Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis

BACKGROUND: Measuring the incidence of HIV and hepatitis C virus (HCV) infection among people who inject drugs (PWID) is key to track progress towards elimination. We aimed to summarise global data on HIV and primary HCV incidence among PWID and associations with age and sex or gender.METHODS: In this systematic review and meta-analysis, we updated an existing database of HIV and HCV incidence studies among PWID by searching MEDLINE, Embase, and PsycINFO, capturing studies published between Jan 1, 2000, and Dec 12, 2022, with no language or study design restrictions. We contacted authors of identified studies for unpublished or updated data. We included studies that estimated incidence by longitudinally re-testing people at risk of infection or by using assays for recent infection. We pooled incidence and relative risk (RR; young [generally defined as ≤25 years] vs older PWID; women vs men) estimates using random-effects meta-analysis and assessed risk of bias with a modified Newcastle-Ottawa scale. This study is registered with PROSPERO, CRD42020220884.FINDINGS: Our updated search identified 9493 publications, of which 211 were eligible for full-text review. An additional 377 full-text records from our existing database and five records identified through cross-referencing were assessed. Including 28 unpublished records, 125 records met the inclusion criteria. We identified 64 estimates of HIV incidence (30 from high-income countries [HICs] and 34 from low-income or middle-income countries [LMICs]) and 66 estimates of HCV incidence (52 from HICs and 14 from LMICs). 41 (64%) of 64 HIV and 42 (64%) of 66 HCV estimates were from single cities rather than being multi-city or nationwide. Estimates were measured over 1987-2021 for HIV and 1992-2021 for HCV. Pooled HIV incidence was 1·7 per 100 person-years (95% CI 1·3-2·3; I 2=98·4%) and pooled HCV incidence was 12·1 per 100 person-years (10·0-14·6; I 2=97·2%). Young PWID had a greater risk of HIV (RR 1·5, 95% CI 1·2-1·8; I 2=66·9%) and HCV (1·5, 1·3-1·8; I 2=70·6%) acquisition than older PWID. Women had a greater risk of HIV (RR 1·4, 95% CI 1·1-1·6; I 2=55·3%) and HCV (1·2, 1·1-1·3; I 2=43·3%) acquisition than men. For both HIV and HCV, the median risk-of-bias score was 6 (IQR 6-7), indicating moderate risk. INTERPRETATION: Although sparse, available HIV and HCV incidence estimates offer insights into global levels of HIV and HCV transmission among PWID. Intensified efforts are needed to keep track of the HIV and HCV epidemics among PWID and to expand access to age-appropriate and gender-appropriate prevention services that serve young PWID and women who inject drugs.FUNDING: Canadian Institutes of Health Research, Fonds de recherche du Québec-Santé, Canadian Network on Hepatitis C, UK National Institute for Health and Care Research, and WHO.</p

Carbon Nanotube Solar Cells

We present proof-of-concept all-carbon solar cells. They are made of a photoactive side of predominantly semiconducting nanotubes for photoconversion and a counter electrode made of a natural mixture of carbon nanotubes or graphite, connected by a liquid electrolyte through a redox reaction. The cells do not require rare source materials such as In or Pt, nor high-grade semiconductor processing equipment, do not rely on dye for photoconversion and therefore do not bleach, and are easy to fabricate using a spray-paint technique. We observe that cells with a lower concentration of carbon nanotubes on the active semiconducting electrode perform better than cells with a higher concentration of nanotubes. This effect is contrary to the expectation that a larger number of nanotubes would lead to more photoconversion and therefore more power generation. We attribute this to the presence of metallic nanotubes that provide a short for photo-excited electrons, bypassing the load. We demonstrate optimization strategies that improve cell efficiency by orders of magnitude. Once it is possible to make semiconducting-only carbon nanotube films, that may provide the greatest efficiency improvement

internationalization strategies and policies in second tier higher education institutions

This study addresses the major objectives and challenges in the internationalization processes of second-tier higher education institutions. We use the examples of universities of applied sciences in the Netherlands, academic colleges in Israel, and community colleges in Canada to offer a global perspective regarding the internationalization efforts in these types of institutions. Through comprehensive comparative analysis of secondary sources, we identify the trends taking place within these types of higher education institutions in these countries. We find that second-tier institutions tend not to have solidified for themselves tailored internationalization approaches and strategies that are uniquely fitting to their own missions, aims and student populations. This oversight creates a situation whereby such institutions, despite their culturally diverse student populations and the promise they hold to create a unique niche within internationalization discourse, fail to utilize the potential inherent in targeted internationalization strategies

Umsetzungsorientierte Konzeption zur Stillegung oder Extensivierung landwirtschaftlicher Nutzflaechen aus lanschaftsoekologischer Sicht

Available from TIB Hannover: FR 5619 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Bodenbelastungen in Verdichtungsgebieten Fallstudie Grossraum Hannover und Stadt Garbsen. Endbericht

TIB: FR 4683 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Umsetzungsorientierte Konzeption zur Stillegung oder Extensivierung landwirtschaftlicher Nutzflaechen aus landschaftsoekologischer Sicht

SIGLEAvailable from TIB Hannover: RR 582(11) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman