Probing structural features in potato starch granules at moderate hydration through the modelling of 1H->13C polarization transfer kinetics.

The structural arrangement of starch polymers in presence of water is known to impact the functional properties of starchy products. In this study, the hydration of potato starch granules was investigated at the molecular level through various 1H->13C polarization transfer solid-state Nuclear Magnetic Resonance (ss-NMR) experiments. The impact of increasing the water content from 12.3 % to 45.9 % was assessed using 13C Cross Polarization Magic Angle Spinning (CPMAS), Variable Contact Time (VCT-CPMAS), Variable Spin Lock (VSL-CPMAS), and T One Rho QUEnching (TORQUE) NMR sequences. Of these, VCT-CPMAS proved to be the most promising. When applied with an optimal number of contact times, it enabled the application of several mathematical models that provided detailed insights into the structuring of protons in the hydrated potato starch granules. At low hydration (12.3 %), the models enabled various structural domains to be distinguished, which we suggest are associated with helical and amorphous structures. At moderate hydration (45.9 %), we tested two fitting models. Two pools of protons were revealed, corresponding to loosely ordered structures on the scale of tens of nanometers. These findings suggest varying water distribution during starch hydration and are likely to indicate variable hydration levels in the multilamellar amorphous structures of starch granules.

HIV seroconversion and associated factors among seronegative pregnant women attending ANC in Ethiopia: an institution-based cross-sectional study.

Background: In countries with limited resources, including Ethiopia, HIV is diagnosed using a rapid serological test, which does not detect the infection during the window period. Pregnant women who test negative for HIV on the first test may seroconvert throughout pregnancy. Women who are seroconverted during pregnancy may not have received interventions, as they are considered HIV-negative unless they are retested for HIV at the end of their pregnancy. Due to limited data on HIV seroconversion, this study aimed to measure the extent of HIV seroconversion and to identify associated factors among seronegative pregnant women attending ANC in Ethiopia. Methods: Institution-based cross-sectional study was conducted among HIV-negative pregnant women attending the ANC in Ethiopia between June and July 2020. Socio-demographic, clinical, and behavioral data were collected through face-to-face questionnaires and participants' records review. HIV retesting was performed to determine the current HIV status of pregnant women. The data collected were entered into Epi data version 4.4.1 and were exported and analyzed by SPSS version 25. A p-value < 0.25 in the bivariate analysis was entered into multivariable logistic regression analysis and a p-value of < 0.05 was considered statistically significant. Result: Of the 494 pregnant women who tested negative for HIV on their first ANC test, six (1.2%) tested positive on repeat testing. Upon multivariable logistic regression, pregnant women who have had a reported history of sexually transmitted infections [AOR = 7.98; 95% CI (1.21, 52.82)], participants' partners reported travel history for work frequently [AOR = 6.00; 95% CI (1.09, 32.99)], and sexually abused pregnant women [AOR = 7.82; 95% CI (1.194, 51.24)] were significantly associated with HIV seroconversion. Conclusion: The seroconversion rate in this study indicates that pregnant women who are HIV-negative in early pregnancy are at an ongoing risk of seroconversion throughout their pregnancy. Thus, this study highlights the benefit of a repeat HIV testing strategy in late pregnancy, particularly when the risk of seroconversion or new infection cannot be convincingly excluded. Therefore, repeated testing of HIV-negative pregnant women in late pregnancy provides an opportunity to detect seroconverted pregnant women to enable the timely use of ART to prevent mother-to-child transmission of HIV infection.

Factors associated with voluntary HIV counseling and testing among young students engaging in casual sexual activity: a cross-sectional study from Eastern China.

