The risk of ESRD remains high among HIV-infected individuals in care but is declining with improvements in virologic suppression. HIV-infected black persons continue to comprise the majority of cases, as a result of higher viral loads, comorbidities, and genetic susceptibility.

Silymarin from the milk thistle herb (Silybum marianum) is used by many patients with chronic viral hepatitis, but its efficacy remains unknown. We performed a systematic review of silymarin for the treatment of chronic viral hepatitis B and C. An exhaustive search strategy identified 148 papers that studied silymarin compounds in liver disease. Of these, four trials included patients with hepatitis C, one included hepatitis B patients, and two, unspecified chronic viral hepatitis. However, only one trial exclusively studied patients with hepatitis C, and none involved patients with only hepatitis B. Silymarin treatment resulted in a decrease in serum transaminases compared with baseline in four studies, and compared with placebo in only one study. There is no evidence that silymarin affects viral load or improves liver histology in hepatitis B or C. No studies were found that investigated the use of silymarin concomitantly with interferon, nucleoside analogues, or other conventional treatments for hepatitis B or C. In conclusion, silymarin compounds likely decrease serum transaminases in patients with chronic viral hepatitis, but do not appear to affect viral load or liver histology. Nevertheless it may be worthwhile to determine its effects in conjunction with standard antiviral treatment.

Compared with HIV-infected subjects who were HCV seronegative, both HCV viremic and HCV aviremic individuals were at increased risk for moderate and advanced CKD.

ImportanceThe COVID-19 pandemic has caused millions of infections and deaths and resulted in unprecedented international public health social and economic crises. As SARS-CoV-2 spread across the globe and its impact became evident, the development of safe and effective vaccines became a priority. Outlining the processes used to establish and support the conduct of the phase 3 randomized clinical trials that led to the rapid emergency use authorization and approval of several COVID-19 vaccines is of major significance for current and future pandemic response efforts.ObservationsTo support the rapid development of vaccines for the US population and the rest of the world, the National Institute of Allergy and Infectious Diseases established the COVID-19 Prevention Network (CoVPN) to assist in the coordination and implementation of phase 3 efficacy trials for COVID-19 vaccine candidates and monoclonal antibodies. By bringing together multiple networks, CoVPN was able to draw on existing clinical and laboratory infrastructure, community partnerships, and research expertise to quickly pivot clinical trial sites to conduct COVID-19 vaccine trials as soon as the investigational products were ready for phase 3 testing. The mission of CoVPN was to operationalize phase 3 vaccine trials using harmonized protocols, laboratory assays, and a single data and safety monitoring board to oversee the various studies. These trials, while staggered in time of initiation, overlapped in time and course of conduct and ultimately led to the successful completion of multiple studies and US Food and Drug Administration–licensed or –authorized vaccines, the first of which was available to the public less than 1 year from the discovery of the virus.Conclusions and RelevanceThis Special Communication describes the design, geographic distribution, and underlying principles of conduct of these efficacy trials and summarizes data from 136 382 prospectively followed-up participants, including more than 2500 with documented COVID-19. These successful efforts can be replicated for other important research initiatives and point to the importance of investments in clinical trial infrastructure integral to pandemic preparedness.

A video-monitored oil-seep capture tent and an intertidal seep tank were developed and deployed to quantify emissions in shallow (5-m) nearshore waters and at an intertidal location at Summerland Beach, California. At two sites, where bubbles appeared clear, gas to oil ratios were 105:1; at a site where bubbles were dark, gas to oil ratio was 8.4:1. Nearshore oil emissions were conservatively estimated at 0.8 L dy’1. The size distribution of oily bubbles sharply peaked at 1500 µm, and the gas to oil ratio varied between bubbles. Oil affected the bubble's buoyancy and hydrodynamics. Time series of seabed emissions showed oil was mostly released in pulses. Several mechanisms that may cause variability in oil emissions were proposed. Intertidal oil emission were estimated a 12 L dy−1. Also, beach surveys showed less than trace amounts of beached oil and no oiled fauna over a 19-month period.

This paper presents our approach to implementing structures that encourage innovation and entrepreneurship behaviors within the Lipscomb University student population. An early step in this process is presented in this paper: extending our undergraduate Information Technology (IT) curriculum with a concentration on entrepreneurship. Specifically, the paper clarifies where our IT courses address specific dimensions of innovation (a precursor to entrepreneurship), how the curriculum can be extended to effectively incorporate entrepreneurship, and where facilitating conditions can be implemented to reinforce entrepreneurial behavior in our student population. The curriculum changes and ideas presented here have a number of long-and short-term benefits for Lipscomb University as a whole and our IT program in particular. The paper ends by soliciting input on several issues that can maximize the effectiveness of this innovative program.

Research developments in recent years in the areas of HIV antiretroviral treatment (ART) and the use of ART as oral or topical pre-exposure prophylaxis have been heralded as a paradigm shift in HIV prevention, similar to the 'protease moment' of 1996. This special issue of Sexual Health aims to present the state of HIV prevention response using these innovations, with special emphasis on the Asia and Pacific region. In particular, it is dedicated to showcasing research to promote debate regarding the potential of new treatment-based prevention approaches and challenges encountered as we transfer the research advances into practice. This special issue covers the fields of epidemiology, clinical research, social and behavioural science, public health and policy analysis. It was put together by our international team of experts in these fields, including: the deputy director of HIV-NAT (Thailand) Dr Jintanat Ananworanich, an expert on treatment strategies for HIV infection; Dr Adeeba Kamarulzaman, an expert in HIV

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