Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review

Toy M, Önder FO, Wörmann T, et al. Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review. BMC infectious diseases. 2011;11(1): 337.BACKGROUND: To provide a clear picture of the current hepatitis B situation, the authors performed a systematic review to estimate the age- and region-specific prevalence of chronic hepatitis B (CHB) in Turkey. METHODS: A total of 339 studies with original data on the prevalence of hepatitis B surface antigen (HBsAg) in Turkey and published between 1999 and 2009 were identified through a search of electronic databases, by reviewing citations, and by writing to authors. After a critical assessment, the authors included 129 studies, divided into categories: 'age-specific'; 'region-specific'; and 'specific population group'. To account for the differences among the studies, a generalized linear mixed model was used to estimate the overall prevalence across all age groups and regions. For specific population groups, the authors calculated the weighted mean prevalence. RESULTS: The estimated overall population prevalence was 4.57, 95% confidence interval (CI): 3.58, 5.76, and the estimated total number of CHB cases was about 3.3 million. The outcomes of the age-specific groups varied from 2.84, (95% CI: 2.60, 3.10) for the 0-14-year olds to 6.36 (95% CI: 5.83, 6.90) in the 25-34-year-old group. CONCLUSION: There are large age-group and regional differences in CHB prevalence in Turkey, where CHB remains a serious health problem

Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection

BACKGROUND Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy. Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively. METHODS We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis. The primary end point was recurrent infection (new episode after initial clinical cure) within 12 weeks after infusion in the modified intention-to-treat population. RESULTS In both trials, the rate of recurrent C. difficile infection was significantly lower with bezlotoxumab alone than with placebo (MODIFY I: 17% [67 of 386] vs. 28% [109 of 395]; adjusted difference, −10.1 percentage points; 95% confidence interval [CI], −15.9 to −4.3; P<0.001; MODIFY II: 16% [62 of 395] vs. 26% [97 of 378]; adjusted difference, −9.9 percentage points; 95% CI, −15.5 to −4.3; P<0.001) and was significantly lower with actoxumab plus bezlotoxumab than with placebo (MODIFY I: 16% [61 of 383] vs. 28% [109 of 395]; adjusted difference, −11.6 percentage points; 95% CI, −17.4 to −5.9; P<0.001; MODIFY II: 15% [58 of 390] vs. 26% [97 of 378]; adjusted difference, −10.7 percentage points; 95% CI, −16.4 to −5.1; P<0.001). In prespecified subgroup analyses (combined data set), rates of recurrent infection were lower in both groups that received bezlotoxumab than in the placebo group in subpopulations at high risk for recurrent infection or for an adverse outcome. The rates of initial clinical cure were 80% with bezlotoxumab alone, 73% with actoxumab plus bezlotoxumab, and 80% with placebo; the rates of sustained cure (initial clinical cure without recurrent infection in 12 weeks) were 64%, 58%, and 54%, respectively. The rates of adverse events were similar among these groups; the most common events were diarrhea and nausea. CONCLUSIONS Among participants receiving antibiotic treatment for primary or recurrent C. difficile infection, bezlotoxumab was associated with a substantially lower rate of recurrent infection than placebo and had a safety profile similar to that of placebo. The addition of actoxumab did not improve efficacy. (Funded by Merck; MODIFY I and MODIFY II ClinicalTrials.gov numbers, NCT01241552 and NCT01513239.

Effect of ecological surface treatment method on friction strength properties of nettle (urtica dioica) fibre yarns

Over the last few decades, more attention is given to lignocellulose based fibres as reinforcement material in the polymer composites owing to the environmental pollution caused by the extensive usage of synthetic and inorganic fibres. Developing new natural fibre reinforced composites is the focus of many researches nowadays. They are made from renewable resources and they have less environmental effect in comparison to inorganic fibre reinforced composites. The interest of consumers in eco-friendly natural fibres and textiles has increased in recent years. Unlike inorganic fibres, natural fibres present light weight, high strength/density ratio and are readily available, environmentally friendly and biodegradable. Many different types of natural fibres are exploited for the production of biodegradable polymer composites. The nettle (Urtica dioica L.) is a well-known plant growing on rural sites of Europe, Asia, and North America. Nettle plant contains fibre similar to hemp and flax. However, similar to other natural fibres, nettle fibres are poorly compatible with the thermoplastic matrix of composites, due to their hydrophilic character which reduces mechanical properties of nettle fibre reinforced thermoplastics. In order to improve the fibrematrix adhesion of the natural fibre reinforced composites, surface treatment processes are applied to the lignocellulose fibres. In this study nettle (urtica dioica) fibre yarns were treated with NaOH by using conventional, ultrasonic and microwave energy methods. After treatment processes tensile strength, elongation, friction strength and SEM observations of the nettle fibre yarns were investigated. All treatment processes were improved the tensile strength, elongation and friction strength properties of the nettle fibre yarns. Also higher tensile strength, elongation and friction strength properties were obtained from treated nettle fibre yarns which treated by using microwave energy method. © Published under licence by IOP Publishing Ltd

Natural fibre-reinforced thermoplastic composites from woven-nonwoven textile preforms: mechanical and fire performance study

Partially and fully biodegradable natural fibre – reinforced composites have been prepared using a novel patented woven-nonwoven technology. Natural fibres included jute and sisal, whereas the matrices were of synthetic polymers derived from petroleum (polypropylene (PP)) or natural (polylactic acid (PLA)) resources. The physical, mechanical and flammability properties of these partially and fully biodegradable composites have been studied and compared with those of similarly produced glass-fibre reinforced PP and PLA composites with a view to enabling their use in automotive applications. Mechanical test results showed that the tensile and flexural moduli of the PLA composites were higher than respective PP composites. In comparison, sisal composites have higher tensile and flexural moduli than jute composites. The fire performance of the composites studied by cone calorimetry showed that while natural fibre reinforcement had no effect on time-toignition, peak heat release was significantly reduced. PLA composites had lower burning propensity compared to respective PP composites

Effects of water and chemical solutions ageing on the physical, mechanical, thermal and flammability properties of natural fibre-reinforced thermoplastic composites

Biocomposites comprising a combination of natural fibres and bio-based polymers are good alternatives to those produced from synthetic components in terms of sustainability and environmental issues. However, it is well known that water or aqueous chemical solutions affect natural polymers/fibres more than the respective synthetic components. In this study the effects of water, salt water, acidic and alkali solutions ageing on water uptake, mechanical properties and flammability of natural fibre-reinforced polypropylene (PP) and poly(lactic acid) (PLA) composites were compared. Jute, sisal and wool fibre- reinforced PP and PLA composites were prepared using a novel, patented nonwoven technology followed by the hot press method. The prepared composites were aged in water and chemical solutions for up to 3 week periods. Water absorption, flexural properties and the thermal and flammability performances of the composites were investigated before and after ageing each process. The effect of post-ageing drying on the retention of mechanical and flammability properties has also been studied. A linear relationship between irreversible flexural modulus reduction and water adsorption/desorption was observed. The aqueous chemical solutions caused further but minor effects in terms of moisture sorption and flexural modulus changes. PLA composites were affected more than the respective PP composites, because of their hydrolytic sensitivity. From thermal analytical results, these changes in PP composites could be attributed to ageing effects on fibres, whereas in PLA composite changes related to both those of fibres present and of the polymer. Ageing however, had no adverse effect on the flammability of the composites