OBJECTIVES: To investigate the factors associated with voluntary HIV counseling and testing (VCT) among young students engaging in casual sexual activity and to establish a scientific rationale for developing targeted intervention strategies for preventing HIV/AIDS in this population. METHODS: Stratified cluster sampling was used to conduct a survey using questionnaires to collect demographic and behavioral information for statistical analysis. RESULTS: Data from 611 young students, who reported engaging in casual sexual activity, were included in the statistical analysis. Among these, 68 (11.13%) students underwent the VCT. Among young students who engaged in casual sexual activity, those who were non-Zhejiang residents (adjusted odds ratio [aOR]: 2.11; 95% Confidence Interval [CI]: 1.17-3.80), those who had received AIDS-themed lectures or health education courses from the school in the past year (aOR = 3.96, 95% CI = 1.49-10.50), those who had received HIV risk self-assessment conducted by the school in the past year (aOR = 2.31, 95% CI = 1.17-4.59), and those who had engaged in commercial sex activity in the past year (aOR = 1.98, 95% CI = 1.07-3.66) were more inclined to have undergone VCT. Male students (aOR = 0.37, 95% CI = 0.18-0.77) and those who used condoms consistently during casual sexual activity (aOR = 0.45, 95% CI = 0.21-0.97) were less likely to undergo VCT. CONCLUSION: Casual sexual activity was relatively prevalent among young students, posing a potential risk for HIV transmission. These findings will be instrumental in the development more effective HIV prevention and control strategies for young students. Additionally, it highlights the necessity of promoting and popularizing VCT among young students without Zhejiang province residency, who are involved in commercial sexual activity, and/or those who lacking HIV education. Moreover, additional research and implementation of refined HIV behavioral interventions specifically tailored to young students are necessary to enhance their awareness and knowledge of HIV prevention.

Polysaccharide-water interactions: NMR and DVS data.

The data provided here relate to the research paper "Assessing the complementarity of TD-NMR, solid-state NMR and Dynamic Vapor Sorption in the characterization of polysaccharide-water interactions". The original data from TD-NMR, ss-NMR and DVS is provided in .dps, topspin and .xls formats respectively, allowing other authors to repeat our processing protocols using different parameters. We also include results obtained by varying the signal treatments. The analysis of these multimodal data have highlighted a variation in polysaccharide-water interactions depending on the type of assembly. These datasets are very useful for discriminating between water bound to polysaccharides and water absorbed or adsorbed into polysaccharide network, a key element in understanding interactions in these assemblies and an essential approach for developing tailor-made polysaccharides-based products.

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics - China, 2015-2022.

Introduction: Human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) clinics play a critical role in identifying and diagnosing HIV cases. This study aimed to describe the trend of HIV positivity rate (HPR) among Chinese VCT clinics between 2015 and 2022. Methods: This study utilized data from the China Information System for Disease Control and Prevention to analyze the trend in the HPR for VCT clinics from 2015 to 2022. The HPR was calculated by dividing the number of newly-reported HIV cases by the number of HIV tests, multiplied by 100%. To identify temporal and spatial trends in the HPR, we employed joinpoint regression analysis and the Getis-Ord hotspot analysis. Results: From 2015 to 2022, VCT clinics in China performed a total of 22,075,386 HIV tests, leading to the identification of 260,353 HIV cases, resulting in a HPR of 1.18%. The HPR consistently declined over the study period, with an average annual percent change (AAPC) of -7.5% (95% confidence interval: -12.6%, -2.2%, P<0.05). The number of HPR hotspots also decreased from 41 in 2015 to 23 in 2022. These HPR hotspots were primarily located in Yunnan, Sichuan, Guangdong, and Guangxi provincial-level administrative divisions (PLADs). Among the 31 PLADs, 16 showed a significant decrease in HPR during the study period (AAPC<0, PAAPC<0.05). Conclusions: VCT clinics in China have played a significant role in identifying HIV cases. The declining HPR observed in these clinics may indicates the progress has been made in some degree in mitigating HIV among high-risk populations. Therefore, it is crucial to further improving the utilization of VCT clinics for HIV testing.

Multicenter Study of Diagnostic Tool for Patients with Hemophilia: From Bedside to Comprehensive Investigations.

