Pty Ltd Research Articles

The Biota orientalis, oil extract Epiitalis®, is efficacious at reducing the symptoms of knee osteoarthritis: a pilot, multi-site, dose-ranging, randomized, blinded, placebo-controlled trial

ObjectiveTo explore the safety, and efficacy of a proprietary hydrolyzed oil extract from seeds of Biota orientalis (hBO/Epiitalis®, Interpath Pty Ltd) in patients with knee pain due to osteoarthritis (OA).MethodsPatients aged 40–65 with X-ray diagnosed knee OA and knee pain ≥ 60 on a 100-point VAS (visual analog scale) were enrolled and randomized into four groups to receive daily hBO for 56 days as high (hBO-HD, 640 mg), mid (hBO-MD, 320 mg) or low (hBO-LD, 160 mg) doses, or a matched placebo oil. The primary outcome was change in VAS knee pain from baseline to 56 days in the mITT (modified intention to treat) population. Exploratory outcomes were the mWOMAC (modified Western Ontario and McMaster Universities Arthritis Index), and the SF-36 QoL (quality of life) questionnaire. The OMERACT-OARSI (Outcome Measures in Arthritis Clinical Trials–Osteoarthritis Research Society International) responder index was also calculated.Results223 patients were included in the mITT population. Reductions in VAS scores between baseline and day 56 [Least square mean (LS mean) and 95% confidence interval (CI) of LS mean] were 36.4 (31.7–41.0), 37.9 (33.2–42.7), 35.7 (31.2–40.1) and 9.8 (14.5–15.2) for the hBO-HD, hBO-MD, hBO-LD, and placebo groups respectively. The VAS changes in all hBO groups were significantly different (p < 0.0001) vs. changes in the placebo group. hBO treatment led to similar quantitative beneficial changes in mWOMAC, SF-36 and OMERACT-OARSI responder index. There were no SAEs and no adverse events ascribed to the intervention.ConclusionIn a 56-day trial, hBO was safe, and was efficacious at reducing symptoms in patients with knee OA. Registration: NCT04117490; Oct 7, 2019.

Corrigendum: The alignment of projects dealing with wetland restoration and alien control: A challenge for conservation management in South Africa

Original article: https://doi.org/10.17159/sajs.2022/11540 Errors that appear in the Discussion of the Research Article by Sieben et al. are corrected here. Dr Graham Harding (Registered PCO, Invader Plant Specialists (Pty) Ltd) is acknowledged for drawing the authors’ attention to these errors.

Food insecurity, a perceived barrier to healthy eating in the lake Victoria region, Kenya: findings from a qualitative study

Consumption of poor-quality diets was noted as prevalent in the Lake Victoria Region, Kenya. As a strategy to communicate desirable change and promote healthy eating in the region, a 30-member panel of policymakers and implementers developed and proposed 12 food-based dietary guidelines (FBDGs) in 2017-2018. The objective of this study was to assess barriers in adopting the proposed FBDGs amongst community members in the lowlands of Kisumu and Homa Bay counties. Qualitative, descriptive cross-sectional design was used to collect data from 72 focus-group discussions (FGD). The FGD was conducted among 216 school going children (10-13y), 216 high school students (15-18y), 207 adult males (26-74y) and 211 females (18-71y). The participants were asked to state whether the proposed FBDGs reflected their daily dietary practices? If the answer was no, the FGD participants were asked to elaborate on the perceived barriers. Each FGD consisted of 8-12 participants. The demographics of FGD participants were collected before the start of FGD sessions. All FGD proceedings were audio-recorded and transcribed verbatim. Demographic information of participants was analyzed and presented using descriptive statistics. The FGD responses were coded and analyzed based on the main code, the barriers. Barriers to healthy eating in the study area were mainly linked to low production of food, food unavailability and inaccessibility. Specific factors which contributed to the food insecurity situation included; dry and sunny weather, seasonality in food availability, limited resources to secure potential farmland with fences, gender influence on land use, high cost of food, lack of money to purchase food, low income, sale of farm produce with resultant inadequate quantities of food consumed and inappropriate meal composition. Food insecurity was a perceived barrier to healthy eating in the lowlands of the Lake Victoria region. This research suggests the need to address food systems and economic structures to improve food production, distribution, accessibility and consumption in the region. Coding was done with the aid of NVivo8 (QSR International Pty Ltd Version 8, 2008). This study was registered with the Kenyan National Commission for Science Technology and Innovation (NACOSTI/P/18/12634/22291). Key words: Healthy eating, Lake Victoria, barriers, food insecurity, food unavailability, food inaccessibility

