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Obstruction and/or reflux compromise venous emptying, make for the different pathophysiology of chronic venous insufficiency (CVI). We present a patient, presented with stubborn lower limb edema of CVI caused by post-thrombotic syndrome (PTS), succeeded in responding to the therapy of femoral vein valve by axillary vein bypass after ineffectual valvuloplasty and led a normal life. During 3 months observation, the bridging vessel may completely restore the original anatomical structure. Through the literature study, there is no similar operation reported. It shows that this operation may be feasible for some selected patients.

Though stigma is a recognized contributor to the disproportionate HIV burden among sexual and gender minorities (SGM) in sub-Saharan Africa, data describing this association among Zimbabwean SGM are limited. We examined relationships between SGM stigma and HIV and the potential for social cohesion to moderate the association among Zimbabwean men who have sex with men, transgender women, and genderqueer individuals. Consenting participants (n = 1511) recruited through respondent-driven sampling for a biobehavioral survey in Harare and Bulawayo completed structured interviews and received HIV testing. Reported SGM stigma was common (68.9% in Harare and 65.3% in Bulawayo) and associated with HIV infection in Harare (adjusted prevalence ratio [aPR] = 1.82, 95% confidence interval [CI] = 1.27–2.62) and Bulawayo (aPR = 1.51, 95% CI = 1.15–2.00) in relative risk regression. Social cohesion did not moderate these relationships. Findings demonstrate stigma’s association with HIV vulnerability among Zimbabwean SGM, highlighting the need for stigma-mitigation to reduce HIV transmission in this population.

The Information-Motivation-Behavioral Skills (IMB) Model has been used to understand adherence to medications and intentions to uptake pre-exposure prophylaxis (PrEP) to prevent HIV infection. In the current study, the IMB Model was used to understand factors that predict adherence to PrEP among a community-based cohort of 204 Black men who have sex with men (MSM) and transgender women (TGW) using structural equation modeling. PrEP motivation was directly associated with PrEP behavioral skills (β = .320, p = .009), and PrEP behavioral skills were directly associated with PrEP adherence (β = .416, p = .001). PrEP knowledge and PrEP motivation were not associated with PrEP adherence, directly or indirectly. The analysis identified intervenable factors that predicted PrEP adherence. Screening for motivation and behavioral skills could be used to identify where additional support to improve PrEP adherence is needed, or whether to offer alternative PrEP modalities or delivery strategies. RESUMEN: El Modelo de Información-Motivación-Habilidades Conductuales (IMB) ha sido utilizado para comprender la adherencia a los medicamentos y la intención de tomar la profilaxis pre-exposición (PrEP) para prevenir la infección por el VIH. En el estudio actual, se usó el modelo IMB para comprender los factores que predicen la adherencia a la PrEP entre una cohorte reclutada en la comunidad de 204 hombres que tienen sexo con hombres (HSH) y mujeres transgénero (TGW) de raza negra, usando modelos de ecuaciones estructurales. La motivación de adherir a la PrEP se asoció directamente con las habilidades conductuales de la PrEP adherencia (β = 0,320, p = 0,009), y las habilidades conductuales de la PrEP adherencia se asociaron directamente con la adherencia a la PrEP (β = 0,416, p = 0,001). El conocimiento de PrEP y la motivación de adherir a la PrEPno se asociaron con la adherencia a la PrEP, ni directa o indirectamente. El análisis identificó factores intervenibles que predijeron la adherencia a la PrEP. La evaluación de la motivación de adherir a la PrEP y las habilidades conductuales de la PrEP adherencia podría ser usado para identificar situaciones en que se necesita apoyo adicional para mejorar la adherencia a la PrEP, o si se deben ofrecer modalidades alternativas de recibir PrEP o estrategias alternativas para entregar PrEP.

