17 research outputs found

    Automatic parametrisation of beached microplastics

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    Four sandy beaches on the island of Malta were regularly sampled for Large MicroPlastic (LMP) particles having a diameter between 1mm and 5mm, at stations located at the waterline, and 10m inshore. The extracted LMPs were characterised (dimensions, surface roughness, colour) by microscopic analyses, as well as by a developed algorithm. Two-thirds of the isolated particles were smooth and the majority of these belonged to the grey -white colour category suggesting that these were preproduction pellets. Roughly six times as many particles were recorded within the inshore sampling stations as the particles recorded at the waterline stations. The automated image processing algorithm performed well when the dimension and colour parameter values it delivered were compared with those obtained by microscopic analyses.peer-reviewe

    Retreatment for hepatitis C virus direct-acting antiviral therapy virological failure in primary and tertiary settings: The REACH-C cohort

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    Virological failure occurs in a small proportion of people treated for hepatitis C virus (HCV) with direct-acting antiviral (DAA) therapies. This study assessed retreatment for virological failure in a large real-world cohort. REACH-C is an Australian observational study (n = 10,843) evaluating treatment outcomes of sequential DAA initiations across 33 health services between March 2016 to June 2019. Virological failure retreatment data were collected until October 2020. Of 408 people with virological failure (81% male; median age 53; 38% cirrhosis; 56% genotype 3), 213 (54%) were retreated once; 15 were retreated twice. A range of genotype specific and pangenotypic DAAs were used to retreat virological failure in primary (n = 56) and tertiary (n = 157) settings. Following sofosbuvir/velpatasvir/voxilaprevir availability in 2019, the proportion retreated in primary care increased from 21% to 40% and median time to retreatment initiation declined from 294 to 152 days. Per protocol (PP) sustained virological response (SVR12) was similar for people retreated in primary and tertiary settings (80% vs 81%; p = 1.000). In regression analysis, sofosbuvir/velpatasvir/voxilaprevir (vs. other regimens) significantly decreased likelihood of second virological failure (PP SVR12 88% vs. 77%; adjusted odds ratio [AOR] 0.29; 95%CI 0.11–0.81); cirrhosis increased likelihood (PP SVR12 69% vs. 91%; AOR 4.26; 95%CI 1.64–11.09). Indigenous Australians had lower likelihood of retreatment initiation (AOR 0.36; 95%CI 0.15–0.81). Treatment setting and prescriber type were not associated with retreatment initiation or outcome. Virological failure can be effectively retreated in primary care. Expanded access to simplified retreatment regimens through decentralized models may increase retreatment uptake and reduce HCV-related mortality

    Automating the characterisation of beach microplastics through the application of image analyses

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    Four sandy beaches on the island of Malta in the Central Mediterranean were regularly sampled for Large MicroPlastic (LMP) particles having a diameter between 1 mm and 5 mm, at stations located at the waterline and 10 m inshore. The 10975 extracted LMP particles were characterised (dimensions, surface roughness, colour) through unaided visual observation, microscopic analyses, and an algorithm developed within the current study. Two-thirds of the isolated particles were smooth and the majority of these belonged to the grey-white colour category, with a low degree of opaqueness and discolouration, and a high degree of transparency, suggesting that these were dominated by low-density polyethylene LMPs. Conflicting evidence concerning the relative residence time of the isolated LMPs within seawater emerged from the colour and contour roughness determination, although an abundance of primary LMPs (production pellets) within our sample might have been responsible for the low contour roughness results obtained. Roughly six times as many particles were recorded within the inshore sampling stations as the particles recorded at the waterline stations. The developed algorithm performed very well when the dimension and colour parameter values it delivered were compared with those obtained by microscopic analyses

    A case of the syndrome of inappropriate ADH secretion in the setting of pre eclampsia

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    BACKGROUND: Hyponatremia is a rare complication of pre eclampsia. We present a case of syndrome of inappropriate ADH secretion (SIADH) in the setting of pre eclampsia.CASE REPORT: A 40 year old lady known to have type 1 diabetes on insulin pump therapy presented with hypertension at 33 weeks gestation. Treatment with labetalol 100 mg bd was initiated but she was admitted at 34 weeks due to lack of BP control. Sodium levels were 136 mmol/L (135–145 mmol/L) on admission. Labetalol was increased to 300 mg tds and she was discharged after four days with a sodium level of 129 mmol/L. She was readmitted at 35 weeks with pre-eclampsia as evidenced by severe headaches, persistent hypertension(186/92 mmHg), a high uric acid (400 umol/L), low platelet count (91×10^9/L) and proteinuria (1557.1 mg/24 hrs). Her sodium rapidly dropped to 125 mmol/L. Urine sodium was 38 mmol/L, urine osmolality: 267 mOsm/kg, serum osmolality: 269 mOsm/kg. The patient was euvolemic with normal thyroid and adrenal function. These results were consistent with SIADH. Labour was induced but an emergency caesarean section was performed in view of signs of foetal distress. The baby’s sodium level was 127 mmol/L. The mother’s fluid intake was restricted to 1.25 litres/day initially and then to 2 litres/day. Within 48 hours of delivery, her sodium improved from 125 mmol/L to 133 mmol/L. Proteinuria decreased to 759.9 mg/24 hrs and platelet count and uric acid normalised.DISCUSSION: Pre eclampsia is associated with reduced intravascular volume which may stimulate ADH release resulting in SIADH. Foetal sodium rapidly equilibrates with maternal sodium and this can cause foetal jaundice, tachypnoea and seizures if serum sodium is <130 mmol/L. Acute hyponatremia further increases the likelihood of seizures in pre eclampsia. Management includes fluid restriction and delivery in a timely manner.peer-reviewe

    The Economics of Museums

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