BackgroundPrisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa.MethodsScreening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis.ResultsOverall, 680 inmates were included with a median age of 30 years [interquartile range: 24–35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8–32.1), HBV infection (OR = 4.8; CI 1.8–12.8), HCV infection (OR = 52.6; CI 4.1–673.8), use of traditional medicines (OR = 3.7; CI 1.4–10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1–9.8) compared to Dakar.ConclusionsHIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates.
Termites have co-evolved with a complex gut microbiota consisting mostly of exclusive resident taxa, but key forces sustaining this exclusive partnership are still poorly understood. The potential for primary reproductives to vertically transmit their gut microbiota (mycobiome and bacteriome) to offspring was investigated using colony foundations from field-derived swarming alates of Macrotermes subhyalinus. Metabarcoding based on the fungal internal transcribed spacer (ITS) region and the bacterial 16S rRNA gene was used to characterize the reproductives mycobiome and bacteriome over the colony foundation time. The mycobiome of swarming alates differed from that of workers of Macrotermitinae and changed randomly within and between sampling time points, highlighting no close link with the gut habitat. The fungal ectosymbiont Termitomyces was lost early from the gut of reproductives, confirming the absence of vertical transmission to offspring. Unlike fungi, the bacteriome of alates mirrored that of workers of Macroterminae. Key genera and core OTUs inherited from the mother colony mostly persisted in the gut of reproductive until the emergence of workers, enabling their vertical transmission and explaining why they were found in offspring workers. These findings demonstrate that the parental transmission may greatly contribute to the maintenance of the bacteriome and its co-evolution with termite hosts at short time scales.
This paper studies optimal insurance against private idiosyncratic shocks in a life-cycle model with intensive labor supply and endogenous retirement. In this environment, the optimal labor tax is hump-shaped in age: insurance benefits of taxation push for increasing-in-age taxes while rising labor supply elasticities and optimal late retirement of highly productive workers push for lowering taxes for old workers. In calibrated numerical simulations, the optimum achieves sizable welfare gains that age-dependent taxes do not deliver under the status quo U.S. Social Security. Nevertheless, an optimal combination of age-dependent linear taxes with increasing-in-age retirement benefits generates welfare gains close to optimal.
The esogastric anastomotic fistula,occurring after the replacement of esophagus by the stomach, is a post-operative complication always feared and awaited. Apart from other causes, there exist the anatomical dispositions notably the vascular and technical factors that stress this potential risk despite certain advantages of esophagogastroplasty. The goal of our study was to study the arterial distribution of the gastric transplants in order to identify the better modalities of their making. We used 39 stomachs taken from fresh cadavers of autochtone subjects. After a modeling treatment using three different techniques, they were subjected to a radiographic opacification of the right gastro-epiploic artery with sulphate of barium follow by an x-rays in incidence full-face (25 kv, 10 mAS). It was a matter of 15 entire stomachs (E.E.) with denudation of the small curvature, of 12 wide gastric tubes (W.T.) prepared according to the Akiyama technique modified and of 12 narrow tubes (N.T.) tubulized according to the Marmuse method. We studied the anastomotic type of the gastro-epiploic arterial circle according to the classification of Koskas, the collateral branches of the arterial circles of the gastric curvatures, the antral and corporeal anastomosis of these circles and the distribution anastomotic at the level of the summit of the anastomotic. Only 28 pieces (15 E.E., 8 W.T. and 5 N.T.) were able to be the object of a complete angiographic exploitation. The anastomosis of the arterial circle was type I in 64.1% of the cases, type II in 15.4% of the cases, type III in 15.4% of the cases and type IV in 5.1% of the cases. The average number of collateral branches originating from gastro-epiploic arterial circle was respectively 24, 17 and 22 for the E.E., the W.T. and the N.T. Only the two first ones presented collateral branches being borne of the small curvature circle. Fifty per cent of the N.T. did not possess any antral or corporeal anastomosis between the two arterial circles; some of them were even for a quarter of the W.T. In the case of gastric tubulization there existed an irrigation defect of the summit of the plasty for a third of the N.T. and a quarter of the W.T., despite a constant intramural bridge anastomosis between the two gastro-epiploic arteries. The usage of the entire stomach must be recommended for gastric oesophagoplasty; but when the operative indications require a resection of the small curvature it is preferable to use a wide gastric tube whose diameter respects the two left third of the initial width of the organ.
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