Summary
Background
With the development of direct‐acting anti‐virals (DAAs), almost all patients with chronic hepatitis C virus (HCV) infection can achieve sustained viral response (SVR).
Aim
To ...evaluate the short‐term risk of HCC among patients with SVR by DAAs, including those with cirrhosis or previous HCC.
Methods
This large‐scale, multicentre cohort study included 1,675 consecutive patients who achieved SVR by treatment with interferon‐free sofosbuvir‐based regimens, divided into groups with (n = 152) or without previous HCC (n = 1,523). The Kaplan‐Meier method and Cox proportional hazard analysis were used to calculate the cumulative HCC incidence and related factors of HCC.
Results
During the follow‐up period (median: 17 months), 46 (2.7%) patients developed HCC. The 1‐year cumulative rates of de novo HCC were 0.4% and 4.9% for the noncirrhosis and cirrhosis groups respectively (log‐rank test: P < 0.001). For cirrhotic patients, serum α‐fetoprotein level at the end of treatment (EOT‐AFP) was the strongest predictor of de novo HCC. The 1‐year cumulative de novo HCC rates were 1.4% and 13.1% in the EOT‐AFP < 9.0 ng/mL and ≥ 9.0 ng/mL groups (cut‐off value) respectively (log‐rank test: P < 0.001). The 1‐year cumulative rates of HCC recurrence were 6.5% and 23.1% for the noncirrhosis and cirrhosis groups respectively (log‐rank test: P = 0.023). For cirrhotic patients, previous HCC characteristics were significantly associated with HCC recurrence. In contrast, sex, age and metabolic features did not influence de novo HCC or recurrence.
Conclusions
For cirrhotic patients after elimination of HCV, serum EOT‐AFP level and previous HCC characteristics would be useful markers for predicting de novo HCC or recurrence.
Linked ContentThis article is linked to Tan and Lim paper. To view this article visit https://doi.org/10.1111/apt.14437.
Ultrahigh-energy density (UHED) states greater than 1 Gbar pressure are typically observed under extreme conditions, such as in the core of an inertial confinement fusion implosion. A novel ...alternative approach for generating volumetric UHED states is to use nanowire arrays irradiated with a femtosecond ultrahigh-intensity laser. In this paper, we present an experimental investigation on laser absorption and energy transport in nanowire arrays irradiated with a picosecond kilojoule petawatt laser. The laser–target interactions were studied by measuring the x-ray emission and escaping hot electrons from a bare Cu foil and a foil with a nanowire array grown on its surface. The measured Cu-Kα and He-α emissions from the nanowire array were higher than those from the flat foil. In addition, hot electrons observed from the front surface of the nanowire array were enhanced. On the other hand, despite the stronger Kα emission from the nanowire array and the enhancement of hot electrons escaping from the front surface of the nanowire array, the number of hot electrons observed from the rear side of the flat foil target was slightly lower than that of the flat foil. A comparison of the experimental results with the results of a two-dimensional particle-in-cell simulation code suggested that the magnetic fields generated around the periodic nanowire array trap hot electrons, improving the electron-to-target energy coupling and efficiently producing UHED states.
Abstract
The High Energy Accelerator Research Organization (KEK) has two light sources: Photon Factory (PF, 2.5 GeV) and Photon Factory Advanced Ring (PF-AR, 6.5 GeV). In 2017, the operation of a new ...beam transport line (BT) of PF-AR was started, and the simultaneous top-up injection for both PF and PF-AR was realized. These days, there have been strong demands for the reduction of the operating cost of accelerators, and its importance is greater in PF-AR with higher ring-energy of 6.5 GeV. In 2019, the 5 GeV operation was started in PF-AR. However, the new BT of PF-AR (ARBT) was designed for the energy of 6.5 GeV, then the simultaneous top-up injection is no longer available under the condition of 5 GeV operation of PF-AR and 2.5 GeV operation of PF. In order to mitigate this impact, the pseudo-top-top injection has been employed by fine-tuning the current of a common DC bending magnet placed at the intersection of ARBT and the BT of PF (PFBT) within a given time frame. However, this scheme reduces the flexibility of the operation schedules, and will not be able to respond adequately to low emittance optics of PF-AR that may bring the shorter beam lifetime. In order to realize true-top-up injection, a modification of BTs’ optics design was carried out to add new horizontal steering magnets and a flattened-duct. The beam commissioning succeeded and the application to the user-run will start in this May. This time, details of modification and its extended plan will be presented.