Background: Hemophilia cannot be diagnosed in most laboratories of economically less-developed countries leading to high mortality and morbidity rates. Aim: A diagnostic tool was established ranging from bleeding assessment and a simple bedside test of mixing venous clotting time (VCT) to comprehensive DNA analysis for patients with hemophilia. Methods: Patients with known (n=80) and suspected hemophilia (n=14) were included. Their bleeding symptoms were initially evaluated using verified translated-Thai ISTH bleeding assessment tool. Then, blood samples were drawn using a two-syringe technique, 2 mL each was placed in three tubes, for the mixing VCT and citrate blood was kept for coagulogram and coagulation factor assay. Finally, DNA analysis was determined. Results: A total of 94 patients with hemophilia (A68, B26) defined as severe (A 57, B 17), moderate (A 7, B 5), and mild degrees (A 4, B 4) with the mean (SD) age of 14.0 (11.7) years and 24 normal controls aged 25.5 (4.5), were enrolled in the study. The mean (SD) bleeding score of patients with hemophilia was 13.5 (5.5), which did not significantly differ between patients with hemophilia A and B. The mixing venous clotting time offered the presumptive diagnosis of hemophilia A and B, which were subsequently confirmed by the prolonged APTT, low FVIII:C and FIX:C and mutations on the factor VIII and IX genes. Conclusion: A diagnostic tool for bleeding assessment, mixing venous clotting time, coagulogram, coagulation factor assay, and DNA analysis for patients with hemophilia has been established in the existing health-care system.

Next generation high resolution perovskite direct conversion detector: Monte Carlo design optimisation and virtual clinical trial.

We implement virtual clinical integration of next-generation perovskite detectors into common x-ray imaging devices. This was achieved by performing Monte Carlo (MC) optimisation of the design and benchmarking of low cost, high spatial resolution, direct conversion perovskite crystal x-ray flat panel imagers for a next generation of breast-, MV-, and kV-cone beam CT detectors. Semiconductor methylammonium lead bromide perovskite crystals energy deposition efficiencies calculated in TOPAS were benchmarked against four common detector materials for twelve detector crystal thicknesses between 40 to 15 mm and ten beam energies ranging from 20 keV to 6 MeV. Based on these simulations, Koning's dedicated breast CT, and Varian's Truebeam kV- and MV-cone beam CT systems were designated as suitable applications for perovskite detectors. System specific Fastcat hybrid MC cone beam CT image simulation was subsequently used to optimise the perovskite detector design and conduct virtual clinical trials. Device-specific optimal perovskite crystal thicknesses were calculated to be 0.30, 0.86, and 1.99 mm for Koning breast CT and Truebeam kV- and MV-cone beam CT systems, respectively. Replacing the current detectors on these machines with low cost perovskite crystal detectors could be advantageous as it would simultaneously yield 12.1%, 9.5% and 86.1% improvements in detective quantum efficiency as well as increases in contrast to noise ratio in brain, lung, and bone tissues.

Late diagnosis of HIV infection and its associated factors in Jiading District of Shanghai between 1998 and 2022 / 上海预防医学

ObjectiveTo investigate the late diagnosis of HIV infection and associated factors in Jiading District between 1998 and 2022， and to provide the information for the development of AIDS prevention and control strategy. MethodsInformation of newly reported HIV/AIDS cases in Jiading District between 1998 and 2022 were obtained from the National Information System for Comprehensive AIDS Prevention and Control. Logistic regression was used to explore the associated factors of late diagnosis of HIV infection. ResultsIn total， 809 HIV/AIDS cases was newly reported， 324 of which were late diagnosis with the overall rate of late diagnosis of 40.1%. Despite an increased tendency from 2016 to 2018， the rate of late diagnosis showed a downward trend from 1998 to 2015. The late diagnosis rate was 29.5% in 2015. From 2016 to 2022， the average rate was 34.9%. The average age of cases with a late diagnosis was 44.8±14.6 years old. Age groups over 50 had the highest risk，at 57.7%， accounting for 35.8% of all cases of late diagnosis. All age groups older than 30（OR=1.37‒3.50） had a higher rate of late diagnosis than the group between age 21 and 30. In comparison to patients at VCT clinic， the rate of late diagnosis among sexually transmitted disease （STD） outpatients （OR=2.23， 95%CI：1.42‒3.49） and other clinical patients （OR=2.75， 95%CI：1.88‒4.01） was higher. ConclusionThe late diagnosis rate of HIV infection is relatively high in Jiading District. AIDS education and prevention activities should be strengthened among people aged over 50 years. For early detection of HIV infection， VCT clinic platform’s function should be fully utilized. Medical institutions should pay attention to HIV testing in patients.

Optimization of acquisition and processing times for the measurement of 1H to 13C polarization transfer kinetics.

Solid-state NMR (ssNMR) is a unique technique allowing the study of macromolecular assemblies in their native state without prior modification. The proposed method simplifies the current long and tedious data-acquisition and processing protocols for Variable Contact Time (VCT) ssNMR experiments used in dynamic studies of macromolecular assemblies. Using cellulose nanocrystals as a model for polysaccharide assembly, the acquisition time was reduced by decreasing the number of scans and shortening the recycling time required for the 1H to 13C polarization transfers.•A tenfold reduction in the acquisition time for each kinetic point was achieved while maintaining a good signal to noise ratio.•The processing time for the pseudo-2D solid-state NMR data was also shortened by using signal intensities derived from peak picking rather than the classically-used spectral deconvolution method.•These optimizations enabled the molecular dynamic parameters T1ρ H, THH, TCH to be accessed within a day.

Assessment of cellulose interactions with water by ssNMR: 1H->13C transfer kinetics revisited.

To evaluate cellulose interactions with water, 1H->13C polarization transfer kinetics during Variable Contact Time CP-MAS NMR spectroscopy were studied and modelled using cellulose of different origins. The increase in the temporal resolution of the plot relating signal intensity to contact-time made it possible to compare different physical models for use in fitting the kinetic curve. These models involve combinations of variables, such as proton spin diffusions, that require a better understanding of their physicochemical and structural bases. To that end, hydrogen interactions were modulated by adding water, first by varying cellulose water content, second by exchanging hydroxyl protons with D2O, and last by varying the spinning rate. The results demonstrate that this approach makes it possible to probe interactions of polysaccharides with structural water, as well as to follow the evolution of the proton-proton interactions during hydration through spin diffusion times.

HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis.

Background: HIV disproportionately affects people who inject drugs, transgender people, sex workers, men who have sex with men, and incarcerated people. Recognized as key populations (KP), these groups face increased impact of HIV infection and reduced access to health assistance. In 1990, the Center for Disease Control and Prevention organized technical guidance on HIV Voluntary Counseling and Testing (VCT-HIV), with subsequent trials comparing intervention methodologies, no longer recommending this strategy. However, KP needs have not been explicitly considered. Methods: We assessed VCT-HIV effectiveness for sexual risk-reduction among KP (PROSPERO 2020 CRD42020088816). We searched Pubmed, EMBASE, Global Health, Scopus, PsycINFO, and Web of Science for peer-reviewed, controlled trials from February, 2020, to April, 2022. We screened the references list and contacted the main authors, extracted data through Covidence, applied the Cochrane Risk-of-Bias tool, and performed the meta-analysis using Review Manager. Findings: We identified 17 eligible trials, including 10,916 participants and evaluated HIV risk behaviors. When compared to baseline, VCT-HIV reduced unsafe sex frequency (Z=5.40; p<0.00001, I²=0%). Interpretation: While our meta-analysis identified VCT-HIV as protective for sexual risk behaviors for among KP, the results are limited to MSM and PWID, demonstrating the paucity of data on the other KP. Also, it highlights the importance of applying a clear VCT-HIV guideline as well as properly training the counselors. Funding: Research funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ/MS-DIAHV N° 24/2019), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.

Mitigating Dysphonia, Pain, and Vocal Handicap after Violent Video Game Voice Overs: A Pilot Investigation into Vocal Combat Technique Training.

