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•DAAs have dramatically improved the outcome of cirrhotic patients with HCV infection.•Since the advent of DAAs there has been a 50% decline in the number of liver transplants.•At ...least 600 liver grafts every year can currently be allocated to indications other than HCV.•Survival of LT recipients with HCV or HBV infection is currently comparable, because of DAAs.
Direct-acting antivirals (DAAs) have dramatically improved the outcome of patients with hepatitis C virus (HCV) infection including those with decompensated cirrhosis (DC). We analyzed the evolution of indications and results of liver transplantation (LT) in the past 10 years in Europe, focusing on the changes induced by the advent of DAAs.
This is a cohort study based on data from the European Liver Transplant Registry (ELTR). Data of adult LTs performed between January 2007 to June 2017 for HCV, hepatitis B virus (HBV), alcohol (EtOH) and non-alcoholic steatohepatitis (NASH) were analyzed. The period was divided into different eras: interferon (IFN/RBV; 2007-2010), protease inhibitor (PI; 2011-2013) and second generation DAA (DAA; 2014-June 2017).
Out of a total number of 60,527 LTs, 36,382 were performed in patients with HCV, HBV, EtOH and NASH. The percentage of LTs due to HCV-related liver disease varied significantly over time (p <0.0001), decreasing from 22.8% in the IFN/RBV era to 17.4% in the DAA era, while those performed for NASH increased significantly (p <0.0001). In the DAA era, the percentage of LTs for HCV decreased significantly (p <0.0001) from 21.1% (first semester 2014) to 10.6% (first semester 2017). This decline was more evident in patients with DC (HCV-DC, −58.0%) than in those with hepatocellular carcinoma (HCC) associated with HCV (HCV-HCC, −41.2%). Conversely, three-year survival of LT recipients with HCV-related liver disease improved from 65.1% in the IFN/RBV era to 76.9% in the DAA era, and is now comparable to the survival of recipients with HBV infection (p = 0.3807).
In Europe, the number of LTs due to HCV infection is rapidly declining for both HCV-DC and HCV-HCC indications and post-LT survival has dramatically improved over the last three years. This is the first comprehensive study of the overall impact of DAA treatment for HCV on liver transplantation in Europe.
After the advent of direct-acting antivirals in 2014, a dramatic decline was observed in the number of liver transplants performed both in patients with decompensated cirrhosis due to hepatitis C virus (HCV), minus 60%, and in those with hepatocellular carcinoma associated with HCV, minus 41%. Furthermore, this is the first large-scale study demonstrating that the survival of liver transplant recipients with HCV-related liver disease has dramatically improved over the last three years and is now comparable to the survival of recipients with hepatitis B virus infection. The reduction in HCV-related indications for LT means that there is a greater availability of livers, at least 600 every year, which can be allocated to patients with indications other than HCV.
Hypercholesterolemia is a clinically relevant condition with an ascertained role in atherogenesis. In particular, its presence directly correlates to the risk of atherosclerotic cardiovascular ...disease (ASCVD). As known, cardiovascular diseases pose a significant economic burden worldwide; however, a clear picture of the economic impact of ASCVD secondary to hypercholesterolemia is lacking. This study aiming at conducting a systematic review of the current literature to assess the economic impact of familial hypercholesterolemia (FH), non-familial hypercholesterolemia (non-FH) or mixed dyslipidemia. A literature search was performed in Medline/PubMed and Embase database up to September 1st, 2020, exploring evidence published from 2010. The literature review was conducted in accordance with PRISMA guidelines. To be included the studies must be conducted on people who have been diagnosed with familial hypercholesterolemia, non-familial hypercholesterolemia or mixed dyslipidemia, and report data/information on costs attributable to these conditions and their sequelae. A total of 1260 studies were retrieved. After reading the titles and abstract, 103 studies were selected for full reading and eight met the criteria for inclusion. All but one studies were published in the American continent, with the majority conducted in US. An observational design with a prevalence approach were used and all estimated the economic burden of CVD. Direct cost estimates as annual average health expenditure on all population, ranging from $17 to $259 million. Few studies assessing the economic impact of hypercholesterolemia are available in the literature and new researches are needed to provide a more updated and reliable picture. Despite this scarceness of evidence, this review adds important data for future discussion on the knowledge of the economic impact of hypercholesterolemia and costs of care associated to this condition, with important implication for public health researches and novel therapies implementation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a ...detailed analysis of their effects in large studies is lacking.
Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis.
Between March 1 and June 27, 2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39 of 204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10–23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78–9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31–0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06–3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05–3.67) emerged as associated with death
Twenty-five percent of patients requiring hospitalization for COVID-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.
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The supercritical carbon dioxide extraction of lyophilized berries of Aristotelia chilensis (Mol.) Stuntz was studied as possible pre-treatment for enhanced anthocyanin recovery. Effect of pressure, ...temperature, and process time on the extracted oil yields and on the anthocyanins recovery in the pre-treated fractions were considered. The operating parameters were optimized using the central composite design, and extractions were run in the pressure, temperature, and time ranges of 99.6 to 200.4 bar, 36.6 to 53.4degreesC, and 0.7-2.3 h. The successive multiple regression analysis indicated pressure and time as major influencing parameters on the extraction yield. Those parameters induced no clear changes in the fatty acid composition of almost all the extracted oils, obtaining an average linoleic acid amount between 35-44% weight in the lipophilic fractions. Standardized methanol extractions demonstrated the influence of the different conditions in the SCO.sub.2 pre-treatment processes, resulting in extracted anthocyanin increments ranging from 9 to 26%. Keywords: supercritical carbon dioxide extraction, Aristotelia chilensis (Mol.) Stuntz, fatty acids, anthocyanin, central composite design
We present the first systematic study of the stellar populations of ultra-diffuse galaxies (UDGs) in the field, integrating the large area search and characterization of UDGs by the SMUDGes survey ...with the twelve-band optical photometry of the S-PLUS survey. Based on Bayesian modeling of the optical colors of UDGs, we determine the ages, metallicities, and stellar masses of 100 UDGs distributed in an area of ∼330 deg2 in the Stripe 82 region. We find that the stellar masses and metallicities of field UDGs are similar to those observed in clusters and follow the trends previously defined in studies of dwarf and giant galaxies. However, field UDGs have younger luminosity-weighted ages than do UDGs in clusters. We interpret this result to mean that field UDGs have more extended star formation histories, including some that continue to form stars at low levels to the present time. Finally, we examine stellar population scaling relations that show that UDGs are, as a population, similar to other low surface brightness galaxies.
We present new planetary nebulae (PNe) positions, radial velocities and magnitudes for six early-type galaxies obtained with the Planetary Nebulae Spectrograph (PNS), along with derived ...two-dimensional velocity and velocity dispersion fields, and the α parameters (i.e. the number of PNe per unit luminosity). We also present new deep absorption-line long-slit kinematics for three galaxies in the sample, obtained with the FOcal Reducer and low dispersion Spectrograph (FORS2) at the Very Large Telescope (VLT).
We extend this study to include additional 10 early-type galaxies with PNe radial velocity measurements available from the literature, including previous PNS studies, in order to obtain a broader description of the outer-halo kinematics in early-type galaxies. These data extend the information derived from stellar absorption-line kinematics to typically several and up to 8 effective radii.
The combination of photometry, absorption-line and PNe kinematics shows (i) a good agreement between the PNe number density distribution and the stellar surface brightness in the region where the two data sets overlap; (ii) a good agreement between PNe and absorption-line kinematics; (iii) that the mean rms velocity profiles fall into two groups, with part of the galaxies characterized by slowly decreasing profiles and the remainder having steeply falling profiles; (iv) a larger variety of velocity dispersion radial profiles; (v) that twists and misalignments in the velocity fields are more frequent at large radii, including some fast rotator galaxies; (vi) that outer haloes are characterized by more complex radial profiles of the specific angular momentum-related λR parameter than observed within 1 R
e; (vii) that many objects are more rotationally dominated at large radii than in their central parts and (viii) that the halo kinematics are correlated with other galaxy properties, such as total B band and X-ray luminosity, isophotal shape, total stellar mass, V/σ and α parameter, with a clear separation between fast and slow rotators.
