Adherence to COVID-19 preventive measures among residents in selected townships, Yangon Region, Myanmar: a community-based cross-sectional study.

BACKGROUND: To fight the current coronavirus disease (COVID-19) pandemic, many countries have implemented various mitigation measures to contain the spread of the disease. By engaging with health service providers, the community's participation in adherence to preventive measures is certainly required in the implementation of COVID-19 mitigation strategies. Therefore, this study aimed to assess the level of adherence to COVID-19 preventive measures and its associated factors among the residents, Yangon Region, Myanmar. METHODS: A community-based cross-sectional study was carried out among 636 residents in Yangon Region, Myanmar, from October to December 2021. A multistage non-probability sampling method, purposively selected for three townships in Yangon Region and convenience sampling for 212 participants from each township, was applied and the data were collected by face-to-face interviews using structured and pretested questionnaires. Data were entered, coded, and analyzed using IBM SPSS version 25.0. Simple and multiple logistic regression analysis were performed to identify the significant variables of adherence to COVID-19 preventive measures. RESULTS: As a level of adherence to COVID-19 preventive measures, the proportion of residents who had good adherence was 39.3% (95% CI 35.5-43.2%), moderate adherence was 37.6% (95% CI 33.8-41.5%), and poor adherence was 23.1% (95% CI 19.9-26.6%). The age group of 31-40 years (AOR: 3.13, 95% CI 1.62-6.05), 30 years and younger (AOR: 3.22, 95% CI 1.75-5.92), Burmese ethnicity (AOR: 2.52, 95% CI 1.44-4.39), own business (AOR: 3.19, 95% CI 1.15-8.87), high school education level and below (AOR: 1.64, 95% CI 1.02-2.69), less than 280.90 USD of monthly family income (AOR: 1.51, 95% CI 1.01-2.29), low knowledge about COVID-19 (AOR: 1.90, 95% CI 1.26-2.88) were significantly associated with poor adherence to COVID-19 preventive measures. CONCLUSIONS: In this study, nearly one-fourth of the residents were experiencing poor adherence to COVID-19 preventive measures. Therefore, building up the risk communication through the community using widely used mainstream media, the continuation of disease surveillance and announcement of updated information or advice for the public to increase awareness towards COVID-19, and enforcement to follow the recommended directions and regulations of health institutions are vital to consider for improving the adherence to preventive measures against COVID-19 among the residents.

Enhancing the Performance of Perovskite Light-Emitting Diodes via Synergistic Effect of Defect Passivation and Dielectric Screening.

Metal halide perovskites, particularly the quasi-two-dimensional perovskite subclass, have exhibited considerable potential for next-generation electroluminescent materials for lighting and display. Nevertheless, the presence of defects within these perovskites has a substantial influence on the emission efficiency and durability of the devices. In this study, we revealed a synergistic passivation mechanism on perovskite films by using a dual-functional compound of potassium bromide. The dual functional potassium bromide on the one hand can passivate the defects of halide vacancies with bromine anions and, on the other hand, can screen the charged defects at the grain boundaries with potassium cations. This approach effectively reduces the probability of carriers quenching resulting from charged defects capture and consequently enhances the radiative recombination efficiency of perovskite thin films, leading to a significant enhancement of photoluminescence quantum yield to near-unity values (95%). Meanwhile, the potassium bromide treatment promoted the growth of homogeneous and smooth film, facilitating the charge carrier injection in the devices. Consequently, the perovskite light-emitting diodes based on this strategy achieve a maximum external quantum efficiency of ~ 21% and maximum luminance of ~ 60,000 cd m-2. This work provides a deeper insight into the passivation mechanism of ionic compound additives in perovskite with the solution method.

Biochemical and biological characterization of the venoms of Naja kaouthia and Naja mandalayensis from Myanmar and neutralization effects of BPI cobra antivenom.

