HIV diagnosis period influences ART initiation: findings from a prospective cohort study in China.

BACKGROUND: We estimated the predictive effects of ART-related perceptions on the actual ART uptake behavior among ART naïve PLWH stratified by different time of HIV diagnosis under the new strategy. METHODS: A prospective cohort study was conducted among ART naïve PLWH in Guangzhou, China from June 2016 to June 2017. Cox regression model was used to evaluate the predictive effects of ART-related perceptions on ART initiation among PLWH stratified by different timepoint of HIV diagnosis (i.e., before or after the update of the new treatment policy). RESULTS: Among 411 participants, 150 and 261 were diagnosed before (pre-scaleup group) and after (post-scaleup group) the implementation of the new strategy, respectively. The ART initiation rate in the post-scaleup group (88.9%) was higher than that in the pre-scaleup group (73.3%) (p < 0.001). A significant difference of mean score was detected in each HBM construct between pre- and post-scaleup groups (p < 0.05). After adjusting for significant background variables, among all participants, only the self-efficacy [adjusted HR (HRa) = 1.23, 95% CI 1.06 to 1.43, p = 0.006], has a predictive effect on ART initiation; in pre-scaleup group, all constructs of HBM-related ART perceptions were predictors of ART initiation (HRa = 0.71 to 1.83, p < 0.05), while in post-scaleup group, no significant difference was found in each construct (p > 0.05). CONCLUSIONS: The ART initiation rate was high particularly among participants who diagnosed after the new treatment strategy. The important role of the time of HIV diagnosis on ART initiation identified in this study suggested that future implementation interventions may consider to modify the ART-related perceptions for HIV patients who diagnosed before the implementation of the new ART strategy, while expand the accessibility of ART service for those who diagnosed after the implementation of the new strategy.

Intention to start ART after the launch of expanded treatment strategy among people living with HIV in China: a behavioral theory-based cross-sectional study.

This study investigated the prevalence of intention to start antiretroviral therapy (ART) immediately among people living with HIV (PLWH) in China and associated perceptions toward ART based on behavioral theories. The study was initiated after the launch of an expanded ART strategy. A cross-sectional study was conducted among 450 PLWH who were ART naive in the city of Guangzhou, China, from June 2016 to February 2017. Among the participants, 311 (69.1%) showed intention to start ART immediately. The summary logistic regression analysis indicated that intention to start ART immediately was significantly associated with perceived severity [multivariate odds ratios (ORm) = 1.62, 95%CI = 1.15-2.28, p < 0.01], perceived barriers (ORm =0.56, 95%CI = 0.38-0.84, p < 0.01), self-efficacy (ORm =2.90, 95%CI = 2.05-4.09, p < 0.001), and subjective norms (ORm =1.95, 95%CI = 1.17-3.25, p < 0.05). The intention to start ART immediately among PLWH in Guangzhou was below the 90-90-90 target. Further promotion research should focus on these perceptional factors.

Role of Zirconia in Oxide-Zeolite Composite for Thiolation of Methanol with Hydrogen Sulfide to Methanethiol.

In this paper, the molecular sieve NaZSM-5 was modified with zirconium dioxide (ZrO2) by a hydrothermal coating process and other methods. By comparing the effects of the crystal phase structure of ZrO2 and the compositing method on the physicochemical properties and catalytic performance of the obtained composites, the structure-performance relationship of these composite catalysts was revealed. The results indicate that in the hydrothermal system used for the preparation of NaZSM-5, Zr4+ is more likely to dissolve from m-ZrO2 than from t-ZrO2, which can subsequently enter the molecular sieve, causing a greater degree of desiliconization of the framework. The larger specific surface area (360 m2/g) and pore volume (0.52 cm3/g) of the m-ZrO2/NaZSM-5 composite catalyst increase the exposure of its abundant acidic (0.078 mmol/g) and basic (0.081 mmol/g) active centers compared with other composites. Therefore, this catalyst exhibits a shorter induction period and better catalytic performance. Furthermore, compared with the impregnation method and mechanochemical method, the hydrothermal coating method produces a greater variety of acid-base active centers in the composite catalyst due to the hydrothermal modifying effect.

Quantitative Analysis of Anterior Chamber Inflammation Using the Novel CASIA2 Optical Coherence Tomography.

PURPOSE: We evaluated the clinical utility of a novel anterior segment optical coherence tomography (AS-OCT) device, CASIA2, to evaluate parameters indicative of anterior chamber (AC) inflammation severity in uveitis, including AC cell number, flare, and keratic precipitates (KPs). DESIGN: Prospective evaluation of a diagnostic device. METHODS: Uveitis eyes were classified into active and inactive groups. The number of hyperreflective dots representing AC cells and optical density ratio (aqueous-to-air relative intensity [ARI] index) for flare qualification were calculated from AS-OCT images. In addition, a program was designed to quantify the posterior corneal surface smoothness (PCSS) of each image for KPs evaluation. The maximum, minimum, and average PCSS values were calculated from 128 images per eye and compared among active uveitis, inactive uveitis, and control eyes. Correlations between Standardization of Uveitis Nomenclature grade and both hyperreflective dot number and ARI index were evaluated. Receiver operating characteristic (ROC) curves were constructed to test the values of these indicators for uveitis diagnosis. RESULTS: AC hyperreflective dot count, ARI index, and maximum and average PCSS values were all significantly higher in the active uveitis group than in the inactive and control groups. Hyperreflective dot count and ARI index were associated with Standardization of Uveitis Nomenclature cell and flare grade. According to ROC curve analysis, maximum PCSS was the best indicator for the diagnosis of uveitis involving the anterior segment, meanwhile the hyperreflective dot number was the best to identify active AC inflammation from the inactive. CONCLUSIONS: Quantification of AC cell number, flare, and KPs using the CASIA2 device is a promising strategy for the objective assessment of AC inflammation.