Hospital and laboratory data indicate that human T-lymphotropic virus type 1 (HTLV-1) is endemic to central Australia, but no community-based studies of its prevalence or disease burden have been ...reported. We determined the prevalence rates of HTLV-1 infection and of HTLV-1-associated diseases in a remote Indigenous community.
A remote Northern Territory community.
All residents were asked to complete a health survey and offered a limited clinical examination, together with serological tests for HTLV-1 and Strongyloides, and HTLV-1 proviral load (PVL) assessment.
HTLV-1 seropositivity rates; HTLV-1 PVL (copies/105 peripheral blood leucocytes PBL); presentation with HTLV-1-related clinical disease.
HTLV-1 serostatus was determined for 97 of 138 residents (70%). The prevalence of HTLV-1 infection was significantly higher among adults (30 of 74 people tested) than children (1 of 23; P = 0.001). Nine of 30 HTLV-1-positive adults had a clinical syndrome that was potentially attributable to HTLV-1 infection (chronic lung disease, seven; symptomatic strongyloidiasis, two). The median HTLV-1 PVL was significantly higher for adults with chronic lung disease than for those who were asymptomatic (chronic lung disease, 649 copies/105 PBL IQR, 162-2220; asymptomatic adults, 40 copies/105 PBL IQR, 0.9-229; P = 0.017). Ten of 72 adults tested were seropositive for Strongyloides (six of 28 HTLV-1-positive participants and four of 44 HTLV-1-negative participants; P = 0.17), as were three of 15 children tested; the three children were HTLV-1-negative.
The prevalence of HTLV-1 infection and the rate of disease potentially attributable to HTLV-1 were high among adults in this remote community.
Infection with the human T cell leukaemia virus type 1 (HTLV-1) subtype C is endemic among Aboriginal people in central Australia. To provide insights into the risk factors for transmission, we ...conducted the first large-scale, community-based prevalence study in seven remote Aboriginal communities. Residents >2 years old were invited to participate in the study between August 2014 and June 2018. HTLV-1 infection was defined as a positive western blot (WB) test or a positive HTLV-1 PCR. 720 community residents participated in the study (children <15 years, 142; adults, 578). Prevalences for children and adults were 3.5% (5/142) and 36.8% (213/578), respectively, reaching 49.3% (106/215) for those older than 45 years. A wide range of proviral loads were measured for both asymptomatic and symptomatic participants with no difference within groups according to age or gender; however, median PVL was 1.34 log10 higher for symptomatic participants. The adult prevalence of HTLV-1 infection in central Australia is the highest reported worldwide. Sexual contact is likely to be the predominant mode of transmission.
Summary Background Cutaneous T-cell lymphomas are rare, generally incurable, and associated with reduced quality of life. Present systemic therapies rarely provide reliable and durable responses. We ...aimed to assess efficacy and safety of brentuximab vedotin versus conventional therapy for previously treated patients with CD30-positive cutaneous T-cell lymphomas. Methods In this international, open-label, randomised, phase 3, multicentre trial, we enrolled adult patients with CD30-positive mycosis fungoides or primary cutaneous anaplastic large-cell lymphoma who had been previously treated. Patients were enrolled across 52 centres in 13 countries. Patients were randomly assigned (1:1) centrally by an interactive voice and web response system to receive intravenous brentuximab vedotin 1·8 mg/kg once every 3 weeks, for up to 16 3-week cycles, or physician's choice (oral methotrexate 5–50 mg once per week or oral bexarotene 300 mg/m2 once per day) for up to 48 weeks. The primary endpoint was the proportion of patients in the intention-to-treat population achieving an objective global response lasting at least 4 months per independent review facility. Safety analyses were done in all patients who received at least one dose of study drug. This trial was registered with ClinicalTrials.gov , number NCT01578499. Findings Between Aug 13, 2012, and July 31, 2015, 131 patients were enrolled and randomly assigned to a group (66 to brentuximab vedotin and 65 to physician's choice), with 128 analysed in the intention-to-treat population (64 in each group). At a median follow-up of 22·9 months (95% CI 18·4–26·1), the proportion of patients achieving an objective global response lasting at least 4 months was 56·3% (36 of 64 patients) with brentuximab vedotin versus 12·5% (eight of 64) with physician's choice, resulting in a between-group difference of 43·8% (95% CI 29·1–58·4; p<0·0001). Grade 3–4 adverse events were reported in 27 (41%) of 66 patients in the brentuximab vedotin group and 29 (47%) of 62 patients in the physician's choice group. Peripheral neuropathy was seen in 44 (67%) of 66 patients in the brentuximab vedotin group (n=21 grade 2, n=6 grade 3) and four (6%) of 62 patients in the physician's choice group. One of the four on-treatment deaths was deemed by the investigator to be treatment-related in the brentuximab vedotin group; no on-treatment deaths were reported in the physician's choice group. Interpretation Significant improvement in objective response lasting at least 4 months was seen with brentuximab vedotin versus physician's choice of methotrexate or bexarotene. Funding Millennium Pharmaceuticals Inc (a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd), Seattle Genetics Inc.