Snakebite is a neglected public health issue, with many scientific and medical issues to be solved. Cobras are among the most common venomous snakes in Myanmar and are responsible for a considerable number of severe snakebite envenoming. There are three species of cobra (Naja kaouthia, Naja mandalayensis and Ophiophagus hannah) in Myanmar. The study aims to characterize the N. kaouthia and N. mandalayensis venoms and to investigate the efficacy of anti-cobra antivenom (BPI) against the two venoms. Protein components and fibrinogenolytic activity were determined by SDS-PAGE. Enzymatic activities for PLA2, protease and acetylcholinesterase were determined by spectrophotometric method. Anticoagulant activity was determined by recalcification time of citrated human plasma. Myotoxicity, necrotizing activity, median lethal dose (LD50) and median effective dose (ED50) were determined by WHO recommended methods. The SDS-PAGE displayed the proteins and enzymes containing in two venoms were different. N. kaouthia venom exhibited more in PLA2, acetylcholinesterase, anticoagulant, fibrinogenolytic and necrotizing activities than N. mandalayensis venom. N. mandalayensis venom had more protease activity and myotoxicity than N. kaouthia venom. The median lethal dose (LD50) of N. kaouthia and N. mandalayensis venom was 4.33 µg/mouse and 5.04 µg/mouse respectively. Both venoms induced fibrinogen Aα chain degradation in 30 min (N. kaouthia) and in 6 h (N. mandalayensis). The same median effective dose (ED50) (19.56 µg/mouse) showed that anti-NK antivenom can neutralize against lethal effect of N. mandalayensis venom. It can also neutralize the protease activity, anticoagulant activity and fibrinogenolytic activity of both venoms. Immunodiffusion and immunoblotting studies showed that the antivenom recognized its homologous venom (N. kaouthia) and cross-reacted against the heterologous venom (N. mandalayensis). The anti-NK antivenom is suitable to use for N. mandalayensis bite if monospecific antivenom is not available.

A Fluorination Strategy and Low-Acidity Anchoring Group in Self-Assembled Molecules for Efficient and Stable Inverted Perovskite Solar Cells.

Herein, we synthesized two donor-acceptor (D-A) type small organic molecules with self-assembly properties, namely MPA-BT-BA and MPA-2FBT-BA, both containing a low acidity anchoring group, benzoic acid. After systematically investigation, it is found that, with the fluorination, the MPA-2FBT-BA demonstrates a lower highest occupied molecular orbital (HOMO) energy level, higher hole mobility, higher hydrophobicity and stronger interaction with the perovskite layer than that of MPA-BT-BA. As a result, the device based-on MPA-2FBT-BA displays a better crystallization and morphology of perovskite layer with larger grain size and less non-radiative recombination. Consequently, the device using MPA-2FBT-BA as hole transport material achieved the power conversion efficiency (PCE) of 20.32 % and remarkable stability. After being kept in an N2 glove box for 116 days, the unsealed PSCs' device retained 93 % of its initial PCE. Even exposed to air with a relative humidity range of 30±5 % for 43 days, its PCE remained above 91 % of its initial condition. This study highlights the vital importance of the fluorination strategy combined with a low acidity anchoring group in SAMs, offering a pathway to achieve efficient and stable PSCs.

N-DMBI Doping of Carbon Nanotube Yarns for Achieving High n-Type Thermoelectric Power Factor and Figure of Merit.

The application of carbon nanotube (CNT) yarns as thermoelectric materials for harvesting energy from low-grade waste heat including that generated by the human body, is attracting considerable attention. However, the lack of efficient n-type CNT yarns hinders their practical implementation in thermoelectric devices. This study reports efficient n-doping of CNT yarns, employing 4-(1, 3-dimethyl-2, 3-dihydro-1H-benzimidazole-2-yl) phenyl) dimethylamine (N-DMBI) in alternative to conventional n-dopants, with o-dichlorobenzene emerging as the optimal solvent. The small molecular size of N-DMBI enables highly efficient doping within a remarkably short duration (10 s) while ensuring prolonged stability in air and at high temperature (150 °C). Furthermore, Joule annealing of the yarns significantly improves the n-doping efficiency. Consequently, thermoelectric power factors (PFs) of 2800, 2390, and 1534 µW m-1  K-2 are achieved at 200, 150, and 30 °C, respectively. The intercalation of N-DMBI molecules significantly suppresses the thermal conductivity, resulting in the high figure of merit (ZT) of 1.69×10-2 at 100 °C. Additionally, a π-type thermoelectric module is successfully demonstrated incorporating both p- and n-doped CNT yarns. This study offers an efficient doping strategy for achieving CNT yarns with high thermoelectric performance, contributing to the realization of lightweight and mechanically flexible CNT-based thermoelectric devices.

