Propagation and rupture of elastoviscoplastic liquid plugs in airway reopening model

The propagation and rupture of mucus plugs in human lungs is investigated experimentally by injecting synthetic mucus in a pre-wetted capillary tube. The rheology of our test liquid is thoroughly characterized, and four samples of synthetic mucus are considered in order to reproduce elastoviscoplastic regimes of physiological interest for airway reopening. Our experiments demonstrate the significant impact of the viscoplasticity and viscoelasticity of mucus. In support to our experiments, we propose a one-dimensional reduced-order model that takes into account capillarity, and elastoviscoplasticity. Our model manages to capture the cross-section averaged dynamics of the liquid plug and is used to elucidate and interpret the experimental evidence. Relying on it, we show that the liquid film thickening due to non-Newtonian effects favors plug rupture, whereas the increase of the effective viscosity due to higher yield stresses hinders plug rupture. As a result of such two effects, increasing the polymeric concentration in the mucus phase leads to a net increase of the rupture time and traveling length. Hence, non-Newtonian effects hinder airway reopening

HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme

BACKGROUND & AIMS: Strategies to implement HBV screening and treatment are critical to achieve HBV elimination but have been inadequately evaluated in sub-Saharan Africa (sSA). METHODS: We assessed the feasibility of screen-and-treat interventions in 3 real-world settings (community, workplace, and hospital) in Senegal. Adult participants were screened using a rapid HBsAg point-of-care test. The proportion linked to care, the proportion who had complete clinical staging (alanine transaminase [ALT], viral load, and FibroScan®), and the proportion eligible for treatment were compared among the 3 intervention groups. RESULTS: In 2013-2016, a total of 3,665 individuals were screened for HBsAg in the community (n = 2,153) and in workplaces (n = 1,512); 199/2,153 (9.2%) and 167/1,512 (11%) were HBsAg-positive in the community and workplaces, respectively. In the hospital setting (outpatient clinics), 638 HBsAg-positive participants were enrolled in the study. All infected participants were treatment naïve. Linkage to care was similar among community-based (69.9%), workplace-based (69.5%), and hospital-based interventions (72.6%, p = 0.617). Of HBV-infected participants successfully linked to care, full clinical staging was obtained in 47.5% (66/139), 59.5% (69/116), and 71.1% (329/463) from the community, workplaces, and hospitals, respectively (p <0.001). The proportion eligible for treatment (EASL criteria) differed among community- (9.1%), workplace- (30.4%), and hospital-based settings (17.6%, p = 0.007). Acceptability of antiviral therapy, adherence, and safety at 1 year were very good. CONCLUSIONS: HBV screen-and-treat interventions are feasible in non-hospital and hospital settings in Senegal. However, the continuum of care is suboptimal owing to limited access to full clinical staging. Improvement in access to diagnostic services is urgently needed in sSA. LAY SUMMARY: Hepatitis B infection is highly endemic in Senegal. Screening for infection can be done outside hospitals, in communities or workplaces. However, the hepatitis B continuum of care is suboptimal in Senegal and needs to be simplified to scale-up diagnosis and treatment coverage

Corrélations entre les dimensions des végétations adénoïdes et les mensurations des arcades dentaires

Introduction : L’hypertrophie des végétations adénoïdes est souvent associée à la ventilation buccale. Cette dernière peut impacter les mensurations des arcades dentaires. L’objectif de cette étude était de déterminer les relations entre les mensurations d’arcades et les dimensions des végétations adénoïdes. Matériels et méthodes : Une étude transversale a été réalisée sur 86 enfants. Les dimensions des végétations adénoïdes ont été déterminées à partir de neuf méthodes d’évaluations radiographiques et les mensurations des arcades réalisées sur les moulages. L’association entre le grade des végétations adénoïdes et les mensurations des arcades a été recherchée par une corrélation de Spearman. L’association entre les variables quantitatives d’évaluation des végétations adénoïdes et les mensurations d’arcades a été recherchée par une corrélation de Pearson. La puissance de ces associations a été analysée en utilisant les valeurs de Cohen en 1988. La signification est fixée à p = 0,05. Résultats : La profondeur d’arcade était significativement et positivement corrélée au grade des végétations selon la méthode de Holmberg et Linder-Aronson (rho = 0,55 ; p = 0,005) et aux mensurations des végétations selon les méthodes de Kemaloglu, Fujioka, Johannesson, De Menezes et Maran avec r respectivement égal à 0,65 ; 0,59 ; 0,63 ; 0,47 ; 0,74 et p respectivement égal à 0,001 ; 0,002 ; 0,001 ; 0,019 et < 0,001. Elle était aussi significativement mais négativement corrélée aux mensurations des végétations selon la méthode de Hibbert (r = – 0,52 ; p = 0,008). Le recouvrement était significativement et négativement corrélé aux mensurations des végétations selon la méthode de De Menezes (r = – 0,541 ; p = 0,006). Discussion : La puissance des associations montre que l’utilisation respective des méthodes de Maran et de De Menezes permet de mieux mettre en évidence l’association entre les dimensions des végétations adénoïdes et la profondeur d’arcade et le recouvrement