Hepatitis B testing and treatment in HIV patients in The Gambia - compliance with international guidelines and clinical outcomes

Background Compliance with WHO guidelines on HBV screening and treatment in HIV-coinfected patients is often challenging in resource limited countries and has been poorly assessed in sub-Saharan Africa. Methods Between 2015 and 2016, we assessed physician’s compliance with WHO guidelines on HIV-HBV coinfection in the largest HIV clinic in The Gambia, and the hepatic outcomes in HIV-HBV coinfected patients as compared to randomly selected HIV-monoinfected controls. Results 870 HIV-infected patients regularly seen in this clinic agreed to participate in our study. Only 187 (21.5%, 95% CI 18.8–24.3) had previously been screened for HBsAg, 23 (12.3%, 95% CI 8.0–17.9) were positive of whom none had liver assessment and only 6 (26.1%) had received Tenofovir. Our HBV testing intervention was accepted by all participants and found 94/870 (10.8%, 95% CI 8.8–13.1) positive, 78 of whom underwent full liver assessment along with 40 HBsAg-negative controls. At the time of liver assessment, 61/78 (78.2%) HIV-HBV coinfected patients received ART with 7 (11.5%) on Tenofovir and 54 (88.5%) on Lamivudine alone. HIV-HBV coinfected patients had higher APRI score compared to controls (0.58 vs 0.42, p = 0.002). HBV DNA was detectable in 52/53 (98.1%) coinfected patients with 14/53 (26.4%) having HBV DNA >20,000 IU/L. 10/12 (83.3%) had at least one detectable 3TC-associated HBV resistance, which tended to be associated with increase in liver fibrosis after adjusting for age and sex (p = 0.05). Conclusions Compliance with HBV testing and treatment guidelines is poor in this Gambian HIV programme putting coinfected patients at risk of liver complications. However, the excellent uptake of HBV screening and linkage to care in our study suggests feasible improvements

Robotic manipulation for the shoe-packaging process

[EN] This paper presents the integration of a robotic system in a human-centered environment, as it can be found in the shoe manufacturing industry. Fashion footwear is nowadays mainly handcrafted due to the big amount of small production tasks. Therefore, the introduction of intelligent robotic systems in this industry may contribute to automate and improve the manual production steps, such us polishing, cleaning, packaging, and visual inspection. Due to the high complexity of the manual tasks in shoe production, cooperative robotic systems (which can work in collaboration with humans) are required. Thus, the focus of the robot lays on grasping, collision detection, and avoidance, as well as on considering the human intervention to supervise the work being performed. For this research, the robot has been equipped with a Kinect camera and a wrist force/ torque sensor so that it is able to detect human interaction and the dynamic environment in order to modify the robot¿s behavior. To illustrate the applicability of the proposed approach, this work presents the experimental results obtained for two actual platforms, which are located at different research laboratories, that share similarities in their morphology, sensor equipment and actuation system.This work has been partly supported by the Ministerio de Economia y Competitividad of the Spanish Government (Key No.: 0201603139 of Invest in Spain program and Grant No. RTC-2016-5408-6) and by the Deutscher Akademischer Austauschdienst (DAAD) of the German Government (Projekt-ID 54368155).Gracia Calandin, LI.; Perez-Vidal, C.; Mronga, D.; Paco, JD.; Azorin, J.; Gea, JD. (2017). Robotic manipulation for the shoe-packaging process. The International Journal of Advanced Manufacturing Technology. 92(1-4):1053-1067. https://doi.org/10.1007/s00170-017-0212-6S10531067921-4Pedrocchi N, Villagrossi E, Cenati C, Tosatti LM (2017) Design of fuzzy logic controller of industrial robot for roughing the uppers of fashion shoes. Int J Adv Manuf Technol 77(5):939–953Hinojo-Perez JJ, Davia-Aracil M, Jimeno-Morenilla A, Sanchez-Romero L, Salas F (2016) Automation of the shoe last grading process according to international sizing systems. Int J Adv Manuf Technol 85(1):455–467Dura-Gil JV, Ballester-Fernandez A, Cavallaro M, Chiodi A, Ballarino A, von Arnim V., Brondi C, Stellmach D (2016) New technologies for customizing products for people with special necessities: project fashion-able. Int J Comput Integr Manuf. In Press, doi: 10.1080/0951192X.2016.1145803Jatta F, Zanoni L, Fassi I, Negri S (2004) A roughing/cementing robotic cell for custom made shoe manufacture. Int J Comput Integr Manuf 17(7):645–652Nemec B, Zlajpah L (2008) Robotic cell for custom finishing operations. Int J Comput Integr Manuf 21(1):33–42Molfino R, et al (2004) Modular, reconfigurable prehensor for grasping and handling limp materials in the shoe industry. 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Tuneable VCSEL aiming for the application in interconnects and short haul systems

