The efficacy and safety of maternal tenofovir disoproxil fumarate (TDF) in reducing mother-to-infant hepatitis B virus (HBV) transmissions is not clearly understood. We conducted a prospective, multicenter trial and enrolled 118 hepatitis B surface antigen (HBsAg)-and hepatitis B e antigen-positive pregnant women with HBV DNA 7.5 log 10 IU/mL. The mothers received no medication (control group, n 5 56, HBV DNA 8.22 6 0.39 log 10 IU/mL) or TDF 300 mg daily (TDF group, n 5 62, HBV DNA 8.18 6 0.47 log 10 IU/mL) from 30-32 weeks of gestation until 1 month postpartum. Primary outcome was infant HBsAg at 6 months old. At delivery, the TDF group had lower maternal HBV DNA levels (4.29 6 0.93 versus 8.10 6 0.56 log 10 IU/mL, P < 0.0001). Of the 121/123 newborns, the TDF group had lower rates of HBV DNA positivity at birth (6.15% versus 31.48%, P 5 0.0003) and HBsAg positivity at 6 months old (1.54% versus 10.71%, P 5 0.0481). Multivariate analysis revealed that the TDF group had lower risk (odds ratio 5 0.10, P 5 0.0434) and amniocentesis was associated with higher risk (odds ratio 6.82, P 5 0.0220) of infant HBsAg positivity. The TDF group had less incidence of maternal alanine aminotransferase (ALT) levels above two times the upper limit of normal for 3 months (3.23% versus 14.29%, P 5 0.0455), a lesser extent of postpartum elevations of ALT (P 5 0.007), and a lower rate of ALT over five times the upper limit of normal (1.64% versus 14.29%, P 5 0.0135) at 2 months postpartum. Maternal creatinine and creatinine kinase levels, rates of congenital anomaly, premature birth, and growth parameters in infants were comparable in both groups. At 12 months, one TDF-group child newly developed HBsAg positivity, presumably due to postnatal infection and inefficient humoral responses to vaccines. Conclusions: Treatment with TDF for highly viremic mothers decreased infant HBV DNA at birth and infant HBsAg positivity at 6 months and ameliorated maternal ALT elevations. (HEPATOLOGY 2015;62:375-386) D espite the 75%-90% reduction of chronic hepatitis B viral (HBV) infection following universal infant immunization, active/passive immunoprophylaxis has not eradicated mother-toinfant HBV transmission. [1][2][3][4] Approximately 10% of chronic HBV infections cannot be prevented.5-7 The major risks of chronic HBV infection in the immunization era are maternal hepatitis B surface antigen (HBsAg)/hepatitis B e antigen (HBeAg) positivity and high maternal viral load.5-9 Moreover, after immunoprophylaxis, children with HBV infection have a higher risk of developing hepatocellular carcinoma. 10,11 To achieve the goal of global eradication of HBV infection, better strategies aimed at interrupting Abbreviations: ALT, alanine aminotransferase; anti-HBs, antibody to hepatitis B surface antigen; D0, day 0, initiation of TDF treatment (baseline); D1M, 1 month after TDF treatment; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; P0, at partum; PXM, X months postpartum; SNR, signal-to-noise ratio; TDF, tenofov...
Quantitative maternal HBsAg predicts infection in infants as well as maternal viral load does. Antiviral therapy may be considered in pregnant women with an HBsAg level above 4-4.5 log IU/mL to interrupt mother-to-infant transmission. (Hepatology 2016;64:1451-1461).
This study examined how maturation and the size of deviance affect the development of mismatch responses to Mandarin lexical tones by a multi-deviant oddball paradigm with both large deviant T1/T3 and small deviant T2/T3 pairs in newborns and 6-month-olds. The T1/T3 pair elicited a positive mismatch response (P-MMR) at birth but an adult-like mismatch negativity (MMN) at 6 months of age. For the T2/T3 pair, no significant MMR was seen in newborns, whereas a P-MMR was found when infants are 6 months old. Results suggest that the developmental trajectories of MMRs are dependent on the neural maturation and the discriminability of tonal changes.
Clay minerals are the most reactive and important inorganic components in soils, but soil mineralogy classifies as a minor topic in soil sciences. Revisiting soil mineralogy has been gradually required. Clay minerals in soils are more complex and less well crystallized than those in sedimentary rocks, and thus, they display more complicated X-ray diffraction (XRD) patterns. Traditional characterization methods such as XRD are usually expensive and time-consuming, and they are therefore inappropriate for large datasets, whereas visible and near-infrared reflectance spectroscopy (VNIR) is a quick, cost-efficient, and nondestructive technique for analyzing soil mineralogic properties of large datasets. The main objectives of this review are to bring readers up to date with information and understanding of VNIR as it relates to soil mineralogy and attracts more attention from a wide variety of readers to revisit soil mineralogy. We begin our review with a description of fundamentals of VNIR. We then review common methods to process soil VNIR spectra and summary spectral features of soil minerals with particular attention to those <2 μm fractions. We further critically review applications of chemometric methods and related model building in spectroscopic soil mineral studies. We then compare spectral measurement with multivariate calibration methods, and we suggest that they both produce excellent results depending on the situation. Finally, we suggest a few avenues of future research, including the development of theoretical calibrations of VNIR more suitable for various soil samples worldwide, better elucidation of clay mineral-soil organic carbon (SOC) interactions, and building the concept of integrated soil mapping through combined information (e.g., mineral composition, soil organic matter-SOM, SOC, pH, and moisture).
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