Correction: Viraemic-time predicts mortality among people living with HIV on second-line antiretroviral treatment in Myanmar: A retrospective cohort study.

[This corrects the article DOI: 10.1371/journal.pone.0271910.].

Antisolvent-Free Heterogenous Nucleation Enabled by Employing 4-Tert-Butyl Pyridine Additive and Two-Step Annealing for Efficient CsPbI2 Br Perovskite Solar Cells.

All inorganic perovskite based on CsPbI2 Br has attracted significant attention due to its relatively thermal stable structure compare to its hybrid counterparts. With a wide bandgap of 1.9 eV and excellent light absorption capability, it has been extensively explored for applications in indoor photovoltaics and as a front absorber in tandem devices. However, the uncontrollable crystallization process during solvent evaporation and thermal annealing leads to both macroscopic defects like cracks and microscopic defects such as voids. In this study, a metastable adduct with lead (II) halides by incorporating 4-tert-butyl pyridine as a volatile Lewis base monodentate ligand in the precursor solution is formed. The strategic preferential decomposition of the adduct during the early-stage low-temperature annealing facilitated the desorption of lead (II) halides, inducing antisolvent-free heterogenous nucleation. This, in turn, promoted crystal growth during subsequent high-temperature annealing, resulting in dense films with low defect density. As a result, a maximum open-circuit voltage of 1.30 V is achieved with the champion power conversion efficiency of 16.5% in CsPbI2 Br-based perovskite solar cell. The work reveals a new mechanism of using Lewis acid-base adduct to obtain high quality perovskite films other than hindering crystallization in traditional way.

Benzophenone: A Small Molecule Additive for Enhanced Performance and Stability of Inverted Perovskite Solar Cells.

In this study, we investigated the impact of benzophenone (BP), a small molecule additive, on the performance and stability of inverted perovskite solar cells (PSCs). Specifically, we introduced BP into the perovskite precursor solution of FAPbI3 to fabricate PSCs with an ITO/PEDOT:PSS/BP:FAPbI3/PCBM/C60/PCB/Ag architecture. The incorporation of BP with an optimum concentration of 2 mg mL-1 significantly enhanced the power conversion efficiency (PCE) of the inverted PSC from 13.12 to 18.84% with negligible hysteresis. Notably, the BP-based PSCs retained ∼90% of their initial PCE after being stored in ambient air with 30% relative humidity at 25 °C for 700 h. In contrast, control devices showed rapid degradation, retaining only 30% of their initial value within 300 h under the same conditions. We attributed the superior performance and stability of the BP-based PSCs to the grain boundary passivation of the perovskite film. The improvement was mainly attributed to the intermolecular interaction between the O-donor Lewis base BP material and both Pb2+ and FA+ in FAPbI3. This effectively suppresses trap-assisted recombination and promotes the conversion of the δ-phase to photoactive and stable α-phase FAPbI3. Overall, our findings suggest that BP is a promising additive for improving the performance and stability of inverted PSCs.

Burden of Chikungunya Virus Infection during an Outbreak in Myanmar.

Chikungunya virus (CHIKV) infection is a re-emerging arboviral disease with no approved vaccine, although numerous options are in development. Before vaccine implementation, disease burden, affected age group, and hospitalization rate information should be documented. In 2019, a sizeable outbreak of the East Central South African genotype of CHIKV occurred in Myanmar, and during this period, a cross-sectional study was conducted in two regions, Mandalay and Yangon, to examine the molecular and seropositivity rate of the CHIKV infection. The participants (1124) included dengue-suspected pediatric patients, blood donors, and healthy volunteers, who were assessed using molecular assays (quantitative real-time RT-PCR), serological tests (anti-CHIKV IgM capture and IgG indirect enzyme-linked immunosorbent assays), and neutralization tests. The tests confirmed the following positivity rates: 11.3% (127/1124) for the molecular assay, 12.4% (139/1124) for the anti-CHIKV IgM Ab, 44.5% (500/1124) for the anti-CHIKV IgG Ab, and 46.3% (520/1124) for the CHIKV neutralizing Ab. The highest rate for the molecular test occurred with the dengue-suspected pediatric patients. The seroprevalence rate through natural infection was higher in the healthy volunteers and blood donors than that in the pediatric patients. The results of this study will help stakeholders determine the criteria for choosing appropriate recipients when a CHIKV vaccine is introduced in Myanmar.

