Acceptability, feasibility and appropriateness of intensified health education, SMS/phone tracing and transport reimbursement for uptake of voluntary medical male circumcision in a sexually transmitted infections clinic in Malawi: a mixed methods study.

Introduction: Uptake of voluntary medical male circumcision (VMMC) remains a challenge in many settings. Innovative implementation strategies are required to scale-up VMMC uptake. Methodology: RITe was a multi-faceted intervention comprising transport reimbursement (R), intensified health education (IHE) and SMS/Telephone tracing (Te), which increased the uptake of VMMC among uncircumcised men with sexually transmitted infections (STIs) in Malawi. Using a concurrent exploratory mixed-method approach, we assessed the intervention's acceptability, feasibility and appropriateness among men with STIs and healthcare workers (HCWs) at Bwaila District Hospital. Participants completed Likert scale surveys and participated in-depth interviews (IDIs) and focus group discussions (FGDs). We calculated percentages of responses to survey items and summarized common themes using thematic analysis. Median scores and interquartile ranges (IQR) were calculated for acceptability, feasibility and appropriateness of each strategy at baseline and end-line and compared using the Wilcoxon signed rank test. Results: A total of 300 surveys, 17 IDIs and 4 FGDs were conducted with men and HCWs between baseline and end-line. The mean age for men in the survey was 29 years (SD ±8) and most were married/cohabiting (59.3%). Mean age for HCWs was 38.5 years (SD ±7), and most were female (59.1%). For acceptability, participants agreed that RITe was welcome, approvable, and likable. Despite participants agreeing that RITe was a good idea, culture and religion influenced appropriateness, particularly at baseline, which improved at end-line for Te and R. For feasibility, HCWs agreed that RITe was easy to implement, but expressed concerns that R (end-line median = 4, IQR: 2, 4) and Te (end-line median = 4, IQR: 4, 4), were resource intensive, hence unsustainable. Interviews corroborated the survey results. Participants reported that IHE provided important information, Te was a good reminder and R was attractive, but they reported barriers to R and Te such as electricity, limited access to phones and distrust in the government. Conclusions: The RITe intervention was acceptable, feasible and appropriate. However, culture/religion and structural barriers affected perceptions of appropriateness and feasibility, respectively. Continued awareness raising on VMMC and addressing setting-specific structural factors are required to overcome barriers that impede demand-creation interventions for VMMC. Study registration: ClinicalTrials.gov identifier: NCT04677374. Registered on December 18, 2020.

A Conference Designathon to Spark Innovation: Actionable Ideas to Enhance Sexually Transmitted Disease Control.

BACKGROUND: Designathons can be used to enhance public health training and spur innovation. A designathon is a 3-stage participatory activity that includes preparation, intensive collaboration, and follow-up activities. We organized a designathon focused on developing actionable sexually transmitted disease (STD) control strategies and examined the content of ideas resulting from an STD designathon. METHODS: For this designathon, we created four groups: early career researchers, silver group (people with >10 years of experience), travelers (people from low- and middle-income countries and those who received a conference scholarship) and a community group. Each group developed its own plan to consult members, iteratively develop ideas, and aggregate insights. Each group developed STD control strategies that were presented. Cross-cutting themes across these ideas were identified. RESULTS: Designathon participants included a subset of conference participants. Cross-cutting themes from final ideas included cocreating STD interventions with end-users, using sex-positive framing, enhancing open access digital STD resources, and reducing STD stigma. Early career researchers presented a call for community ideas focusing on ending STD epidemics by increasing accessibility to STD care services among all populations. The silver group proposed digital innovations, including an AI-powered tool for testing and treatment and a social game to promote sex positivity. The traveler group conceptualized an information hub to support implementation of STD programs. Community members underscored the importance of a more human-centered approach to STD control, which reduces stigma and normalizes sex and sexual pleasure. CONCLUSION: Sex positive campaigns and open access digital resources should be considered within STD programs. Implementation research studies are needed to evaluate these ideas.

Effectiveness of an intervention to increase uptake of voluntary medical male circumcision among men with sexually transmitted infections in Malawi: a preinterventional and postinterventional study.

