Prevalence of HIV, hepatitis B virus, and hepatitis C virus among incarcerated people in Iran: a systematic review and meta-analysis.

OBJECTIVES: Incarcerated people are at higher risk for HIV, Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) infections. This review systematically summarized the evidence on the prevalence of these infections among incarcerated people in Iran. STUDY DESIGN: A systematic review and meta-analysis. METHODS: We searched Embase, PubMed, Web of Science, Scopus, PsychInfo, Iranian databases, including IranMedex, Magiran, Scientific Information Database (SID), and IranDoc. A grey literature review was conducted to find unpublished reports from the Ministry of Health and experts throughout the country. Included studies reported data on the prevalence of HIV, HBV, or HCV infections. A random-effects meta-analysis was performed to estimate the pooled prevalence. A meta-regression analysis was also conducted. RESULTS: Of 1461 screened records, 23 records were eligible (total participants = 199,855). The pooled prevalence of HIV (17 studies), HBV (6 studies), and HCV (10 studies) was 2.77% (95% CI: 1.96, 3.70), 2.89% (95% CI: 2.28, 3.56), and 21.57% (95% CI: 13.62, 30.76), respectively. Meta-regression analyses showed that HIV (P-value = 0.05) and HCV (P-value = 0.02) were reduced over time using survey year as the interested variable in the model. Also, lifetime history of drug injection had a significant association with the HIV infection (P-value = 0.03). CONCLUSION: The findings suggest that the prevalences of these infections are relatively considerable among Iranian incarcerated people. These findings support developing interventions to reduce the risk of the acquisition and circulation of these infections among incarcerated people, and continued harm reduction programs among most at-risk incarcerated people, as well as HCV treatment.

The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis.

INTRODUCTION: More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. OBJECTIVES: To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. METHODS: We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. RESULTS: The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. CONCLUSIONS: The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. KEY WORDS: Mortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.

Coupling the dynamics of diffused gases and microbial growth in modified atmosphere packaging.

Coupling microbial dynamics with the complete dynamics of the packaging gases is still a challenge. In this work the microbial growth kinetic parameters for Pseudomonas and Lactic Acid Bacteria (LAB) in MAP are identified based on accurate estimation of diffusivity of gases and parameter scaled sensitivity approaches. The microbial dynamics are also compared with those estimated based on partial pressure measurement. Scaled sensitivity coefficient analysis using dissolved gases as variable inputs, shows that in most cases the only coefficients large enough for estimation were those for CO2max-diss, and for µmax. The current data showed that dissolved gases led significant differences on the microbial parameter of CO2max values when compared with the headspace gases. On the other hand, the (so-called) dissolved specific growth rate follows a clear trend down for both microorganisms in relation to the increase of the initial headspace CO2. Finally, current results indicate a possible correlation between CO2max-diss, CO2max-headspace, and µmax as functions of CO2init.

Ongoing incident hepatitis C virus infection among people with a history of injecting drug use in an Australian prison setting, 2005-2014: The HITS-p study.

Hepatitis C virus (HCV) transmission is high in prisons. This study investigated trends in HCV incidence and associated factors among a cohort of prisoners with a history of injecting drug use in New South Wales, Australia. Data were available from the Hepatitis C Incidence and Transmission Study-prisons (HITS-p) from 2005 to 2014. Temporal trends in HCV incidence were evaluated. Factors associated with time to HCV seroconversion among people with ongoing injecting was assessed using Cox proportional hazards. Among 320 antibody-negative participants with a history of injecting drug use (mean age 26; 72% male), 62% (n=197) reported injecting drug use during follow-up. Overall, 93 infections were observed. HCV incidence was 11.4/100 person-years in the overall population and 6.3/100 person-years among the continually imprisoned population. A stable trend in HCV incidence was observed. Among the overall population with ongoing injecting during follow-up, ≥weekly injecting drug use frequency was independently associated with time to HCV seroconversion. Among continuously imprisoned injectors with ongoing injecting during follow-up, needle/syringe sharing was independently associated with time to HCV seroconversion. This study demonstrates that prison is a high-risk environment for acquisition of HCV infection. Needle and syringe sharing was associated with HCV infection among continually imprisoned participants, irrespective of frequency of injecting or the type of drug injected. These findings highlight the need for the evaluation of improved HCV prevention strategies in prison, including needle/syringe programmes and HCV treatment.