Phenanthroline-carbolong interface suppress chemical interactions with active layer enabling long-time stable organic solar cells.

To restrain the chemical reaction at cathode interface of organic solar cells, two cathode interfacial materials are synthesized by connecting phenanthroline with carbolong unit. Consequently, the D18:L8-BO based organic solar cell with double-phenanthroline-carbolong achieve the highest efficiency of 18.2%. Double-phenanthroline-carbolong with larger steric hindrance and stronger electron-withdrawing property confirms to suppress the interfacial reaction with norfullerene acceptor, resulting the most stable device. Double-phenanthroline-carbolong based device can sustain 80% of its initial efficiency for 2170 h in dark N2 atmosphere, 96 h under 85 oC and keep 68% initial efficiency after been illuminated for 2200 h, which are significantly better than bathocuproin based devices. Moreover, superb interfacial stability of double-phenanthroline-carbolong cathode interface enables thermal posttreatment of organic sub-cell in perovskite/organic tandem solar cells and obtained a remarkable efficiency of 21.7% with excellent thermal stability, which indicates the potentially wide application of phenanthroline-carbolong materials for stable and efficient solar device fabrications.

Seroprevalence and associated risk factors of Toxoplasma gondii infection among slaughterhouse workers in Yangon Region, Myanmar: A cross-sectional study.

BACKGROUND: Toxoplasmosis, having the significant consequences affecting mortality and quality of life, is still prevalent in various places throughout the world. The major gap in surveillance for Toxoplasma gondii infection among high-risk population, slaughterhouse workers, is an obstacle for the effective policies formulation to reduce the burden of toxoplasmosis in Myanmar. Therefore, this study aimed to assess the seroprevalence of toxoplasmosis and associated factors of seropositivity among slaughterhouse workers in Yangon Region, Myanmar. METHODS: A cross-sectional study that was conducted from June to November 2020 included 139 slaughterhouse workers involving at five main slaughterhouses under Yangon City Development Committee, Myanmar. The presence of IgG and IgM anti-T. gondii antibodies in serum was detected using the OnSite Toxo IgG/IgM Combo Rapid Test. A face-to-face interview was also performed using pretested structured questionnaires to obtain the detail histories: sociodemographic characteristics, level of knowledge, occupational factors, and environmental factors related to T. gondii infection. Bivariate logistic regression was used to determine the factors associated with T. gondii infection. RESULTS: Of all participants, the overall seroprevalence of anti-T. gondii was 43.9% (95% CI: 35.5-52.5%), of whom 98.4% (95% CI: 91.2-100.0%) were reactive only for IgG antibody and 1.6% (95% CI: 0.0-8.8%) were reactive for IgG and IgM antibodies. The significant factors associated with the seropositivity of T. gondii antibodies were blood transfusion history (OR: 5.74, 95% CI: 1.17-28.09), low level of knowledge (OR: 2.91, 95% CI: 1.46-5.83), contact with animal organs, muscles or blood (OR: 14.29, 95% CI: 1.83-111.51), and animals most frequently slaughtered (cattle) (OR: 3.22, 95% CI: 1.16-8.93). CONCLUSIONS: A high seroprevalence of toxoplasmosis was detected among slaughterhouse workers in Yangon Region and it raises a significant public health concern. Therefore, providing health education regarding toxoplasmosis, enforcement of personal hygiene practices in workplaces, the establishment of training for occupational hygiene, and commencement of the risk assessment and serological screening for toxoplasmosis are crucial to curtail the prevalence of T. gondii infection among slaughterhouse workers.

Coinfection and circulation of chikungunya virus and dengue virus in pediatric patients in Myanmar, 2019.