OBJECTIVE: To evaluate the effect a multistrategy demand-creation and linkage intervention on voluntary medical male circumcision (VMMC) uptake, time to VMMC and predictors of VMMC uptake among men with sexually transmitted infections (STIs). DESIGN: Pragmatic preinterventional and postinterventional quasi-experimental study combined with a prospective observational design. SETTING: A public and specialised STI clinic in Lilongwe, Malawi. POPULATION: Uncircumcised men who presented to the STI clinic. METHODS AND INTERVENTION: The intervention consisted of transport reimbursement ('R'), intensified health education ('I') and short-messaging services/telephonic tracing ('Te'), abbreviated (RITe). A preintervention phase was conducted at baseline while RITe was rolled-out in the intervention phase in a sequential manner called implementation blocks: 'I' only-block 1; 'I+Te'-block 2 and RITe-block 3. MAIN OUTCOME MEASURES: Primary: VMMC uptake and time to VMMC for the full intervention and for each block. Secondary: predictors of VMMC uptake. RESULTS: A total of 2230 uncircumcised men presented to the STI clinic. The mean age was 29 years (SD±9), 58% were married/cohabiting, HIV prevalence was 6.4% and 43% had urethral discharge. Compared with standard of care (8/514, 1.6%), uptake increased by 100% during the intervention period (55/1716, 3.2%) (p=0.048). 'I' (25/731, 113%, p=0.044) and RITe (17/477, 125%, p=0.044) significantly increased VMMC uptake. The median time to VMMC was shorter during the intervention period (6 days, IQR: 0, 13) compared with standard of care (15 days, IQR: 9, 18). There was no significant incremental effect on VMMC uptake and time to VMMC between blocks. Men with genital warts were 18 times more likely to receive VMMC (adjusted relative risk=18.74, 95% CI: 2.041 to 172.453). CONCLUSIONS: Our intervention addressing barriers to VMMC improved VMMC uptake and time to VMMC among uncircumcised men with STIs, an important subpopulation for VMMC prioritisation. TRIAL REGISTRATION NUMBER: NCT04677374.

Dramatic Shift in the Etiology of Genital Ulcer Disease Among Patients Visiting a Sexually Transmitted Infections Clinic in Lilongwe, Malawi.

BACKGROUND: Genital ulcer diseases (GUDs) are a common syndrome associated with sexually transmitted infections. Genital ulcer diseases increase the risk of HIV transmission, necessitating appropriate diagnosis and treatment. We provide an updated GUD etiology assessment in Malawi to guide diagnostic development and treatment algorithms. METHODS: We enrolled patients 18 years or older presenting with GUD at a sexually transmitted infection clinic in Lilongwe, Malawi, between May and October 2021. We purposively sampled by HIV status. Swabs of ulcers were tested for Treponema pallidum, herpes simplex virus (HSV)-1 and HSV-2, Haemophilus ducreyi, and Chlamydia trachomatis using polymerase chain reaction. Blood was collected for syphilis and HSV-2 serologies and acute HIV testing. Participants were treated per Malawi guidelines. Ulcer resolution (size reduced by >50%) was evaluated 14 days later. RESULTS: Fifty participants enrolled (30 without HIV, 2 with acute HIV infection, 18 with HIV seropositivity; 32 men, 18 women). Forty-six (92%) had an etiology identified. Syphilis was more common among those without HIV (22 of 30 [73%]) than participants with HIV (PWH; 8 of 20 [40%]; P = 0.04). Herpes simplex virus was more common among PWH (11 of 20 [55%]) than participants without (2 of 30 [7%]; P = 0.0002). One-fifth (9 of 50 [18%]) had H. ducreyi. Among those who returned for follow-up (n = 45), 9 (20%) had unresolved ulcers; persistent GUD was slightly more common in PWH (6 of 19 [32%]) than participants without (3 of 26 [12%]; P = 0.14). CONCLUSIONS: We observed a dramatic increase in syphilis ulcer proportion in a population whose GUDs were previously HSV predominant. Observed differences in etiology and resolution by HIV status could play an important role in the ongoing transmission and treatment evaluation of GUD.

Clinical and genomic diversity of Treponema pallidum subsp. pallidum: A global, multi-center study of early syphilis to inform vaccine research.

