Suchergebnisse

AbstractAccounting for SARS-CoV-2 adsorption on solids suspended in wastewater is a necessary step towards the reliable estimation of virus shedding rate in a sewerage system, based on measurements performed at a terminal collection station, i.e., at the entrance of a wastewater treatment plant. This concept is extended herein to include several measurement stations across a city to enable the estimation of spatial distribution of virus shedding rate. This study presents a pioneer general model describing the most relevant physicochemical phenomena with a special effort to reduce the complicated algebra. This is performed both in the topology regime, introducing a discrete-continuous approach, and in the domain of independent variables, introducing a monodisperse moment method to reduce the dimensionality of the resulting population balance equations. The resulting simplified model consists of a large system of ordinary differential equations. A sensitivity analysis is performed with respect to some key parameters for a single pipe topology. Specific numerical techniques are employed for the integration of the model. Finally, a parametric case study for an indicative—yet realistic—sewerage piping system is performed to show how the model is applied to SARS-CoV-2 adsorption on wastewater solids in the presence of other competing species. This is the first model of this kind appearing in scientific literature and a first step towards setting up an inverse problem to assess the spatial distribution of virus shedding rate based on its concentration in wastewater.

BackgroundThe aim of our study was to assess the extent of late presentation for HIV care in Northern Greece during the period 2000 to 2010 and to explore correlations aiming to provide guidance for future interventions.MethodsHIV‐positive patients with no prior history of HIV care at presentation and with a CD4 T cell count within three months from the first confirmatory Western blot result were eligible for this study. Late presentation and advanced HIV disease were defined in concordance with the recommendations of the European Late Presenter Consensus working group. Time trends in presentation status and risk factors linked to late presentation and advanced HIV disease were identified in multivariable logistic regression models. Additional analyses after multiple imputation of missing values were performed to assess the robustness of our findings.ResultsThe status at presentation was evaluated for 631 eligible HIV‐positive individuals. Overall, 52.5% (95% CI: 48.6% to 56.4%) of patients presented late for HIV care and 31.2% (95% CI: 27.6% to 34.8%) presented with advanced HIV disease. Time trends were consistent with an improvement in the presentation status of our study population (p<0.001). Risk factors associated with late presentation in multivariable logistic regression were intravenous drug use, heterosexual HIV transmission, immigrant status and age at diagnosis.ConclusionsDespite the trend for improvement, a significant proportion of newly diagnosed HIV‐positive patients present late for care. Targeted interventions with focus on social groups such as the elderly, persons who inject drugs, immigrants and individuals at risk for heterosexual HIV transmission are mandated.