A respondent-driven sampling survey among men who have sex with men and transwomen, and genderqueer in Zimbabwe found that active syphilis overall and among participants living with HIV was >6 times and ~4 times higher, respectively, than estimates among the general adult male population in the country., Background Syphilis increases human immunodeficiency virus (HIV) acquisition risk and impacts the immunologic and virologic response among people living with HIV (PLHIV). We assessed the prevalence of active or current syphilis and HIV/syphilis and their correlates among men who have sex with men (MSM), transwomen, and genderqueer (TGW/GQ) individuals in Zimbabwe. Methods Among a respondent-driven sample of MSM and TGW/GQ who were tested for HIV and syphilis in Harare and Bulawayo, Zimbabwe in 2019 (n = 1511), multiple logistic regression was used to assess correlates of active syphilis. Unadjusted logistic regression was used among PLHIV (n = 340) due to small sample size. All analyses were unweighted as data did not reach convergence for HIV. Results Prevalence of active syphilis overall and among PLHIV was 5.5% and 10.1%, respectively, in Harare, and 5.6% and 11.0%, respectively, in Bulawayo. Participants were more likely to have active syphilis if they were PLHIV (adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.4–3.6), aged 25–34 years (aOR, 2.2 years; 95% CI, 1.3–3.8 years; reference, 18–24 years), or self-report sexually transmitted infection symptoms (aOR, 1.8; 95% CI, 1.1–3.0). Compared with Bulawayo TGW/GQ, MSM in Harare (aOR, 0.2; 95% CI, 0.1–0.5) and Bulawayo (aOR, 0.2; 95% CI, 0.1–0.4), and TGW/GQ in Harare (aOR, 0.2; 95% CI, 0.1–0.6) were less likely to have active syphilis. Among PLHIV, coinfection was 13.0% among TGW/GQ and 9.7% among MSM. Odds of coinfection were higher for those aged 25 to 34 years (OR, 3.7 years; 95% CI, 1.2–11.1 years) and lower among Harare MSM (OR, 0.2; 95% CI, 0.1–0.7), Bulawayo MSM (OR, 0.1; 95% CI, 0.0–0.4), and Harare TGW/GQ (OR, 0.1; 95% CI, 0.0–0.4) compared with Bulawayo TGW/GQ. Conclusions Findings highlight a high burden of syphilis among MSM and TGW/GQ and underscore the importance of HIV/syphilis detection and improved service delivery for these groups.

Background: Congenital portosystemic shunt (CPS) is a developmental anomaly of the portal vein system. The disease can cause blood from the portal vein to flow into the vena cava, resulting in various atypical clinical manifestations. Pelvic congestion syndrome (PCS) caused by CPS is particularly rare.Case presentation: A young woman with PCS had an abnormal communicating branch of the left ovarian vein (OV). Her left OV drained normally into the left renal vein, and at the same time communicated with the portal vein, forming an extrahepatic portosystemic shunt. With embolization of her left OV, the patient was cured of PCS.Conclusions: Adequate knowledge of vascular variants helps clinicians in their treatment.

The COVID-19 pandemic has had serious health, economic and psychosocial consequences. Marginalized populations including female sex workers face the stark choice of risking exposure to SARS-CoV-2 as they engage with clients or prioritizing their health at the cost of losing a primary source of income. As part of an ongoing open-label, randomized controlled trial providing daily oral pre-exposure prophylaxis and adherence support, we interviewed 193 of 200 enrolled young female sex workers (18-24 years) in Kisumu, Kenya, about COVID-19 awareness and precautions, access to health services, and sex work during Kenya's pandemic-related lockdown. Nearly all participants were aware of COVID-19 and reported taking protective measures, but only half reported concerns about acquiring SARS-CoV-2. Night curfews and bar closures adversely affected participants' sex work business, reducing the number of clients and payment amounts from clients. Nearly 15% experienced violence from a client or regular, non-paying sex partner during the lockdown period. Participants' access to healthcare services was not disrupted.La pandemia de COVID-19 puede tener graves consecuencias sanitarias, económicas y psicosociales. Poblaciones marginadas como las mujeres trabajadoras sexuales se enfrentan a la dura elección de arriesgarse a exponerse al SARS-CoV-2 mientras interactúan con los clientes o priorizar su salud a riesgo de perder su principal fuente de ingresos. Como parte de un ensayo controlado aleatorio abierto en curso que proporcionaba profilaxis pre-exposición (PrEP) oral diaria y apoyo para la adherencia, entrevistamos a 193 de 200 las mujeres trabajadoras sexuales jóvenes (de 18 a 24 años) en Kisumu, Kenia, sobre su conocimiento y precauciones frente al COVID-19, acceso a servicios de salud, y trabajo sexual durante el confinamiento por la pandemia en Kenia. Casi todas las participantes conocían el COVID-19 y reportaron que tomaron medidas de protección, pero sólo la mitad dijeron estar preocupadas por infectarse con el SARS-CoV-2. Los toques de queda nocturnos y los cierres de bares afectaron negativamente al negocio del trabajo sexual, reduciendo el número de clientes y la cantidad que recibieron de los clientes. Casi el 15% experimentó violencia por parte de un cliente o por una pareja sexual habitual que no paga durante el periodo de confinamiento. El acceso de las participantes a los servicios de salud no se vio interrumpido.