The W3C Semantic Sensor Network Incubator group (the SSN-XG) produced an OWL 2 ontology to describe sensors and observations — the SSN ontology, available at http://purl.oclc.org/NET/ssnx/ssn. The ...SSN ontology can describe sensors in terms of capabilities, measurement processes, observations and deployments. This article describes the SSN ontology. It further gives an example and describes the use of the ontology in recent research projects.
The treatment of acute promyelocytic leukemia has improved considerably after recognition of the effectiveness of all-trans-retinoic acid (ATRA), anthracycline-based chemotherapy, and arsenic ...trioxide (ATO). Here we report the use of all 3 agents in combination in an APML4 phase 2 protocol. For induction, ATO was superimposed on an ATRA and idarubicin backbone, with scheduling designed to exploit antileukemic synergy while minimizing cardiotoxicity and the severity of differentiation syndrome. Consolidation comprised 2 cycles of ATRA and ATO without chemotherapy, followed by 2 years of maintenance with ATRA, oral methotrexate, and 6-mercaptopurine. Of 124 evaluable patients, there were 4 (3.2%) early deaths, 118 (95%) hematologic complete remissions, and all 112 patients who commenced consolidation attained molecular complete remission. The 2-year rate for freedom from relapse is 97.5%, failure-free survival 88.1%, and overall survival 93.2%. These outcomes were not influenced by FLT3 mutation status, whereas failure-free survival was correlated with Sanz risk stratification (Ptrend = .03). Compared with our previously reported ATRA/idarubicin-based protocol (APML3), APML4 patients had statistically significantly improved freedom from relapse (P = .006) and failure-free survival (P = .01). In conclusion, the use of ATO in both induction and consolidation achieved excellent outcomes despite a substantial reduction in anthracycline exposure. This trial was registered at the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) as ACTRN12605000070639.
Agency in language planning and policy Liddicoat, Anthony J.; Taylor-Leech, Kerry
Current issues in language planning,
03/2021, Letnik:
ahead-of-print, Številka:
ahead-of-print
Journal Article
Recenzirano
Odprti dostop
The role of agency in language planning and policy (LPP) is a recent focus of scholarship. Interest in agency has seen new issues and contexts being given prominence in LPP research. In this ...introduction, we present an overview of theoretical definitions of agency and the ways it has emerged as a concept in LPP scholarship. We consider how developments in methods and approaches to LPP research have led to a greater focus on social actors and their agency in LPP decision-making. We also consider how agency can be conceptualised within the field of language planning, how it may be exercised and who may exercise agency.
The constitutively active BCR-ABL tyrosine kinase is the cause of chronic myeloid leukemia. Imatinib is the first small synthetic molecular inhibitor of the BCR-ABL tyrosine kinase with clinical ...activity in chronic-phase myeloid leukemia. This 5-year follow-up of patients with the disease who began continuous treatment with imatinib reports that the drug can induce durable hematologic and cytogenetic responses in a high proportion of patients.
This 5-year follow-up of patients with chronic myeloid leukemia who began continuous treatment with imatinib reports that the drug can induce durable hematologic and cytogenetic responses in a high proportion of patients.
Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the expansion of a clone of hematopoietic cells that carries the Philadelphia chromosome (Ph).
1
The Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, t(9;22)(q34;q11).
2
The molecular consequence of this translocation is a novel fusion gene,
BCR-ABL,
which encodes a constitutively active protein, tyrosine kinase.