Characterization of polyphenol oxidase from blueberry (Vaccinium corymbosum L.).

Polyphenol oxidase (PPO) was extracted and characterized from high-bush blueberries. PPO showed an optimum activity at pH 6.1-6.3 and 35°C, with the enzyme showing significant activity over a wide temperature range (25-60°C). Catechol was the most readily oxidized substrate followed by 4-methylcatechol, DL-DOPA, and dopamine. Blueberry PPO showed a Km of 15mM and Vmax of 2.57 ΔA420nm/min×10-1, determined with catechol. PPO was completely inactivated in 20min at 85°C, however, after 30minat 75°C it showed about 10% residual activity. Thermal treatment at 55 and 65°C for 30min resulted in the partial inactivation of PPO. Ascorbic acid, sodium diethyldithiocarbamic acid, L-cysteine, and sodium metabisulfite were effective inhibitors of PPO at 1.0mM. Benzoic acid and cinnamic acid series inhibitors showed relatively weak inhibition of PPO (21.8-27.6%), even at as high as 2.0mM concentration.

One-step global parameter estimation of kinetic inactivation parameters for Bacillus sporothermodurans spores under static and dynamic thermal processes.

Bacillus sporothermodurans produces highly heat-resistant endospores, that can survive under ultra-high temperature. High heat-resistant sporeforming bacteria are one of the main causes for spoilage and safety of low-acid foods. They can be used as indicators or surrogates to establish the minimum requirements for heat processes, but it is necessary to understand their thermal inactivation kinetics. The aim of the present work was to study the inactivation kinetics under both static and dynamic conditions in a vegetable soup. Ordinary least squares one-step regression and sequential procedures were applied for estimating these parameters. Results showed that multiple dynamic heating profiles, when analyzed simultaneously, can be used to accurately estimate the kinetic parameters while significantly reducing estimation errors and data collection.

Total phenolics, antioxidant properties and quality of fresh-cut onions (Allium cepa L.) treated with mild-heat.

This study investigated the effect of mild-heat on fresh-cut onion slices by treating in hot water (50, 60, 70°C) for 1 min. Total phenolics (TP), antioxidant properties, colour, and weight loss of slices were evaluated during 4°C storage at 7-day intervals (21 days total). The 60°C heat treatment resulted in a significant increase in TP, from 44.92 to 52.32 mg GAE/100g. Except for 50 and 70°C treatments, TP in control and 60°C treated fresh-cut onions decreased during storage. The antioxidant properties of fresh-cut onions were 1.31, 0.99, and 62.49 µM TE/g using ABTS, DPPH, and ORAC assays, respectively. The mild-heat treatments did not affect ABTS and DPPH antioxidant activities and the colour of fresh-cut onions. The storage time had mixed effect on the antioxidant properties (ABTS decreased; DPPH and ORAC remained fairly stable). The 50°C samples exhibited the lowest weight loss during 21-day storage.

Total phenolics, carotenoids, ascorbic acid, and antioxidant properties of fresh-cut mango (Mangifera indica L., cv. Tommy Atkin) as affected by infrared heat treatment.