Myanmar is an endemic country for arboviruses, and outbreaks occur frequently. A cross-sectional analytical study was conducted during the peak season of the chikungunya virus (CHIKV) outbreak in 2019. A total of 201 patients with acute febrile illness who were admitted to the 550-bedded Mandalay Children Hospital in Myanmar were enrolled in the study, and virus isolation, serological tests, and molecular tests for the dengue virus (DENV) and CHIKV were performed for all samples. Out of 201 patients, 71 (35.3%) were only DENV-infected, 30 (14.9%) were only CHIKV-infected and 59 (29.4%) were coinfected with DENV and CHIKV. The viremia levels of the DENV- and CHIKV- mono-infected groups were significantly higher than those of the group coinfected with DENV and CHIKV. Genotype I of DENV-1, genotypes I and III of DENV-3, genotype I of DENV-4 and the East/Central/South African genotype of CHIKV were co-circulating during the study period. Two novel epistatic mutations of CHIKV (E1:K211E and E2:V264A) were noted. This study highlighted that there were many coinfection cases during the outbreak and that the co-circulation of both viruses in DENV-endemic regions warrants effective monitoring of these emerging pathogens via comprehensive surveillance to facilitate the implementation of effective control measures.

Characterization of HIV-Related Stigma in Myanmar.

Characterizing HIV-related stigma and its impacts are important for interventions toward their elimination. A cross-sectional study was conducted in 2016 to evaluate enacted and internalized stigma among adult people living with HIV (PLWH) across four cities in Myanmar using the India Stigma Index questionnaire. Multivariable regression analyses were performed to determine differences in measured enacted and internalized stigma outcomes. Among 1,006 participants, 89% reported any stigma indicator, 47% enacted stigma, and 87% internalized stigma. In regression analysis, city and duration of illness were associated with higher enacted stigma, and younger age was associated with higher internalized stigma. Those with HIV duration > 7.4 years had mean enacted stigma nearly 2 units higher than the overall mean. Internalized stigma increased with duration of illness and leveled off at 5 years. PLWH from smaller cities experienced lower stigma. In Myanmar, nearly 90% of PLWH experience stigma, results that reflect a unique transition point.

Advanced HIV disease and associated attrition after re-engagement in HIV care in Myanmar from 2003 to 2019: a retrospective cohort study.

BACKGROUND: The burden of advanced HIV disease (AHD) and predictors of outcomes among people living with HIV (PLHIV) re-engaging in care are not well known. METHODS: We conducted a retrospective cohort study of PLHIV who re-engaged in care after being lost to follow-up (LFU), from 2003 to 2019, in Myanmar. We calculated the incidence rates of attrition after re-engagement and performed Cox regression to identify risk factors for attrition. RESULTS: Of 44 131 PLHIV who started antiretroviral treatment, 12 338 (28.0%) were LFU at least once: 7608 (61.6%) re-engaged in care, 4672 (61.4%) with AHD at re-engagement. The death and LFU rates were 2.21-fold (95% CI 1.82 to 2.67) and 1.46-fold (95% CI 1.33 to 1.61) higher among patients who re-engaged with AHD (p>0.001). Death in patients who re-engaged with AHD was associated with male sex (adjusted HR [aHR] 2.63; 95% CI 1.31 to 5.26; p=0.006), TB coinfection (aHR 2.26; 95% CI 1.23 to 4.14; p=0.008) and sex work (aHR 7.49, 95% CI 2.29 to 22.52; p<0.001). History of intravenous drug use was identified as a predictor of being LFU. CONCLUSIONS: Re-engagement in HIV care in Myanmar is frequent and those who re-engage carry a high burden of AHD. As AHD at re-engagement is associated with higher attrition rates, implementation of differentiated interventions that enable earlier linkage to care and prompt identification and management of AHD in this population is necessary.

Continuum of care of mothers and immunization status of their children: A secondary analysis of 2015-2016 Myanmar Demographic and Health Survey.

Objective: To assess the association between the continuum of care of mothers and the immunization status of their 12-23 months old children. Study design: A secondary data analysis using the Myanmar Demographic and Health Survey (2015-16) data, a cross-sectional, household-based, nationally representative survey conducted during 2015-2016. Methods: We included 1669 pairs of mothers and their children in this analysis. We categorized the children into fully immunized and no/not fully immunized children and define a continuum of care (CoC) of the mother if women received antenatal care ≥ four times, delivered with skilled birth attendances, and received postnatal care within 48 h after delivery. We used the multivariable binary logistics regression using STATA version 15.1 with the survey command (svy) and reported the results by adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: The mother's CoC prevalence was 42.5%, and that of fully immunized children was 33.5%. However, only one-fifth of mothers and their children received the continuum of care services altogether. The children of mothers who received CoC were more likely to be fully vaccinated than those who did not (aOR = 1.60, 95%CI: 1.21, 2.13, P < 0.001). The child's birth order, employment status, and wealth status of the households are independent predictors of the full immunization of children. Conclusions: We concluded that receiving the CoC in mothers influenced their children's vaccination status. Hence, integrating maternal health programs and immunization programs is essential to achieving sustainable development goals in Myanmar.

