Hepatitis B reactivation after withdrawal of pre-emptive lamivudine in patients with haematological malignancy on completion of cytotoxic chemotherapy

Background: The hepatic outcome of hepatitis B surface antigen (HBsAg) positive patients undergoing chemotherapy after withdrawal of pre-emptive lamivudine is unknown. Aims: To examine the occurrence of hepatitis B virus (HBV) reactivation after withdrawal of pre-emptive lamivudine. Methods: Pre-emptive lamivudine was started one week before initiation of chemotherapy in 46 consecutive HBsAg positive patients and continued for the entire duration of chemotherapy. Pre-emptive lamivudine was stopped at a median 3.1 (range 3.0–3.4) months after completion of chemotherapy. Patients were longitudinally followed up after withdrawal of pre-emptive lamivudine. Results: Median time of follow up after withdrawal of lamivudine was 25.7 (range 5.7–75.7) months. Eleven of the 46 patients (23.9%) developed HBV reactivation after withdrawal of pre-emptive lamivudine. Eight of the 16 patients with high pre-chemotherapy HBV DNA (⩾10(4) copies/ml) compared with three of the 30 patients with low pre-chemotherapy HBV DNA (<10(4) copies/ml) developed HBV reactivation (50.0% v 10.0%, respectively; p<0.001). Hepatitis B e antigen positive patients were also more likely to develop HBV reactivation (5/11 (45.5%) v 6/35 (17.1%), respectively; p = 0.041). A high pre-chemotherapy HBV DNA (⩾10(4) copies/ml) was the most important risk factor for HBV reactivation after withdrawal of pre-emptive lamivudine on Cox proportional hazards analysis (relative risk 16.13, (95% confidence interval 2.99-87.01; p = 0.001). Conclusions: HBV reactivation is more likely to occur in patients with high pre-chemotherapy HBV DNA after withdrawal of pre-emptive lamivudine. A more prolonged course of antiviral therapy may be necessary in these patients after completion of chemotherapy in order to reduce post-chemotherapy HBV reactivation

Physical and psychosocial safety climate scales: psychometric evidence and invariance measurement in a Portuguese sample

Accident prevention is one of the key rules for workplace safety, and the safety climate has been linked to the possibility of influencing not only the safety behavior of workers but also the occurrence of accidents. Thus, this study aims to present the psychometric evidence of the physical and psychosocial safety climate scales in a Portuguese sample. From a sample of 844 participants, 505 men and 339 women, aged between 17 and 68 years (M = 37.09, SD = 10.57), the results show that the one-factor solution yielded the best fit to the data with acceptable reliability in both scales. The invariance measure between professions was only observed in the psychosocial safety climate scale, thus alerting to the susceptibility to different professional populations of the physical safety climate scale. Understanding the safety climate is critical to reducing occupational disease, injuries and accidents, and further study should deepen the psychometric qualities of both scales.info:eu-repo/semantics/publishedVersio

An ICMP-Based Mobility Management Approach Suitable for Protocol Deployment Limitation

Mobility management is one of the important tasks on wireless networks. Many approaches have been proposed in the past, but none of them have been widely deployed so far. Mobile IP (MIP) and Route Optimization (ROMIP), respectively, suffer from triangular routing problem and binding cache supporting upon each node on the entire Internet. One step toward a solution is the Mobile Routing Table (MRT), which enables edge routers to take over address binding. However, this approach demands that all the edge routers on the Internet support MRT, resulting in protocol deployment difficulties. To address this problem and to offset the limitation of the original MRT approach, we propose two different schemes, an ICMP echo scheme and an ICMP destination-unreachable scheme. These two schemes work with the MRT to efficiently find MRT-enabled routers that greatly reduce the number of triangular routes. In this paper, we analyze and compare the standard MIP and the proposed approaches. Simulation results have shown that the proposed approaches reduce transmission delay, with only a few routers supporting MRT

Hyper-organizational space in the work of J. G. Ballard

This paper explores three hyper-organizational spaces: the skyscraper, the resort and the office-park. Drawing on Henri Lefebvre's account of the production of space, we consider how these spaces are socially produced, how they materialize relations of power and how inhabitants engage in struggle to change these spaces. Three novels by J. G. Ballard are selected to explore each of these spaces. We argue that in each of these novels, such hyper-organizational environments can be understood as the product of ongoing struggle between centrally planned and practiced space, and peripheral lived space. This both animates these spaces and the lived relations that comprise them, as well as potentially destroying them