REFORMULATION OF SUB JUDICE RULE AND PRIOR RESTRAINT OF PUBLICATIONS RESOLVED: A VICTORY FOR PRESS FREEDOM Midi Television (Pty) Ltd v Director of Public Prosecution (Western Cape) 2007 9 BCLR 958 (SCA)

In order to ensure the integrity and accountability of an emerging constitutional democracy, a free and open press is of critical importance. Lately, there has been a growing judicial distrust in the media, with a discernible trend towards “the erosion of free press rights” in South Africa (Danay and Foster “The Sins of the Media: The SABC Decision and the Erosion of Free Press Rights” 2006 SAJHR 563). It is submitted that the decision by the Supreme Court of Appeal in Midi Television (Pty) Ltd v Director of Public Prosecution (Western Cape) is a victory for the protection of press and media freedom, which will stem the descent into legal censorship. The issue for decision by the court was the extent to which freedom of expression (s 16(1) of the Constitution of the Republic of SouthAfrica, 1996 (hereinafter “the Constitution”)) may be limited to protect the preservation of the administration of justice and the right to a fair trial (s 34 of the Constitution). In his determination of this issue, Nugent JA reformulated the sub judice rule and dealt with the prior restraint of allegedly defamatory statements by the press. The aim of this note is to evaluate the judgment and the potential ramifications for freedom of the press and the media.

Development of an artificial intelligence model for predicting the likelihood of human embryo euploidy based on blastocyst images from multiple imaging systems during IVF.

Development of an artificial intelligence model for predicting the likelihood of human embryo euploidy based on blastocyst images from multiple imaging systems during IVF.

Concurrent 19. Presentation for: Developing an in-depth understanding of PFAS to deliver an effective remediation strategy

Presented on Wednesday 18 May: Session 19 Esso Australia Resources Pty Ltd and BHP Petroleum (Bass Strait) Pty Ltd own a range of offshore and onshore hydrocarbon production facilities, which have been operated by Esso Australia Pty Ltd (Esso) for over 50 years. The Longford Fire Training Ground (FTG) is located adjacent to the Longford Plants and has been utilised by Esso for many years to train personnel in practical hydrocarbon firefighting skills, including applying firefighting foams to extinguish liquid hydrocarbon pool fires. In line with historical standard oil-field practices, per and polyfluoroalkyl substance (PFAS) containing firefighting foams were used at the Longford FTG. In response to the reported use of these foams and the potential for contamination associated with historical site operations, the Longford premises were the subject of recent environmental audit and clean-up plans with oversight by an EPA Victoria auditor. Esso engaged a broad range of experts to complete the environmental investigation and develop a remediation action plan that complied with the PFAS National Environmental Management Plan. Key aspects of this project included: understanding the location and setting, with respect to geological conditions and groundwater impacts; development of remediation objectives and strategy; identification of practical remediation methods including short-term and longer-term measures to mitigate priority PFAS sources within the FTG; and a planning framework for future management of the premises. This paper shares how a responsible operator applies a disciplined and scientifically based environmental approach to further the state of knowledge on practical PFAS remediation methods and achieve a sustainable environmental outcome in the communities that they operate in. To access the presentation click the link on the right. To read the full paper click here

Concurrent 14. Presentation for: The transformation of Australia’s first commercial CSG field into a major gas project: how innovation and subsurface understanding has driven its success

