A mathematical model by route of transmission and fibrosis progression to estimate undiagnosed individuals with HCV in different Italian regions

Background: Although an increase in hepatitis C virus (HCV) prevalence from Northern to Southern Italy has been reported, the burden of asymptomatic individuals in different Italian regions is currently unknown. Methods: A probabilistic approach, including a Markov chain for liver disease progression, was applied to estimate current HCV viraemic burden. The model defined prevalence by geographic area using an estimated annual historical HCV incidence by age, treatment rate, and migration rate from the Italian National database. Viraemic infection by age group was estimated for each region by main HCV transmission routes of individuals for stage F0–F3 (i.e. patients without liver cirrhosis and thus potentially asymptomatic) and F4 (patients with liver cirrhosis, thus potentially symptomatic). Results: By January 2020, it was estimated that there were 409,184 Italian individuals with HCV (prevalence of 0.68%; 95% CI: 0.54–0.82%), of which 300,171 (0.50%; 95% CI: 0.4–0.6%) were stage F0–F3. Considering all individuals with HCV in stage F0–F3, the geographical distributions (expressed as the proportion of HCV infected individuals by macroarea within the overall estimated number of F0–F3 individuals and prevalence values, expressed as the percentage of individuals with HCV versus the overall number of individuals for each macroarea) were as follows: North 42.1% (0.45%; 95% CI: 0.36–0.55%), Central 24.1% (0.61%; 95% CI: 0.48–0.74%), South 23.2% (0.50%; 95% CI: 0.4–0.61%), and the Isles 10.6% (0.49%; 95% CI: 0.39–0.59%). The population of people who inject drugs accounted for 50.4% of all individuals infected (F0–F3). Undiagnosed individuals (F0–F3) were ~ 15 years younger (⁓ 50 years) compared with patients with stage F4 (⁓ 65 years), with similar age distributions across macroareas. In contrast to what has been reported on HCV epidemiology in Italy, an increasing trend in the proportion of potentially undiagnosed individuals with HCV (absolute number within the F0–F3) from South (23.2%) to North (42.1%) emerged, independent of similar regional prevalence values. Conclusion: This targeted approach, which addresses the specific profile of undiagnosed individuals, is helpful in planning effective elimination strategies by region in Italy and could be a useful methodology for other countries in implementing their elimination plans

Vähittäiskaupan tuotantoprosessin hukan elimi-nointi Lean-näkökulmasta

Tämän pro gradu -tutkielman tavoite syntyi toimeksiantoyrityksen antamasta tutkimus-ongelmasta selvittää tehottomuuteen liittyvät tekijät oman tuotannon prosessissa. Tavoit-teena on tunnistaa, arvioida ja vähentää Lean-filosofiasta tuotuja hukkakategorioita ja mahdollisesti parantaa tuottavuutta sekä kannattavuutta. Vastaus pyritään hahmottamaan teoreettisessa osiossa Lean-filosofian kautta määritte-lemällä Lean-periaatteet, miten tehottomuutta tunnistetaan ja miten toimintaa paranne-taan. Tehottomuus tuodaan esiin Lean-ajattelussa käytetyn kahdeksan hukkakategorian avulla. Taustalla esitetään lyhyesti prosessijohtamisen teoriaa, jotta erilaisia Lean-mallissa käytettyjä työkaluja on helpompi soveltaa. Kvalitatiivisen tutkimuksen tuloksia avataan enemmän empiirisessä osiossa, joka rakentuu asiakaskyselyn, prosessikuvauksen, haastat-telun ja hukkatarkistuslistojen ympärille. Haastattelun kautta ilmenee, että oman tuotannon prosessivaiheissa olisi kehitettävää ja prosessit tulisi pyrkiä standardoimaan. Hukkatarkistuslistojen avulla määritellään suu-rimmat kehitysalueet, jotka painottuvat varastointiin ja ylituotantoon. Huomioitavaa on, että lisäarvoa tuottavat tekijät on arvioitu asiakkaan näkökulmasta, jolloin kaikkia tehot-tomuuteen liittyviä tekijöitä ei ole mahdollista poistaa. Viimeisessä osiossa tuodaan esiin parannusehdotukset, joita toimeksiantoyritys voi soveltaa tarpeen mukaan. Toimintaa on ehditty harjoittamaan suhteellisen vähän aikaa, minkä vuoksi eri työkalujen soveltaminen on tässä vaiheessa hyvin mahdollista.fi=Opinnäytetyö kokotekstinä PDF-muodossa.|en=Thesis fulltext in PDF format.|sv=Lärdomsprov tillgängligt som fulltext i PDF-format