OBJECTIVE: to investigate how the Vocal Combat Technique (VCT) may mitigate vocal symptoms in voice over actors using vocal violence. METHODS: Five voice over actors (3 male, 2 females, Mean = 29.6 years) completed two study sessions of 45 minutes-to-1 hour of vocally violent voice over work held approximately 4 weeks apart. During session one, participants completed voice over work as they typically would, whereas they received 3-hours of VCT training to improve/assist in healthy vocal techniques prior to session two. Pre- and post-session measures for both sessions included self-perceptual ratings of vocal symptoms, auditory-perceptual evaluation, and traditional acoustic measures of frequency and perturbation. RESULTS: Participants showed substantial mitigating effects of VCT training on acoustic perturbation measures (jitter, shimmer, harmonics-to-noise ratio), and self-ratings of vocal symptoms (Vocal-Handicap Index-10, McGill Pain Scale for vocal discomfort, and Evaluation of the Ability to Sing Easily) with calculated medium to large effect sizes (d = 0.61-1.95). There were no changes in auditory perceptual ratings across sessions. CONCLUSION: Our pilot investigation yielded positive improvements in vocal symptomology in five voice over actors who were trained in VCT. Next steps should include a larger enrollment of voice actors to determine optimal preventative and recovery techniques.

Automated variable power cold microwave tissue processing: A novel universal tissue processing protocol without using formaldehyde and xylene.

The tissue processing technique is used to preserve the biological structure of tissue samples harvested from biopsy as closely as possible to their in vivo state for the diagnoses and study of disease on the cellular level. This process includes fixation, dehydration, clearing, paraffin infiltration. The protocol follows paraffin block embedding, microtome slicing, staining, and microscope slide studying. Tissue processing is a time-sensitive task as histopathologists must rapidly prevent the decomposition of tissue samples and promptly provide diagnoses on time. However, there are different tissue processing protocols for processing tissues with different types and sizes. Fatty tissues and tissues thicker than 1.5 mm are more susceptible to human errors when choosing a proper tissue processing protocol when preparing separate batches of tissues. In this research, a novel automated variable power cold microwave tissue processor was developed using a universal tissue processing protocol (processing time of 97 min) to simultaneously process all tissue types up to 4 mm in thickness. The tissue processor operated with a relatively smaller number of reagents without formaldehyde or xylene. These materials cause severe health and safety issues for humans and the environment. The quality of healthy and diseased processed tissues (sizes 1×1×1 to 24×15×4 mm) of fatty, thyroid, breast, placenta, skin, prostate, stomach, and bladder was examined under a light microscope by defining MAS (morphology, artifacts, and staining) criteria for evaluating cellular details, tissue arrangement, tissue integrity, stain uptake, and visual distinction of a tissue structure in light microscopy. It was found that the new tissue processor has successfully processed both healthy and diseased fatty and nonfatty tissue samples, while all tissue samples also met MAS criteria. Light microscopy showed outstanding integrity and arrangement in the tissue structures with an excellent visual distinction.

Determinants of HIV voluntary counseling and testing: a multilevel modelling of the Ethiopian Demographic and Health Survey.