Adsorption and its influence are often neglected during photocatalytic degradation of organic pollutants. To call attention to these issues, a novel bismuth oxybromide (BiOBr) microsphere with hierarchical flower-like structure was fabricated through a facile hydrothermal process using polyvinyl pyrrolidone (PVP) as additive in this work, and then the adsorption of the BiOBr microspheres to RhB and its influence on the photocatalytic degradation of RhB were investigated in detail. Experimental results show that the BiOBr microspheres have a very strong adsorption capacity to RhB. The adsorption behavior follows the Langmuir model and the quasi second order kinetic equation. Tests of the photocatalytic degradation of RhB under visible irradiation verify that the adsorption of the BiOBr microspheres to RhB greatly boosts the degradation of RhB due to the "enriching effect", and a complete degradation of 20 mg L

Background Lower extremity deep venous insufficiency (DVI) occurs secondary to structural or functional abnormalities of deep venous valves in the affected extremities. The effectiveness of surgical treatment for improvement of the hemodynamic status in these patients remains controversial in clinical practice. Method In this case report, we describe a patient who presented with severe right lower extremity edema and liposclerosis and underwent venography, which suggested a variation in the number of femoral veins. The valve within the duplicated femoral vein was significantly incompetent; however, the valve of the main trunk of the femoral vein showed normal function. We performed embolization of the duplicated femoral vein. Results The patient tolerated the procedure well without recurrent symptoms. Conclusions Individualized assessment based on venography findings is useful to establish the therapeutic approach in patients with DVI.

Prior HIV testing and awareness of HIV-positive status were assessed among HIV-positive adults at 20 clinics in Eswatini. Of 2196 HIV-positive adults, 1183 (53.8%) reported no prior HIV testing, and 1948 (88.7%) were unaware of their HIV-positive status. Males [adjusted odds ratio, AOR, (95% confidence interval): 0.7 (0.5–0.9)], youth 18–25 years [AOR 0.6 (0.4–0.95)], adults ≥ 50 years [AOR 0.5 (0.3–0.9)], those needing family support [AOR 0.6 (0.5–0.8)], and those living ≥ 45 min from clinic [AOR 0.5 (0.4–0.8)] were less likely to know their HIV-positive status. More HIV testing is needed to achieve 95-95-95 targets, with targeted strategies for those less likely to test for HIV.

Globally, men who have sex with men (MSM), transgender women, and genderqueer individuals are at greater risk for HIV than the general population although little data are available from these groups in Zimbabwe, a country with a national adult HIV prevalence of 12·9%. We aimed to examine progress towards the UNAIDS 90-90-90 treatment targets and factors associated with meeting the targets among a sample of MSM, transgender women, and genderqueer individuals in Zimbabwe.In this cross-sectional survey in 2019, we used respondent-driven sampling to identify MSM, transgender women, and genderqueer individuals aged at least 18 years to participate in a biobehavioural survey in Harare and Bulawayo, Zimbabwe. Participants were eligible to participate if they were assigned male at birth; had engaged in anal or oral sex with a man in the past 12 months; resided in Harare or Bulawayo for at least 1 month; spoke English, Shona, or Ndebele; provided written informed consent; and were in possession of a valid recruitment coupon if applicable. Enrolled participants completed a questionnaire and underwent HIV testing, and off-site viral load testing was done on all HIV-positive samples. Unweighted bivariate analyses and multivariable logistic regression models were used to evaluate the association of sociodemographic, behavioural, and other factors with HIV-positive status awareness among MSM, transgender women, and genderqueer individuals, and with viral load suppression among MSM. Analyses were done firstly using self-reported information and then by classifying those with a viral load of less than 200 copies per mL as being aware of their status and on treatment (viral load recategorisation).Among MSM, 248 (21%; 95% CI 19-24) of 1176 tested positive for HIV. Of those who tested positive, based on self-report, 119 (48%; 95% CI 42-54) reported knowing their HIV status, of whom 112 (94%; 88-98) reported using antiretroviral therapy (ART), of whom 89 (79%; 71-87) had viral load suppression. Based on viral load recategorisation, 180 (73%; 67-78) of 248 MSM testing HIV positive reported knowing their HIV status, of whom 174 (97%; 93-99) reported using ART, of whom 151 (87%; 81-91) had viral load suppression. 92 (28%; 23-33) of 335 transgender women and genderqueer individuals tested positive for HIV. Based on self-reports from these individuals 34 (37%; 27-48) of 92 participants reported knowing their HIV status, of whom 31 (91%; 76-98) reported using ART, of whom 27 (87%; 70-96%) had viral load suppression. Based on viral load recategorisation of data from transgender women and genderqueer participants, 53 (58%; 47-58) of 92 reported awareness of their HIV status, of whom 50 (94%; 84-99) reported using ART, of whom 46 (92%; 81-98) had viral load suppression. HIV-positive MSM aged 18-24 years had lower odds of being aware of their status than those aged at least 35 years (adjusted odds ratio [aOR] 0·34; 95% CI 0·13-0·92), as did HIV-positive MSM aged 25-34 years (aOR 0·26; 0·12-0·56). HIV-positive MSM aged 18-24 years also had a lower odds of having viral load suppression than those aged 35 years and older (aOR 0·35; 0·16-0·78), as did those aged 25-34 years (aOR 0·36; 0·19-0·67). No factors were significantly associated with awareness among transgender women and genderqueer individuals in multivariable models.Our survey showed that HIV prevalence was high and the largest difference between our results and the 90-90-90 treatment targets was in HIV status awareness, indicating the need for improvements in engaging MSM (especially young MSM), transgender women, and genderqueer individuals in HIV testing services.US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.

