Investigating the effects of cytokine biomarkers on HIV incidence: a case study for individuals randomized to pre-exposure prophylaxis vs. control.

Introduction: Understanding and identifying the immunological markers and clinical information linked with HIV acquisition is crucial for effectively implementing Pre-Exposure Prophylaxis (PrEP) to prevent HIV acquisition. Prior analysis on HIV incidence outcomes have predominantly employed proportional hazards (PH) models, adjusting solely for baseline covariates. Therefore, models that integrate cytokine biomarkers, particularly as time-varying covariates, are sorely needed. Methods: We built a simple model using the Cox PH to investigate the impact of specific cytokine profiles in predicting the overall HIV incidence. Further, Kaplan-Meier curves were used to compare HIV incidence rates between the treatment and placebo groups while assessing the overall treatment effectiveness. Utilizing stepwise regression, we developed a series of Cox PH models to analyze 48 longitudinally measured cytokine profiles. We considered three kinds of effects in the cytokine profile measurements: average, difference, and time-dependent covariate. These effects were combined with baseline covariates to explore their influence on predictors of HIV incidence. Results: Comparing the predictive performance of the Cox PH models developed using the AIC metric, model 4 (Cox PH model with time-dependent cytokine) outperformed the others. The results indicated that the cytokines, interleukin (IL-2, IL-3, IL-5, IL-10, IL-16, IL-12P70, and IL-17 alpha), stem cell factor (SCF), beta nerve growth factor (B-NGF), tumor necrosis factor alpha (TNF-A), interferon (IFN) alpha-2, serum stem cell growth factor (SCG)-beta, platelet-derived growth factor (PDGF)-BB, granulocyte macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), and cutaneous T-cell-attracting chemokine (CTACK) were significantly associated with HIV incidence. Baseline predictors significantly associated with HIV incidence when considering cytokine effects included: age of oldest sex partner, age at enrollment, salary, years with a stable partner, sex partner having any other sex partner, husband's income, other income source, age at debut, years lived in Durban, and sex in the last 30 days. Discussion: Overall, the inclusion of cytokine effects enhanced the predictive performance of the models, and the PrEP group exhibited reduced HIV incidences compared to the placebo group.

A novel optimization rainfall coupling model based on stepwise decomposition technique.

Traditional decomposition integration models decompose the original sequence into subsequences, which are then proportionally divided into training and testing periods for modeling. Decomposition may cause data aliasing, then the decomposed training period may contain part of the test period data. A more effective method of sample construction is sought in order to accurately validate the model prediction accuracy. Semi-stepwise decomposition (SSD), full stepwise decomposition (FSD), single model semi-stepwise decomposition (SMSSD), and single model full stepwise decomposition (SMFSD) techniques were used to create the samples. This study integrates Variational Mode Decomposition (VMD), African Vulture Optimization Algorithm (AVOA), and Least Squares Support Vector Machine (LSSVM) to construct a coupled rainfall prediction model. The influence of different VMD parameters α is examined, and the most suitable stepwise decomposition machine learning coupled model algorithm for various stations in the North China Plain is selected. The results reveal that SMFSD is relatively the most suitable tool for monthly precipitation forecasting in the North China Plain. Among the predictions for the five stations, the best overall performance is observed at Huairou Station (RMSE of 18.37 mm, NSE of 0.86, MRE of 107.2%) and Jingxian Station (RMSE of 24.74 mm, NSE of 0.86, MRE of 51.71%), while Hekou Station exhibits the poorest performance (RMSE of 25.11 mm, NSE of 0.75, MRE of 173.75%).

An unconventional approach for the efficient recovery of iron, cobalt, copper and silicon from copper slag.

High-grade heavy metal elements in copper slag (CS) are worth recovering. Unfortunately, the high viscosity of leaching solution, low leaching efficiency, difficult filtration and low separation efficiency of valuable components exist in the traditional sulfuric acid leaching process. In this study, the above problems are solved by sulfuric acid pretreatment + curing + water leaching. Moreover, iron, cobalt and copper ions in solution are separated by stepwise precipitation. The final iron, cobalt, copper and silicon recoveries are 99.01 %, 98.45 %, 93.13 % and 99.52 %, respectively. Thermodynamic calculations show that H4SiO4 can be converted to insoluble SiO2 to improve filtration properties under curing conditions of sulfur dioxide partial pressures of 10-20∼0 atm, oxygen partial pressures of 10-20∼0 atm and 400-600k. Simulation studies of the phase equilibria of the components of the leach solution by Visual MINTEQ showed that the oxidation of Fe2+ to Fe3+ is necessary for the removal of Fe2+ from the solution by precipitation. This study provides a new idea for the efficient utilization of CS.

Nanoscale Spatiotemporal Dynamics of Microbial Adhesion: Unveiling Stepwise Transitions with Plasmonic Imaging.

Understanding bacterial adhesion at the nanoscale is crucial for elucidating biofilm formation, enhancing biosensor performance, and designing advanced biomaterials. However, the dynamics of the critical transition from reversible to irreversible adhesion has remained elusive due to analytical constraints. Here, we probed this adhesion transition, unveiling nanoscale, step-like bacterial approaches to substrates using a plasmonic imaging technique. This method reveals the discontinuous nature of adhesion, emphasizing the complex interplay between bacterial extracellular polymeric substances (EPS) and substrates. Our findings not only deepen our understanding of bacterial adhesion but also have significant implications for the development of theoretical models for biofilm management. By elucidating these nanoscale step-like adhesion processes, our work provides avenues for the application of nanotechnology in biosensing, biofilm control, and the creation of biomimetic materials.

Synergistic and stepwise treatment of resveratrol and catechol in Haematococcus pluvialis for the overproduction of biomass and astaxanthin.

To increase the production of biomass and astaxanthin from Haematococcus pluvialis to meet the high market demand for astaxanthin, this study recruited two typical and negligible phytohormones (namely resveratrol and catechol) for the stepwise treatments of H. pluvialis. It was found that the hybrid and sequential treatments of resveratrol (200 µmol) and catechol (100 µmol) had achieved the maximum astaxanthin content at 33.96 mg/L and 42.99 mg/L, respectively. Compared with the hybrid treatment, the physiological data of H. pluvialis using the sequential strategy revealed that the enhanced photosynthetic performance via the Calvin cycle by RuBisCO improved the biomass accumulation during the macrozooid stage; meanwhile, the excessive ROS production had occurred to enhance astaxanthin production with the help of NADPH overproduction during the hematocyst stage. Overall, this study provides improved knowledge of the impacts of phytohormones in improving biomass and astaxanthin of H. pluvialis, which shed valuable insights for advancing microalgae-based biorefinery.

Characterization and classification of pathogenic bacteria using native fluorescence and spectral deconvolution.

Identification and classification of pathogenic bacterial strains is of current interest for the early treatment of diseases. In this work, protein fluorescence from eight different pathogenic bacterial strains were characterized using steady state and time resolved fluorescence spectroscopy. The spectral deconvolution method was also employed to decompose the emission contribution from different intrinsic fluorophores and extracted various key parameters, such as intensity, emission maxima, emission line width of the fluorophores, and optical redox ratio. The change in average lifetime values across different bacterial strains exhibits good statistical significance (p ≤ 0.01). The variations in the photophysical characteristics of bacterial strains are due to the different conformational states of the proteins. The stepwise multiple linear discriminate analysis of fluorescence emission spectra at 280 nm excitation across eight different bacterial strains classifies the original groups and cross validated group with 100% and 99.5% accuracy, respectively.

Dietary patterns and the risk of diabetes in Korean adults: A cross-sectional and prospective cohort study.