Background: The continuing increase in syphilis rates worldwide necessitates development of a vaccine with global efficacy. We conducted a multi-center, observational study to explore Treponema pallidum subsp. pallidum ( TPA ) molecular epidemiology essential for vaccine research by analyzing clinical data and specimens from early syphilis patients using whole-genome sequencing (WGS) and publicly available WGS data. Methods: We enrolled patients with primary (PS), secondary (SS) or early latent (ELS) syphilis from clinics in China, Colombia, Malawi and the United States between November 2019 - May 2022. Inclusion criteria included age ≥18 years, and syphilis confirmation by direct detection methods and/or serological testing. TPA detection and WGS were conducted on lesion swabs, skin biopsies/scrapings, whole blood, and/or rabbit-passaged isolates. We compared our WGS data to publicly available genomes, and analysed TPA populations to identify mutations associated with lineage and geography. Findings: We screened 2,820 patients and enrolled 233 participants - 77 (33%) with PS, 154 (66%) with SS, and two (1%) with ELS. Median age of participants was 28; 66% were cis -gender male, of which 43% reported identifying as "gay", "bisexual", or "other sexuality". Among all participants, 56 (24%) had HIV co-infection. WGS data from 113 participants demonstrated a predominance of SS14-lineage strains with geographic clustering. Phylogenomic analysis confirmed that Nichols-lineage strains are more genetically diverse than SS14-lineage strains and cluster into more distinct subclades. Differences in single nucleotide variants (SNVs) were evident by TPA lineage and geography. Mapping of highly differentiated SNVs to three-dimensional protein models demonstrated population-specific substitutions, some in outer membrane proteins (OMPs) of interest. Interpretation: Our study involving participants from four countries substantiates the global diversity of TPA strains. Additional analyses to explore TPA OMP variability within strains will be vital for vaccine development and improved understanding of syphilis pathogenesis on a population level. Funding: National Institutes of Health, Bill and Melinda Gates Foundation.

Optimization of Ternary InxGa1-xN Quantum Wells on GaN Microdisks for Full-Color GaN Micro-LEDs.

Red, green, and blue light InxGa1-xN multiple quantum wells have been grown on GaN/γ-LiAlO2 microdisk substrates by plasma-assisted molecular beam epitaxy. We established a mechanism to optimize the self-assembly growth with ball-stick model for InxGa1-xN multiple quantum well microdisks by bottom-up nanotechnology. We showed that three different red, green, and blue lighting micro-LEDs can be made of one single material (InxGa1-xN) solely by tuning the indium content. We also demonstrated that one can fabricate a beautiful InxGa1-xN-QW microdisk by choosing an appropriate buffer layer for optoelectronic applications.

Characterizing Network-Based HIV Testing Interventions to Guide HIV Testing and Contact Tracing at STI Clinics in Lilongwe, Malawi.

BACKGROUND: Understanding heterogeneity across patients in effectiveness of network-based HIV testing interventions may optimize testing and contact tracing strategies, expediting linkage to therapy or prevention for contacts of persons with HIV (PWH). SETTING: We analyzed data from a randomized controlled trial of a combination intervention comprising acute HIV testing, contract partner notification (cPN), and social contact referral conducted among PWH at 2 STI clinics in Lilongwe, Malawi, between 2015 and 2019. METHODS: We used binomial regression to estimate the effect of the combination intervention vs. passive PN (pPN) on having any (1) contact, (2) newly HIV-diagnosed contact, and (3) HIV-negative contact present to the clinic, overall and by referring participant characteristics. We repeated analyses comparing cPN alone with pPN. RESULTS: The combination intervention effect on having any presenting contact was greater among referring women than men [prevalence difference (PD): 0.17 vs. 0.10] and among previously vs. newly HIV-diagnosed referring persons (PD: 0.20 vs. 0.11). Differences by sex and HIV diagnosis status were similar in cPN vs. pPN analyses. There were no notable differences in the intervention effect on newly HIV-diagnosed referrals by referring participant characteristics. Intervention impact on having HIV-negative presenting contacts was greater among younger vs. older referring persons and among those with >1 vs. ≤1 recent sex partner. Effect differences by age were similar for cPN vs. pPN. CONCLUSION: Our intervention package may be particularly efficacious in eliciting referrals from women and previously diagnosed persons. When the combination intervention is infeasible, cPN alone may be beneficial for these populations.

Substrate-Induced Anisotropic Growth of CuAlO2 Platelets in a Liquid-Solid Reaction.