Botrytis cinerea is one of the most destructive pathogens of cherry tomatoes during preharvest and postharvest phase. Our previous study demonstrated that volatile organic compounds (VOCs) produced by Hanseniaspora uvarum could markedly suppress the mycelium growth and conidia germination of B. cinerea. However, the main inhibitory VOCs of H. uvarum are not fully clear. In this study, a total of 21 volatile organic monomers (VOMs) of H. uvarum were tested for their antifungal activity against B. cinerea in vitro. It was found that trans-cinnamaldehyde, 2-nonanone, ethyl caprylate, benzyl alcohol, hexanoic acid, hexyl alcohol, isobutyl acetate, ethyl propionate, isoamyl acetate, ethyl 2-methylbutyrate, phenethyl alcohol, ethyl acetate, 4-ethylphenol, 3-phenyl-1-propanol, ethyl cinnamate, 3-methyl-1-butanol, and ethyl 3-hydroxybhexanoate could significantly inhibit mycelium growth within 3 days at higher concentrations, whereas ethyl 3-hydroxybutyrate, ethyl caprate, decanoic acid, and lauric acid exhibited a lower inhibition. Furthermore, the five VOMs, including trans-cinnamaldehyde, 2-nonanone, ethyl caprylate, benzyl alcohol, and hexanoic acid, also had the efficiency on inhibiting conidia germination. In particular, trans-cinnamaldehyde was the best inhibitor of mycelium growth and conidia germination. Hence, trans-cinnamaldehyde was also tested in vivo as postharvest biofumigants. In vivo assay showed that trans-cinnamaldehyde could significantly reduce B. cinerea infection of cherry tomatoes and maintain fruit hardness, color, total soluable solids, and titratable acidity under conditions of artificial and natural infection. Collectively, these results indicated that trans-cinnamaldehyde, the main inhibitory VOMs of H. uvarum, has the potential for effectively controlling postharvest gray mold of cherry tomatoes and maintaining fruit quality in commercial application.

The vibration of the barrel, induced by the interaction with a high-speed moving projectile, has a considerable influence on the shooting accuracy of a weapon. The finite element model of a multi-barrel was established with the goal to investigate its vibration characteristics in this paper, and the natural frequency and mode shape were analyzed by finite element method. To verify the result of finite element modal analysis (FEMA), a modal testing system basis on SC310W multi-path data-collecting system and hammer hitting method was set up. Results show that the low order vibrations of the multi-barrel artillery were mainly vertical, horizontal and torsional vibration, but the local vibration at high orders. The error of natural frequencies between the results obtained by simulation and test was 8.82 % in the first mode frequency and 1.37 % in the eighth. The FEMA can effectively simulate the actual vibration of the multi-barrel artillery.