BACKGROUND: Human immunodeficiency virus (HIV) counseling and testing services are vital to reduce the spread of HIV infection, and to create an opportunity for early treatment and reduction of HIV/AIDS-related mortality. However, only 12 sub-Saharan African (SSA) countries reached the first 90% target (90% of people living with HIV to know their status). Hence, this study aimed to investigate the determinants of HIV counseling and testing among reproductive-age women in Ethiopia. METHODS: Ethiopian Demographic and Health Survey (EDHS 2016) data was used to identify the determinants of HIV counseling and testing among reproductive-age women in Ethiopia. A weighted sample of 14,599 reproductive age women was included in the study. A multilevel binary logistic regression model was fitted to identify the determinants of HIV counseling and testing. The odds' ratio with a 95% Confidence Interval (CI) and the corresponding P-value ≤ 0.05 was employed to declare the statistically significant variables. RESULTS: In this study, both individual and community-level variables were significantly associated with Voluntary Counseling and Testing (VCT) uptake among women. Women aged 25-34 years (Adjusted Odds Ratio (AOR) 2.29, 95% CI 2.05, 2.56), aged ≥ 35 years (AOR 1.55, 95% CI 1.38, 1.75), attending primary education (AOR 1.68, 95% CI 1.51, 1.88), secondary education (AOR 3.07, 95% CI 2.64, 3.58), and higher education (AOR 5.15, 95% CI 4.17, 6.36), women with medium household wealth (AOR 1.56, 95% CI 1.32, 1.84), richer (AOR 1.88, 95% CI 1.58, 2.24), and richest wealth index (AOR 2.37, 95% CI 1.91, 2.94), having comprehensive knowledge (AOR 1.21, 95% CI 1.06, 1.37), ever married (AOR 3.87, 95% CI 3.46, 4.32), having sexual risky behavior (AOR 2.09, 95% CI 1.69, 2.49), women from communities with high HIV knowledge (AOR 2.03, 95% CI 1.68, 2.45), women from communities with high literacy level (AOR 1.16, 95% CI 1.05, 1.51) and women from communities with high wealth quintile (AOR 1.20, 95% CI 1.03,1.57) had higher odds of VCT uptake. However, those women having stigma (AOR 0.81, 95% CI 0.74, 0.92) had reduced odds of VCT uptake. CONCLUSION: This study revealed that not only individual level factors but also community level factors determine the status of HIV voluntary counseling and testing. Hence, strengthening both individual and community based interventions are crucial to increase the women HIV counseling and testing practice in the country.

Anthropomorphic lung phantom based validation of in-room proton therapy 4D-CBCT image correction for dose calculation.

PURPOSE: Ventilation-induced tumour motion remains a challenge for the accuracy of proton therapy treatments in lung patients. We investigated the feasibility of using a 4D virtual CT (4D-vCT) approach based on deformable image registration (DIR) and motion-aware 4D CBCT reconstruction (MA-ROOSTER) to enable accurate daily proton dose calculation using a gantry-mounted CBCT scanner tailored to proton therapy. METHODS: Ventilation correlated data of 10 breathing phases were acquired from a porcine ex-vivo functional lung phantom using CT and CBCT. 4D-vCTs were generated by (1) DIR of the mid-position 4D-CT to the mid-position 4D-CBCT (reconstructed with the MA-ROOSTER) using a diffeomorphic Morphons algorithm and (2) subsequent propagation of the obtained mid-position vCT to the individual 4D-CBCT phases. Proton therapy treatment planning was performed to evaluate dose calculation accuracy of the 4D-vCTs. A robust treatment plan delivering a nominal dose of 60Gy was generated on the average intensity image of the 4D-CT for an approximated internal target volume (ITV). Dose distributions were then recalculated on individual phases of the 4D-CT and the 4D-vCT based on the optimized plan. Dose accumulation was performed for 4D-vCT and 4D-CT using DIR of each phase to the mid position, which was chosen as reference. Dose based on the 4D-vCT was then evaluated against the dose calculated on 4D-CT both, phase-by-phase as well as accumulated, by comparing dose volume histogram (DVH) values (Dmean, D2%, D98%, D95%) for the ITV, and by a 3D-gamma index analysis (global, 3%/3mm, 5Gy, 20Gy and 30Gy dose thresholds). RESULTS: Good agreement was found between the 4D-CT and 4D-vCT-based ITV-DVH curves. The relative differences ((CT-vCT)/CT) between accumulated values of ITV Dmean, D2%, D95% and D98% for the 4D-CT and 4D-vCT-based dose distributions were -0.2%, 0.0%, -0.1% and -0.1%, respectively. Phase specific values varied between -0.5% and 0.2%, -0.2% and 0.5%, -3.5% and 1.5%, and -5.7% and 2.3%. The relative difference of accumulated Dmean over the lungs was 2.3% and Dmean for the phases varied between -5.4% and 5.8%. The gamma pass-rates with 5Gy, 20Gy and 30Gy thresholds for the accumulated doses were 96.7%, 99.6% and 99.9%, respectively. Phase-by-phase comparison yielded pass-rates between 86% and 97%, 88% and 98%, and 94% and 100%. CONCLUSIONS: Feasibility of the suggested 4D-vCT workflow using proton therapy specific imaging equipment was shown. Results indicate the potential of the method to be applied for daily 4D proton dose estimation.