Revealing the Hidden Mechanism of Enhanced Responsivity of Doped p-i-n Perovskite Photodiodes via Coupled Opto-Electronic Model.

Organic-inorganic halide perovskites have demonstrated preeminent optoelectronic performance in recent years due to their unique material properties, and have shown great potential in the field of photodetectors. In this study, a coupled opto-electronic model is constructed to reveal the hidden mechanism of enhancing the performance of perovskite photodetectors that are suitable for both inverted and regular structure doped p-i-n perovskite photodiodes. Upon illumination, the generation rate of photogenerated carriers is calculated followed by carrier density distribution, which serves as a coupled joint to further analyze the recombination rate, electric field strength, and current density of carriers under different doping types and densities. Moreover, experiments were carried out in which the doping types and densities of the active layer were regulated by changing the precursor ratios. With optimal doping conditions, the inverted and regular perovskite photodiodes achieved an external quantum efficiency of 74.83% and 73.36%, and a responsivity of 0.417 and 0.404 A/W, respectively. The constructed coupled opto-electronic model reveals the hidden mechanism and along with the doping strategy, this study provides important guidance for further analysis and improvement of perovskite-based photodiodes.

Genomic tracking of SARS-COV-2 variants in Myanmar

BackgroundIn December 2019, the COVID-19 disease started in Wuhan, China. WHO declared a pandemic on March 12, 2020, and the disease started in Myanmar on March 23, 2020. December brought variants around the world, threatening the healthcare systems. To counter those threats, Myanmar started the COVID-19 variant surveillance program in late 2020. MethodsWhole genome sequencing was done six times between January 2021 and March 2022. We chose 83 samples with a PCR threshold cycle of less than 25. Then, we used MiSeq FGx for sequencing and Illumina DRAGEN COVIDSeq pipeline, command line interface, GISAID, and MEGA version 7 for data analysis. Result and DiscussionJanuary 2021 results showed no variant. The second run during the rise of cases in June 2021 showed multiple variants like Alpha, Delta, and Kappa. There is only Delta in the third run at the height of mortality in August, and Delta alone continued until the fourth run in December. After the world reported the Omicron variant in November, Myanmar started a surveillance program. The fifth run in January 2022 showed both Omicron and Delta variants. The sixth run in March 2022 showed only Omicron BA.2. Amino acid mutation at receptor binding domain (RBD) of Spike glycoprotein started since the second run coupling with high transmission, recurrence, and vaccine escape. We also found the mutation at the primer targets used in current RT-PCR platforms. ConclusionThe occurrence of multiple variants and mutations claimed vigilance at ports of entry and preparedness for effective control measures. Genomic surveillance with the observation of evolutionary data is required to predict imminent threats of the current disease and diagnose emerging infectious diseases.

Viraemic-time predicts mortality among people living with HIV on second-line antiretroviral treatment in Myanmar: A retrospective cohort study.

