents of biological compounds. The conditions of EAE were 30 mL/g of LSR, 20 U/g of enzyme concentration with L-Gly-Na molar ratio at 2:4:1, and 40% water content for 60 min to acquire the highest bioactive compound contents. Scanning electron microscopy (SEM) is employed to analyze the surface of Bacopa monnieri leaves before and after extraction. Comparing seven extraction methods was conducted to find the most favorable ones. The result showed that the UMEAE method was the most effective way to exploit the compounds. The study suggested that UMEAE effectively extracts phenolics, flavonoids, terpenoids, and protein from DBMP.