ABSTRACT Objective To estimate a value set for the calculation of Italian-specific quality-adjusted life years (QALYs), based on preferences elicited on EuroQol five-dimensional (EQ-5D) questionnaire ...health states using the time trade-off technique. Methods The revised standard Measurement and Valuation of Health protocol was followed. Twenty-five health states, divided into three groups and given to 450 subjects, were selected to obtain 300 observations per state. Subjects aged 18 to 75 years were recruited to be representative of the Italian general adult population for age, sex, and geographical distribution. To improve efficiency, face-to-face interviews were conducted by using the Computer Assisted Personal Interviewing approach. Several random effects regression models were tested to predict the full set of EQ-5D questionnaire health states. Model selection was based on logical consistency of the estimates, sign and magnitude of the regression coefficients, goodness of fit, and parsimony. Results The model that satisfied the criteria of logical consistency and was more efficient includes 10 main effect dummy variables for the EQ-5D questionnaire domain levels and the D1 interaction term, which accounts for the number of dimensions at levels 2 or 3 beyond the first. This model has an R2 of 0.389 and a mean absolute error of 0.03, which are comparable to or better than those of models used in other countries. The utility estimates after state 11111 range from 0.92 (21111) to −0.38 (33333). Italian utility estimates are higher than those estimated in the United Kingdom and Spain and used so far to assess QALYs and conduct cost-utility evaluations in Italy. Conclusions A specific value set is now available to calculate QALYs for the conduction of health economic studies targeted at the Italian health care system.
ABSTRACT
This paper presents a method for finding ram pressure stripped (RPS) galaxy candidates by performing a morphological analysis of galaxy images obtained from the Legacy survey. We consider a ...sample of about 600 galaxies located in different environments such as groups and clusters, tidally interacting pairs and the field. The sample includes 160 RPS previously classified in the literature into classes from J1 to J5, based on the increasing level of disturbances. Our morphological analysis was done using the astromorphlib software followed by the inspection of diagnostic diagrams involving combinations of different parameters like the asymmetry (A), concentration (C), Sérsic index (n), and bulge strength parameters $F(G,\, M_{20})$. We found that some of those diagrams display a distinct region in which galaxies classified as J3, J4, and J5 decouples from isolated galaxies. We call this region as the morphological transition zone and we also found that tidally interacting galaxies in pairs are predominant within this zone. Nevertheless, after visually inspecting the objects in the morphological transition zone to discard obvious contaminants, we ended up with 33 bona fide new RPS candidates in the studied nearby groups and clusters (Hydra, Fornax, and CLoGS sample), of which one-third show clear evidence of unwinding arms. Future works may potentially further increase significantly the samples of known RPS using such method.
The stellar kinematics of the spheroids and discs of S0 galaxies
contain clues to their formation histories. Unfortunately, it is difficult to disentangle the two components and to recover their ...stellar kinematics in the faint outer parts of the galaxies using conventional absorption line spectroscopy. This paper therefore presents the stellar kinematics of six S0 galaxies derived from observations of planetary nebulae, obtained using the Planetary Nebula Spectrograph. To separate the kinematics of the two components, we use a maximum-likelihood method that combines the discrete kinematic data with a photometric component decomposition. The results of this analysis reveal that: the discs of S0 galaxies are rotationally supported; however, the amount of random motion in these discs is systematically higher than in comparable spiral galaxies; and the S0s lie around one magnitude below the Tully-Fisher relation for spiral galaxies, while their spheroids lie nearly one magnitude above the Faber-Jackson relation for ellipticals. All of these findings are consistent with a scenario in which spirals are converted into S0s through a process of mild harassment or 'pestering,' with their discs somewhat heated and their spheroid somewhat enhanced by the conversion process. In such a scenario, one might expect the properties of S0s to depend on environment. We do not see such an effect in this fairly small sample, although any differences would be diluted by the fact that the current location does not necessarily reflect the environment in which the transformation occurred. Similar observations of larger samples probing a broader range of environments, coupled with more detailed modelling of the transformation process to match the wide range of parameters that we have shown can now be measured, should take us from these first steps to the definitive answer as to how S0 galaxies form.
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