Author Correction: 150,000-year palaeoclimate record from northern Ethiopia supports early, multiple dispersals of modern humans from Africa

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Curbing the hepatitis C virus epidemic in Pakistan: The impact of scaling up treatment and prevention for achieving elimination

Background: The World Health Organization (WHO) has developed a global health strategy to eliminate viral hepatitis. We project the treatment and prevention requirements to achieve the WHO HCV elimination target of reducing HCV incidence by 80% and HCV-related mortality by 65% by 2030 in Pakistan, which has the second largest HCV burden worldwide.Methods: We developed an HCV transmission model for Pakistan, and calibrated it to epidemiological data from a national survey (2007), surveys among people who inject drugs (PWID), and blood donor data. Current treatment coverage data came from expert opinion and published reports. The model projected the HCV burden, including incidence, prevalence and deaths through 2030, and estimated the impact of varying prevention and direct-acting antiviral (DAA) treatment interventions necessary for achieving the WHO HCV elimination targets.Results: With no further treatment (currently ∼150 000 treated annually) during 2016-30, chronic HCV prevalence will increase from 3.9% to 5.1%, estimated annual incident infections will increase from 700 000 to 1 100 000, and 1 400 000 HCV-associated deaths will occur. To reach the WHO HCV elimination targets by 2030, 880 000 annual DAA treatments are required if prevention is not scaled up and no treatment prioritization occurs. By targeting treatment toward persons with cirrhosis (80% treated annually) and PWIDs (double the treatment rate of non-PWIDs), the required annual treatment number decreases to 750 000. If prevention activities also halve transmission risk, this treatment number reduces to 525 000 annually.Conclusions: Substantial HCV prevention and treatment interventions are required to reach the WHO HCV elimination targets in Pakistan, without which Pakistan\u27s HCV burden will increase markedly

Detecting and Characterizing Young Quasars. III. The Impact of Gravitational Lensing Magnification

We test the impact of gravitational lensing on the lifetime estimates of seven high-redshift quasars at redshift $z\gtrsim6$. The targeted quasars are identified by their small observed proximity zone sizes, which indicate extremely short quasar lifetimes $(t_Q\lesssim10^5 \text{ yrs})$. However, these estimates of quasar lifetimes rely on the assumption that the observed luminosities of the quasars are intrinsic and not magnified by gravitational lensing, which would bias the lifetime estimates towards younger ages. In order to test possible effects of gravitational lensing, we obtain high-resolution images of the seven quasars with the {\em Hubble Space Telescope (HST)} and look for signs of strong lensing. We do not find any evidence of strong lensing, i.e., all quasars are well-described by point sources, and no foreground lensing galaxy is detected. We estimate that the strong lensing probabilities for these quasars are extremely small $(\sim1.4\times10^{-5})$, and show that weak lensing changes the estimated quasar lifetimes by only $\lesssim0.2$ dex. We thus confirm that the short lifetimes of these quasars are intrinsic. The existence of young quasars indicates a high obscured fraction, radiatively inefficient accretion, and/or flickering light curves for high-redshift quasars. We further discuss the impact of lensing magnification on measurements of black hole masses and Eddington ratios of quasars.Comment: 14 pages, 4 figures, 3 tables. Accepted by the Astrophysical Journa

Tryptophan metabolism, its relation to inflammation and stress markers and association with psychological and cognitive functioning: Tasmanian Chronic Kidney Disease pilot study

Raw Data in five data sheets including Patients relevant metadata, quantified metabolites (given at Οg/L as well as Οmol/L), psychology measures, common medication and comorbidities. (XLS 58 kb

Impact of opioid substitution therapy on antiretroviral therapy outcomes:a systematic review and meta-analysis