This study reports a simplified method to grow CuAlO2 crystals of submillimeter sizes with a highly anisotropic shape of a platelet. The solid-state reaction of forming CuAlO2 at ca. 1373 K in the first stage of the conventional flux method is no longer required. The CuAlO2 platelets nucleated directly onto the (0001)sapphire surface in a melt of Cu2O saturated with Al2O3 at 1473 K. The excess flux was mostly removed by the capped alumina plate on cooling with a limited amount of residue which can be leached afterward. The CuAlO2 platelets all have a 3R crystal structure with no line and planar defects observed by TEM. The CuAlO2 crystals emit a luminescence at 3.49 eV associated with resonant Raman effect resulted from a band-to-band transition in room-temperature PL measurement. The facile fabrication method for growing highly anisotropic CuAlO2 crystals paves the way for their practical application in photoelectrochemical devices.

Timing advances of commercial divalent-ion co-doped LYSO:Ce and SiPMs in sub-100 ps time-of-flight positron emission tomography.

Objective.Together with novel photodetector technologies and emerging electronic front-end designs, scintillator material research is one of the key aspects to obtain ultra-fast timing in time-of-flight positron emission tomography (TOF-PET). In the late 1990s, Cerium-doped lutetium-yttrium oxyorthosilicate (LYSO:Ce) has been established as the state-of-the-art PET scintillator due to its fast decay time, high light yield and high stopping power. It has been shown that co-doping with divalent ions, such as Ca2+and Mg2+, is beneficial for its scintillation characteristics and timing performance. Therefore, this work aims to identify a fast scintillation material to combine it with novel photosensor technologies to push the state of the art in TOF-PET.Approach.This study evaluates commercially available LYSO:Ce,Ca and LYSO:Ce,Mg samples manufactured by Taiwan Applied Crystal Co., LTD regarding their rise and decay times as well as their coincidence time resolution (CTR) with both ultra-fast high-frequency (HF) readout and commercially available readout electronics, i.e. the TOFPET2 ASIC.Main results.The co-doped samples exhibit state-of-the-art rise times of on average 60 ps and effective decay times of on average 35 ns. Using the latest technological improvements made on NUV-MT SiPMs by Fondazione Bruno Kessler and Broadcom Inc., a 3 × 3 × 19 mm3LYSO:Ce,Ca crystal achieves a CTR of 95 ps (FWHM) with ultra-fast HF readout and 157 ps (FWHM) with the system-applicable TOFPET2 ASIC. Evaluating the timing limits of the scintillation material, we even show a CTR of 56 ps (FWHM) for small 2 × 2 × 3 mm3pixels. A complete overview of the timing performance obtained with different coatings (Teflon, BaSO4) and different crystal sizes coupled to standard Broadcom AFBR-S4N33C013 SiPMs will be presented and discussed.Significance.This work thoroughly evaluates commercially available co-doped LYSO:Ce crystals and, in combination with novel NUV-MT SiPMs, shows a TOF performance that significantly exceeds the current state of the art.

Impact of different corn milling methods for high-moisture and dry corn on finishing cattle performance, carcass characteristics, and nutrient digestion.

Two experiments were conducted to evaluate the effect of different corn milling methods for high-moisture and dry corn on finishing cattle performance, carcass traits, and nutrient digestion. In experiment 1, steers (N = 600 [60 pens]; initial body weight [BW] = 402 ± 17 kg) were fed for 134 d to evaluate the effect of milling method and corn type on performance and carcass characteristics. Treatments were evaluated as a 2 × 3 factorial design with factors being milling method (Automatic Ag roller mill [ROLL] or hammer mill [HAMMER]) and corn type (high-moisture [HMC], dry [DC], or 50:50 blend of HMC and DC [BLEND]). There were no milling method × corn type interactions for final BW, gain (ADG), or dry matter intake (DMI; P ≥ 0.32), but there tended to be an interaction for G:F (P = 0.09). Cattle fed ROLL HMC had 4.7% greater gain:feed (G:F; P ≤ 0.01) with 55% lower fecal starch (P < 0.01) compared to HAMMER HMC, whereas processing did not impact (P = 0.74) G:F in DC diets. There were no further effects (P ≥ 0.14) on performance or carcass traits regardless of milling method or corn type. In experiment 2, seven ruminally fistulated steers were utilized in a 4 × 7 incomplete Latin rectangle to evaluate the effects of DC or HMC processed with either ROLL or HAMMER (2 × 2 factorial treatment design) on nutrient digestion. Feeding HMC decreased the amount of excreted dry matter (DM) and organic matter (OM; P ≤ 0.01) regardless of mill type, but there was a tendency (P ≤ 0.13) for an interaction between corn type and mill type for DM and OM digestibility. There was no difference between milling treatments fed as HMC (P ≥ 0.69), but the HAMMER DC diet was more digestible than the ROLL DC (P = 0.05). As expected, HMC-based diets had greater (P < 0.01) starch digestibility compared to DC, but milling method had no impact on starch digestibility (P = 0.56). There were no differences (P = 0.56) in average ruminal pH, but HMC diets had greater variance (P = 0.04) and greater area less than pH 5.6 (P = 0.05) compared to DC based diets while milling method did not impact either (P > 0.33). Processing HMC with a roller mill improved G:F compared to processing with a hammer mill, but had little effect when corn was fed as dry corn or HMC:DC blend. Furthermore, feeding cattle HMC compared to DC increases nutrient digestibility, but milling method had little impact.