UNLABELLED: Mango (Mangifera indica L.) is a major tropical fruit that has not been exploited for fresh-cut or minimally processed products on a scale similar to apples, pineapples, or melons. The objective of this study was to investigate the effect of infrared (IR) treatment on total phenolics, carotenoids, ascorbic acid, and antioxidant properties of fresh-cut cubes from 'Tommy Atkin' mangoes. Mango cubes were IR treated (5, 10, 15 min) and evaluated at 4-d intervals during 16-d storage at 4 ± 1 °C. Total phenolics, carotenoids, and ascorbic acid content in fresh-cut control mango cubes were 43.33, 1.37, and 15.97 mg/100 g FW, respectively. IR treatments increased total phenolics (59.23 to 71.16 mg/100 g FW) and decreased ascorbic acid (12.14 to 15.38 mg/100 g, FW). Total carotenoids showed a mixed trend (1.13 to 1.66 mg/100 g, FW). The IR treatment showed a significant positive impact on antioxidant properties (µM TE/100 g, FW) of mango cubes, as assayed by ABTS (261.5 compared with 338.0 to 416.4), DPPH (270.5 compared with 289.4 to 360.5), and ORAC (6686 compared with 8450 to 12230). Total phenolics, carotenoids, ascorbic acid, and antioxidant capacity decreased over 16-d storage. However, IR treated samples had consistently higher ABTS, DPPH, and total phenolics during storage. It was demonstrated that IR treatment can be effectively used in improving antioxidant properties of fresh-cut mangoes with minimal effect on the visual appearance. PRACTICAL APPLICATION: Various methods/treatments are in use for extending the quality of fresh-cut fruits, including mild heat treatment. This study explored the application of infrared (IR) heat for processing fresh-cut mango cubes and evaluated its effect on vitamin C and antioxidant capacity during 16-d storage. This is the first study reporting on the use of IR heat in fresh-cut fruits. IR treatment was shown to be effective in retaining antioxidant properties of fresh-cut mango cubes with minimal effect on the visual appearance.

Inverse method to estimate kinetic degradation parameters of grape anthocyanins in wheat flour under simultaneously changing temperature and moisture.

Thermal and moisture effects on grape anthocyanin degradation were investigated using solid media to simulate processing at temperatures above 100 degrees C. Grape pomace (anthocyanin source) mixed with wheat pastry flour (1: 3, w/w dry basis) was used in both isothermal and nonisothermal experiments by heating the same mixture at 43% (db) initial moisture in steel cells in an oil bath at 80, 105, and 145 degrees C. To determine the effect of moisture on anthocyanin degradation, the grape pomace-wheat flour mixture was heated isothermally at 80 degrees C at constant moisture contents of 10%, 20%, and 43% (db). Anthocyanin degradation followed a pseudo first-order reaction with moisture. Anthocyanins degraded more rapidly with increasing temperature and moisture. The effects of temperature and moisture on the rate constant were modeled according to the Arrhenius and an exponential relationship, respectively. The nonisothermal reaction rate constant and activation energy (mean +/- standard error) were k(80 degrees C, 43% (db) moisture) = 2.81 x 10(-4)+/- 1.1 x 10(-6) s(-1) and DeltaE = 75273 +/- 197 J/g mol, respectively. The moisture parameter for the exponential model was 4.28 (dry basis moisture content)(-1). One possible application of this study is as a tool to predict the loss of anthocyanins in nutraceutical products containing grape pomace. For example, if the process temperature history and moisture history in an extruded snack fortified with grape pomace is known, the percentage anthocyanin loss can be predicted.

Novel primers for the amplification of nuclear DNA introns in the entomopathogenic nematode Heterorhabditis bacteriophora and their cross-amplification in seven other Heterorhabditis species.

We describe 24 novel primers that amplify intron regions in housekeeping and structural genes of Heterorhabditis bacteriophora. The cross-amplification potential of these primers in seven other Heterorhabditis species was determined. The results obtained showed interspecific nucleotide, length and splice site variability in the sequenced introns and for one gene, an intron gain was observed. These primers will be useful tools for studying population genetics, genetic diversity and intron DNA evolution within the genus Heterorhabditis and other genera of rhabditid nematodes.

