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► Systematic review of global hepatitis B prevalence and modeling of data. ► HBsAg-positive persons increased from 223 million in 1990 to 240 million in 2005. ► HBsAg prevalence varied geographically with highest endemicity in sub-Saharan Africa. ► HBsAg prevalence decreased overall but global differences exist. ► Demographic changes call for targeted hepatitis B prevention. Chronic hepatitis B virus infection is one of the most serious infections and a major risk factor for deaths from cirrhosis and liver cancer. We estimate age-, sex- and region-specific prevalence of chronic HBV infection and calculate the absolute number of persons being chronically infected. A systematic review of the literature for studies reporting HBV infection was conducted and worldwide HBsAg seroprevalence data was collected over a 27-year period (1980–2007). Based on observed data, age-specific prevalence and endemicity were estimated on a global level and for all world regions for 1990 and 2005 using an empirical Bayesian hierarchical model. From 1990 to 2005, the prevalence of chronic HBV infection decreased in most regions. This was particularly evident in Central sub-Saharan Africa, Tropical and Central Latin America, South East Asia and Central Europe. Despite this decrease in prevalence, the absolute number of HBsAg positive persons increased from 223 million in 1990 to 240 million in 2005. Age-specific prevalence varied by geographical region with highest endemicity levels in sub-Saharan Africa and prevalence below 2% in regions such as Tropical and Central Latin America, North America and Western Europe. Asian regions showed distinct prevalence patterns with lower intermediate prevalence in South Asia, but up to 8.6% HBsAg prevalence in East Asia. Strong declines were seen in South East Asian children. Declines in HBV infection prevalence may be related to expanded immunization. The increasing overall number of individuals being chronically infected with HBV, and the widespread global differences in HBV prevalence call for targeted approaches to tackle HBV-related mortality and morbidity. HBV infection prevalence data are needed at country and sub-national level to estimate disease burden and guide health and vaccine policy.

Objective The objective is to systematically estimate the current cancer incidence and mortality from the six leading cancer types globally and by sub-regions resulting from exposure to known risk factors such as tobacco use, elevated body weight, alcohol consumption, inadequate physical activity, unhealthy diet and infections. Methods Cancer incidence, mortality and burden of disease caused by the main cancer risk factors were calculated using comparative risk assessment methods and updated data on mortality and risks. Results Lung cancer was the most common cancer in men and breast cancer the most common cancer in women, both in terms of incidence and mortality. The five leading behavioral and dietary risks—high body mass index, low fruit and vegetable intake, physical inactivity, tobacco use and alcohol use—were responsible for 24% of new cancer cases and 30% of cancer deaths. Cancers with the largest proportions attributable to preventable risk factors were cervical cancer (100%) and lung cancer (71%). Seventy percent of liver cancers and 60% of stomach cancers were due to infectious agents. A higher proportion of cancer deaths was attributed to infections in low- and middle-income than in high-income countries. Conclusions The cancer burden is driven by changes in exposure to influential risk factors and can be influenced by preventive interventions aimed at reducing these exposures.

The use of measurement instruments has become a major issue in physical therapy, but their use in daily practice is infrequent. The aims of this case report were to develop and evaluate a plan for the systematic implementation of 2 measurement instruments frequently recommended in Dutch physical therapy clinical guidelines: the Patient-Specific Complaints instrument and the Six-Minute Walk Test. A systematic implementation plan was used, starting with a problem analysis of aspects of physical therapist practice. A literary search, structured interviews, and sounding board meetings were used to identify barriers and facilitators. Based on these factors, various strategies were developed through the use of a planning model for the process of change. Barriers and facilitators were revealed in various domains: physical therapists' competence and attitude (knowledge and resistance to change), organization (policy), patients (different expectations), and measurement instruments (feasibility). The strategies developed were adjustment of the measurement instruments, a self-analysis list, and an education module. Pilot testing and evaluation of the implementation plan were undertaken. The strategies developed were applicable to physical therapist practice. Self-analysis, education, and attention to the practice organization made the physical therapists aware of their actual behavior, increased their knowledge, and improved their attitudes toward and their use of measurement instruments. The use of a planning model made it possible to tailor multifaceted strategies toward various domains and phases of behavioral change. The strategies will be further developed in programs of the Royal Dutch Society for Physical Therapy. Future studies should examine the use of measurement instruments as an integrated part of the process of clinical reasoning. The focus of future studies should be directed not only toward physical therapists but also toward the practice organization and professional associations.