Presented on Wednesday 18 May: Session 14 Mount Isa Mines Limited discovered coal seam gas (CSG) in the ‘Dawson Valley’ in 1991. It was the first commercial coal seam gas field in Australia, with production and sales of gas commencing circa 1994, then operated by Conoco and known as Meridian SeamGas. In 2010, Westside Corporation acquired a 51% operating interest in Meridian SeamGas from Anglo American (Anglo) and Mitsui Moura Investment Pty Ltd (MMI). Over the last 10 years, Westside has increased sales by 466% from 9 terajoules per day (TJ/d) to 42 TJ/d with gas being sold to both domestic and export markets. Further acreage acquisition to the north and south increased the asset area by 264%; now known as the Greater Meridian Fields (GMF). The steep rise in gas demand, complex market dynamics, regulatory environment, and competition from large global oil and gas operators makes it a challenging environment for smaller gas producers in Australia. Remaining agile and employing innovative approaches to optimise field development are key factors for Westside’s growth. In particular, the pad-based drilling of up dip multi-lateral wells has reduced cost and surface footprint, while enabling more efficient gas drainage. To support this field development, a more robust subsurface framework was required. Adequate knowledge of the distribution and variability of coal thickness, gas content/composition, structure, and geohazards forms the basis of the static model. It is used for resource definition and for the optimal planning and execution of multi-lateral wells, reducing drilling risks. To access the presentation click the link on the right. To read the full paper click here

ESG Poster ESG10: Key lessons in planning for proactive decommissioning – a review of the Thevenard Island decommissioning project

Poster ESG10 Chevron Australia Pty Ltd (CAPL) has operated an oil and gas production facility on Thevenard Island (TVI), a gazetted Nature Reserve, since 1988 on behalf of the TVI Joint Venture. CAPL is currently decommissioning the asset following cessation of production in 2014. Decommissioning activities include plugging and abandonment of onshore and offshore production wells, decommissioning onshore infrastructure and facilities, decommissioning offshore platforms and pipelines, and remediating and rehabilitating the terrestrial environment. CAPL is currently undertaking decommissioning and retirement of its facilities on TVI, including remediation and rehabilitation activities. CAPL is committed to progressing the decommissioning and rehabilitation activities in a timely manner to deliver positive outcomes for environment, local community and other users of TVI. Delivering on historical commitments and applying best practice to ensure the lease area can be relinquished as a functioning and sustainable ecosystem is key to being a responsible operator and maintaining social licence to operate. This paper will provide an overview of decommissioning activities and progress to date, with a focus on onshore operations, and discuss challenges encountered as well as lessons learnt from decommissioning planning and sequencing, implementation of the regulatory framework and in-field execution. To access the poster click the link on the right. To read the full paper click here

ESG Poster ESG11: Lighting the way

Poster ESG11 Historically, Chevron Australia Pty Ltd have utilised Mobile Diesel Lighting Towers (MDLTs), with ‘turtle friendly’ luminaires at the Gorgon natural gas project (located on Barrow Island, Western Australia), operated by Chevron Australia on behalf of a joint venture of the Australian subsidiaries of Chevron (47.3%), ExxonMobil (25%), Shell (25%), Osaka Gas (1.25%), Tokyo Gas (1%) and JERA (0.417%). MDLTs are a known, relatively safe and reliable light source that can be utilised in most locations, though they emit noise, odour, vibrations, waste hydrocarbons and CO2 as well as requiring regular refuelling and general engine maintenance. With recent and significant improvements in solar energy harvest, and battery storage efficiencies, Mobile Solar Lighting Towers (MSLTs) have technical and performance characteristics that are comparable, and in many instances superior, to MDLTs. In addition to these characteristics, Chevron Australia has successfully worked with its Australian supplier, conducting trials on site to introduce a range of additional design and performance improvements. These improvements include simple Human–Machine Interface (HMI) touch screen interface allowing remote automation through WiFi or 4G, real-time battery and performance monitoring, CCTV, geofencing and GPS tracking. The benefits of replacing just 25 owned MDLTs with solar includes the abatement of over 600 tonnes of CO2 and direct operational cost savings of almost A$50 000 per year (not including indirect cost savings or avoided carbon emissions costs). Further, net present value calculations demonstrate a financial benefit exceeding A$1 000 000 over 5 years when the solar towers are leased compared with maintaining existing or purchasing new diesel units. These MSLT units are delivering environmental benefits, direct and indirect financial savings, and reduced health, safety and environment risk, which have been welcomed by the on-site workforce. To access the poster click the link on the right. To read the full paper click here

Australian Transfer-Pricing in the Aftermath of Glencore Investment Pty Ltd v Commissioner of Taxation of the Commonwealth of Australia (2019)

