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Hydration and glycogen affect T1 relaxation times of liver tissue
No full textT1 mapping is a useful tool for the assessment of patients with nonalcoholic fatty liver disease but still suffers from a large unexplained variance in healthy subjects. This study aims to characterize the potential effects of liver glycogen concentration and body hydration status on liver shortened modified Look-Locker inversion recovery (shMOLLI) T1 measurements. Eleven glycogen phantoms and 12 healthy volunteers (mean age: 31 years, three females) were scanned at 3 T using inversion recovery spin echo, multiple contrast spin echo (in phantoms), shMOLLI T1 mapping, multiple-echo spoiled gradient recalled echo and 13C spectroscopy (in healthy volunteers). Phantom r1 and r2 relaxivities were determined from measured T1 and T2 values. Participants underwent a series of five metabolic experiments to vary their glycogen concentration and hydration levels: feeding, food fasting, exercising, underhydration, and rehydration. Descriptive statistics were calculated for shMOLLI T1, inferior vena cava to aorta cross-sectional area ratio (IVC/Ao) as a marker of body hydration status, glycogen concentration, T2* and proton density fat fraction values. A linear mixed model for shMOLLI R1 was constructed to determine the effects of glycogen concentration and IVC/Ao ratio. The mean shMOLLI T1 after fasting was 737 ± 67 ms. The mean within-subject change was 80 ± 45 ms. The linear mixed model revealed a glycogen r1 relaxivity in volunteers (0.18 M−1 s−1, p = 0.03) close to that determined in phantoms (0.28 M−1 s−1). A unit change in IVC/Ao ratio was associated with a drop of −0.113 s−1 in R1 (p
Special issue on Lessons learnt from a pandemic: COVID-19 in perspective
No full textThis Special Issue on ‘Lessons learnt from a pandemic’ presents the voluntary collaboration of the entire cohort of first-year medical anthropology master’s students at the University of Oxford during the still ongoing COVID-19 pandemic in the 2020-2021 academic year. All lectures, seminars, supervisions and tutorials were held through e-communication during the several months of lockdown. Hence this joint project was envisaged specifically as a way of creating a community while in lockdown, welcoming personal initiative and fostering resilience in this extraordinary year. In medical anthropology at Oxford, a 2500-word essay is written weekly in term time, and tutorials in critical medical anthropology alternate with others on ecological approaches to biomedicine. In the first trimester of this year, of the three essay prompts, every week students could choose one addressing COVID-19. These essays were single-authored, and the students received feedback on them in the tutorials. They were then asked to resubmit their essays either revised on their own or in co-authorship in the following term
Mean-field limits: from particle descriptions to macroscopic equations
No full textWe rigorously derive pressureless Euler-type equations with nonlocal dissipative terms in velocity and aggregation equations with nonlocal velocity fields from Newton-type particle descriptions of swarming models with alignment interactions. Crucially, we make use of a discrete version of a modulated kinetic energy together with the bounded Lipschitz distance for measures in order to control terms in its time derivative due to the nonlocal interactions
Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019
No full textBackground
Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019.
Methods
We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates.
Findings
Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08–1·29) deaths due to tuberculosis and 8·50 million (7·45–9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000–279 000) deaths due to tuberculosis and 1·15 million (1·01–1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000–425 000) more deaths and 1·01 million (0·82–1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820–11 400) more deaths and 81 100 (63 300–100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69–5·02), 6·17 (5·48–7·02), and 1·17 (1·07–1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03–2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05–1·08) times greater among females than males.
Interpretation
As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones.
Funding
Bill & Melinda Gates Foundation
Associations between the household environment and stunted child growth in rural India: a cross-sectional analysis
No full textStunting is a major unresolved and growing health issue for India. Yet there remains scant evidence for the development and application of integrated, multifactorial child health interventions across Indias most rural communities. We examine the associations between household environmental characteristics and stunting in children under 5 years across rural Rajasthan, India. We used DHS-3 India data from 1194 children living across 109,041 interviewed households. Multiple logistic regression analyses independently examined the association between (1) main source of drinking water, (2) main type of sanitation facilities, (3) main cooking fuel type, and (4) agricultural land ownership and stunting adjusting for child age. After adjusting for child age, household access to (1) improved drinking water source was associated with a 23% reduced odds (OR=077, 95% CI 05 to 100), (2) improved sanitation facility was associated with 41% reduced odds (OR=051, 95% CI 03 to 082), and (3) agricultural land ownership was associated with a 30% reduced odds of childhood stunting (OR 070, 95% CI 051 to 094). Cooking fuel source was not associated with stunting. Although further research is needed, intervention programmes should consider shifting from nutrition-specific to nutrition-sensitive solutions to address Indias childhood malnutrition crisis. Results and implications are discussed
Improving knowledge, attitudes and practice to prevent COVID-19 transmission in healthcare workers and the public in Thailand
No full textBackground
Key infection prevention and control measures to limit transmission of COVID-19 include social distancing, hand hygiene, use of facemasks and personal protective equipment. However, these have limited or no impact if not applied correctly through lack of knowledge, inappropriate attitude or incorrect practice. In order to maximise the impact of infection prevention and control measures on COVID-19 spread, we undertook a study to assess and improve knowledge, attitudes and practice among 119 healthcare workers and 100 general public in Thailand. The study setting was two inpatient hospitals providing COVID-19 testing and treatment. Detailed information on knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations.