OBJECTIVE: The aim of this study was to identify dietary patterns associated with diabetes in Korean adults and to investigate their association with diabetes risk in both a cross-sectional and prospective study. METHODS: Predefined food groups collected by the Korea National Health and Nutrition Examination Survey (KNHANES 2015-2018, n = 19 721) were entered in a reduced rank regression (RRR) model, followed by stepwise linear regression analyses to identify the most predictive dietary patterns. We evaluated the construct validity of dietary patterns in two independent samples from KNHANES 2019 to 2021 (n = 14 223) and the Health Examinees (HEXA) cohort study (n = 30 013). Associations between dietary patterns and diabetes risk were examined using multivariable regression and multivariable-adjusted Cox proportional hazard models, respectively. RESULTS: A dietary pattern was identified with high positive loadings for refined white rice, kimchi and salted vegetables, wheat flour and bread, and seasonings, and high negative loadings for whole grains, legumes with tofu and soymilk, poultry, eggs, and plant oils. The higher pattern scores were significantly associated with diabetes risk in KNHANES 2015 to 2018 (male: odds ratio [OR]: 1.59; 95% confidence interval [CI]: 1.35, 1.88; female: OR: 1.37; 95% CI: 1.18, 1.52), KNHANES 2019 to 2021 (male: OR: 1.47; 95% CI: 1.01, 1.69; female: OR: 1.37; 95% CI: 1.18, 1.54), and HEXA study (male: hazard ratio [HR]: 1.10; 95% CI: 1.01, 1.34; female: HR: 1.24; 95% CI: 1.02, 1.52). CONCLUSIONS: Dietary patterns derived by RRR followed by stepwise linear regression analyses were associated with increased risks of diabetes among Korean adults.

Conversion of Phosphogypsum into Porous Calcium Silicate Hydrate for the Removal and Recycling of Pb(II) and Cd(II) from Wastewater.

The discharge of lead and cadmium wastewater, along with the pollution caused by phosphogypsum, represents a particularly urgent environmental issue. This study employed a straightforward hydrothermal method to convert phosphogypsum into porous calcium silicate hydrate (P-CSH), which was then used to remove and recover Pb(II) and Cd(II) from wastewater. The adsorption capacities of P-CSH for Pb(II) and Cd(II) were notably high at 989.3 mg/g and 290.3 mg/g, respectively. The adsorption processes adhered to the pseudo-second-order kinetics model and the Langmuir isotherm model. Due to identical adsorption sites on P-CSH for both Pb(II) and Cd(II), competitive interaction occurred when both ions were present simultaneously. Additionally, the adsorption efficacy was minimally impacted by the presence of common coexisting cations in wastewater. The dominant mechanisms for removing Pb(II) and Cd(II) via P-CSH were chemical precipitation and surface complexation. Moreover, the adsorbed heavy metals were efficiently separated and reclaimed from the wastewater through a stepwise desorption process. The primary components of the residue from stepwise desorption were quartz and amorphous SiO2. Following dissolution via pressurized alkaline leaching, this residue could be recycled for synthesizing P-CSH. This research offered a new strategy for the resourceful use of phosphogypsum and heavy metal wastewater.

Stepwise Ultra-pH-Sensitive Micelles Overcome a pKa Barrier for Systemic Lymph Node Delivery.

While local nanoparticle delivery to lymph nodes is well studied, there are few design criteria for intravenous delivery to the entire lymph node repertoire. In this study, we investigated the effect of NP pH transition on lymph node targeting by employing a series of ultra-pH-sensitive (UPS) polymeric micelles. The UPS library responds to pH thresholds (pKa 6.9, 6.2, and 5.3) over a range of physiological pH. We observed a dependence of intravenous lymph node targeting on micelle pH transition. UPS6.9 (subscript indicates pKa) shows poor lymph node delivery, while UPS5.3 delivers efficiently to lymph node sets. We investigated targeting mechanisms of UPS5.3, observing an accumulation among lymph node lymphatics and a dependence on lymph node-resident macrophages. To overcome the pH-threshold barrier, which limits UPS6.9, we rationally designed a nanoparticle coassembly of UPS6.9 with UPS5.3, called HyUPS. The HyUPS micelle retains the constitutive pH transitions of each polymer, showing stepwise responses to discrete pH thresholds. We demonstrate that HyUPS improves UPS6.9 delivery to lymph nodes, extending this platform for disease detection of lymph node metastasis.

Stepwise Construction of MoS2@CoAl-LDH/NF 3D Core-Shell Nanoarrays with High Hole Mobility for High-Performance Asymmetric Supercapacitors.