Glencore Investment Pty Ltd v Commissioner of Taxation of the Commonwealth of Australia (2019) 272 FCR 30 has dominated the Australian transfer pricing landscape for the past two years, with international tax specialists awaiting the outcome with great anticipation. The decision in the Federal Court of Australia and its subsequent appeal to the Full Federal Court and the High Court are of great importance to Australian transfer pricing due to its direct implications on the Australian Commissioner of Taxation’s powers of reconstruction. While dealing with older statutory legislation, the insights of the court and the methods utilised to come to a decision have the potential to provide a strong interpretative precedent in future transfer pricing disputes. It is the opinion of the author that the outcome in Glencore will affect the current transfer pricing regime despite the gradual strengthening of the Commissioner of Taxation’s powers under the new legislation. This article revisits the decision in Glencore and aims to provide a frame of reference for the use of members of the tax community and other individuals interested in understanding the context of the appeal and the implications this will have for Australian transfer pricing.

1415-P: Risk–Benefit Data from the Worldwide EndoBarrier (EB) Registry

Uncertainty exists re risk:benefit of proximal intestinal exclusion with EB, a novel endoscopic duodenal jejunal liner device for obesity, both with and without diabetes. In view of this, during 2017, an independent, secure, on line registry was established under the auspices of the Association of British Clinical Diabetologists, for the collection of safety and efficacy data worldwide. As of December 2021, data had been entered on 10patients {age 52.1 ± 10.3 year, 53% male, 87% diabetes, BMI 41.1 ± 8.9 kg/m2} and showed many benefits (Table 1) . There were 43 (4.2%) SAEs and 139 (13.9%) less serious AEs (Table 2) . All SAE patients made a full recovery and most derived significant benefit. The benefits of EB therapy are likely to reduce the complications of diabetes. This international data from the EB registry suggests that the likely benefits of EB, far outweigh the risks Disclosure R.E.J. Ryder: None. J.P. Teare: None. A. Ruban: None. M. Haluzik: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Lilly Diabetes, Novartis AG. L. Munro: None. H. Frydenberg: None. J.J. McMaster: None. S. Fishman: None. R.V. Cohen: Advisory Panel; GI Dynamics. Research Support; Johnson &amp; Johnson, Medtronic. C.M. Aboud: None. G.J. Holtmann: Research Support; AbbVie Inc., Allergan, Arena Pharmaceuticals, Inc., Bayer, Bristol Myers, Datapharm Australia Pty Ltd Commonwealth Laboratories, Pty Limited, Eli Lilly Australia Pty Limited, F.Hoffmann-La Roche Limited, Falk Foundation, Falk GmbH and Co Kg, GI Therapies Pty Ltd, Gilead Sciences Pty Limited, MedImmune Ltd Celgene Pty Limited, Mylan, Nestle Pty Ltd, Prometheus Laboratories, Quintiles Pty Limited, Servatus, Takeda Development Center Asia, Pty Ltd, Vital Food Processors Ltd. C. de Jonge: None. J. Greve: Advisory Panel; GI Dynamics. Other Relationship; Bariatric Solutions International, Ethicon, Inc. J.C. Mason: None. H. Sourij: Advisory Panel; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Daiichi Sankyo, Eli Lilly and Company, Merck Sharp &amp; Dohme Corp., Novo Nordisk. Research Support; Boehringer Ingelheim International GmbH, Sanofi. Speaker's Bureau; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp &amp; Dohme Corp., Novartis AG, Novo Nordisk. R. Drummond: Research Support; Fractyl Health, Inc. Speaker's Bureau; AstraZeneca, Bristol-Myers Squibb Company. B. McGowan: Advisory Panel; Johnson &amp; Johnson, Lilly, Novo Nordisk. Research Support; Novo Nordisk. Speaker's Bureau; AstraZeneca, Novo Nordisk. Stock/Shareholder; Reset Health. S.A. Amiel: Advisory Panel; Medtronic, Novo Nordisk. Other Relationship; Sanofi. M. Yadagiri: None. P. Sen Gupta: None. K. Laubner: None. J. Seufert: Advisory Panel; Abbott, Sanofi-Aventis Deutschland GmbH. Research Support; Boehringer Ingelheim International GmbH. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Lilly, Novo Nordisk, Sanofi-Aventis Deutschland GmbH. Funding Association of British Clinical Diabetologists

AES Engineering forms new company in Australia

In a move that is in line with its ongoing global growth strategy, UK-based AES Engineering Group Ltd has formed a partnership with two companies in New South Wales (NSW), Australia, to launch new company Aesseal NSW Pty Ltd.