Zimbabwe is scaling up pre-exposure prophylaxis (PrEP) for key populations, including men who have sex with men (MSM) and transgender women (TGW). To assess implementation and inform HIV programming, we evaluated gaps in PrEP awareness, uptake and use, and correlates of awareness and uptake among a sample of MSM, TGW and genderqueer individuals (GQ) in Harare and Bulawayo, Zimbabwe.Respondent-driven sampling was used to recruit 1194 MSM and 344 TGW/GQ aged ≥18 to participate in a cross-sectional survey assessing HIV-related outcomes in 2019. Consenting participants completed a questionnaire on socio-demographic information, sexual risk practices and engagement in HIV services and underwent HIV testing. Descriptive statistics were used to assess the PrEP cascade. Multiple logistic regression models were used to identify factors associated with PrEP awareness and uptake among HIV-negative participants. Data were unweighted as the sample did not reach convergence on key estimates.Among the 1167 HIV-negative participants, most (79.2%) were MSM compared to TGW/GQ (20.8%). Median age was 24 years. Overall, 45.8% were aware of PrEP and of those, 31.3% had ever taken PrEP. Most (71.1%) reporting never taking PrEP were willing to start PrEP; the main reasons for never starting PrEP included not knowing where to access it (24.8%) and fearing side effects (20.4%). Among those who had ever taken PrEP, 74.9% had taken PrEP in the last 6 months; of these, 42.4% had taken PrEP the day of or day preceding the survey. Side effects represented the most common (59.5%) reason for discontinuing PrEP. MSM (adjusted odds ratio [aOR]: 2.5, 95% confidence interval [CI]: 1.8-3.6) and TGW/GQ in Harare (aOR: 3.1, 95% CI: 2.1-4.7), and TGW/GQ in Bulawayo (aOR: 2.4, 95% CI: 1.1-5.3) had higher awareness of PrEP than MSM in Bulawayo. Overall, TGW/GQ were more likely to have ever taken PrEP compared to MSM (aOR: 1.6, 95% CI: 1.01-2.4).Findings emphasize the need for tailored interventions to promote PrEP among key populations. As HIV programs in Zimbabwe continue to expand PrEP services, these data, including barriers to starting and continuing PrEP, can inform strategies to address gaps along the PrEP cascade.

Background The main cause of severe chronic venous insufficiency is deep venous incompetence. Deep venous reconstructive surgeries are reserved for cases that do not show a good response to conservative therapies. Method We present the case of a 68-year-old man presenting with swelling, pain, and pigmentation in his left lower limb for 14 years and ulcers for 10 years. Descending venography identified a Kistner’s grade IV reflux in the deep vein of the left lower limb. Internal valvuloplasty was performed following Kistner’s method. Meanwhile, external wrapping with a 1-cm-wide polyester-urethane vascular patch was performed to strengthen the vein wall in the venospasm condition. Results Symptoms were immediately relieved postoperatively. Refractory ulcers healed five months after the procedure. At the six-month follow-up, color duplex ultrasound of the deep vein of the left lower limb showed no reflux in the proximal segment of the femoral vein. Conclusion Internal valvuloplasty combined with sleeve wrapping is feasible in the treatment of severe deep venous incompetence with good short-term results.

Heuristic approaches are recently prevalent. Although they cannot be explained in mathematics, its performances are also impressive. In this paper, comparing with Genetic Algorithm (GA), we make the vehicle avoid obstacles in simulation by applying Grey Wolf Optimizer (GWO) to train the Artificial Neural Network (ANN). This method is unsupervised. Its inputs are the distances between vehicle and obstacle which are collected by rangefinders, while its outputs are the two steering angles that decide which direction the vehicle turns to. The fitness is lifetime of the vehicle. Finally, the experimental results show that the convergence speed of GWO is faster than that of GA.

Stem cell therapy is emerging as an exciting new strategy for the treatment of chronic wounds representing a promising approach of regenerative medicine. Induced pluripotent stem cells (iPSC) represent an innovative, adult-derived, stem cell source with enhanced therapeutic and translational potential. iPSC are pluripotent stem cells derived from somatic donor cells, harvested via noninvasive techniques from a limitless donor pool. The use of iPSC technologies allows for generation of autologous pluripotent stem cell populations with enhanced in vivo survival while obviating ethical issues surrounding destruction of embryos. Because of their ability to differentiate into and repopulate all cell types found in the skin, iPSC have the potential to enhance each phase of wound healing via paracrine and direct cellular effects. Current methods that generate iPSC are often inefficient, predispose cells to mutagenesis, and yield impure cellular populations. Because undifferentiated cells carry tumorigenic potential, selection of terminally differentiated cells and use of cell-free extracellular vesicles may improve iPSC safety profile. While the ideal delivery platform for improving cell function and survival is yet to be designed, advances in bioengineered materials to create next-generation delivery scaffolds have shown promising results. Thus, despite tremendous advantages and promise for tissue regeneration, further studies to improve iPSC safety profile and generation methods are urgently needed prior to widespread clinical adoption.