A review of HIV in prisons in Nepal.

BACKGROUND: HIV in prisons is a serious public health concern. People in prison are at risk of contracting HIV through injecting drug use, unprotected sex and tattooing. However, most countries have largely neglected HIV prevention and care in prisons. OBJECTIVES: The aim of this study is to review HIV prevention and care in Nepal's prisons MATERIALS AND METHODS: This was carried out by Systematic review of published and grey literature. RESULTS: Nepal's National HIV Strategy acknowledges the importance of prisons in broader HIV prevention efforts. However, prison conditions are poor and there is no accurate information regarding HIV prevalence or risk behaviours among prisoners. HIV prevention interventions have largely been limited to ad hoc training workshops. Antiretroviral treatment is not available to HIV infected prisoners. CONCLUSION: There is recognition in Government policy documents that prisons must be involved in efforts to stem the HIV epidemic. However, HIV prevention and care remains largely non-existent in Nepal's prisons. Efforts to obtain external funding to initiate and maintain programs such as drug dependency treatment and condom distribution are required. Attention could also be given to introducing alternatives to incarceration for less serious offenders and drug dependent offenders.

Confidence intervals for modeling anthocyanin retention in grape pomace during nonisothermal heating.

Degradation of nutraceuticals in low- and intermediate-moisture foods heated at high temperature (>100 degrees C) is difficult to model because of the nonisothermal condition. Isothermal experiments above 100 degrees C are difficult to design because they require high pressure and small sample size in sealed containers. Therefore, a nonisothermal method was developed to estimate the thermal degradation kinetic parameter of nutraceuticals and determine the confidence intervals for the parameters and the predicted Y (concentration). Grape pomace at 42% moisture content (wb) was heated in sealed 202 x 214 steel cans in a steam retort at 126.7 degrees C for > 30 min. Can center temperature was measured by thermocouple and predicted using Comsol software. Thermal conductivity (k) and specific heat (C(p)) were estimated as quadratic functions of temperature using Comsol and nonlinear regression. The k and C(p) functions were then used to predict temperature inside the grape pomace during retorting. Similar heating experiments were run at different time-temperature treatments from 8 to 25 min for kinetic parameter estimation. Anthocyanin concentration in the grape pomace was measured using HPLC. Degradation rate constant (k(110 degrees C)) and activation energy (E(a)) were estimated using nonlinear regression. The thermophysical properties estimates at 100 degrees C were k = 0.501 W/m degrees C, Cp= 3600 J/kg and the kinetic parameters were k(110 degrees C)= 0.0607/min and E(a)= 65.32 kJ/mol. The 95% confidence intervals for the parameters and the confidence bands and prediction bands for anthocyanin retention were plotted. These methods are useful for thermal processing design for nutraceutical products.

Effect of surveillance of Barrett's oesophagus on the clinical outcome of oesophageal cancer.

BACKGROUND: Surveillance programmes for Barrett's oesophagus have been implemented in an effort to detect oesophageal adenocarcinoma at an earlier and potentially curable stage. The aim of this study was to examine the impact of endoscopic surveillance on the clinical outcome of patients with adenocarcinoma complicating Barrett's oesophagus. METHOD: Consecutive patients who underwent oesophageal resection for high-grade dysplasia or adenocarcinoma arising from Barrett's oesophagus were studied retrospectively. The pathological stage and survival of patients identified as part of a surveillance programme were compared with those of patients presenting with symptomatic adenocarcinoma. RESULTS: Seventeen patients in the surveillance group and 74 in the non-surveillance group underwent oesophagectomy. Disease detected in the surveillance programme was at a significantly earlier stage: 13 of 17 versus 11 of 74 stage 0 or I, three versus 26 stage II, and one versus 37 stage III or IV (P < 0.001). Lymphatic metastases were seen in three of 17 patients in the surveillance group and 42 of 74 who were not under surveillance (P = 0.004). Three-year survival was 80 and 31 per cent respectively (P = 0.008). CONCLUSION: Patients with surveillance-detected adenocarcinoma of the oesophagus are diagnosed at an earlier stage and have a better prognosis than those who present with symptomatic tumours.