The lung microbiome in HIV-positive patients with active pulmonary tuberculosis

Tuberculosis poses one of the greatest infectious disease threats of our time, especially when associated with human immunodeficiency virus (HIV) infection. Very little data is available on the lung microbiome in pulmonary tuberculosis (PTB) in HIV-positive patients. Three patient cohorts were studied: (i) HIV-positive with no respiratory disease (control cohort), (ii) HIV-positive with pneumonia and (iii) HIV-positive with PTB. Sputum specimens were collected in all patients and where possible a paired BALF was collected. DNA extraction was performed using the QIAamp DNA mini kit (QIAGEN, Germany) and extracted DNA specimens were sent to Inqaba Biotechnical Industries (Pty) Ltd for 16S rRNA gene sequence analysis using the Illumina platform (Illumina Inc, USA). Data analysis was performed using QIMME II and R Studio version 3.6.2 (2020). The lung microbiomes of patients with PTB, in the context of HIV co-infection, were dominated by Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes. Loss of biodiversity and dysbiosis was found in these patients when compared to the HIV-positive control cohort. Microbial community structure was also distinct from the control cohort, with the dominance of genera such as Achromobacter, Mycobacterium, Acinetobacter, Stenotrophomonas and Pseudomonas in those patients with PTB. This is the first study to describe the lung microbiome in patients with HIV and PTB co-infection and to compare findings with an HIV-positive control cohort. The lung microbiomes of patients with HIV and PTB were distinct from the HIV-positive control cohort without PTB, with an associated loss of microbial diversity.

Developing an in-depth understanding of PFAS to deliver an effective remediation strategy

Esso Australia Resources Pty Ltd and BHP Petroleum (Bass Strait) Pty Ltd own a range of offshore and onshore hydrocarbon production facilities, which have been operated by Esso Australia Pty Ltd (Esso) for over 50 years. The Longford Fire Training Ground (FTG) is located adjacent to the Longford Plants and has been utilised by Esso for many years to train personnel in practical hydrocarbon firefighting skills, including applying firefighting foams to extinguish liquid hydrocarbon pool fires. In line with historical standard oil-field practices, per and polyfluoroalkyl substance (PFAS) containing firefighting foams were used at the Longford FTG. In response to the reported use of these foams and the potential for contamination associated with historical site operations, the Longford premises were the subject of recent environmental audit and clean-up plans with oversight by an EPA Victoria auditor. Esso engaged a broad range of experts to complete the environmental investigation and develop a remediation action plan that complied with the PFAS National Environmental Management Plan. Key aspects of this project included: understanding the location and setting, with respect to geological conditions and groundwater impacts; development of remediation objectives and strategy; identification of practical remediation methods including short-term and longer-term measures to mitigate priority PFAS sources within the FTG; and a planning framework for future management of the premises. This paper shares how a responsible operator applies a disciplined and scientifically based environmental approach to further the state of knowledge on practical PFAS remediation methods and achieve a sustainable environmental outcome in the communities that they operate in.

Key lessons in planning for proactive decommissioning – a review of the Thevenard Island decommissioning project

Chevron Australia Pty Ltd (CAPL) has operated an oil and gas production facility on Thevenard Island (TVI), a gazetted Nature Reserve, since 1988 on behalf of the TVI Joint Venture. CAPL is currently decommissioning the asset following cessation of production in 2014. Decommissioning activities include plugging and abandonment of onshore and offshore production wells, decommissioning onshore infrastructure and facilities, decommissioning offshore platforms and pipelines, and remediating and rehabilitating the terrestrial environment. CAPL is currently undertaking decommissioning and retirement of its facilities on TVI, including remediation and rehabilitation activities. CAPL is committed to progressing the decommissioning and rehabilitation activities in a timely manner to deliver positive outcomes for environment, local community and other users of TVI. Delivering on historical commitments and applying best practice to ensure the lease area can be relinquished as a functioning and sustainable ecosystem is key to being a responsible operator and maintaining social licence to operate. This paper will provide an overview of decommissioning activities and progress to date, with a focus on onshore operations, and discuss challenges encountered as well as lessons learnt from decommissioning planning and sequencing, implementation of the regulatory framework and in-field execution.