Sequential natural deep eutectic solvent pretreatments of apple pomace: A novel way to promote water extraction of pectin and to tailor its main structural domains.

To establish a "green" biorefinery extraction of apple pomace pectin, a sequential pretreatment with three natural deep eutectic solvents (NADES, choline chloride (CC): glycerol (G); CC: lactic acid (LA); potassium carbonate (K): G) was used prior to hot water extraction. A synergistic effect of CC:G and CC:LA pretreatments was observed and led to the highest recovery of pectin. The sequential NADES/water extraction process also provided a mean to tailor pectin main structure. It was explained as resulting from ion exchange and individual NADES components effects. The 13C solid state NMR T1ρH and THH parameters indicated a reorganization of cellulose in the residues following extraction of pectin, notably after alkaline K:G pretreatment/water extraction. Hence, sequential NADES pretreatments/water extraction represents a "green" alternative to mild mineral acid to extract pectin and to tailor its main structures, while the residual pomace can be further sources of valuable compounds and polymers.

The psychosocial determinants of the intention to test for HIV among young men in KwaZulu-Natal province, South Africa.

Background: Voluntary counselling and testing is one of the effective prevention strategies against the HIV/AIDS epidemic. This study investigated the psychosocial determinants of the intention to be tested for HIV among young men in South Africa's KwaZulu-Natal province using the theory of planned behaviour as the guiding framework.Method: A facilitator-administered questionnaire was used to collect data among 350 isiZulu-speaking men between the ages of 18 and 35.Results: Results show that 24% reported ever having tested. Intention to test showed strong positive correlations with subjective norm to test (r = 0.67), intention to use condoms (r = 0.65), intention to reduce alcohol use (r = 0.60), subjective norm to reduce alcohol use (r = 0.54), and subjective norm to use condoms (r = 0.51). For multiple regression, attitude, subjective norm and perceived behavioural control explained 43% of the variance in intention to test, with subjective norm and perceived behavioural control making significant unique contributions. An additional 12% of the variance was explained by intention to reduce alcohol and drug use, and use condoms.Conclusion: Behavioural interventions to encourage HIV testing among men should target normative and control beliefs but also other risky behaviours (e.g. alcohol abuse and condom use) as reductions in these behaviours appear to be positively associated with motivation to undergo HIV testing.

Factors Affecting Voluntary HIV/AIDS Counseling and Testing Service Utilization Among Youth in Gondar City, Northwest Ethiopia.

BACKGROUND: Voluntary counseling and testing (VCT) is a vital response to human immunodeficiency virus (HIV) infection among adolescents in sub-Saharan Africa. Determining the status of VCT services is important to link HIV care and antiretroviral therapy. METHODS: An institutional cross-sectional study design was conducted among 841 young students at Gondar College of Teachers' Education. A self-administered questionnaire was used to gather the data. Descriptive statistics were performed. Bivariate and multivariable binary logistic regressions were used to identify factors associated with the use of VCTs. The adjusted odds ratio (AOR) with 95% confidence was used to report statistical significance. RESULTS: The majority (71%) were aware of VCT services. More than one-third (37.8%, 95% CI: 34.6-41.2) participants had used VCT services. Having peer groups used VCT (AOR=2.04, 95% CI: 1.31-3.20), having partner (AOR: =1.6, 95% CI: 1.04-2.45), desiring to have VCT in the future (AOR=3.58, 95% CI: 1.98-6.50), being aware of VCT (AOR= 1.98, 95% CI: 1.20-3.34), knew infected/dead individuals with HIV/AIDS (AOR=1.67, 95% CI: 1.07-2.61), know test sites (AOR=2.01, 95% CI: 1.29-3.13) were positively associated, whereas being married (AOR=0.36, 95% CI: 0.20-0.63) and fear of confidentiality (AOR=0.23, 95% CI: 0.10-0.52) were major barriers to use. CONCLUSION: Low use of VCTs, which was far away from the 90:90:90 WHO goal, has been noted. The use of VCT services was associated with having peer groups that used VCT, having a partner, wanting to have VCT in the future, knowing the infected/dead individual with HIV/AIDS, fear of confidentiality of results, knowing the test sites, and having awareness of VCT. Efforts are needed to strengthen the health system that also needs to pay attention to education about HIV and VCT.