Two experiments tested how processing of corn grain for finishing cattle influences growth performance and nutrient digestion. Producers can use corn in dry or high-moisture form but normally use either a hammer mill or roller mill. When using high-moisture corn, we observed a 5% improvement in gain:feed (G:F) for rolling as compared to hammer milling, which is likely due to more uniform particle size and improved digestion. Unlike the performance study, milling method did not impact digestion for high-moisture corn. Using a hammer-mill for dry corn improved digestion compared to rolling which was not supported by improved performance in the finishing study. Using high-moisture corn increases risk of ruminal acidosis compared to dry corn, but also improves feed efficiency if acidosis can be minimized.

The effect of corn silage hybrid and inclusion on performance of finishing steers and silage hybrid effects on digestibility and performance of growing steers.

Three experiments evaluated the effects of three corn silage hybrids, inclusion, and nutrient digestibility in growing and finishing diets. The three hybrids tested included a control (CON), a hybrid containing a brown midrib (bm3) trait (BM3), and an experimental bm3 hybrid with the soft endosperm trait (BM3-SOFT). Experiment 1 utilized 360 crossbred steers (body weight [BW] = 334; SD = 25 kg) to evaluate inclusion of silage in a finishing diet at (15% or 45% of diet dry matter [DM]) and silage hybrid (CON, BM3, or BM3-SOFT). Experiment 2 and 3 utilized 216 crossbred steers (BW = 324; SD = 10 kg) and six ruminally fistulated steers (BW = 274; SD = 27 kg), respectively, to evaluate effects of either CON, BM3, or BM3-SOFT silage hybrids on performance and nutrient digestibility in growing diets. In Exp. 1, there was a silage inclusion × hybrid interaction for average daily gain (ADG) and gain-to-feed ratio (G:F). All treatments with 15% silage had greater (P ≤ 0.04) ADG and G:F compared with 45% silage. Cattle fed BM3-SOFT had greater ADG and G:F than cattle fed CON or BM3 when silage was included at 15% of the diet. When silage was fed at 45% of the diet DM, ADG did not differ between cattle fed either bm3 hybrid. Cattle fed BM3 had the greatest G:F (P < 0.01), with no difference between BM3-SOFT and CON. At 15% silage inclusion, hot carcass weight (HCW) was greater (P < 0.01) for cattle fed BM3-SOFT compared with cattle fed CON and BM3 but did not differ between cattle fed BM3 and CON. At 45% silage inclusion, steers fed either bm3 hybrid did not differ in HCW but were both heavier (P < 0.01) compared with cattle fed CON. In Exp. 2, ending BW, dry matter intake (DMI), and ADG were greater (P < 0.01) for steers fed either bm3 hybrid compared to steers fed the CON, but not different between steers fed the bm3 hybrids. There were no differences (P = 0.26) in G:F between the silage hybrids. In Exp. 3, steers fed either bm3 had greater (P < 0.01) neutral detergent fiber (NDF) and acid detergent fiber (ADF) digestibility than steers fed the CON. Ruminal pH was lower (P < 0.01), and total volatile fatty acid (VFA) concentration was greater (P < 0.01) for steers fed bm3 hybrids compared to steers fed CON. Feeding silage with the bm3 trait improved fiber digestibility, which increased DMI and subsequent ADG in high-forage growing diets. Feeding corn silage with the bm3 trait improved performance compared to non-bm3 corn silage when included above typical roughage concentration.

High-throughput nanopore sequencing of Treponema pallidum tandem repeat genes arp and tp0470 reveals clade-specific patterns and recapitulates global whole genome phylogeny.

