Phylogenetic analysis identified 11 clusters (2-6 individuals). Clusters included seroconverters only (n=1), prevalent cases and seroconverters (n=4), and prevalent cases only (n=6). Superinfection was identified in one prevalent case and two seroconverters. The annual incidence of superinfection was higher among seroconverters than prevalent cases and was higher than the rate of primary HIV infection in the cohort.
 
  This report provides important insights into HIV genetic diversity, drug resistance, and superinfection among MSM and TWG in sub-Saharan Africa. These findings may help to inform future HIV prevention interventions in these high-risk groups.
 This report provides important insights into HIV genetic diversity, drug resistance, and superinfection among MSM and TWG in sub-Saharan Africa. These findings may help to inform future HIV prevention interventions in these high-risk groups.
  Sedative use in older adults increases the risk of falls, fractures, and hospitalizations. The D-PRESCRIBE (Developing Pharmacist-Led Research to Educate and Sensitize Community Residents to the Inappropriate Prescriptions Burden in the Elderly), pragmatic randomized clinical trial demonstrated that community-based, pharmacist-led education delivered simultaneously to older adults and their primary care providers reduce the use of sedatives by 43% over 6 months. However, the associated health benefits and cost savings have yet to be described. This study evaluates the cost-effectiveness of the D-PRESCRIBE intervention compared to usual care for reducing the use of potentially inappropriate sedatives among older adults.
 
  A cost-utility analysis from the public health care perspective of Canada estimated the costs and quality-adjusted life-years (QALYs) associated with the D-PRESCRIBE intervention compared to usual care over a 1-year time horizon. Transition probabilities, intervention effectiveness, utilitypands, consideration should be given to interprofessional models of remuneration for quality prescribing and deprescribing services.When the fourth edition of the Brain Trauma Foundation's Guidelines for the Management of Severe Traumatic Brain Injury were finalized in late 2016, it was known that the results of the RESCUEicp (Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension) randomized controlled trial of decompressive craniectomy would be public after the guidelines were released. The guideline authors decided to proceed with publication but to update the decompressive craniectomy recommendations later in the spirit of "living guidelines," whereby topics are updated more frequently, and between new editions, when important new evidence is published. The update to the decompressive craniectomy chapter presented here integrates the findings of the RESCUEicp study as well as the recently published 12-mo outcome data from the DECRA (Decompressive Craniectomy in Patients With Severe Traumatic Brain Injury) trial. Incorporation of these publications into the body of evidence led to the generation of 3 new level-IIA recommendations; a fourth previously presented level-IIA recommendation remains valid and has been restated.  https://www.selleckchem.com/products/hc-7366.html  To increase the utility of the recommendations, we added a new section entitled Incorporating the Evidence into Practice. This summary of expert opinion provides important context and addresses key issues for practitioners, which are intended to help the clinician utilize the available evidence and these recommendations. The full guideline can be found at https//braintrauma.org/guidelines/guidelines-for-the-management-of-severe-tbi-4th-ed#/.The purpose of this research was to investigate the effects of cow manure and acacia wood-derived biochar on the immobilization of arsenic (As) and manganese (Mn) in contaminated mine tailings using Mott dwarf Napier grass (Pennisetum purpureum cv. Mott). Cow manure or acacia wood-derived biochar was separately mixed with mine tailings at rates of 1, 3, and 5% (w/w). Samples of mine tailings and plants were collected every 30 d during the 120-d period. The total As and Mn accumulation amounts in the plants were analyzed in both the underground (roots) and aboveground (stems and leaves) parts of the plants. The results revealed that cow manure and acacia wood-derived biochar can reduce the mobilization of As and Mn in mine tailings and thus reduce their uptake and accumulation in P. purpureum. Acacia wood-derived biochar was able to stabilize and immobilize As and Mn in mine tailings, allowing the metals to be taken up for plant utilization despite the lower plant growth (biomass and relative growth rates) than that obtained with added cow manure. The accumulation amounts of As in the aboveground and underground parts of P. purpureum grown in mine tailings with 5% BC application were 0.52 ± 0.05 mg kg-1 and 1.57 ± 0.1 mg kg-1, respectively, while the accumulation amounts of As in the aboveground and underground parts were 31 ± 1.08 mg kg-1 and 73.05 ± 2.60 mg kg-1, respectively. In other words, the percentage reductions in As and Mn uptake and accumulation in the aboveground and underground parts were 78.6% and 63.9% for As and 72.5% and 69.3% for Mn, respectively. The results of this study can be applied for the remediation of heavy metal-contaminated areas, especially gold mines and surrounding areas, as well as in other areas.
  Improperly disposed medicines could adversely affect the environment and increase the risk of drug misuse or accidental poisoning.
 
  To evaluate the disposal practices of unused and expired medicines among the general population in Bandung, Indonesia.
 
  This was a descriptive cross-sectional survey conducted among 497 respondents in Bandung, Indonesia. Data were collected through interviews using a prevalidated structured questionnaire. Descriptive statistics were calculated using the Statistical Package for Social Science (SPSS) version 23. Ethics approval was obtained.
 
  General public knowledge and attitude regarding unused and expired medication disposal practice.
 
  Approximately 95% of the respondents had unused medicines stored in their homes, with nonsteroidal anti-inflammatory drugs (NSAIDs), vitamins/nutritional supplements, and antibiotics were the most common types of medicines left unused. The majority of the respondents checked the expiration date of the drugs before purchasing (72.8%). The most common disposal method of unwanted medicines was throwing away in household garbage (82.