INTRODUCTION: Despite HIV viral load (VL) monitoring being serial, most studies use a cross-sectional design to evaluate the virological status of a cohort. The objective of our study was to use a simplified approach to calculate viraemic-time: the proportion of follow-up time with unsuppressed VL above the limit of detection. We estimated risk factors for higher viraemic-time and whether viraemic-time predicted mortality in a second-line antiretroviral treatment (ART) cohort in Myanmar. METHODS: We conducted a retrospective cohort analysis of people living with HIV (PLHIV) who received second-line ART for a period >6 months and who had at least two HIV VL test results between 01 January 2014 and 30 April 2018. Fractional logistic regression assessed risk factors for having higher viraemic-time and Cox proportional hazards regression assessed the association between viraemic-time and mortality. Kaplan-Meier curves were plotted to illustrate survival probability for different viraemic-time categories. RESULTS: Among 1,352 participants, 815 (60.3%) never experienced viraemia, and 172 (12.7%), 214 (15.8%), and 80 (5.9%) participants were viraemic <20%, 20-49%, and 50-79% of their total follow-up time, respectively. Few (71; 5.3%) participants were ≥80% of their total follow-up time viraemic. The odds for having higher viraemic-time were higher among people with a history of injecting drug use (aOR 2.01, 95% CI 1.30-3.10, p = 0.002), sex workers (aOR 2.10, 95% CI 1.11-4.00, p = 0.02) and patients treated with lopinavir/ritonavir (vs. atazanavir; aOR 1.53, 95% CI 1.12-2.10, p = 0.008). Viraemic-time was strongly associated with mortality hazard among those with 50-79% and ≥80% viraemic-time (aHR 2.92, 95% CI 1.21-7.10, p = 0.02 and aHR 2.71, 95% CI 1.22-6.01, p = 0.01). This association was not observed in those with viraemic-time <50%. CONCLUSIONS: Key populations were at risk for having a higher viraemic-time on second-line ART. Viraemic-time predicts clinical outcomes. Differentiated services should target subgroups at risk for a higher viraemic-time to control both HIV transmission and mortality.

Organic Solar Cell With Efficiency Over 20% and VOC Exceeding 2.1 V Enabled by Tandem With All-Inorganic Perovskite and Thermal Annealing-Free Process.

Organic solar cells (OSCs) based on polymer donor and non-fullerene acceptor achieve power conversion efficiency (PCE) more than 19% but their poor absorption below 550 nm restricts the harvesting of high-energy photons. In contrast, wide bandgap all-inorganic perovskites limit the absorption of low-energy photons and cause serious below bandgap loss. Therefore, a 2-terminal (2T) monolithic perovskite/organic tandem solar cell (TSC) incorporating wide bandgap CsPbI2 Br is demonstrated as front cell absorber and organic PM6:Y6 blend as rear cell absorber, to extend the absorption of OSCs into high-energy photon region. The perovskite sub-cell, featuring a sol-gel prepared ZnO/SnO2 bilayer electron transporting layer, renders a high open-circuit voltage (VOC ). The VOC is further enhanced by employing thermal annealing (TA)-free process in the fabrication of rear sub-cell, demonstrating a record high VOC of 2.116 V. The TA-free Ag/PFN-Br interface in organic sub-cell facilitates charge transport and restrains nonradiative recombination. Consequently, a remarkable PCE of 20.6% is achieved in monolithic 2T-TSCs configuration, which is higher than that of both reported single junction and tandem OSCs, demonstrating that tandem with wide bandgap all-inorganic perovskite is a promising strategy to improve the efficiency of OSCs.

Simultaneous Tuning of Alkyl Chains and End Groups in Non-fused Ring Electron Acceptors for Efficient and Stable Organic Solar Cells.

Fine-tuning the alkyl chains and end groups of non-fused ring electron acceptors (NFREAs) plays vital roles in the promotion of charge transfer (CT) and power conversion efficiency (PCE). In this work, we developed a series of A-D-A'-D-A-type NFREAs, which possess the same terminals (A), the cyclopentadithiophene unit (D), and the thieno[3,4-c]pyrrole-4,6-dione (A'). Despite the subtle difference in side chains and halogenated end groups, the six acceptors exhibit a considerable difference in the efficiency and device stability of the organic solar cells (OSCs). Among the molecules, chlorinated NFREAs show a broader light absorption than the fluorinated ones do. Compared with C8C8-4F (1-octylnonyl and fluorination) and C6C4-4Cl (2-butyloctyl and chlorination), C8C8-4Cl (1-octylnonyl and chlorination) exhibits a lower highest occupied molecular orbital level, higher electron mobility, and denser molecular packing. The OSCs based on PM6:C8C8-4Cl yield the best PCE of 14.11%, which is attributed to the faster charge transport, high miscibility, and preferable morphology. Moreover, the PM6:C8C8-4Cl devices retain 91.1% of the initial PCE after being placed in air with 67% relative humidity for 50 days. This work shows that the simultaneous optimization of side chains and end groups facilitates the CT and improves the stability in the OSCs, offering a novel view into the molecular design of A-D-A'-D-A-type NFREAs.