Abstract
In recent years, there has been an increasing demand for high-intensity beams in the field of electron beam irradiation. This includes mass production of nuclear medicine examinations using
...99
Mo and high-efficiency production through material modification via material irradiation. Although superconducting cavities can achieve high-current beam acceleration, a compact accelerator is desirable for general-purpose irradiation beams. In this paper, we designed a practical 10 MeV, 50 mA high-current beam irradiator using a new Nb
3
Sn superconducting cavity.
Background
Anaphylaxis is a life‐threatening syndrome resulting from the sudden release of mast cell‐ and basophil‐derived mediators into the circulation. However, pathological evidence of the ...association between inflammatory mediators and human anaphylaxis is insufficient.
Objective
The aim of this study was to better understand the relationship between in vivo production of inflammatory mediators and the pathogenesis of anaphylaxis. We also sought to evaluate mast cell activation in anaphylaxis.
Methods
We measured the concentrations of various inflammatory mediators in urine samples, which were collected from 32 anaphylactic patients during the onset of anaphlaxis and during clinical remission, 21 patients with asthma on acute exacerbation and 15 healthy control subjects. Blood and urine specimens were collected from the patients after provocation test. Urinary leukotriene E4 (LTE4), 9α, 11β‐prostaglandin F2 (9α, 11β‐PGF2), eosinophil‐derived neurotoxin (EDN) and leukotriene B4 glucuronide (LTBG) concentrations were determined by enzyme immunoassay, and the activity of plasma platelet‐activating factor acetylhydrolase and serum tryptase concentration were measured using commercially available kits.
Results
Significantly higher concentrations of urinary LTE4 and 9α, 11β‐PGF2, which immediately decreased during clinical remission, were observed in the anaphylactic patients than in asthmatic patients on acute exacerbation and healthy control subjects. Concentrations of EDN and LTBG were not significantly different among the anaphylactic patients, asthmatic patients on acute exacerbation and healthy subjects. There was a significant correlation between urinary LTE4 and 9α, 11β‐PGF2 concentrations in the anaphylactic patients (r=0.672, P=0.005, n=32). In addition, LTE4 concentration in patients with anaphylactic shock is significantly elevated compared with that in patients without anaphylactic shock.
Conclusions
This is a report on the significant increase in urinary LTE4 and 9α, 11β‐PGF2 concentrations during anaphylaxis. Urinary LTE4 and 9α, 11β‐PGF2 concentrations may be a reliable marker of endogenous production of inflammatory mediators associated with anaphylaxis.
Abstract
Infrared (IR) SASE-FEL emission was successfully generated for macro pulses of about 1 μs with the maximum repetition rate of 5 Hz at the cERL. In the future, high-power FEL operation will ...be planned to increase electron bunches drastically with energy recovery. Therefore, the dump line was redesigned and reconstructed to increase the momentum acceptance and to improve the magnet system for avoiding serious beam loss in the high power FEL operation. Furthermore, the first beam-transport study was performed by transporting the beam directly from the injector to the beam dump through the reconstructed dump line. In this paper, we present the reconstructed dump line and the beam-transport study. The new dump line can be a model for dump lines of high-power ERL-FELs.
This study aimed to assess the association between airflow limitation (AL) severity and reduced bone mineral density (BMD) in Japanese men.