Frankia sp. HFPArI3 (host plant Alnus rubra Bong.) was grown in defined medium and the culture solution was analyzed for the presence of various cytokinins and related compounds. N6- (Δ 2-isopentenyl) adenosine was the only cytokinin detected by both high performance liquid chromatography and gas chromatography-mass spectrometry, at levels of approximately 1 ng/ml culture medium.

Bidens pilosa L. (Compositae) is a common weed of warm areas of the world, and a serious weed among many agricultural crops (Holm et al. 1977). Phenylheptatriyne has been extracted from the leaves of B. pilosa and found to be allelopathic to seedling growth (Campbell et al. 1982). The objective of this experiment was to determine the effect of hydrophobic root exudates collected from the undisturbed rhizosphere of B. pilosa on seedling growth of selected crop species, without the presence of the donor weeds.

Total elbow arthroplasty (TEA) is used to treat end −stage elbow pathologies, yet implant failure is common due to excessive joint loading. This study compared elbow-joint loading, kinematics, and kinetics in TEA patients and healthy controls, and assessed the influence of elbow flexion–extension (FE) and shoulder elevation (SE). Seventeen participants (6 TEA, 11 controls) performed a door-opening task. Musculoskeletal modeling was used to estimate elbow kinematics, net joint moments FE and varus-valgus (VV)), and humeroulnar joint reaction forces (HUJRF). Statistical parametric mapping (SPM) analyzed time-series differences between groups, while cross-correlation assessed relationships between kinematics and loading. TEA patients showed reduced peak elbow extension (43.9 ± 14.9° vs. 5.8 ± 7.2° in controls, 0°=full extension, p < 0.001). Total HUJRF was highly correlated with SE (TEA r̄=0.83 ± 0.07; controls r̄=0.89 ± 0.06) and moderately correlated with FE angle (TEA r̄= 0.83 ± 0.03; controls r̄= 0.73 ± 0.07). VV moments showed moderate correlations with SE (TEA r̄= 0.59 ± 0.16; controls r̄= 0.66 ± 0.09) and FE angle (TEA r̄=0.66 ± 0.08; controls r̄=0.68 ± 0.05). These results suggest TEA patients adapt their movements to compensate for reduced motion while maintaining similar peak joint loads. Postoperative care should address movement patterns alongside load management. Further refinement of musculoskeletal models is needed to improve HUJRF estimation plus support rehabilitation and prosthetic design.

Background: Obesity is a significant health problem in South Africa. Surgery is the most effective means of durable weight loss for the morbidly obese. Of the surgical options, laparoscopic adjustable gastric banding is the most controversial. We aimed to assess a single surgeon's experience with a specific band. Methods: A retrospective observational study of a continuous cohort of laparoscopic adjustable gastric Cousin Bioring[R] band placements from a single private South African hospital was conducted. Three hundred and fifty bands were placed in 347 patients, 75% were female. Variables analysed were BMI obesity class, comorbidities, weight loss, diabetes resolution, adherence to aftercare, patient satisfaction, complications and death. Results: Outcomes were assessed in 343 patients (4 patients lost to follow-up). The mean follow-up was 39 months (IQR 29-66 months). The mean preoperative BMI was 43.3 kg/[m.sup.2] (IQR 37.4-47.6 kg/[m.sup.2]). Most weight loss occurred in the first year, and 66% achieved > 40% excess weight loss. Resolution of type 2 diabetes and prediabetes occurred in 56.4% and 89.8% of patients respectively. Increasing age (p = 0.002), class 3 obesity (p < 0.001) and suboptimal aftercare (p < 0.001) were associated with failure. One patient developed band erosion and 40 developed band slippage, 34 of whom underwent secondary surgery (32 removals, 2 revisions). All complications were grade I-III. There was no high grade complication, and no death. Conclusions: Bioring[R] gastric banding achieved moderately good weight loss and resolution of type 2 diabetes with a Low complication rate. BMI > 60 and suboptimal aftercare predicted poor outcome. Keywords: gastric banding, South Africa