Assemblages de tensioactifs cationiques / acides gras (préparation, interactions et structures)

Nous avons étudié la formation des agrégats gelés dans les mélanges tensioactifs ammonium quaternaire / acide gras à 1% massique dans l eau et leur évolution par dialyse. Nous avons mis en évidence un rapport molaire limite r = 0,66 (2 acides gras pour 1 ammonium quaternaire) pour lequel les propriétés des mélanges changent. En dessous de ce rapport des bicouches de forme mal définie sont formées, la dialyse permet d extraire une partie d ammonium quaternaire et faire ainsi augmenter le rapport r jusqu à ce qu il atteigne 0,66. Au dessus de ce rapport les vésicules stables, non affectées par la dialyse sont formées. L encapsulation efficace des molécules hydrosolubles est possible dans la cavité aqueuse des vésicules. L arrêt de la dialyse peut avoir une origine cinétique, induite probablement par le renforcement des liaisons hydrogène à deux dimensions à la surface des bicouches.Frozen aggregates formed in 1 weight % in water mixtures of quaternary ammonium surfactant / fatty acid and dialysis thereof were studied. The occurrence of a limiting ratio r = 0.66 (2 fatty acids per 1 quaternary ammonium), for which the properties of the mixtures change is shown. Below this ration, ill-defines aggregates are formed and the quaternary ammonium surfactant is extracted by dialysis till the limiting ration of 0.66 is met. Above this ratio, vesicles unaffected by dialysis are formed. Efficient encapsulation of water-soluble molecules inside the inner core of vesicles is investigated. The dialysis arrest is probably due to the slow down of the extraction kinetics, induced by the build-up of two dimensional hydrogen bonds on the surface of the bilayers.VERSAILLES-BU Sciences et IUT (786462101) / SudocSudocFranceF

Fatty acid-cationic surfactant vesicles: counter-ion self-encapsulation

International audienceVesicles of fatty acids in the fluid state show interesting biomimetic properties and are potentially versatile substitutes to phospholipid vesicles in materials science. However, their use is hindered by a poor stability against variations in pH, ionic strength, temperature etc., which can be improved by using, for instance, mixtures of fatty acids and other amphiphilic molecules. Here we report an original property of fatty acid vesicles with aliphatic chains in the gel state prepared from mixtures of fatty acids and cationic surfactants. Apart from encapsulating added solutes in high yields and showing a high durability, even against drastic dialysis, dilution, concentration etc., these vesicles also spontaneously encapsulate the counter-ions (H+ and halides) released upon surfactant association. This "self-encapsulation'' leads to large and sustainable pH gradients across the bilayer (Delta pH approximate to 3 over months), and is mediated by the formation of gel-phase bilayers with little defects. Both the formation of the vesicles and their ability for self-encapsulation of counter-ions have a broad generality and can be exploited with other surfactants to generate pH gradients ranging from acid to base

Virus C hepatitis and type 2 diabetes: a cohort study in southern Italy.