3
–
5
Imatinib (Gleevec, Novartis; formerly called STI571) is a relatively specific inhibitor of the BCR-ABL tyrosine kinase and has efficacy in CML.
6
–
11
Before the availability of imatinib, interferon alfa plus cytarabine was considered standard therapy for patients . . .
Spatial information science has a critical role to play in meeting the major challenges facing society in the coming decades, including feeding a population of 10 billion by 2050, addressing ...environmental degradation, and acting on climate change. Agriculture and agri-food value-chains, dependent on spatial information, are also central. Due to agriculture's dual role as not only a producer of food, fibre and fuel, but also as a major land, water and energy consumer, agriculture is at the centre of both the food-water-energy-environment nexus and resource security debates. The recent confluence of a number of advances in data analytics, cloud computing, remote sensing, computer vision, robotic and drone platforms, and IoT sensors and networks have lead to a significant reduction in the cost of acquiring and processing data for decision support in the agricultural sector. When combined with cost-effective automation through development of swarm farming technologies, the technology has the potential to decouple productivity and cost efficiency from economies of size, reducing the need to increase farm size to remain economically viable. We argue that these pressures and opportunities are driving agricultural value-chains towards high-resolution data-driven decision-making, where even decisions made by small rural landowners can be data-driven. We survey recent innovations in data, especially focusing on sensor, spatial and data mining technologies with a view to their agricultural application; discuss economic feasibility for small farmers; and identify some technical challenges that need to be solved to reap the benefits. Flexibly composable information resources, coupled with sophisticated data sharing technologies, and machine learning with transparently embedded spatial and aspatial methods are all required.
Reductions in transfusion requirements/improvements in hematologic parameters have been associated with iron chelation therapy in transfusion-dependent patients, including those with myelodysplastic ...syndromes; data on there reductions/improvements have been limited to case reports and small studies.
To explore this observation in a large population of patients, we report a post-hoc analysis evaluating hematologic response to deferasirox in a cohort of iron-overloaded patients with myelodysplastic syndromes enrolled in the Evaluation of Patients' Iron Chelation with Exjade(®) (EPIC) study using International Working Group 2006 criteria.
Two-hundred and forty-seven, 100 and 50 patients without concomitant medication for myelodysplastic syndromes were eligible for analysis of erythroid, platelet and neutrophil responses, respectively. Erythroid, platelet and neutrophil responses were observed in 21.5% (53/247), 13.0% (13/100) and 22.0% (11/50) of the patients after a median of 109, 169 and 226 days, respectively. Median serum ferritin reductions were greater in hematologic responders compared with non-responders at end of study, although these differences were not statistically significant. A reduction in labile plasma iron to less than 0.4 μmol/L was observed from week 12 onwards; this change did not differ between hematologic responders and non-responders.
This analysis suggests that deferasirox treatment for up to 1 year could lead to improvement in hematologic parameters in some patients with myelodysplastic syndromes.
Maize (Zea mays L.), also known as corn, is the third most cultivated crop in the world. Northern corn leaf blight (NCLB) is a globally devastating maize foliar disease caused by Setosphaeria turcica ...(Luttrell) Leonard and Suggs. Early intelligent diagnosis and warning is an effective and economical strategy to control this disease. Today, deep learning is beginning to play an essential role in agriculture. Notably, deep convolutional neural networks (DCNN) are amongst the most successful machine learning techniques in plant disease detection and diagnosis. Our study aims to identify NCLB in the maize-producing area in Jilin Province based on several DCNN models. We established a database of 985 leaf images of healthy and infected maize and applied data augmentation techniques including image segmentation, image resizing, image cropping, and image transformation, to expand to 30 655 images. Several proven convolutional neural networks, such as AlexNet, GoogleNet, VGG16, and VGG19, were then used to identify diseases. Based on the best performance of the DCNN pre-trained model GoogleNet, some of the recent loss functions developed for deep facial recognition tasks such as ArcFace, CosFace, and A-Softmax were applied to detect NCLB. We found that a pre-trained GoogleNet architecture with the Softmax loss function can achieve an excellent accuracy of 99.94% on NCLB diagnosis. The analysis was implemented in Python with two deep learning frameworks, Pytorch and Keras. The techniques, training, validation, and test results are presented in this paper. Overall, our study explores intelligent identification technology for NCLB and effectively diagnoses NCLB from images of maize.
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