Widely tunable vertical cavity surface emitting lasers (VCSEL) are of high interest for optical communications, gas spectroscopy and fiber-Bragg-grating measurements. In this paper we present tunable VCSEL operating at wavelength around 850 nm and 1550 nm with tuning ranges up to 20 nm and 76 nm respectively. The first versions of VCSEL operating at 1550 nm with 76 nm tuning range and an output power of 1.3mW were not designed for high speed modulation, but for applications where only stable continious tuning is essential (e.g. gas sensing). The next step was the design of non tunable VCSEL showing high speed modulation frequencies of 10 GHz with side mode supression ratios beyond 50 dB. The latest version of these devices show record output powers of 6.7mW at 20 °C and 3mW at 80 °C. The emphasis of our present and future work lies on the combination of both technologies. The tunable VCSEL operating in the 850 nm-region reaches a modulation bandwidth of 5.5GHz with an output power of 0.8mW

Universities and community-based research in developing countries: community voice and educational provision in rural Tanzania

The main focus of recent research on the community engagement role of universities has been in developed countries, generally in towns and cities and usually conducted from the perspectives of universities rather than the communities with which they engage. The purpose of this paper is to investigate the community engagement role of universities in the rural areas of developing countries, and its potential for strengthening the voice of rural communities. The particular focus is on the provision of primary and secondary education. The paper is based on the assumption that in order for community members to have both the capacity and the confidence to engage in political discourse for improving educational capacity and quality, they need the opportunity to become involved and well-versed in the options available, beyond their own experience. Particular attention is given in the paper to community-based research (CBR). CBR is explored from the perspectives of community members and local leaders in the government-community partnerships which have responsibility for the provision of primary and secondary education in rural Tanzania. The historical and policy background of the partnerships, together with findings from two case studies, provide the context for the paper

Research agenda for preventing mosquito-transmitted diseases through improving the built environment in sub-Saharan Africa

Mosquito-transmitted diseases are a major threat to health in sub-Saharan Africa, but could be reduced through modifications to the built environment. Here we report findings from a major workshop held to identify the research gaps in this area, namely: (1) evidence of the health benefits to changes to the built environment, (2) understanding how mosquitoes enter buildings, (3) novel methods for reducing mosquito-house entry, (4) sustainable approaches for reducing mosquito habitats, (5) case studies of micro-financing for healthy homes and (6) methods for increasing scale-up. Multidisciplinary research is essential to build out mosquito-transmitted diseases, and not build them in

Acceptability and feasibility of a screen-and-treat programme for hepatitis B virus infection in The Gambia: the Prevention of Liver Fibrosis and Cancer in Africa (PROLIFICA) study.