Supercapacitors (SCs) have received widespread attention as excellent energy storage devices, and the design of multicomponent electrode materials and the construction of ingenious structures are the keys to enhancing the performance of SCs. In this paper, MoS2 nanorods were used as the carrier structure to induce the anchoring of CoAl-LDH nanosheets and grow on the surface of nickel foam (NF) in situ, thus obtaining a uniformly distributed MoS2 nanorod@CoAl-LDH nanosheet core-shell nanoarray material (MoS2@CoAl-LDH/NF). On the one hand, the nanorod-structured MoS2 as the core provides high conductivity and support, accelerates electron transfer, and avoids agglomeration of CoAl-LDH nanosheets. On the other hand, CoAl-LDH nanosheet arrays have abundant interfacially active sites, which accelerate the electrolyte penetration and enhance the electrochemical activity. The synergistic effect of the two components and the unique core-shell nanostructure give MoS2@CoAl-LDH/NF a high capacity (14,888.8 mF cm-2 at 2 mA cm-2) and long-term cycling performance (104.4% retention after 5000 charge/discharge cycles). The integrated MoS2@CoAl-LDH/NF//AC device boasts a voltage range spanning from 0 to 1.5 V, achieving a peak energy density of 0.19 mW h cm-2 at 1.5 mW cm-2. Impressively, it maintains a capacitance retention rate of 84.6% after enduring 10,000 cycles, demonstrating exceptional durability and stability.

The association among negative life events, alexithymia, and depressive symptoms in a psychosomatic outpatient sample.

BACKGROUND: Depression is a life-threatening mental health problem. Various factors have been demonstrated to be associated with depressive symptoms, including negative life events (NLEs) and alexithymia. A retrospective study was conducted to investigate the relationship among negative life events, alexithymia, and depression symptoms in a psychosomatic outpatient sample in China. METHODS: A total of 2747 outpatients (aged 18 - 65) were included in this investigation. The Life Events Scale (LES), Toronto alexithymia scale (TAS-26), and 9-item Patient Health Questionnaire (PHQ-9) were used to assess NLEs, alexithymia, and depressive symptoms, respectively. A stepwise regression analysis model was established to investigate the relationship among alexithymia, NLEs, and depressive symptoms. RESULTS: Overall, 67.0% of the patient sample had a PHQ-9 score of 10 or higher. The stepwise regression analysis model showed a well-fitted model, in which NLEs and alexithymia explain a total of 34.2% of the variance of depressive symptoms in these participants. NLEs (ß = 0.256, p < 0.001) and dimensions of alexithymia (difficult describing feelings (ß = 0.192, p < 0.001) and identifying feelings (ß = 0.308, p < 0.001)) were positively correlated with symptoms of depression. CONCLUSIONS: Previous studies have confirmed the correlation between NLEs and depression, alexithymia and depression, respectively. In our study, we used a stepwise regression model to explain the relationship among those variables simultaneously, and found that NLEs and alexithymia could function as predictors of depressive symptoms. Based on this discovery, alexithymia-focused treatment strategies could be alternative in depressive patients with alexithymia, but this remains to be verified in the future.

Water quality assessment in a large plateau lake in China from 2014 to 2021 with machine learning models: Implications for future water quality management.

Amid the global surge of eutrophication in lakes, investigating and analyzing water quality and trends of lakes becomes imperative for formulating effective lake management policies. Water quality index (WQI) is one of the most used tools to assess water quality by integrating data from multiple water quality parameters. In this study, we analyzed the spatio-temporal variations of 11 water quality parameters in one of the largest plateau lakes, Erhai Lake, based on surveys from January 2014 to December 2021. Leveraging machine learning models, we gauged the relative importance of different water quality parameters to the WQI and further utilized stepwise multiple linear regression to derive an optimal minimal water quality index (WQImin) that required the minimal number of water quality parameters without compromising the performance. Our results indicated that the water quality of Erhai Lake typically showed a trend towards improvement, as indicated by the positive Mann-Kendall test for WQI performance (Z = 2.89, p < 0.01). Among the five machine learning models, XGBoost emerged as the best performer (coefficient of determination R2 = 0.822, mean squared error = 3.430, and mean absolute error = 1.460). Among the 11 water quality parameters, only four (i.e., dissolved oxygen, ammonia nitrogen, total phosphorus, and total nitrogen) were needed for the optimal WQImin. The establishment of the WQImin helps reduce cost in future water quality monitoring in Erhai Lake, which may also serve as a valuable framework for efficient water quality monitoring in similar waters. In addition, the elucidation of spatio-temporal patterns and trends of Erhai Lake's water quality serves as a compass for authorities, offering insights to bolster lake management strategies in the future.