Sequencing of most Treponema pallidum genomes excludes repeat regions in tp0470 and the tp0433 gene, encoding the acidic repeat protein (arp). As a first step to understanding the evolution and function of these genes and the proteins they encode, we developed a protocol to nanopore sequence tp0470 and arp genes from 212 clinical samples collected from ten countries on six continents. Both tp0470 and arp repeat structures recapitulate the whole genome phylogeny, with subclade-specific patterns emerging. The number of tp0470 repeats is on average appears to be higher in Nichols-like clade strains than in SS14-like clade strains. Consistent with previous studies, we found that 14-repeat arp sequences predominate across both major clades, but the combination and order of repeat type varies among subclades, with many arp sequence variants limited to a single subclade. Although strains that were closely related by whole genome sequencing frequently had the same arp repeat length, this was not always the case. Structural modeling of TP0470 suggested that the eight residue repeats form an extended α-helix, predicted to be periplasmic. Modeling of the ARP revealed a C-terminal sporulation-related repeat (SPOR) domain, predicted to bind denuded peptidoglycan, with repeat regions possibly incorporated into a highly charged ß-sheet. Outside of the repeats, all TP0470 and ARP amino acid sequences were identical. Together, our data, along with functional considerations, suggests that both TP0470 and ARP proteins may be involved in T. pallidum cell envelope remodeling and homeostasis, with their highly plastic repeat regions playing as-yet-undetermined roles.

Uptake of voluntary medical male circumcision among men with sexually transmitted infections in Lilongwe, Malawi: a protocol for a pre-interventional and post-interventional study.

INTRODUCTION: Voluntary medical male circumcision (VMMC) is one of the key interventions for HIV prevention. However, its uptake among men in Malawi is low. Implementation science strategies for demand creation of VMMC increase uptake. We designed an implementation science demand-creation intervention to increase the uptake of VMMC among men with sexually transmitted infections (STIs). METHODS AND ANALYSIS: We designed a pragmatic pre-interventional and post-interventional quasi-experimental study combined with a prospective observational design to determine the uptake, acceptability, appropriateness and feasibility of a multifaceted intervention for scale up of uptake of VMMC among men with STIs at Bwaila STI clinic in Lilongwe, Malawi. The intervention includes transport reimbursement (R), intensified health education (I) and short messaging service (SMS)/telephonic tracing (Te) (RITe). The intervention will be implemented in phases: pre-implementation and implementation. Pre-implementation phase will be used for collecting baseline data, while the RITe intervention will be rolled-out in the implementation phase. The RITe intervention will be implemented in a sequential and incremental manner called implementation blocks: block 1: intensified health education; block 2: intensified health education and SMS/telephonic tracing; and block 3: intensified health education, SMS/telephonic tracing and transport reimbursement. The target sample size is 80 uncircumcised men for each intervention block, including the pre-implementation sample, making a total of 320 men (280 total, 70 per block will be surveyed). The primary outcome is uptake of VMMC during the implementation period. Mixed methods assessments will be conducted to evaluate the acceptability, appropriateness and feasibility of the RITe intervention. ETHICS AND DISSEMINATION: The study protocol was approved by the Malawi's National Health Sciences Research Ethics Committee (approval number: 19/10/2412), University of North Carolina at Chapel Hill's Institutional Review Board (approval number: 19-2559) and University of the Witwatersrand's Health Research Ethics Committee (approval number: M200328). Results will be disseminated via publication in a peer-reviewed journal and presentations at relevant scientific conferences and meetings. TRIAL REGISTRATION NUMBER: NCT04677374.

The Singularity Paramagnetic Peak of Bi0.3Sb1.7Te3 with p-type Surface State.

The magnetization measurement was performed in the Bi0.3Sb1.7Te3 single crystal. The magnetic susceptibility revealed a paramagnetic peak independent of the experimental temperature variation. It is speculated to be originated from the free-aligned spin texture at the Dirac point. The ARPES reveals that the Fermi level lies below the Dirac point. The Fermi wavevector extracted from the de Haas-van Alphen oscillation is consistent with the energy dispersion in the ARPES. Our experimental results support that the observed paramagnetic peak in the susceptibility curve does not originate from the free-aligned spin texture at the Dirac point.

Effect of protein and glucogenic precursor supplementation on forage digestibility, serum metabolites, energy utilization, and rumen parameters in sheep.

