Tenofovir alafenamide or tenofovir disoproxil fumarate in pregnancy to prevent HBV transmission: Maternal ALT trajectory and infant outcomes.

BACKGROUND: The use of antiviral agents, specifically tenofovir disoproxil fumarate (TDF), in pregnant women to prevent mother-to-child HBV transmission is a key step towards hepatitis elimination. However, data on using tenofovir alafenamide (TAF) is insufficient. The frequent occurrence of postpartum ALT flares may impact the clinical implementation. METHODS: The maternal and infant outcomes were compared in multi-centre trials of high viral load HBsAg/HBeAg+ pregnant women receiving TAF or TDF from the third trimester until 2 weeks postpartum with intensive follow-ups. To explore the dynamic pre- and postpartum changes in ALT levels, we used a group-based trajectory model for analysing data of 332 women from three prospective studies. RESULTS: After treatment, the maternal HBV DNA levels significantly decreased from baseline to delivery: 7.87 ± 0.59 to 3.99 ± 1.07 Log10 IU/mL TAF (n = 78) and 8.30 ± 0.36 to 4.47 ± 0.86 Log10 IU/mL (TDF, n = 53), with viral load reductions of 3.87 versus 3.83 Log10 IU/mL. The HBsAg-positive rates among 12-month-old infants were 1.28% (1/78) versus 1.82% (1/55) respectively (p = 1.00). Of the TAF or TDF-treated mothers, 25.64% versus 16.98% experienced ALT > 2X ULN, and 11.54% versus 1.89% received extended antiviral treatment. Our model revealed four distinct ALT patterns: stable ALT (87.2%), moderate (8.0%) or marked (2.4%) postpartum flares, or prepartum elevations (2.4%). CONCLUSIONS: TAF effectively reduces mother-to-child HBV transmission, but prophylaxis failure still occurred in few cases. Postpartum ALT flares are common in women receiving TAF or TDF during pregnancy. Approximately 12.8% of mothers may require extended postpartum antiviral treatment. CLINICAL TRIAL NUMBER: NCT03695029 (ClinicalTrials.gov).

Fresh Frozen Plasma Transfusion: An Independent Risk Factor for Hemodynamically Significant Patent Ductus Arteriosus in Premature Infants.

OBJECTIVE: The incidence of patent ductus arteriosus (PDA), a major complication of prematurity, may be reduced by restricting fluid administration. Prophylactic fresh frozen plasma (FFP) transfusion may reduce the incidence of intraventricular hemorrhage in these infants, but risks transfusion-related volume overload. We conducted a retrospective study to investigate whether FFP transfusion is a risk factor for hemodynamically significant PDA (hsPDA) in very low birth weight (BW) premature infants. STUDY DESIGN: From January 2009 to December 2014, 102 premature infants with gestational age (GA) less than or equal to 30 weeks were admitted to a level III neonatal intensive care unit, and 88 patients were enrolled. Patients were further divided into non-hsPDA (n = 29) and hsPDA groups (n = 59). We retrospectively reviewed demographic characteristics and various perinatal and postnatal variables. Univariate and multivariable analyses were performed to identify risk factors for hsPDA. RESULTS: Compared with non-hsPDA patients, hsPDA patients had lower mean BW and GA, a higher incidence of severe respiratory distress symptoms, perinatal infection, use of surfactant, and need for FFP transfusion. However, multivariable logistic regression analysis showed that only FFP transfusion remained an independent risk factor for hsPDA (adjusted odds ratio = 3.880, 95% confidence interval: 1.214-12.402, p = 0.022) after adjusting for confounding factors. CONCLUSION: FFP transfusion is a significant risk factor for the subsequent development of hsPDA in our study population. FFP transfusion may complicate the fluid management of premature infants and increase the risk of hsPDA. KEY POINTS: · Hemodynamic significant PDA is an important complication of preterm infant.. · FFP transfusion may complicate the fluid management of premature infants.. · FFP transfusion is an independent risk factor for hsPDA in very low birth weight premature infants..

Author Correction: High-quality AlN grown with a single substrate temperature below 1200 °C.

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High-quality AlN grown with a single substrate temperature below 1200 °C.

1.5-µm AlN grown by metal-organic chemical vapor deposition (MOCVD), with a single substrate temperature of 1180 °C, exhibits atomically flat surface and the XRD (102) peak width of 427 arcsec. The results are achieved with a pulsed NH3-flow condition, serving as an alternative for the commonly used temperature-varied buffer structure, which is often complicated and time-consuming. Inserting two pulsed-NH3-flow AlN layers in the epitaxial structure not only releases the lattice strain via the formation of three-dimensional nano-islands, but also smoothens the surface with prolonged lateral migration of Al adatoms. This effective growth technique substantially simplifies the manufacture of device-quality AlN.

Toxicity and quantitative structure-activity relationships of nitriles based on Pseudokirchneriella subcapitata.

This study presents the toxicity data of various nitriles to Pseudokirchneriella subcapitata using a closed algal toxicity testing technique with no headspace. Two different response endpoints, i.e., dissolved oxygen (DO) production and algal growth rate, were used to evaluate the toxicity of nitriles. In general, the DO endpoint revealed higher inhibitory effects than that from algal growth rate. Furthermore, halogen-substituted nitriles were found to be extremely toxic to P. subcapitata. With increasing numbers of the halogen atoms, stronger toxicity was observed. The bromine substitutent also seems to be more toxic than chlorine substitutent. Quantitative structure-activity relationships (QSARs) were established based on the chemicals' Elumo values and hydrophobicity (logK(ow)). Such relationships may thus be useful in predicting the toxicity of other compounds of the same mode of toxic action. Furthermore, for various aquatic organisms, the relative sensitivity relationship is: Pimephales promelas > or = P. subcapitata> Tetrahymena Pyriformis>Daphnia magna>luminescent bacteria (Microtox). The alga, P. subcapitata, was found to be quite sensitive to nitriles compared to other organisms.