Objective Peripheral artery disease (PAD) affects more than 200 million people worldwide, among whom more than two-thirds reside in low- and middle-income countries. China, as the largest low- and middle-income country, faces a challenge from the burden of PAD as the country undergoes economic expansion. We compared the patterns of PAD between China and Western countries to determine if there are differences in risk factors, awareness, or treatment of PAD. Methods Literature searches were performed both in English databases and Chinese databases covering January 1, 1995, to March 1, 2020. Both landmark and high-quality articles were evaluated. Results The prevalence of PAD in high-income countries increases linearly with age, whereas PAD increases slowly until the middle 60s and exponentially thereafter in China. In contrast with Western countries, the prevalence of PAD in China is reported to be higher in women than in men. There is a higher prevalence of risk factors in China, but the rates of awareness and treatment of these risk factors are low. Conclusions The lack of awareness and lower rates of treatment and control of PAD and its risk factors in China may be underlying the higher prevalence of PAD in women than in men as well as the steep increase in PAD after the middle 60s. In all countries, more attention should be paid to the planning and implementation of preventative strategies and clinical services. The societal and economic effects of PAD are considerable and ongoing studies are needed to help curtail the burden of this disease.

While oral pre-exposure prophylaxis (PrEP) has proven efficacious for HIV prevention, consistent use is necessary to achieve its intended impact. We compared effectiveness of enhanced PrEP (enPrEP) adherence support to standard of care (sPrEP) among Black MSM and TGW attending a community clinic in Harlem, NY. EnPrEP included peer navigation, in-person/online support groups, and SMS messages. Self-reported adherence over previous 30 days, collected in quarterly interviews, was defined as ≥ 57%. Crude and adjusted analyses examined factors associated with adherence. A total of 204 participants were enrolled and randomized; 35% were lost to follow-up. PrEP adherence was 30% at 12-months; no intervention effect was observed (p = 0.69). Multivariable regression analysis found that lower adherence was associated with low education and depressive symptoms. We found that an enhanced adherence intervention did not improve PrEP adherence. Findings point to the need for innovative methods to improve PrEP adherence among Black MSM and TGW. Clinical Trial Registration NCT02167386, June 19, 2014

The modal frequencies of a structure are affected by continuous changes in ambient factors, such as temperature, wind speed etc. This study incorporates nonlinear principal component analysis (NLPCA) with support vector regression (SVR) to build a mathematical model to reflect the correlation between ambient factors and modal frequencies. NLPCA is first used to eliminate the high correlation among different ambient factors and extract the nonlinear principal components. The extracted nonlinear principal components are input into the SVR model for training and predicting. The proposed method is verified by the measured data provided in the Guangzhou New TV Tower (GNTVT) Benchmark. The grid search method (GSM), genetic algorithm (GA) and fruit fly optimization algorithm (FOA) are applied to determine the optimal hyperparameters for the SVR model. The optimized result of FOA is most suitable for the NLPCA-SVR model. As evaluated by the hypothesis test and goodness-of-fit test, the results show that the proposed method has a high generalization performance and the correlation between the ambient factor and modal frequency can be strongly reflected. The proposed method can effectively eliminate the effects of ambient factors on modal frequencies.

Most of the existing work on topology control is to minimize the interference or delay separately. However, minimizing the interference and reducing the delay are two conflicting goals; therefore, considering a trade-off between them is necessary. In this paper, our goal is to minimize the interference while guaranteeing the end-to-end delay under a constraint. We take into account three optimization objectives, including the maximum interference, average interference and average path interference. We propose a centralized algorithm with a greedy strategy that can minimize the maximum interference while satisfying the delay constraint. A distributed algorithm (LDMST) is proposed to minimize the average interference. In LDMST, each node builds a delay-constrained minimum spanning tree (DMST). To minimize the path interference, a localized delay-constrained Bellman–Ford (LDBF) algorithm is proposed. LDBF employs an improved Bellman–Ford algorithm to find the optimal path, which has the minimum interference and satisfies the delay constraint. The final topology is composed of these optimal paths. The simulation results illustrate that the proposed topology control algorithms exhibit good performance in terms of the interference objectives and can also guarantee the end-to-end delay under the constraint.