The transformation of Australia’s first commercial CSG field into a major gas project: how innovation and subsurface understanding has driven its success

Mount Isa Mines Limited discovered coal seam gas (CSG) in the ‘Dawson Valley’ in 1991. It was the first commercial coal seam gas field in Australia, with production and sales of gas commencing circa 1994, then operated by Conoco and known as Meridian SeamGas. In 2010, Westside Corporation acquired a 51% operating interest in Meridian SeamGas from Anglo American (Anglo) and Mitsui Moura Investment Pty Ltd (MMI). Over the last 10 years, Westside has increased sales by 466% from 9 terajoules per day (TJ/d) to 42 TJ/d with gas being sold to both domestic and export markets. Further acreage acquisition to the north and south increased the asset area by 264%; now known as the Greater Meridian Fields (GMF). The steep rise in gas demand, complex market dynamics, regulatory environment, and competition from large global oil and gas operators makes it a challenging environment for smaller gas producers in Australia. Remaining agile and employing innovative approaches to optimise field development are key factors for Westside’s growth. In particular, the pad-based drilling of up dip multi-lateral wells has reduced cost and surface footprint, while enabling more efficient gas drainage. To support this field development, a more robust subsurface framework was required. Adequate knowledge of the distribution and variability of coal thickness, gas content/composition, structure, and geohazards forms the basis of the static model. It is used for resource definition and for the optimal planning and execution of multi-lateral wells, reducing drilling risks.

Lighting the way

Historically, Chevron Australia Pty Ltd have utilised Mobile Diesel Lighting Towers (MDLTs), with ‘turtle friendly’ luminaires at the Gorgon natural gas project (located on Barrow Island, Western Australia), operated by Chevron Australia on behalf of a joint venture of the Australian subsidiaries of Chevron (47.3%), ExxonMobil (25%), Shell (25%), Osaka Gas (1.25%), Tokyo Gas (1%) and JERA (0.417%). MDLTs are a known, relatively safe and reliable light source that can be utilised in most locations, though they emit noise, odour, vibrations, waste hydrocarbons and CO2 as well as requiring regular refuelling and general engine maintenance. With recent and significant improvements in solar energy harvest, and battery storage efficiencies, Mobile Solar Lighting Towers (MSLTs) have technical and performance characteristics that are comparable, and in many instances superior, to MDLTs. In addition to these characteristics, Chevron Australia has successfully worked with its Australian supplier, conducting trials on site to introduce a range of additional design and performance improvements. These improvements include simple Human–Machine Interface (HMI) touch screen interface allowing remote automation through WiFi or 4G, real-time battery and performance monitoring, CCTV, geofencing and GPS tracking. The benefits of replacing just 25 owned MDLTs with solar includes the abatement of over 600 tonnes of CO2 and direct operational cost savings of almost A$50 000 per year (not including indirect cost savings or avoided carbon emissions costs). Further, net present value calculations demonstrate a financial benefit exceeding A$1 000 000 over 5 years when the solar towers are leased compared with maintaining existing or purchasing new diesel units. These MSLT units are delivering environmental benefits, direct and indirect financial savings, and reduced health, safety and environment risk, which have been welcomed by the on-site workforce.

Safety and efficacy of BCG re-vaccination in relation to COVID-19 morbidity in healthcare workers: A double-blind, randomised, controlled, phase 3 trial

