Background Varicella-zoster virus (VZV) infection disproportionately affects people with HIV (PWH) primarily presenting as Herpes Zoster. However, VZV seroprevalence, its association with zoster, and clinical outcomes, remain understudied in era of modern antiretroviral therapy (ART). We assessed VZV seroprevalence, rates of VZV illness, and associated healthcare costs in a large PWH cohort over 20 years. Methods We performed retrospective chart reviews of patients followed at a regional HIV clinic from 1/1/2000-12/31/2020. Serological, immunization, clinical, and costing data were extracted from in-house databases. VZV-related inpatient admissions, emergency department (ED), and urgent care (UC) visits were identified using relevant ICDN codes and validated where possible by two-physicians. Healthcare utilization costs were adjusted to 2020 Cdn$. Results Of 3006 PWH, VZV serology was available for 2628; of these 2503 (95.2%) were seropositive. Only 39% of known seronegative patients were subsequently immunized for varicella. During 29,768 years of patient follow-up, 38 hospitalizations and 138 ED/UC visits due to VZV infection were identified. Most occurred in VZV seropositive PWH <50 years of age (82%), unimmunized (99.2%) and not on ART (64.8%). Nearly 25% of hospitalizations were due to laboratory confirmed VZV meningitis/encephalitis. The average admission cost was $33,001 Canadian dollars (Cdn$); the total measured cost of VZV illness was $1,258,718 Cdn$. Discussion Despite ART and vaccines for chickenpox and shingles, VZV still caused significant costs and morbidity for PWH, occurring at younger ages and often as encephalitis/meningitis. Supporting ART adherence may reduce VZV illness and hospitalization costs in PWH, and the cost-effectiveness of expanding shingles vaccine use warrants further study.
Purpose of the study: Recent advances in strategies for soft materials have transformed the wearable or bioelectronics from a rigid form into a soft, having advantages in terms of mechanical similarity with human tissue. Conductive nanocomposites are promising components as conductive interconnects in stretchable electronic system. This study is about optimizations of nanocomposite for enhancing its performances without degrading mechanical properties. Methodology: First, we summarize the recent advances in metallic nanocomposites. Next, we discuss the 3-dimensional percolation theory, which is basic theoretical basis to understand the random system of nanocomposite. From this, we also briefly search important parameters having potential to change percolative connections of nanoparticles. Main Findings: We investigated required parameters, which could affect the percolation network of conductive fillers in matrix. Dimension, shape and volume fraction of fillers are very important to realize the high conductivity of conductive composite. By calculating some parameters with theoretical formula, we analyzed the effect of shape and dimensions on performance of conductive composite. Implications: This study can help researchers to understand the potential parameters that could affect the performances of conductive nanocomposite and analyze them in qualitative and quantitative approaches. Novelty: The potential applications of optimized conductive nanocomposite, especially focused on wearable and bio-implantable system are discussed.
Bridges in extreme environments combine the mission of connecting remote areas with the challenge of surviving in harsh environments. For the high quality construction and long term application of bridges, the design and application of high-performance concrete (HPC) are researched in this paper. Firstly, the application of HPC in bridges under cold environment is studied. Based on the failure mechanism of concrete and mix ratio design of HPC in cold area, the conclusion is drawn that adding appropriate amount of diatomaceous earth materials can better adapt to cold environment. Then, what kind of HPC is suitable for bridge in coastal environment is explored. By studying the failure mechanism and mix ratio of concrete in coastal areas, it is found that adding the appropriate amount of blast-furnace slag (GGBS) can better resist the damage caused by the ocean. Finally, the working condition of HPC is defined as the construction of bridges in hot environment. The HPC was designed after consulting the difficulties of concrete pouring in hot weather. The experimental results show that adding a proper amount of fly ash can solve this problem. This study can provide a reference for using HPC to build bridges in different extreme environments.
The North Saskatchewan River flows southwest to northeast through a 22-km-long valley in the City of Edmonton, supplying the drinking water to dozens of downstream communities. During heavy rains, combined sewers occasionally overflow into the river, which has a significant negative impact on the water quality and the sensitive environment. The West Edmonton Sanitary Sewer (WESS) W12, a syphon connecting the Rat Creek Trunk to the Gold Bar Wastewater Treatment Plant across the river, was designed and constructed to take the overflow to the wastewater treatment plant. Due to the complexity of the project, various 3D technologies were applied to facilitate decision-making processes. 3D models were developed for design review and design conflict detection, while 4D models were established to help create a robust construction schedule. Construction sequencing animation was used to convey design intents and demonstrate construction stages to contractors and workers. The combined applications of 3D technologies helped the project team to identify critical issues, and assured effective communication among engineers, management, contractors, and other parties. Therefore, it provided more opportunities for the success of the project.
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