Supplementation of glucogenic precursors in roughage diets may increase production responses due to improved efficiencies of nutrient utilization. Therefore, the objective of this study was to determine the effect of source of supplemental glucogenic potential (GP) on forage digestibility, serum metabolites, energy utilization, and rumen parameters of growing wethers consuming a roughage diet (8.8% crude protein, 71.4% ash-free neutral detergent fiber). Crossbred wethers (49.1 ± 4.7 kg initial BW; n = 16) were utilized in a 4 × 4 replicated Latin Square design with four periods of 21 d. Supplements were designed to supplement increasing amount of GP: 1) no supplementation (CON; 0 g), 2) 40 g of calcium propionate (CAP; 30 g of GP), 3) 70 g of blood meal + 100 g of feather meal (BF; 40 g of GP), or 4) combination of CAP and BF (COMBO; 70 g of GP). Total fecal and urine collection was conducted from days 13-17 to calculate digestibility estimates and urinary losses. An acetate tolerance test was administered on day 17 to determine the effect of GP on acetate clearance. Blood samples were collected on day 19 and were analyzed for serum concentrations of glucose, urea N (SUN), non-esterified fatty acids, and amino acids. Rumen fluid was collected on day 21 to determine supplementation effects on ruminal volatile fatty acid (VFA) and ammonia concentrations. Wethers receiving BF and COMBO supplementation had greatest (P ≤ 0.01) DM and OM total tract digestibility. Supplementation did not affect (P ≥ 0.37) NDF digestibility or digestible energy. Urinary nitrogen excretion was greatest (P = 0.02) for BF and COMBO. Circulating serum essential amino acid concentration was increased (P < 0.01) in BF and COMBO compared to CAP and CON. In addition, BF and COMBO had increased (P < 0.01) SUN concentrations compared to CAP and CON. Acetate half-life was not affected (P = 0.39) by supplementation strategy. However, area under the curve (AUC) for acetate was decreased (P = 0.04) with supplementation of BF and COMBO compared to CON-fed wethers. Ruminal propionate concentration was increased (P ≤ 0.01) for wethers fed CAP and COMBO supplementation, which resulted in decreased (P ≤ 0.01) A:P ratio. Overall, these results indicate that the increased propionate supply by providing propionate salts did not result in a protein sparing impact or increased N retention.

A Review on Low-Dimensional Nanomaterials: Nanofabrication, Characterization and Applications.

The development of modern cutting-edge technology relies heavily on the huge success and advancement of nanotechnology, in which nanomaterials and nanostructures provide the indispensable material cornerstone. Owing to their nanoscale dimensions with possible quantum limit, nanomaterials and nanostructures possess a high surface-to-volume ratio, rich surface/interface effects, and distinct physical and chemical properties compared with their bulk counterparts, leading to the remarkably expanded horizons of their applications. Depending on their degree of spatial quantization, low-dimensional nanomaterials are generally categorized into nanoparticles (0D); nanorods, nanowires, and nanobelts (1D); and atomically thin layered materials (2D). This review article provides a comprehensive guide to low-dimensional nanomaterials and nanostructures. It begins with the classification of nanomaterials, followed by an inclusive account of nanofabrication and characterization. Both top-down and bottom-up fabrication approaches are discussed in detail. Next, various significant applications of low-dimensional nanomaterials are discussed, such as photonics, sensors, catalysis, energy storage, diverse coatings, and various bioapplications. This article would serve as a quick and facile guide for scientists and engineers working in the field of nanotechnology and nanomaterials.

The Magnetic Susceptibility Bifurcation in the Ni-Doped Sb2Te3 Topological Insulator with Antiferromagnetic Order Accompanied by Weak Ferromagnetic Alignment.

The magnetic susceptibility reveals a discontinuity at Néel temperature and a hysteresis loop with low coercive field was observed below Néel temperature. The magnetic susceptibility of zero field cool and field cool processes coincide at a temperature above the discontinuity, and they split at temperature blow the discontinuity. The magnetic susceptibility splitting is larger at lower external magnetic fields. No more magnetic susceptibility splitting was observed at a magnetic field above 7000 Oe which is consistent with the magnetic anisotropy energy. Our study supports that these magnetic susceptibility characteristics originate from an antiferromagnetic order accompanied by weak ferromagnetism.

Urine Lipoarabinomannan Testing in Adults With Advanced Human Immunodeficiency Virus in a Trial of Empiric Tuberculosis Therapy.