Bilio pancreatic diversion following failure of laparoscopic adjustable gastric banding.

BACKGROUND: This study examines the failure rate with laparoscopic adjustable gastric banding (LABG) and results of band removal with synchronous biliopancreatic diversion without (BPD) or with duodenal switch (BPDDS). METHODS: Failure of LAGB was defined as removal of the band due to insufficient weight loss or a complication. RESULTS: The band was removed in 85 of 1,439 patients (5.9%), most commonly for persistent dysphagia and recurrent slippage. The removal rate and slippage rate decreased from 10.8 and 14.2% to 2.8 and 1.3%, respectively, following introduction of the pars flaccida technique. Fifteen of 27 patients with previous open vertical banded gastroplasty (VBG) required removal of the band. Mean percentage excess weight loss 12 months following open BPD, laparoscopic BPD, open BPDDS, and laparoscopic BPDDS was 44, 37, 35, and 28%, respectively. CONCLUSION: LAGB fails in 6% of patients and removal of the band with synchronous BPD or BPDDS can be performed laparoscopically. Patients with failed primary VBG have a high failure rate with LAGB.

A comparison of laparoscopic adjustable gastric banding in adolescents and adults.

BACKGROUND: Laparoscopic adjustable gastric banding (AGB) induces effective weight loss in adults, but its efficacy in adolescents has yet to be determined. METHODS: Since 1996, data have been collected prospectively on all patients undergoing laparoscopic AGB procedures performed at our hospital by a single surgeon (G.F.). Patients <20 years old at surgery (adolescents) were compared with- patients >20 years old (adults) who were matched for sex and body mass index (BMI). RESULTS: Seventeen adolescents with a median age of 17 years (range, 12-19) and a BMI of 42.2 kg/m2 (range, 30.3-70.5) were compared to 17 adults with a median age of 41 years (range, 23-70) and a BMI of 41.8 kg/m2 (range, 30.1-71.5). There were no significant differences between the adolescents and the adults in complications or weight loss. The BMI dropped to 30.1 kg/m2 (range, 22.6-39.4) in adolescents and 33.1 kg/m2 (range, 28.4-41.3) in adults at 2-month follow-up. CONCLUSION: Laparoscopic AGB is as effective in adolescents as it is in adults.

Drug consumption facilities: an update since 2000.

The topic of drug consumption facilities or rooms (DCRs) was reviewed by Dolan, Kimber and others in Harm Reduction Digest 10, published in the September 2000 issue of DAR. As one of the first English language papers on the topic this paper has been cited extensively. Now, 3 years on, these authors and have brought together an international team of experts to revisit the topic. In this update they: (i) highlight where DCRs are operating or under consideration, (ii) review briefly new literature and (iii) discuss future directions. This Digest is a 'must read' for policy makers, advocates and practitioners in the drug field.

TP53 mutations in malignant and premalignant Barrett's esophagus.

In order to improve the efficacy of endoscopic surveillance of Barrett's esophagus, markers of neoplastic progression in addition to dysplasia are required. The aim of the present study was to assess TP53 mutational analysis as a method of identifying patients with Barrett's esophagus who are at greatest risk of adenocarcinoma, for whom endoscopic surveillance is most appropriate. TP53 mutational analysis was initially performed on premalignant and malignant tissue from 30 patients undergoing esophagectomy for adenocarcinoma, and on premalignant biopsies from 48 patients participating in a Barrett's surveillance program. Surveillance patients were followed up endoscopically and histologically for a median of 5 years following TP53 assessment. Mutational analysis was performed by single-strand conformation polymorphism analysis and direct DNA sequencing. TP53 mutations were detected in 10 of 30 esophageal adenocarcinomas, and were more common in well-differentiated carcinomas. An identical TP53 mutation was detected in carcinoma and adjacent dysplasia. Two patients with premalignant Barrett's esophagus had TP53 mutations and one of these patients developed adenocarcinoma on follow up whilst the other has not yet progressed beyond metaplasia. No patient without TP53 mutation developed high-grade dysplasia or adenocarcinoma. TP53 mutations are detected in 33% of esophageal adenocarcinomas and in 4% of premalignant Barrett's esophagus in patients undergoing endoscopic surveillance. TP53 mutation can be detected before the development of high-grade dysplasia or carcinoma, and may be useful in stratifying the risk of adenocarcinoma in patients with Barrett's esophagus.