Cost-effectiveness of facility-based, stand-alone and mobile-based voluntary counseling and testing for HIV in Addis Ababa, Ethiopia.

BACKGROUND: Globally, there is a consensus to end the HIV/AIDS epidemic by 2030, and one of the strategies to achieve this target is that 90% of people living with HIV should know their HIV status. Even if there is strong evidence of clients' preference for testing in the community, HIV voluntary counseling and testing (VCT) continue to be undertaken predominantly in health facilities. Hence, empirical cost-effectiveness evidence about different HIV counseling and testing models is essential to inform whether such community-based testing are justifiable compared with additional resources required. Therefore, the purpose of this study was to compare the cost-effectiveness of facility-based, stand-alone and mobile-based HIV voluntary counseling and testing methods in Addis Ababa, Ethiopia. METHODS: Annual economic costs of counseling and testing methods were collected from the providers' perspective from July 2016 to June 2017. Ingredients based bottom-up costing approach was applied. The effectiveness of the interventions was measured in terms of the number of HIV seropositive clients identified. Decision tree modeling was built using TreeAge Pro 2018 software, and one-way and probabilistic sensitivity analyses were conducted by varying HIV positivity rate, costs, and probabilities. RESULTS: The cost of test per client for facility-based, stand-alone and mobile-based VCT was $5.06, $6.55 and $3.35, respectively. The unit costs of test per HIV seropositive client for the corresponding models were $158.82, $150.97 and $135.82, respectively. Of the three models, stand-alone-based VCT was extendedly dominated. Mobile-based VCT costs, an additional cost of USD 239 for every HIV positive client identified when compared to facility-based VCT. CONCLUSION: Using a mobile-based VCT approach costs less than both the facility-based and stand-alone approaches, in terms of both unit cost per tested individual and unit cost per HIV seropositive cases identified. The stand-alone VCT approach was not cost-effective compared to facility-based and mobile-based VCT. The incremental cost-effectiveness ratio for mobile-based VCT compared with facility-based VCT was USD 239 per HIV positive case.

A study regarding follow-ups after green pit viper bites treated according to the practice guideline by the Ministry of Public Health of Thailand.

Introduction: For patients bitten by a Green Pit Viper (GPV), the Ministry of Public Health (MoPH) guideline suggests a physician order blood tests immediately after the ED arrival and repeat them 2 h later, if initial results are normal. If repeat tests remain normal, the patient can be discharged and scheduled for outpatient-follow-up at 24, 48 and 72 h.Objectives: To determine the probability of abnormal blood tests at the second draw (2 h after the first draw), and to determine the probability of adverse events within 24+/-12 h among those discharged home for outpatient-follow-up.Methods: This retrospective study included patients with a history of GPV (Trimeresurus albolabris or Trimeresurus macrops) bite who were 15 years or older presenting to our ED from 2008 to 2015. We excluded those with other types of animal bites or those with missing medical records.Results: 320 cases were included. The majority were male (56.3%) and median age was 44 years old. There were only 4 cases (1.3%) with abnormal venous clotting time (VCT) or platelet count (PC) at the second blood draws when the first test results were normal. Of those discharged after the second blood draws came back normal, and who had outpatient follow-up at 24+/-12 h, 3 had minor adverse events and none received antivenom.Conclusions: This study showed a very low probability of abnormal test results 2 h after initial tests. However, they were still needed if the first tests were done too early. This study also confirms the safety of the guideline's recommendation for outpatient follow-up, especially within the first 24 h, with a very low rate of minor adverse events, and instruction to seek immediate medical attention if symptoms worsen.