SummaryBackgroundBCG vaccination prevents severe childhood tuberculosis (TB) and was introduced in South Africa in the 1950s. It is hypothesised that BCG trains the innate immune system by inducing epigenetic and functional reprogramming, thus providing non-specific protection from respiratory tract infections. We evaluated BCG for reduction of morbidity and mortality due to COVID-19 in healthcare workers in South Africa.MethodsThis randomised, double-blind, placebo-controlled trial recruited healthcare workers at three facilities in the Western Cape, South Africa, unless unwell, pregnant, breastfeeding, immunocompromised, hypersensitivity to BCG, or undergoing experimental COVID-19 treatment. Participants received BCG or saline intradermally (1:1) and were contacted once every 4 weeks for 1 year. COVID-19 testing was guided by symptoms. Hospitalisation, COVID-19, and respiratory tract infections were assessed with Cox proportional hazard modelling and time-to-event analyses, and event severity with post hoc Markovian analysis. This study is registered with ClinicalTrials.gov, NCT04379336.FindingsBetween May 4 and Oct 23, 2020, we enrolled 1000 healthcare workers with a median age of 39 years (IQR 30–49), 70·4% were female, 16·5% nurses, 14·4% medical doctors, 48·5% had latent TB, and 15·3% had evidence of prior SARS-CoV-2 exposure. Hospitalisation due to COVID-19 occurred in 15 participants (1·5%); ten (66·7%) in the BCG group and five (33·3%) in the placebo group, hazard ratio (HR) 2·0 (95% CI 0·69–5·9, p = 0·20), indicating no statistically significant protection. Similarly, BCG had no statistically significant effect on COVID-19 (p = 0·63, HR = 1·08, 95% CI 0·82–1·42). Two participants (0·2%) died from COVID-19 and two (0·2%) from other reasons, all in the placebo group.InterpretationBCG did not protect healthcare workers from SARS-CoV-2 infection or related severe COVID-19 disease and hospitalisation.FundingFunding provided by EDCTP, grant number RIA2020EF-2968. Additional funding provided by private donors including: Mediclinic, Calavera Capital (Pty) Ltd, Thys Du Toit, Louis Stassen, The Ryan Foundation, and Dream World Investments 401 (Pty) Ltd. The computations were enabled by resources in project SNIC 2020–5–524 provided by the Swedish National Infrastructure for Computing (SNIC) at UPPMAX, partially funded by the Swedish Research Council through grant agreement No. 2018–05,973.

The Use of Self-Assembling Peptides (PuraStat™) in Functional Endoscopic Sinus Surgery for Haemostasis and Reducing Adhesion Formation. A Case Series of 94 Patients

Introduction: Functional endoscopic sinus surgery (FESS) is a treatment option for patients with chronic rhinosinusitis. Bleeding and adhesions are common complications postoperatively. Objective: To assess the effectiveness of PuraStat™ (3-D Matrix Medical Technology Pty Ltd, Melbourne, Australia) for use in FESS to achieve haemostasis and reduce adhesion formation. Materials and Methods: A retrospective chart review over four years was performed on 94 patients undergoing FESS by a single surgeon, using PuraStat™ in absence of nasal packing. Results: Twenty-eight patients underwent complete FESS and 66 cases limited FESS most often combined with nasal surgery. Six patients had bleeding postoperatively, of which only four required additional treatment (4.25%). Twenty-three patients (24.47%) required debridement during the follow up, simply performed by suction for 13 or by scissors for 10. No patient required revision surgery for adhesion. Conclusion: PuraStat™ used for the first time in context of FESS seems to be effective in achieving haemostasis, reducing adhesion formation, and avoiding nasal packing in most patients.

Geological and geotechnical investigations for the Salang highway, Afghanistan

The present road over the Hindu Kush Mountain Range via the Salang Pass (termed the Salang Corridor) links the south of Afghanistan, including the capital Kabul, with northern Afghanistan and Central Asia. It is the only route that allows year-round north–south passage of goods and people across the mountain range. However, the present road has suffered years of neglect and is now in a state of serious disrepair. In 2012, the United States Agency for International Development completed a study examining potential alternative routes. Three routes were selected for in-depth study and detailed engineering design. In mid-2017 SMEC International Pty Ltd were appointed to carry out a feasibility study to recommend the most suitable of the three routes and to then carry out a detailed design of the chosen route. This paper outlines the geological and geotechnical studies carried out during the project with a focus on investigations for the detailed design phase, and presents the geotechnical design recommendations arising from those investigations. This paper also explains the difficulties involved in carrying out the investigations including security issues, harsh weather conditions, and maintaining effective communication between the project team both in Afghanistan and around the globe during the COVID-19 pandemic.