Results
Knowledge of the main transmission routes, commonest symptoms and recommended prevention methods was mostly very high (> 80%) in both groups. There was lower awareness of aerosols, food and drink and pets as sources of transmission; of the correct duration for handwashing; recommended distance for social/physical distancing; and about recommended types of face coverings. Information sources most used and most trusted were the workplace, work colleagues, health workers and television. The results were used to produce a set of targeted educational videos which addressed many of these gaps with subsequent improvements on retesting in a number of areas. This included improvements in handwashing practice with an increase in the number of areas correctly washed in 65.5% of the public, and 57.9% of healthcare workers. The videos were then further optimized with feedback from participants followed by another round of retesting.
Conclusions
Detailed information on gaps in knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. This was used to produce targeted educational videos which addressed these gaps with subsequent improvements on retesting. The resulting videos were then disseminated as a resource to aid in efforts to fight COVID-19 in Thailand and worldwide
Characterisation of oxygen defects and nitrogen impurities in TiO2 photocatalysts using variable-temperature X-ray powder diffraction
No full textTiO2-based powder materials have been widely studied as efficient photocatalysts for water splitting due to their low cost, photo-responsivity, earthly abundance, chemical and thermal stability, etc. In particular, the recent breakthrough of nitrogen-doped TiO2, which enhances the presence of structural defects and dopant impurities at elevated temperatures, exhibits an impressive visible-light absorption for photocatalytic activity. Although their electronic and optical properties have been extensively studied, the structure-activity relationship and photocatalytic mechanism remain ambiguous. Herein, we report an in-depth structural study of rutile, anatase and mixed phases (commercial P25) with and without nitrogen-doping by variable-temperature synchrotron X-ray powder diffraction. We report that an unusual anisotropic thermal expansion of the anatase phase can reveal the intimate relationship between sub-surface oxygen vacancies, nitrogen-doping level and photocatalytic activity. For highly doped anatase, a new cubic titanium oxynitride phase is also identified which provides important information on the fundamental shift in absorption wavelength, leading to excellent photocatalysis using visible light
Proxies for paleo-oxygenation: A downcore comparison between benthic foraminiferal surface porosity and I/Ca
No full textBenthic foraminiferal surface porosity (the mean percentage of surface area covered by pores; higher porosity: lower oxygenation) and iodine to calcium ratio (I/Ca, higher I/Ca: higher oxygenation) are both promising paleoceanographic proxies that will advance through testing in down-core studies. Here we report the first down-core comparison (~45 kyr) of these proxies for a core from the southern Brazilian margin (26°40.22′ S, 46°26.46′ W, 475 m water depth). Both proxies are most sensitive to low-O2 conditions (<50 μmol/kg), and not well-constrained at higher O2 concentrations. Porosity values are generally low (<15%) and I/Ca ranges between ~4 and ~ 6 μmol/mol throughout the core. The two proxies are overall consistent, suggesting that bottom-water oxygen concentrations at the site remained above 50 μmol/kg during the last 45 kyr. Several non-O2 factors (e.g., iodate reduction rates, water mass mixing, temperature, foraminiferal shell robustness) could influence the proxies and require further investigation
Microcavity-like exciton-polaritons can be the primary photoexcitation in bare organic semiconductors
No full textStrong-coupling between excitons and confined photonic modes can lead to the formation of new quasi-particles termed exciton-polaritons which can display a range of interesting properties such as super-fluidity, ultrafast transport and Bose-Einstein condensation. Strong-coupling typically occurs when an excitonic material is confided in a dielectric or plasmonic microcavity. Here, we show polaritons can form at room temperature in a range of chemically diverse, organic semiconductor thin films, despite the absence of an external cavity. We find evidence of strong light-matter coupling via angle-dependent peak splittings in the reflectivity spectra of the materials and emission from collective polariton states. We additionally show exciton-polaritons are the primary photoexcitation in these organic materials by directly imaging their ultrafast (5 × 106 m s−1), ultralong (~270 nm) transport. These results open-up new fundamental physics and could enable a new generation of organic optoelectronic and light harvesting devices based on cavity-free exciton-polariton
Observing a superposition
No full textThe bare theory is a no-collapse version of quantum mechanics which predicts certain puzzling results for the introspective beliefs of human observers of superpositions. The bare theory can be interpreted to claim that an observer can form false beliefs about the outcome of an experiment which produces a superpositional result. It is argued that, when careful consideration is given to the observer’s belief states and their evolution, the observer does not end up with the beliefs claimed. This result leads to questions about whether there can be any allure for no-collapse theories as austere as the bare theory