BACKGROUND: The urine lipoarabinomannan (LAM) antigen test is a tuberculosis (TB) diagnostic test with highest sensitivity in individuals with advanced human immunodeficiency virus (HIV). Its role in TB diagnostic algorithms for HIV-positive outpatients remains unclear. METHODS: The AIDS Clinical Trials Group (ACTG) A5274 trial demonstrated that empiric TB therapy did not improve 24-week survival compared to isoniazid preventive therapy (IPT) in TB screen-negative HIV-positive adults initiating antiretroviral therapy with CD4 counts <50 cells/µL. Retrospective LAM testing was performed on stored urine obtained at baseline. We determined the proportion of LAM-positive participants and conducted modified intent-to-treat analysis excluding LAM-positive participants to determine the effect on 24-week survival, TB incidence, and time to TB using Kaplan-Meier method. RESULTS: A5274 enrolled 850 participants; 53% were male and the median CD4 count was 18 (interquartile range, 9-32) cells/µL. Of the 850, 566 (67%) had LAM testing (283 per arm); 28 (5%) were positive (21 [7%] and 7 [2%] in the empiric and IPT arms, respectively). Of those LAM-positive, 1 participant in each arm died and 5 of 21 and 0 of 7 in empiric and IPT arms, respectively, developed TB. After excluding these 28 cases, there were 19 and 21 deaths in the empiric and IPT arms, respectively (P = .88). TB incidence remained higher (4.6% vs 2%, P = .04) and time to TB remained faster in the empiric arm (P = .04). CONCLUSIONS: Among outpatients with advanced HIV who screened negative for TB by clinical symptoms, microscopy, and Xpert testing, LAM testing identified an additional 5% of individuals with TB. Positive LAM results did not change mortality or TB incidence.

Topological Proximity-Induced Dirac Fermion in Two-Dimensional Antimonene.

Antimonene is a promising two-dimensional (2D) material that is calculated to have a significant fundamental bandgap usable for advanced applications such as field-effect transistors, photoelectric devices, and the quantum-spin Hall (QSH) state. Herein, we demonstrate a phenomenon termed topological proximity effect, which occurs between a 2D material and a three-dimensional (3D) topological insulator (TI). We provide strong evidence derived from hydrogen etching on Sb2Te3 that large-area and well-ordered antimonene presents a 2D topological state. Delicate analysis with a scanning tunneling microscope of the evolutionary intermediates reveals that hydrogen etching on Sb2Te3 resulted in the formation of a large area of antimonene with a buckled structure. A topological state formed in the antimonene/Sb2Te3 heterostructure was confirmed with angle-resolved photoemission spectra and density-functional theory calculations; in particular, the Dirac point was located almost at the Fermi level. The results reveal that Dirac fermions are indeed realized at the interface of a 2D normal insulator (NI) and a 3D TI as a result of strong hybridization between antimonene and Sb2Te3. Our work demonstrates that the position of the Dirac point and the shape of the Dirac surface state can be tuned by varying the energy position of the NI valence band, which modifies the direction of the spin texture of Sb-BL/Sb2Te3 via varying the Fermi level. This topological phase in 2D-material engineering has generated a paradigm in that the topological proximity effect at the NI/TI interface has been realized, which demonstrates a way to create QSH systems in 2D-material TI heterostructures.

Evaluation of the Feasibility of NaCaPO4-Blended Zirconia as a New CAD/CAM Material for Dental Restoration.

The computer-aided design/computer-aided manufacturing (CAD/CAM) fabrication technique has become one of the hottest topics in the dental field. This technology can be applied to fixed partial dentures, removable dentures, and implant prostheses. This study aimed to evaluate the feasibility of NaCaPO4-blended zirconia as a new CAD/CAM material. Eleven different proportional samples of zirconia and NaCaPO4 (xZyN) were prepared and characterized by X-ray diffractometry (XRD) and Vickers microhardness, and the milling property of these new samples was tested via a digital optical microscope. After calcination at 950 °C for 4 h, XRD results showed that the intensity of tetragonal ZrO2 gradually decreased with an increase in the content of NaCaPO4. Furthermore, with the increase in NaCaPO4 content, the sintering became more obvious, which improved the densification of the sintered body and reduced its porosity. Specimens went through milling by a computer numerical control (CNC) machine, and the marginal integrity revealed that being sintered at 1350 °C was better than being sintered at 950 °C. Moreover, 7Z3N showed better marginal fit than that of 6Z4N among thirty-six samples when sintered at 1350 °C (p < 0.05). The milling test results revealed that 7Z3N could be a new CAD/CAM material for dental restoration use in the future.