102 research outputs found

    Prevalence of occult hepatitis B infection in a highly endemic area for chronic hepatitis B: A study of a large blood donor population

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    Background and aims: The aim of the present study was to determine the population prevalence of occult hepatitis B (OHB) infection and its clinical profile in a highly endemic area of chronic hepatitis B virus disease. Methods: OHB was first identified by individual sample testing for hepatitis B surface antigen (HBsAg) followed by nucleic acid testing (NAT) and vice versa for 3044 (cohort 1, stored sera from donation within 1 year) and 9990 (cohort 2, prospective study) blood donors, respectively. OHB was confirmed meticulously by ≥2 out of 3 tests with detectable hepatitis B virus (HBV) DNA using a sensitive standardised assay. Detailed serology and viral load in the serum and liver were studied. Results: The prevalence of OHB was 0.13% (4/3044) and 0.11% (11/9967) for cohort 1 and 2, respectively. In cohort 2, 10 out of 11 OHB samples were positive for anti-HBc (hepatitis B core antigen) antibody (all were immunoglobulin G). Seven had detectable anti-HBs. The serum HBV DNA levels were extremely low (highest 14.1 IU/ml). Of the six donors who underwent liver biopsies, all had normal liver biochemistry, extremely low liver HBV DNA (highest 6.21 copies/cell) and nearly normal liver histology. For those with viral sequence generation, none had the common HBsAg mutant G145R. Conclusions: The prevalence of OHB in a highly endemic area of chronic HBV was very low, thus implying a low impact on transfusion services. To implement universal screening, the high cost of NAT should be taken into account. OHB blood donors had very low HBV replication, and normal liver biochemistry and histology, conferring a favourable prognosis.published_or_final_versio

    Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study: protocol of a pragmatic clinical effectiveness study to improve birth outcomes in Ethiopia.

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    INTRODUCTION: The WHO Nutrition Target aims to reduce the global prevalence of low birth weight by 30% by the year 2025. The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study will test the impact of packages of pregnancy interventions to enhance maternal nutrition and infection management on birth outcomes in rural Ethiopia. METHODS AND ANALYSIS: ENAT is a pragmatic, open-label, 2×2 factorial, randomised clinical effectiveness study implemented in 12 rural health centres in Amhara, Ethiopia. Eligible pregnant women presenting at antenatal care (ANC) visits at <24 weeks gestation are enrolled (n=2400). ANC quality is strengthened across all centres. Health centres are randomised to receive an enhanced nutrition package (ENP) or standard nutrition care, and within each health centre, individual women are randomised to receive an enhanced infection management package (EIMP) or standard infection care. At ENP centres, women receive a regular supply of adequately iodised salt and iron–folate (IFA), enhanced nutrition counselling and those with mid-upper arm circumference of <23 cm receive a micronutrient fortified balanced energy protein supplement (corn soya blend) until delivery. In standard nutrition centres, women receive routine counselling and IFA. EIMP women have additional screening/treatment for urinary and sexual/reproductive tract infections and intensive deworming. Non-EIMP women are managed syndromically per Ministry of Health Guidelines. Participants are followed until 1-month post partum, and a subset until 6 months. The primary study outcomes are newborn weight and length measured at <72 hours of age. Secondary outcomes include preterm birth, low birth weight and stillbirth rates; newborn head circumference; infant weight and length for age z-scores at birth; maternal anaemia; and weight gain during pregnancy. ETHICS AND DISSEMINATION: ENAT is approved by the Institutional Review Boards of Addis Continental Institute of Public Health (001-A1-2019) and Mass General Brigham (2018P002479). Results will be disseminated to local and international stakeholders. REGISTRATION NUMBER: ISRCTN15116516

    The SAGE-Spec Spitzer Legacy Program: The Life Cycle of Dust and Gas in the Large Magellanic Cloud

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    The SAGE-Spec Spitzer Legacy program is a spectroscopic follow-up to the SAGE-LMC photometric survey of the Large Magellanic Cloud carried out with the Spitzer Space Telescope. We present an overview of SAGE-Spec and some of its first results. The SAGE-Spec program aims to study the life cycle of gas and dust in the Large Magellanic Cloud and to provide information essential to the classification of the point sources observed in the earlier SAGE-LMC photometric survey. We acquired 224.6 h of observations using the infrared spectrograph and the spectral energy distribution (SED) mode of the Multiband Imaging Photometer for Spitzer. The SAGE-Spec data, along with archival Spitzer spectroscopy of objects in the Large Magellanic Cloud, are reduced and delivered to the community. We discuss the observing strategy, the specific data-reduction pipelines applied, and the dissemination of data products to the scientific community. Initial science results include the first detection of an extragalactic 21 μm feature toward an evolved star and elucidation of the nature of disks around RV Tauri stars in the Large Magellanic Cloud. Toward some young stars, ice features are observed in absorption. We also serendipitously observed a background quasar, at a redshift of z ≈ 0.14, which appears to be hostless

    COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

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    Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

    Синтез регулятора глибини буксируваного підводного апарату

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    The inverse model of vertical motion dynamics of a towed underwater vehicle has been developed as the fourth degree polynomial. The depth controller of the towed underwater vehicle has been obtained on the basis of this model.Синтезирована инверсная модель динамики вертикального движения буксируемого подводного аппарата в виде полинома четвертой степени. На основе этой модели получен регулятор глубины буксируемого подводного аппарата.Синтезовано інверсну модель динаміки вертикального руху буксируваного підводного апарата у вигляді поліному четвертого ступеня. На основі цієї моделі отримано регулятор глибини буксируваного підводного апарата

    Designing urban deep basements in South East England for future ground movement: Progress and opportunities for experimental simulation of long-term heave

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    In recent years, there has been a boom in urban infrastructure projects in and around London that require deep basements to be excavated, such as underground railway stations and shopping malls. The permanent removal of topsoil due to basement construction inevitably causes upward movement of the remaining soil. In London clay and other over-consolidated clay strata, this upward movement continues over many years after the basement structure’s completion, a process known as long-term heave. Urbanisation causes more and more of such deep basements to be constructed to greater depths and sizes than before. This has renewed interest in research on the long-term behaviour of base slabs in over-consolidated clay, because the basement structure must be designed to accommodate these long-term heave movements. The drive towards green construction techniques in next-generation infrastructure will require the methods of design need to be updated to allow more efficient use of material. This paper reviews a range of current techniques used in the design of deep basement slabs where significant long-term heave deformations are expected. While current design guidance is sufficient in ensuring the safety of construction and operation of underground urban spaces, there is a strong feeling within the construction industry that the design criteria are inefficient and need to be improved with the help of experimental data. Geotechnical centrifuge simulation is the main technique for physical modelling of long-term heave behaviour, as artificial gravity allows a year of real-life movements of soil to be replicated in a small-scale model in an hour of laboratory time. This paper reviews recent research in geotechnical centrifuge simulations on heave behaviour of deep excavations in over-consolidated clay, identifying key findings and pointing out areas that will require further research. These experimental simulations will allow the effect of long-term heave to be quantified more accurately in future design guidance, thereby addressing the need to conserve construction material as the requirement for urban underground space increases
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