This cross-sectional study included 290 subjects aged over ...40 years (mean age 72.0, SD 11.6), who underwent a comprehensive health examination, including spirometry and measurement of BMD at the left femoral neck using dual-energy X-ray absorptiometry (DXA), between 2016 and 2017 at Japanese Red Cross Kumamoto Health Care Center. AL was defined as forced expiratory volume in one second (FEV
)/forced vital capacity (FVC) of <0.7. Reversibility tests were not performed in this study. The criteria used for the AL staging were developed according to the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines. The subjects were divided into the following three groups: a control group (normal pulmonary function), GOLD Stage I group (mild AL), and GOLD Stage II-IV group (moderate-to-very severe AL). BMD was classified based on the young adult mean (YAM) as normal (88.6% ≦ YAM -1 SD ≦), osteopenia (70% <YAM <88.6% <- 1 SD and > -2.5 SD), or osteoporosis (YAM ≦ 70% ≦ -2.5 SD). Reduced BMD was defined as osteopenia, osteoporosis, or medication used for osteoporosis. Logistic regression analysis was used to assess the association between AL severity and the reduced BMD.
The prevalence of reduced BMD in subjects with moderate-to-severe AL (76.2%) was significantly higher than in those without AL (47.9%) (
=0.030). In logistic regression models adjusted for age, body mass index, pack-years, physical activity, and alcohol drinking, the risk of reduced BMD (odds ratio: 3.87; 95% confidence interval: 1.20-12.49;
=0.024) was significantly higher in subjects with moderate-to-severe AL than in those with normal pulmonary function.
Present results suggest that reduced BMD is associated with AL severity in Japanese men.
The purpose of this study was to estimate the prevalence of subjects with chronic cough and phlegm and describe their characteristics including the presence or absence of airflow limitation among the ...general population in Japan.
This was an observational cross-sectional survey targeting multiple regions of Japan. Subjects aged 40 years or above who were undergoing comprehensive health examination were recruited. The existence of chronic cough and phlegm, airflow limitation, and treatment for respiratory diseases were examined. Chronic cough and phlegm were defined as having both symptoms for at least 3 months of the year and for at least 2 consecutive years, or as receiving any treatment for chronic bronchitis at the time of recruitment. Airflow limitation was defined as forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) less than 0.7.
In a total of 22,293 subjects, 380 subjects (1.7%) had chronic cough and phlegm. Among these 380 subjects, 21.8% received treatment for a respiratory disease, and 11.6% had airflow limitation. Compared to subjects without both chronic cough and phlegm but with airflow limitation, subjects with chronic cough and phlegm without airflow limitation were younger, more likely to be current smokers (39.6%), and had higher total scores on a chronic obstructive pulmonary disease (COPD) assessment test (CAT). Scores of CAT questions 1-4 (cough, phlegm, chest tightness, breathlessness, respectively) were higher in subjects with chronic cough and phlegm regardless of airflow limitation.
This study demonstrated that subjects identified to have chronic cough and phlegm in comprehensive health examination settings were symptomatic, while most of them did not receive any treatment for respiratory diseases and did not have airflow limitation. Screening subjects for chronic cough and phlegm in a comprehensive health examination followed by a detailed examination of screened subjects could be an effective approach for better management of chronic cough and phlegm. Smoking cessation should be included in the management, in consideration that around 40% of subjects with chronic cough and phlegm were current smokers.
Context. Erythromelalgia is a rare disorder characterized by reddening, severe burning pain, and swelling of the extremities. Food poisoning by Clitocybe acromelalga, a poisonous mushroom, is known ...to induce erythromelalgia; however, its treatment protocol remains unclear. We describe here three cases of erythromelalgia following the consumption of C. acromelalga with varying clinical courses. Case details. Of the three patients, the first patient presented 22 days after the onset of erythromelalgia; although he was treated with aspirin, numbness in the limbs persisted as sequela. Patient 2 presented at 3 days after the symptomatic onset and was immediately treated with high-dose intravenous nicotinic acid, with a dramatic symptomatic improvement. Patient 3, who had milder symptoms, spontaneously recovered within a week without any treatment. Discussion. The clinical manifestations and varying clinical courses associated with C. acromelalga toxicity are discussed here, with the pathogenesis of this mycotoxin and a potential treatment. Detailed interviews of such patients are important, particularly because of the remarkably slow course of this mycotoxin as compared with common food poisonings. Treatment with intravenous nicotinic acid was associated with improvement in one patient. We believe that this painful disorder might thus be treatable, although the mechanism underlying the treatment remains unclear.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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