[Recommended diagnostics for pruritus affecting primary non-lesional skin]. / Empfohlene Diagnostik bei Pruritus auf primär unveränderter Haut.

BACKGROUND: Chronic pruritus affecting primary non-lesional skin (CPNL) manifests as a common symptom across a spectrum of diseases spanning various medical specialties. Given the diverse etiological factors involved, diagnosing the underlying condition poses a significant challenge. OBJECTIVES: To provide a comprehensive overview of clinical, laboratory, and imaging diagnostics for CPNL. MATERIALS AND METHODS: A thorough literature search on the diagnostics of chronic pruritus was conducted using PubMed with specific keywords "chronic pruritus AND non-lesional skin", "chronic itch AND non-lesional skin", "chronic pruritus AND diagnostics", "chronic itch AND diagnostics", "CKD-aP", "hepatic pruritus", "cholestatic pruritus", and "myeloproliferative neoplasms AND pruritus". RESULTS: A systematic diagnostic approach is recommended for patients with CPNL, guided by the prevalence of pruritus-associated diseases. Initial basic diagnostics facilitate a cost-effective and focused evaluation during the initial medical assessment. Information pertaining to underlying diseases can be further refined through specialized diagnostic procedures. CONCLUSIONS: CPNL often presents a diagnostic dilemma. Adopting a stepwise diagnostic strategy facilitates the identification of underlying etiologies, which is crucial for recognizing diseases and administering pruritus-specific pharmacotherapy.

Efficient and harmless removal of insecticide diazinon via the stepwise combination of biodegradation and photodegradation.

Diazinon, an organophosphorus insecticide, is predominantly removed through photodegradation and biodegradation in the environment. However, photodegradation can generate diazoxon, a highly toxic oxidation byproduct, while biodegradation is hard to complete mineralize diazinon, showing limitations in both methods. In this study, we provided an efficient strategy for the complete and harmless removal of diazinon by synergistically employing biodegradation and photodegradation. The diazinon-degrading strain X1 was capable of completely degrading 200 µM of diazinon into 2-isopropyl-6-methyl-4-pyrimidinol (IMP) within 6 h without producing the highly toxic diazoxon. IMP was the only intermediate metabolite in biodegradation process, which cannot be further degraded by strain X1. Through RT-qPCR and prokaryotic expression analyses, the hydrolase OpdB was pinpointed as the key enzyme for diazinon degradation in strain X1. Photodegradation was further used to degrade IMP and a pyridazine ring-opening product of IMP was identified via high resolution mass spectrometry. The acute toxicity of this product to aquatic organisms were 123 times and 6630 times lower than that of diazinon and IMP, respectively. The stepwise application of biodegradation and photodegradation was proved to be a successful approach for the remediation of diazinon and its metabolite IMP. This integrated method ensures the harmless and complete elimination of diazinon and IMP within only 6 h. The research provides a theoretical basis for the efficient and harmless remediation of organophosphorus insecticide residuals in the environment.

Multienzymatic Cascade for Synthesis of Hydroxytyrosol via Two-Stage Biocatalysis.