OBJECTIVES:The relationship between hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM 2) is still uncertain. The objective of this study was to evaluat. The association between HCV infection, measured as positivity to anti-HCV antibodies, an. The incidence of DM 2 in a cohort of subjects sampled fro. The general population and followed up for 20 years.METHODS:At baseline. The cohort consisted of a random sample of 2,472 subjects (72% response rate, age range 30-69 years) fro. The electoral register of a town in Southern Italy. The cohort subjects were examined three times: in 1985 (M1), in 1992 (M2), and in 2005 (M3). At M1, M2, and M3, each participant filled in a questionnaire and had a blood sample taken to measure blood glucose and other serum variables including glutamic pyruvic alanine aminotransferase (ALT). Anti-HCV antibodies were analyzed with standard techniques at M1 and M2. Diabetes type 2 diagnosis was a history of diabetes and/or serum glucose ≥126 mg/dl and/or treatment with insulin or hypoglycemic drugs. Logistic regression was used for multivariable data analysis.RESULTS:Diabetes prevalence was higher in subjects with positive anti-HCV antibodies at M1 and M2, and diabetes incidence was higher in subjects with baseline positive anti-HCV antibodies at M1-M2 and lower at M2-M3. In multivariable models, controlling for gender, age, and body mass index (BMI), there was no association between incident cases of diabetes and positive anti-HCV antibodies at baseline, either at M1-M2 (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.43-1.22) or at M2-M3 (0.65, 0.41-1.04). HCV was associated with DM 2 only in subjects with elevated ALT (OR 0.58, 95% CI 0.31-1.08, if ALT normal; OR 1.47, 95% CI 1-2.16, if ALT elevated, controlling for age, gender, and BMI).CONCLUSIONS:Our findings, in a cohort study at population level, support an association betwee. The presence of anti-HCV antibodies at baseline and a higher incidence of type 2 diabetes i. The following 20 years only in subjects with elevated ALT

Thermophysical and bionotox properties of solvo-surfactants based on ethylene oxide, propylene oxide and glycerol

Thermophys. and bionotox properties of a new class of natural solvo-surfactants, glycerol 1-monoethers, were investigated in comparison with widespread but harmful glycol ethers. Vapor pressures and heats of vaporization were measured between 25 °C and 50 °C, and calcd. thanks to two group contribution methods. Evapn. rates and Hansen parameters, evaluated from TGA measurements and group contributions resp., were compared as well. Bionotox properties, i.e. cytotoxicity, irritating power and biodegradability, were evaluated exptl. Glycerol 1-monoethers turned out to be less volatile than glycol derivs., but contrary to the latter they will not be considered as VOCs. Toxicities and irritating powers are equiv. and increase with increasing alkyl chain length, i.e. with increasing amphiphilicity. Glycerol ethers are degradable at lower concns. compared to glycol compds., which is related to their higher interfacial activity

Absence of Lateral Phase Segregation in Fatty Acid-Based Catanionic Mixtures

International audienceMixtures of ionic surfactants of opposite charge ("catanionic" mixtures) show strongly nonideal behaviors, for example, in terms of evolution of surface tension, critical micelle concentration, or morphology with respect to composition in each surfactant. In several catanionic systems, it has been proposed that the interaction between both surfactants is so strong that lateral phase segregation occurs within bilayers, with crystallites of preferential composition demixing from the excess of the other surfactant. Here, we investigate the temperature-composition phase diagram of the myristic acid/cetyltrimethylammonium mixtures. Combining microcalorimetry, X-ray diffusion, and solid-state deuterium NMR, we demonstrate that no separation is observed in the gel (L(beta)) state. The catanionic mixtures therefore behave like two-dimensional solid solutions with a negative azeotrope: the existence of a composition at which a maximum in melting temperature is observed does not imply the existence of a preferential crystal of this composition, but results from the preferential attraction between unlike amphiphilic molecules. Additionally, this study reveals the presence of a so-called intermediate phase, that is, a phase that shows dynamic properties intermediate between that of the L(beta) and the L(alpha) phase