BACKGROUND: Despite the introduction of immunisation for hepatitis B virus (HBV) in the 1990s, HBV-related morbidity and mortality remain high in sub-Saharan Africa. Identification and treatment of asymptomatic people with chronic HBV infection should reduce the disease burden. We therefore assessed the feasibility of a screen-and-treat programme for HBV infection in The Gambia, west Africa, and estimated the proportion of HBV-infected people who had significant liver disease in need of treatment. METHODS: Between Dec 7, 2011, and Jan 24, 2014, individuals living in randomly selected communities in western Gambia were offered hepatitis B surface antigen (HBsAg) screening via a point-of-care test. The test was also offered to potential blood donors attending the central hospital in the capital, Banjul. HBsAg-positive individuals were invited for a comprehensive liver assessment and were offered treatment according to international guidelines. We defined linkage to care as visiting the liver clinic at least once. Eligibility for treatment was judged in accordance with the 2012 European Association for the Study of the Liver guidelines. FINDINGS: HBsAg screening was accepted by 5980 (weighted estimate 68·9%, 95% CI 65·0-72·4) of 8170 adults from 27 rural and 27 urban communities and 5559 (81·4%, 80·4-82·3) of 6832 blood donors. HBsAg was detected in 495 (8·8%, 7·9-9·7) individuals in communities and 721 (13·0%, 12·1-13·9) blood donors. Prevalence was higher in men (239 [10·5%, 8·9-12·1] of 2328 men vs 256 [7·6%, 6·5-8·7] of 3652 women; p=0·004) and middle-aged participants. Linkage to care was high in the communities, with 402 (81·3%) of 495 HBsAg-positive individuals attending the clinic. However, only 300 (41·6%) of 721 HBsAg-positive people screened at the blood bank linked into care. Of those who attended the clinic, 18 (4·4%, 2·5-7·7) patients from the communities and 29 (9·7%, 6·8-13·6) from the blood bank were eligible for treatment. Male sex was strongly associated with treatment eligibility (odds ratio 4·35, 1·50-12·58; p=0·007). INTERPRETATION: HBV infection remains highly prevalent in The Gambia. The high coverage of community-based screening, good linkage into care, and the small proportion of HBsAg carriers who need treatment suggest that large-scale screening and treatment programmes are feasible in sub-Saharan Africa. FUNDING: European Commission (FP7)

A Systems Biology Approach Identifies Molecular Networks Defining Skeletal Muscle Abnormalities in Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory process of the lung inducing persistent airflow limitation. Extensive systemic effects, such as skeletal muscle dysfunction, often characterize these patients and severely limit life expectancy. Despite considerable research efforts, the molecular basis of muscle degeneration in COPD is still a matter of intense debate. In this study, we have applied a network biology approach to model the relationship between muscle molecular and physiological response to training and systemic inflammatory mediators. Our model shows that failure to co-ordinately activate expression of several tissue remodelling and bioenergetics pathways is a specific landmark of COPD diseased muscles. Our findings also suggest that this phenomenon may be linked to an abnormal expression of a number of histone modifiers, which we discovered correlate with oxygen utilization. These observations raised the interesting possibility that cell hypoxia may be a key factor driving skeletal muscle degeneration in COPD patients

Genetic and Environmental Controls on Nitrous Oxide Accumulation in Lakes

We studied potential links between environmental factors, nitrous oxide (N2O) accumulation, and genetic indicators of nitrite and N2O reducing bacteria in 12 boreal lakes. Denitrifying bacteria were investigated by quantifying genes encoding nitrite and N2O reductases (nirS/nirK and nosZ, respectively, including the two phylogenetically distinct clades nosZ(I) and nosZ(II)) in lake sediments. Summertime N2O accumulation and hypolimnetic nitrate concentrations were positively correlated both at the inter-lake scale and within a depth transect of an individual lake (Lake Vanajavesi). The variability in the individual nirS, nirK, nosZ(I), and nosZ(II) gene abundances was high (up to tenfold) among the lakes, which allowed us to study the expected links between the ecosystem's nir-vs-nos gene inventories and N2O accumulation. Inter-lake variation in N2O accumulation was indeed connected to the relative abundance of nitrite versus N2O reductase genes, i.e. the (nirS+nirK)/nosZ(I) gene ratio. In addition, the ratios of (nirS+ nirK)/nosZ(I) at the inter-lake scale and (nirS+ nirK)/nosZ(I+II) within Lake Vanajavesi correlated positively with nitrate availability. The results suggest that ambient nitrate concentration can be an important modulator of the N2O accumulation in lake ecosystems, either directly by increasing the overall rate of denitrification or indirectly by controlling the balance of nitrite versus N2O reductase carrying organisms.Peer reviewe

Un’applicazione di contornatura automatica di pezzi di forma ignota a priori mediante retroazione di forza

Vicenz