BACKGROUND: Human immunodeficiency virus (HIV)-infected people who inject drugs (PWID) frequently encounter barriers accessing and remaining on antiretroviral therapy (ART). Some studies have suggested that opioid substitution therapy (OST) could facilitate PWID's engagement with HIV services. We conducted a systematic review and meta-analysis to evaluate the impact of concurrent OST use on ART-related outcomes among HIV-infected PWID. METHODS: We searched Medline, PsycInfo, Embase, Global Health, Cochrane, Web of Science, and Social Policy and Practice databases for studies between 1996 to November 2014 documenting the impact of OST, compared to no OST, on ART outcomes. Outcomes considered were coverage and recruitment onto ART, adherence, viral suppression, attrition from ART, and mortality. Meta-analyses were conducted using random-effects modeling, and heterogeneity assessed using Cochran Q test and I2 statistic. RESULTS: We identified 4685 articles, and 32 studies conducted in North America, Europe, Indonesia, and China were included. OST was associated with a 69% increase in recruitment onto ART (hazard ratio [HR], 1.69; 95% confidence interval [CI], 1.32-2.15), a 54% increase in ART coverage (odds ratio [OR], 1.54; 95% CI, 1.17-2.03), a 2-fold increase in adherence (OR, 2.14; 95% CI, 1.41-3.26), and a 23% decrease in the odds of attrition (OR, 0.77; 95% CI, .63-.95). OST was associated with a 45% increase in odds of viral suppression (OR, 1.45; 95% CI, 1.21-1.73), but there was limited evidence from 6 studies for OST decreasing mortality for PWID on ART (HR, 0.91; 95% CI, .65-1.25). CONCLUSIONS: These findings support the use of OST, and its integration with HIV services, to improve the HIV treatment and care continuum among HIV-infected PWID

Participant and workplace champion experiences of an intervention designed to reduce sitting time in desk-based workers : SMART work & life

Background: A cluster randomised controlled trial demonstrated the effectiveness of the SMART Work & Life (SWAL) behaviour change intervention, with and without a height-adjustable desk, for reducing sitting time in desk-based workers. Staff within organisations volunteered to be trained to facilitate delivery of the SWAL intervention and act as workplace champions. This paper presents the experiences of these champions on the training and intervention delivery, and from participants on their intervention participation. Methods: Quantitative and qualitative feedback from workplace champions on their training session was collected. Participants provided quantitative feedback via questionnaires at 3 and 12 month follow-up on the intervention strategies (education, group catch ups, sitting less challenges, self-monitoring and prompts, and the height-adjustable desk [SWAL plus desk group only]). Interviews and focus groups were also conducted at 12 month follow-up with workplace champions and participants respectively to gather more detailed feedback. Transcripts were uploaded to NVivo and the constant comparative approach informed the analysis of the interviews and focus groups. Results: Workplace champions rated the training highly with mean scores ranging from 5.3/6 to 5.7/6 for the eight parts. Most participants felt the education increased their awareness of the health consequences of high levels of sitting (SWAL: 90.7%; SWAL plus desk: 88.2%) and motivated them to change their sitting time (SWAL: 77.5%; SWAL plus desk: 85.77%). A high percentage of participants (70%) reported finding the group catch up session helpful and worthwhile. However, focus groups highlighted mixed responses to the group catch-up sessions, sitting less challenges and self-monitoring intervention components. Participants in the SWAL plus desk group felt that having a height-adjustable desk was key in changing their behaviour, with intrinsic as well as time based factors reported as key influences on the height-adjustable desk usage. In both intervention groups, participants reported a range of benefits from the intervention including more energy, less fatigue, an increase in focus, alertness, productivity and concentration as well as less musculoskeletal problems (SWAL plus desk group only). Work-related, interpersonal, personal attributes, physical office environment and physical barriers were identified as barriers when trying to sit less and move more. Conclusions: Workplace champion and participant feedback on the intervention was largely positive but it is clear that different behaviour change strategies worked for different people indicating that a ‘one size fits all’ approach may not be appropriate for this type of intervention. The SWAL intervention could be tested in a broader range of organisations following a few minor adaptations based on the champion and participant feedback. Trial registration: ISCRCTN registry (ISRCTN11618007)

Learning Lessons From Implementing Enabling Environments Within Prison and Probation: Separating Standards From Process

The probation and prison services within England and Wales are undergoing change which is argued will enhance rehabilitation. One aspect of this change is the introduction of the Enabling Environments standards into Approved Premises and many prison establishments. This paper examines the progress towards this goal across seven sites (four Approved Premises and three prisons) all of which are currently included in a multi-site longitudinal study examining the impact of Enabling Environments. With only one service having gained the award in the last two years, the majority of sites are behind the expected schedule with four re-launching the EE programme. It is argued that embedding the Enabling Environments standards should be seen as an organization change process. Drawing on organizational research and learning, this paper presents four learning points that might be implemented to overcome the difficulties experienced and assist with realizing the change being promoted