11 research outputs found
Recommended from our members
Premixed burner experiments: Geometry, mixing, and flame structure issues
This research program is exploring techniques for improved fuel-air mixing, with the aim of achieving combustor operations up to stoichiometric conditions with minimal NO{sub x} and maximum efficiency. The experimental studies involve the use of a double-concentric natural gas burner that is operable in either premixed or non-premixed modes, and the system allows systematic variation of equivalence ratio, swirl strength shear length region and flow momentum in each annulus. Flame structures formed with various combinations of swirl strengths, flow throughput and equivalence ratios in premixed mode show the significant impact of swirl flow distribution on flame structure emanating from the mixedness. This impact on flame structure is expected to have a pronounced effect on the heat release rate and the emission of NO{sub x}. Thus, swirler design and configuration remains a key factor in the quest for completely optimized combustion. Parallel numerical studies of the flow and combustion phenomena were carried out, using the RSM and the k-E turbulence models. These results have not only indicated the strengths and limitations of CFD in performance and pollutants emission predictions, but have provided guidelines on the size and strength of the recirculation produced and the spatio-temporal structure of the combustion flowfield. The first stage of parametric studies on geometry and operational parameters at Morgan State University have culminated in the completion of a one-dimensional flow code that is integrated with a solid, virtual model of the existing premixed burner. This coupling will provide the unique opportunity to study the impact of geometry on the flowfield and vice-versa, with particular emphasis on concurrent design optimization
Hepatitis C subtyping assay failure in UK patients born in SubâSaharan Africa: implications for global treatment and elimination
Background and Aims:
The newly developed direct-acting antivirals have revolutionized the treatment of chronic hepatitis C virus (HCV), with cure rates as high as 98% in some cohorts. Although genome sequencing has demonstrated that some subtypes of HCV naturally harbor drug resistance associated substitutions (RAS), these are often overlooked as ârarities.â Furthermore, commercial subtyping assays and associated epidemiological findings are skewed towards Western cohorts and whole-genome sequencing can be problematic to deploy without significant infrastructure and training support. We thus aimed to develop a simple, robust and accurate HCV subtyping pipeline, to optimize and streamline molecular detection and sequence-based typing of diverse RAS-containing subtypes.
Methods:
HCV serum derived from 146 individuals, whose likely source of infection was from sub-Saharan Africa (SSA) was investigated with a novel panel of single round polymerase chain reaction (PCR) assays targeting NS5B and NS5A genomic regions. Virus subtype assignments were determined by pairwise-distance analysis and compared to both diagnostic laboratory assignments and free-to-use online typing tools.
Results:
Partial NS5A and NS5B sequences were respectively obtained from 131 to 135 HCV-positive patients born in 19 different countries from SSA but attending clinics in the UK. We determined that routine clinical diagnostic methods incorrectly subtyped 59.0% of samples, with a further 6.8% incorrectly genotyped. Of five commonly used online tools, Geno2Pheno performed most effectively in determining a subtype in agreement with pairwise distance analysis.
Conclusion:
This study provides a simple low-cost pathway to accurately subtype in SSA, guide regional therapeutic choice and assist global surveillance and elimination initiatives
Recommended from our members
Empowerment of women in Nigeriaâs small-scale fisheries: a tool to sustainability
In Nigeria, women play major roles of at least 75% in the fisheries and aquaculture value- chains from production, processing, storage, marketing and trade. Unlike the men, women have not received commensurate levels of attention and empowerment largely because their roles are perceived as âinvisibleâ, poorly evaluated and undocumented without substantial sex-disaggregated data as proof. For these reasons above and in furtherance of identifying key areas in which empowerment needs to be strengthened thus closing the gender gap, this study was undertaken to contribute to information on the nature and empowerment of women and the factors influencing their participation in the small-scale fisheries. The study also aimed at determining relationship between the extent of the womenâs empowerment and some selected determinants using a cumulative empowerment index (CEI). A mix of transdisciplinary, quantitative and qualitative methods was used for this study in Ikosi in Agbowa and Igboolomi fishing communities of Epe and Ibeju-Lekki Local Government Areas of Lagos State respectively. Ten indicators of empowerment : contribution to household income, decision making ability, spending ability, ownership of assets, access to resources, membership in economic or social groups, time allocated to household, productive tasks and leisure activities, coping capacity to household shocks and political awareness were chosen for this purpose. Results obtained in this study showed that women are still very low in the CEI and it is hoped that this will pave way for a strategic framework for including gender âresponsiveness in policies and developmental planning
Simultaneous determination of HCV genotype and NS5B resistance associated substitutions using dried serum spots from SĂŁo Paulo state, Brazil
Hepatitis C virus (HCV) is responsible for more than 180âmillion infections worldwide, and about 80â% of infections are reported in Low and Middle-income countries (LMICs). Therapy is based on the administration of interferon (INF), ribavirin (RBV) or more recently Direct-Acting Antivirals (DAAs). However, amino acid substitutions associated with resistance (RAS) have been extensively described and can contribute to treatment failure, and diagnosis of RAS requires considerable infrastructure, not always locally available. Dried serum spots (DSS) sampling is an alternative specimen collection method, which embeds drops of serum onto filter paper to be transported by posting to a centralized laboratory. Here, we assessed feasibility of genotypic analysis of HCV from DSS in a cohort of 80âpatients from SĂŁo Paulo state Brazil. HCV RNA was detected on DSS specimens in 83â% of samples of HCV infected patients. HCV genotypes 1a, 1b, 2a, 2c and 3a were determined using the sequence of the palm domain of NS5B region, and RAS C316N/Y, Q309R and V321I were identified in HCV 1b samples. Concerning therapy outcome, 75â% of the patients who used INF +RBV as a previous protocol of treatment did not respond to DAAs, and 25â% were end-of-treatment responders. It suggests that therapy with INF plus RBV may contribute for non-response to a second therapeutic protocol with DAAs. One patient that presented RAS (V321I) was classified as non-responder, and combination of RAS C316N and Q309R does not necessarily imply in resistance to treatment in this cohort of patients. Data presented herein highlights the relevance of studying circulating variants for a better understanding of HCV variability and resistance to the therapy. Furthermore, the feasibility of carrying out genotyping and RAS phenotyping analysis by using DSS card for the potential of informing future treatment interventions could be relevant to overcome the limitations of processing samples in several location worldwide, especially in LMICs
Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: An updated systematic review
Objectives Neurogenic claudication due to lumbar spinal stenosis (LSS) is a growing health problem in older adults. We updated our previous Cochrane review (2013) to determine the effectiveness of non-operative treatment of LSS with neurogenic claudication.Design A systematic review.Data sources CENTRAL, MEDLINE, EMBASE, CINAHL and Index to Chiropractic Literature databases were searched and updated up to 22 July 2020.Eligibility criteria We only included randomised controlled trials published in English where at least one arm provided data on non-operative treatment and included participants diagnosed with neurogenic claudication with imaging confirmed LSS.Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias using the Cochrane Risk of Bias Tool 1. Grading of Recommendations Assessment, Development and Evaluation was used for evidence synthesis.Results Of 15â200 citations screened, 156 were assessed and 23 new trials were identified. There is moderate-quality evidence from three trials that: Manual therapy and exercise provides superior and clinically important short-term improvement in symptoms and function compared with medical care or community-based group exercise; manual therapy, education and exercise delivered using a cognitive-behavioural approach demonstrates superior and clinically important improvements in walking distance in the immediate to long term compared with self-directed home exercises and glucocorticoid plus lidocaine injection is more effective than lidocaine alone in improving statistical, but not clinically important improvements in pain and function in the short term. The remaining 20 new trials demonstrated low-quality or very low-quality evidence for all comparisons and outcomes, like the findings of our original review.Conclusions There is moderate-quality evidence that a multimodal approach which includes manual therapy and exercise, with or without education, is an effective treatment and that epidural steroids are not effective for the management of LSS with neurogenic claudication. All other non-operative interventions provided insufficient quality evidence to make conclusions on their effectiveness.PROSPERO registration number CRD42020191860.All data relevant to the study are included in the article or uploaded as supplementary information
Real-World Outcomes of Direct-Acting Antiviral Treatment and Retreatment in United KingdomâBased Patients Infected With Hepatitis C Virus Genotypes/Subtypes Endemic in Africa
Abstract Background Chronic hepatitis C virus (HCV) infection affects 71 million individuals, mostly residing in low- and middle-income countries (LMICs). Direct-acting antivirals (DAAs) give high rates of sustained virological response (SVR) in high-income countries where a restricted range of HCV genotypes/subtypes circulate. Methods We studied United Kingdomâresident patients born in Africa to examine DAA effectiveness in LMICs where there is far greater breadth of HCV genotypes/subtypes. Viral genome sequences were determined from 233 patients. Results Full-length viral genomic sequences for 26 known subtypes and 5 previously unidentified isolates covering 5 HCV genotypes were determined. From 149 patients who received DAA treatment/retreatment, the overall SVR was 93%. Treatment failure was associated primarily with 2 subtypes, gt1l and gt4r, using sofosbuvir/ledipasvir. These subtypes contain natural resistance-associated variants that likely contribute to poor efficacy with this drug combination. Treatment failure was also significantly associated with hepatocellular carcinoma. Conclusions DAA combinations give high SVR rates despite the high HCV diversity across the African continent except for subtypes gt1l and gt4r, which respond poorly to sofosbuvir/ledipasvir. These subtypes are widely distributed across Western, Central, and Eastern Africa. Thus, in circumstances where accurate genotyping is absent, ledipasvir and its generic compounds should not be considered as a recommended treatment option. </jats:sec