Hydroxytyrosol, a naturally occurring compound with antioxidant and antiviral activity, is widely applied in the cosmetic, food, and nutraceutical industries. The development of a biocatalytic approach for producing hydroxytyrosol from simple and readily accessible substrates remains a challenge. Here, we designed and implemented an effective biocatalytic cascade to obtain hydroxytyrosol from 3,4-dihydroxybenzaldehyde and l-threonine via a four-step enzymatic cascade composed of seven enzymes. To prevent cross-reactions and protein expression burden caused by multiple enzymes expressed in a single cell, the designed enzymatic cascade was divided into two modules and catalyzed in a stepwise manner. The first module (FM) assisted the assembly of 3,4-dihydroxybenzaldehyde and l-threonine into (2S,3R)-2-amino-3-(3,4-dihydroxyphenyl)-3-hydroxypropanoic acid, and the second module (SM) entailed converting (2S,3R)-2-amino-3-(3,4-dihydroxyphenyl)-3-hydroxypropanoic acid into hydroxytyrosol. Each module was cloned into Escherichia coli BL21 (DE3) and engineered in parallel by fine-tuning enzyme expression, resulting in two engineered whole-cell catalyst modules, BL21(FM01) and BL21(SM13), capable of converting 30 mM 3,4-dihydroxybenzaldehyde to 28.7 mM hydroxytyrosol with a high space-time yield (0.88 g/L/h). To summarize, the current study proposes a simple and effective approach for biosynthesizing hydroxytyrosol from low-cost substrates and thus has great potential for industrial applications.

Stepwise Functional Brain Architecture Correlates with Atrophy in Progressive Supranuclear Palsy.

BACKGROUND: Stepwise functional connectivity (SFC) detects whole-brain functional couplings of a selected region of interest at increasing link-step topological distances. OBJECTIVE: This study applied SFC to test the hypothesis that stepwise architecture propagating from the disease epicenter would shape patterns of brain atrophy in patients with progressive supranuclear palsy-Richardson's syndrome (PSP-RS). METHODS: Thirty-six patients with PSP-RS and 44 age-matched healthy control subjects underwent brain magnetic resonance imaging on a 3-T scanner. The disease epicenter was defined as the peak of atrophy observed in an independent cohort of 13 cases with postmortem confirmation of PSP pathology and used as seed region for SFC analysis. First, we explored SFC rearrangements in patients with PSP-RS, as compared with age-matched control subjects. Subsequently, we tested SFC architecture propagating from the disease epicenter as a determinant of brain atrophy distribution. RESULTS: The disease epicenter was identified in the left midbrain tegmental region. Compared with age-matched control subjects, patients with PSP-RS showed progressively widespread decreased SFC of the midbrain with striatal and cerebellar regions through direct connections and sensorimotor cortical regions through indirect connections. A correlation was found between average link-step distance from the left midbrain in healthy subjects and brain volumes in patients with PSP-RS (r = 0.38, P < 0.001). CONCLUSIONS: This study provides comprehensive insights into the topology of functional network rearrangements in PSP-RS and demonstrates that the brain architectural topology, as described by SFC propagating from the disease epicenter, shapes the pattern of atrophic changes in PSP-RS. Our findings support the view of a network-based pathology propagation in this primary tauopathy. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Design, Synthesis, and Performance of Photo-Responsive Liquid Crystal Polymers with Stepwise Deformation Capability.

Photo-responsive liquid crystal polymers (LCPs) have potential application value in flexible robots, artificial muscles, and microfluidic control. In recent years, significant progress has been made in the development of LCPs. However, the preparation of LCPs with continuous and controllable stepwise deformation capabilities remains a challenge. In this study, visible photo-responsive cyanostilbene monomer, UV photo-responsive azobenzene monomer, and multiple hydrogen bond crosslinker are used to prepare photo-responsive LCPs capable of achieving continuously and controllable stepwise deformation. The comprehensive investigation of the multiple light response ability and photo-induced deformation properties of these copolymers is conducted. The results reveal that in the first stage of photo-induced deformation under 470 nm blue light irradiation, the deformation angle decreases with a reduction in cyanostilbene content in the copolymer component, ranging from 40° in AZ0-CS4 to 0° in AZ4-CS0. In the second stage of photo-induced deformation under 365 nm UV irradiation, the deformation angle increases with the increase of azobenzene content, ranging from 0° of AZ0-CS4 to 89.4° of AZ4-CS0. Importantly, the deformation between these two stages occurs as a continuous process, allowing for a direct transition from the first-stage to the second-stage deformation by switching the light source from 470 to 365 nm.

