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Cyclocarya paliurus is a well-known multifunctional tree species and its leaves are in especially high demand for tea production and medical utilization in China. To meet the enormous requirements of its leaf production, lots of C. paliurus plantations have been established for harvesting the leaves, producing a large quantity of pruning residues during their management. In this study, biochar at different pyrolysis temperatures (300 °C, 500 °C and 700 °C) were prepared, utilizing the pruning residues, and the effects of biochar additions pyrolyzed at different temperatures on soil properties, growth and leaf secondary metabolite accumulation in C. paliurus were investigated. The results showed that the chemical properties and FT-IR spectra of wheel wingnut-based biochar were significantly influenced by the pyrolysis temperatures, and the application of biochars pyrolyzed at different temperatures significantly affected soil pH and nutrient availability, as well as the growth, nutrient uptake and secondary metabolite accumulation of C. paliurus seedlings (p < 0.05). Correlation analysis indicated that the total contents of polyphenols, flavonoids and triterpenoids in C. paliurus leaves were negatively correlated with the contents of total phosphorus (P) and total potassium (K) in the leaves, but positively correlated with the ratios of carbon (C)/nitrogen (N) and C/P. After 200 days of biochar treatment, the highest biomass production and leaf secondary metabolite accumulation in C. paliurus were obtained in the addition of biochar pyrolyzed at 500 °C. The findings from this pot experiment provide a potential application in C. paliurus plantations, though long-term field experiments are required to optimize the quantity of biochar addition, based on soil conditions and stand age at the planting sites.

Background Gonorrhea (GC) is a major public health threat in the US. The Centers for Disease Control and Prevention (CDC) estimated direct healthcare costs of &271 million in 2018. CDC 2015 guidelines (applicable up to December 18, 2020) recommended cephalosporin plus azithromycin for GC. We used real-world data to assess patterns of inappropriate or suboptimal (IA/SO) or appropriate and optimal (AP&OP) antibiotic (AB) prescription (by CDC 2015 guidelines), and related healthcare costs, in US patients with uncomplicated urogenital GC (uUGG) diagnosed from July 1, 2013–June 30, 2018. Methods A retrospective cohort study of IBM MarketScan data (commercial/Medicare claims) in patients ≥ 12 years old with uUGG. Eligible patients had an AB prescription ±5 days of uUGG diagnosis (index date) and continuous health-plan enrollment with ≥ 6 months’ baseline/≥ 12 months’ follow-up data. Patients with complicated urogenital GC were excluded. Patients were stratified by AB prescription (IA/SO or AP&OP; defined in Table 1) during the first uUGG episode (ie, within 30 days of index). Generalized linear models were used for multivariate analysis. Table 1. Definitions of appropriateness of AB prescriptions Results Of 2847 patients with uUGG (58.5% male), 77.1% had an IA/SO prescription (mostly due to IA AB class [~82.0%] and duration [24.0%]), while only 22.9% had an AP&OP prescription; uUGG episodes were more frequent with IA/SO (n=2386) than AP&OP (n=714) prescriptions during follow-up. Patients with IA/SO prescriptions had higher GC-related total adjusted costs per patient (PP) per index episode (&196) vs those with AP&OP prescriptions (&124, p < 0.0001; Figure). Patients with IA/SO prescriptions also had higher GCrelated total adjusted costs PP during follow-up (&220) vs those with AP&OP prescriptions (&148, p < 0.0001), mostly driven by higher outpatient ambulatory and emergency room (ER) adjusted costs with IA/SO (&148 and &71, respectively) vs AP&OP prescriptions (&129 and &12, respectively, p ≤ 0.0152; Figure). ER visits PP at index and during follow-up were higher with IA/SO vs AP&OP prescriptions (p < 0.0001; Table 2). Figure. GC-related costs per patient with uUGG, stratified by appropriateness of AB prescription* Table 2. GC-related HRU per patient with uUGG, stratified by AB prescription Conclusion Most patients with uUGG were not prescribed treatments in accordance with CDC 2015 guidelines. High IA/SO AB prescriptions and associated healthcare costs suggest an unmet need for improved prescribing practices for uUGG in the US. Disclosures Madison T. Preib, MPH, STATinMED Research (Employee, Former employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Fanny S. Mitrani-Gold, MPH, GlaxoSmithKline plc. (Employee, Shareholder) Ziyu Lan, MSc, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Xiaoxi Sun, MA, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Ashish V. Joshi, PhD, GlaxoSmithKline plc. (Employee, Shareholder)