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  1. Ilankoon IMSK, Ghorbani Y, Chong MN, Herath G, Moyo T, Petersen J
    Waste Manag, 2018 Dec;82:258-275.
    PMID: 30509588 DOI: 10.1016/j.wasman.2018.10.018
    E-waste, or waste generated from electrical and electronic equipment, is considered as one of the fastest-growing waste categories, growing at a rate of 3-5% per year in the world. In 2016, 44.7 million tonnes of e-waste were generated in the world, which is equivalent to 6.1 kg for each person. E-waste is classified as a hazardous waste, but unlike other categories, e-waste also has significant potential for value recovery. As a result it is traded significantly between the developed and developing world, both as waste for disposal and as a resource for metal recovery. Only 20% of global e-waste in 2016 was properly recycled or disposed of, with the fate of the remaining 80% undocumented - likely to be dumped, traded or recycled under inferior conditions. This review paper provides an overview of the global e-waste resource and identifies the major challenges in the sector in terms of generation, global trade and waste management strategies. It lists the specific hazards associated with this type of waste that need to be taken into account in its management and includes a detailed overview of technologies employed or proposed for the recovery of value from e-waste. On the basis of this overview the paper identifies future directions for effective e-waste processing towards sustainable waste/resource management. It becomes clear that there is a strong divide between developed and developing countries with regard to this sector. While value recovery is practiced in centralised facilities employing advanced technologies in a highly regulated industrial environment in the developed world, in the developing world such recovery is practiced in a largely unregulated artisanal industry employing simplistic, labour intensive and environmentally hazardous approaches. Thus value is generated safely in the hi-tech environment of the developed world, whereas environmental burdens associated with exported waste and residual waste from simplistic processing remain largely in developing countries. It is argued that given the breadth of available technologies, a more systematic evaluation of the entire e-waste value chain needs to be conducted with a view to establishing integrated management of this resource (in terms of well-regulated value recovery and final residue disposal) at the appropriately local rather than global scale.
  2. Kowdley KV, Sundaram V, Jeon CY, Qureshi K, Latt NL, Sahota A, et al.
    Hepatology, 2017 04;65(4):1094-1103.
    PMID: 28027579 DOI: 10.1002/hep.29005
    Eight weeks duration of ledipasvir/sofosbuvir (LDV/SOF) can be considered in genotype 1 hepatitis C virus-infected patients who are treatment-naive, do not have cirrhosis, and have a pretreatment viral load <6,000,000 IU/mL. The effectiveness of this regimen, however, has not been fully confirmed by real-world experience. Using data from real-world cohorts, we aimed to determine the effectiveness of 8 weeks of LDV/SOF treatment, examine variables associated with relapse after treatment with this regimen, and compare the effectiveness of 8 weeks and 12 weeks of LDV/SOF treatment. To evaluate the effectiveness of 8 weeks of therapy and characteristics associated with relapse, we used individual patient data from the IFI (Institut für Interdisziplinäre Medizin), Burman's Pharmacy, and Kaiser Permanente Southern California. All patients had fibrosis staging assessed with biopsy, transient elastography, or serum biomarkers. We also performed a systematic review and meta-analysis of six additional real-world cohorts, to compare effectiveness of 8 weeks to 12 weeks duration. In our pooled data analysis, 634 patients were treated for 8 weeks with LDV/SOF, of whom all had outcomes of cure or relapse without loss to follow-up. Per protocol rates of sustained virologic response at 12 weeks were 98.1% (622/634) in the full cohort and 97.9% (571/583) among treatment-eligible patients. Exact logistic regression revealed no specific patient characteristics associated with relapse. Our meta-analysis of six additional real-world cohorts, comprised of 5,637 patients, demonstrated similar risk for relapse between 8 weeks and 12 weeks of LDV/SOF (relative risk = 0.99, 95% confidence interval 0.98-1.00).

    CONCLUSION: An 8-week duration of treatment with LDV/SOF is highly effective in properly selected patients; greater use of this regimen is recommended. (Hepatology 2017;65:1094-1103).

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