Stepwise Stiffening Chromophore Strategy Realizes a Series of Ultralong Blue Room-Temperature Phosphorescent Materials.

Ultralong room-temperature phosphorescent (URTP) materials have attracted wide attention in anti-counterfeiting, optoelectronic display, and bio-imaging due to their special optical properties. However, room-temperature blue phosphorescent materials are very scarce during applications because of the need to simultaneously populate and stabilize high-energy excited states. In this work, a stepwise stiffening chromophore strategy is proposed to suppress non-radiative jump by continuously reducing the internal spin of the chromophore, and successfully developing a series of blue phosphorescent materials. Phosphorescence lifetimes of more than 3 s are achieved, with the longest lifetime reaching 5.44 s and lasting more than 70 s in the naked eye. As far as is know, this is the best result that has been reported. By adjusting the chromophore conjugation, multicolor phosphorescences from cyan to green have been realized. In addition, these chromophores exhibit the same excellent optical properties in urea and polyvinyl alcohmance (PVA). Finally, these materials are successfully applied to luminescent displays.

Tobacco Quitline utilization compared with cigarette smoking prevalence in Virginia across rurality and Appalachian Status, 2011-2019.

Introduction: While cigarette smoking rates have declined, rural and Appalachian populations in the United States have not seen similar decreases. Quitline programs are promising strategies in reducing disparities in these areas, but research on their usage is limited. Methods: We employed Small Area Estimation on the Virginia Behavioral Risk Factor Surveillance System (2011-2019) to estimate county-level smoking prevalence and utilized The Quit Now Virginia Quitline data (2011-2019) to estimate Quitline users. We analyzed differences in Quitline utilization by rurality and Appalachian status using statistical t-tests. Stepwise regression assessed the absolute estimate of county features, including poverty rate, tobacco retailer density, physician availability, coal mining industry, and tobacco agriculture, on Quitline usage. Results: While the average smoking rate overall was 15.3 %, only 7.4 % of smokers accessed Quitline services from 2011 to 2019. Appalachian regions exhibited higher smoking rates (20.9 %) and lower quitline usage (4.8 %) compared to non-Appalachian areas (14 % smoking prevalence, 8 % quitline usage). Rural regions had higher smoking prevalence (19.0 %) than urban areas (12.9 %), but no significant difference in Quitline utilization (7.6 % vs. 7.2 %, p = 0.7). Stepwise regression revealed counties with more tobacco agriculture had 3.2 % (p = 0.04) lower Quitline utilization. Also, more physicians availability in the county was associated with 3.9 % higher Quitline usage (p = 0.03) and Appalachian counties exhibited a 3.6 % lower Quitline usage rate compared to non-Appalachian counties. Conclusion: A significant gap exists between cigarette smoking prevalence and Quitline utilization, particularly in underserved rural and Appalachian areas, despite no clear barriers to accessing this remote cessation resource. Implication: The study underscores persistent disparities in smoking rates, with rural and Appalachian regions in the United States facing higher smoking prevalence and limited utilization of Quitline services. Despite no clear barriers to access, the gap between smoking prevalence and Quitline usage remains significant, particularly in underserved areas. Tailoring interventions to address regional disparities and factors like tobacco agriculture and physician availability is essential to reduce smoking rates and improve Quitline utilization in these communities.

When and how to perform venoplasty for lead placement.

Because of the increasing use of cardiac implantable electronic devices (CIEDs) with one or more intracardiac electrodes, the rate of lead failure is increasing. Moreover, upgrade of the CIED frequently is indicated for cardiac resynchronization therapy or other reasons. Both these situations require a new intervention, preferably using ipsilateral venous access. However, venous obstruction after CIED insertion occurs in 10%-20% of patients and poses a major obstacle for implantation of additional leads. Possible solutions include lead extraction, contralateral lead insertion, and venoplasty. Preprocedural venoplasty is associated with the lowest short- and long-term risks. Here we describe a step-by-step approach to this technique, which can be introduced and safely performed in most interventional catheterization laboratories.