Synchronization tomography: a method for three-dimensional localization of phase synchronized neuronal populations in the human brain using magnetoencephalography.

We present a noninvasive technique which allows the anatomical localization of phase synchronized neuronal populations in the human brain with magnetoencephalography. We study phase synchronization between the reconstructed current source density (CSD) of different brain areas as well as between the CSD and muscular activity. We asked four subjects to tap their fingers in synchrony with a rhythmic tone, and to continue tapping at the same rate after the tone was switched off. The phase synchronization behavior of brain areas relevant for movement coordination, inner voice, and time estimation changes drastically when the transition to internal pacing occurs, while their averaged amplitudes remain unchanged. Information of this kind cannot be derived with standard neuroimaging techniques like functional magnetic resonance imaging or positron emission tomography.

Multivariate analysis of clinical, operative and pathologic features of esophageal cancer: who needs adjuvant therapy?

The failure of adjuvant therapy to significantly improve the prognosis of patients undergoing esophago-gastrectomy for cancer may be because of poor patient selection. We sought prognostic factors that would identify those patients who could benefit from adjuvant therapy. Data on 15 possible prognostic factors were prospectively collected on 225 patients undergoing esophago-gastrectomy at a single institution, and univariate and multivariate analyzes performed. T, N, M and overall UICC stage, differentiation, involvement of the circumferential resection margin and number of metastatic of lymph nodes were identified as significant prognostic factors by univariate analysis. Multivariate analysis revealed that the completeness of resection (R-category), ratio of metastatic to total nodes resected and the presence of vascular invasion were independently significant prognostic factors. Following R0 or R1 resection, patients with a metastatic to total lymph node ratio > 0.2 and /or the presence of vascular invasion have a poor prognosis, and the effects of adjuvant therapy in these patients should be studied.

Evaluation of POSSUM in patients with oesophageal cancer undergoing resection.

BACKGROUND: The Physiogical and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) has been used to produce a numerical estimate of expected mortality and morbidity after a variety of general surgical procedures. The aim of this study was to evaluate the ability of POSSUM to predict mortality and morbidity in patients undergoing oesophagectomy. METHODS: POSSUM predictor equations for morbidity and mortality were applied retrospectively to 204 patients who had undergone oesophagectomy for cancer. Observed morbidity and mortality rates were compared with rates predicted by POSSUM using the Hosmer-Lemeshow goodness-of-fit test. Evaluation of the discriminative capability of POSSUM predictor equations was performed using receiver-operator characteristic (ROC) curve analysis. RESULTS: The observed and predicted mortality rates were 12.7 and 19.1 per cent respectively, and the respective morbidity rates were 53.4 and 62.3 per cent. However, the POSSUM model showed a poor fit with the data both for the observed 30-day mortality (chi2 = 16.26, P = 0.002) and morbidity (chi2 = 63.14, P < 0.001) using the Hosmer-Lemeshow test. ROC curve analysis revealed that POSSUM had poor predictive accuracy both for mortality (area under curve 0.62) and morbidity (area under curve 0.55). CONCLUSION: These data suggest that POSSUM does not accurately predict mortality and morbidity in patients undergoing oesophagectomy and must be modified.