Recovering the adsorption capacity of multi-walled carbon nanotubes (MWCNT) is of importance to the sustainable use of MWCNT for the adsorption of pharmaceuticals and personal care products (PPCP). In this study, different regeneration approaches, including chemical desorption, sonication, and thermal treatment were compared for their efficiencies in regenerating the adsorption capacities of a MWCNT for acetaminophen (AAP), ibuprofen (IBU), and triclosan (TCS). Among chemical solutions possessing different levels of hydrophobicity, pH and salt concentrations, a NaCl solution at a concentration of 0.1 M outperformed others due to the replacement of the adsorbed PPCP by Na+, and hence regenerated the used MWCNT. However, the higher desorption ratio of TCS and IBU (mainly governed by π–π interactions) than that of AAP (dominated by hydrogen-bonding interactions) was due to the smaller bond interactions of π–π interactions than hydrogen-bonding interactions. Furthermore, sonication of the MWCNT immersed in the NaCl solution increased the adsorption capacities of MWCNT by 4.9–33.7%, 36.8–46.9% and 1.1–6.8% for AAP, IBU, and TCS, respectively, possibly because the high-energy pulsation induced by sonication weakened the adhesive interaction between MWCNT and PPCP. Furthermore, thermal regeneration of the MWCNT at 380 °C led to the vaporization and/or oxidation of the adsorbed PPCP, while it maintained the characteristics of the MWCNT. Overall, these results imply that thermal regeneration is potentially the most effective approach for regenerating MWCNT.

BackgroundUniversal antiretroviral treatment (ART) for pregnant women with HIV, Option B+, has been adopted widely for prevention of mother-to-child HIV transmission (PMTCT). Some evidence shows high loss to follow-up (LTF) under this model. However, gaps in data systems limit this evidence. We collected additional information for women and infants LTF from Option B+ in Eswatini to assess more accurate outcomes.MethodsLTF at 6-months postpartum was assessed using facility data. Additional data was gathered from: 1) the national ART database and paper records; 2) patient tracing; and 3) interviews and abstraction from patient-held records. Engagement in care was defined as any clinic visit within 91 days before or after 6-months postpartum or completion of a documented transfer; or, for those traced but not completing study interviews, visits at 6-months postpartum or later (for infants), or visits within 3-months of tracing (for women). Multivariable loglinear models were used to identify correlates of engagement.ResultsOne-hundred-ninety-four (44.7%) of 434 LTF women had outcomes ascertained, including 122 (62.9%) women engaged in care. Among 510 LTF infants, 265 (52.0%) had ascertained outcomes, including 143 (54.0%) engaged in care, 47 (17.7%) pregnancy losses, and 18 (6.8%) deaths. Seventy-two of 189 live infants (38.1%) with ascertained outcomes had a 6-week early infant diagnostic (EID) test. Among women with ascertained outcomes, gestational age of 20+ weeks (vs. fewer than 20 weeks, aRR 0.80; 95% CI 0.68-0.94) and age 25-29 years (vs. 15-24 years, aRR 0.81; 95% CI 0.67-0.97), were associated with lower engagement; initiating ART after first ANC visit was associated with higher engagement (vs. at first ANC visit, aRR 1.12; 95% CI 1.04-1.21). Among infants with ascertained outcomes, mother not initiating ART was associated with lower engagement (vs. ART at first ANC visit, aRR 0.71; 95% CI 0.54-0.91).ConclusionSubstantial numbers of women and infants classified as LTF under Option B+ were engaged in care, though a suboptimal level of 6-week EID testing was observed. These findings highlight a need to improve coverage of routine EID testing, and improve data systems to better capture PMTCT patient outcomes.

The present study was performed to investigate the effects of myofibrillar proteins (MPs) extracted from crocodile (tail, legs, torso) on gel formation mechanism and gel characteristics. The results showed that protein compositions and ratios were different in the three body parts. The tail MPs had a higher surface hydrophobicity than the legs and torso MPs, while the leg MPs had more reactive sulfhydryl groups than the tail and torso MPs (P

OBJECTIVE: This study examined the psychological impact of the coronavirus disease 2019 (COVID-2019) outbreak on medical staff in China. MATERIALS AND METHODS: In February 2020, an online survey was carried out by using an online survey tool (WeChat) to evaluate the effects of the outbreak on the mental health of medical staff in China. RESULTS: A total of 11,118 medical staff responded to the survey. About 4.98% of the respondents reported middle and high levels of anxiety, while 13.47% of the respondents reported middle and high levels of depression since the COVID-19 outbreak. Nurses, frontline medical staff, and younger medical staff were more likely to have anxiety and depression than physicians, nonfrontline medical staff, and older medical staff. CONCLUSIONS: Although the serious psychological impact of COVID-19 is not so common in medical staff in China, programs are needed to protect them against the negative impacts of COVID-19.

Background : Initiating antiretroviral therapy (ART) early during tuberculosis (TB) treatment increases survival; however, implementation is suboptimal. Implementation science studies are needed to identify interventions to address this evidence-to-program gap. Objective : The Start TB Patients on ART and Retain on Treatment (START) Study is a mixed-methods, cluster-randomized trial aimed at evaluating the effectiveness, cost-effectiveness, and acceptability of a combination intervention package (CIP) to improve early ART initiation, retention, and TB treatment success among TB/HIV patients in Berea District, Lesotho. Design : Twelve health facilities were randomized to receive the CIP or standard of care after stratification by facility type (hospital or health center). The CIP includes nurse training and mentorship, using a clinical algorithm; transport reimbursement and health education by village health workers (VHW) for patients and treatment supporters; and adherence support using text messaging and VHW. Routine data were abstracted for all newly registered TB/HIV patients; anticipated sample size was 1,200 individuals. A measurement cohort of TB/HIV patients initiating ART was recruited; the target enrollment was 384 individuals, each to be followed for the duration of TB treatment (6–9 months). Inclusion criteria were HIV-infected; on TB treatment; initiated ART within 2 months of TB treatment initiation; age ≥18; English- or Sesotho-speaking; and capable of informed consent. The exclusion criterion was multidrug-resistant TB. Three groups of key informants were recruited from intervention clinics: early ART initiators; non/late ART initiators; and health care workers. Primary outcomes include ART initiation, retention, and TB treatment success. Secondary outcomes include time to ART initiation, adherence, change in CD4+ count, sputum smear conversion, cost-effectiveness, and acceptability. Follow-up and data abstraction are complete. Discussion : The START Study evaluates a CIP targeting barriers to early ART implementation among TB/HIV patients. If the CIP is found effective and acceptable, this study has the potential to inform care for TB/HIV patients in high-burden, resource-limited countries in sub-Saharan Africa. Keywords : TB/HIV integration; implementation science; cost-effectiveness; acceptability; TB treatment success (Published: 27 June 2017) Citation: Glob Health Action 2016, 9 : 31543 - http://dx.doi.org/10.3402/gha.v9.31543 Supplementary material: To access the supplementary material for this article, please see Supplementary files under ‘Article Tools’

Supplemental Digital Content is Available in the Text., Background: Scale-up of triple-drug antiretroviral therapy (ART) in Africa has transformed the context of childbearing for HIV-positive women and may impact pregnancy incidence in HIV programs. Methods: Using observational data from 47,313 HIV-positive women enrolled at 26 HIV clinics in Kenya and Uganda between 2001 and 2009, we calculated the crude cumulative incidence of pregnancy for the pre-ART and on-ART periods. The causal effect of ART use on incident pregnancy was assessed using inverse probability weighted marginal structural models, and the relationship was further explored in multivariable Cox models. Results: Crude cumulative pregnancy incidence at 1 year after enrollment/ART initiation was 4.0% and 3.9% during the pre-ART and on-ART periods, respectively. In marginal structural models, ART use was not significantly associated with incident pregnancy [hazard ratio = 1.06; 95% confidence interval (CI): 0.99 to 1.12]. Similarly, in Cox models, there was no significant relationship between ART use and incident pregnancy (cause-specific hazard ratio: 0.98; 95% CI: 0.91 to 1.05), but effect modification was observed. Specifically, women who were pregnant at enrollment and on ART had an increased risk of incident pregnancy compared to those not pregnant at enrollment and not on ART (cause-specific hazard ratio: 1.11; 95% CI: 1.01 to 1.23). Conclusions: In this large cohort, ART initiation was not associated with incident pregnancy in the general population of women enrolling in HIV care but rather only among those pregnant at enrollment. This finding further highlights the importance of scaling up access to lifelong treatment for pregnant women.

Subway systems are rapidly developing, and their energy consumption is considerably growing. The ventilation and air conditioning system in the subway station is the key energy-consuming system. It consumes a large amount of energy every day to provide a comfortable environment for passengers, and it has therefore received increasingly more attention from researchers worldwide. In this work, the variation law of the ventilation and air conditioning system of a subway station is analyzed from three aspects (energy consumption, load, and temperature) based on field test data, and the problems existing in the operation and management of the system are analyzed. For example, the results show that the total load of fresh air in the station was as high as 34–37%, and about 30 min was required to adjust the indoor temperature to a stable state. In addition, three general models and seven energy-saving strategies are put forward, and their energy saving potentials are estimated. After optimization, the ventilation and air conditioning system is found to reduce energy consumption by more than 30%. Not only are common problems that exist in the actual operation of the subway station ventilation and air conditioning system found in this research, but valuable measured data is also provided for the theoretical research of the thermal environment of the subway and the design of environmental control systems.