Chronic Hepatitis B Infection: A Review Tang, Lydia S. Y; Covert, Emily; Wilson, Eleanor ...
JAMA : the journal of the American Medical Association,
05/2018, Letnik:
319, Številka:
17
Journal Article
Recenzirano
IMPORTANCE: More than 240 million individuals worldwide are infected with chronic hepatitis B virus (HBV). Among individuals with chronic HBV infection who are untreated, 15% to 40% progress to ...cirrhosis, which may lead to liver failure and liver cancer. OBSERVATIONS: Pegylated interferon and nucleos(t)ide analogues (lamivudine, adefovir, entecavir, tenofovir disoproxil, and tenofovir alafenamide) suppress HBV DNA replication and improve liver inflammation and fibrosis. Long-term viral suppression is associated with regression of liver fibrosis and reduced risk of hepatocellular carcinoma in cohort studies. The cure (defined as hepatitis B surface antigen loss with undetectable HBV DNA) rates after treatment remain low (3%-7% with pegylated interferon and 1%-12% with nucleostide analogue therapy). Pegylated interferon therapy can be completed in 48 weeks and is not associated with the development of resistance; however, its use is limited by poor tolerability and adverse effects such as bone marrow suppression and exacerbation of existing neuropsychiatric symptoms such as depression. Newer agents (entecavir, tenofovir disoproxil, and tenofovir alafenamide) may be associated with a significantly reduced risk of drug resistance compared with older agents (lamivudine and adefovir) and should be considered as the first-line treatment. CONCLUSIONS AND RELEVANCE: Antiviral treatment with either pegylated interferon or a nucleos(t)ide analogue (lamivudine, adefovir, entecavir, tenofovir disoproxil, or tenofovir alafenamide) should be offered to patients with chronic HBV infection and liver inflammation in an effort to reduce progression of liver disease. Nucleos(t)ide analogues should be considered as first-line therapy. Because cure rates are low, most patients will require therapy indefinitely.
While Industry 4.0 has been trending in practice and research, operations management studies in this area remain nascent. Our intent is to understand the current state of research in Industry 4.0 in ...different disciplines and deduce insights and opportunities for future research in operations management. In this paper, we provide a focused analysis to examine the state-of-the-art research in Industry 4.0. To learn about researchers' perspectives about Industry 4.0, we conducted a large-scale, cross-disciplinary and global survey on Industry 4.0 topics among researchers in industrial engineering, operations management, operations research, control and data science at the 9th IFAC MIM 2019 Conference in Berlin in August 2019. By using our survey findings and literature analysis, we build structural and conceptual frameworks to understand the current state of knowledge and to propose future research opportunities for operations management scholars.
Glossary of Abbreviations
AGV: Automated guided vehicle; AI: Artificial intelligence; APS: Advanced planning system: a wide variety of software tools and techniques, with many applications in manufacturing and logistics (including the service sector); BDA: Big data analytics; CAS: Complex adaptive system: a system composed of many interacting parts that evolve and adapt over time; CIM: Computer integrated manufacturing; CPFR: Collaborative planning, forecasting and replenishment; CPS: Cyber-physical system: a seamless integration of computation and physical components; DAMCLS: Decision analysis, modelling, control and learning systems; ERP: Enterprise resource planning; FMS: Flexible manufacturing system; I4.0: Industry 4.0; IFAC: International Federation of Automatic Control: a federation is concerned with the impact of control technology on society; IME: Industrial and mechanical engineering; IoT: Internet-of-Things; IT: Information technology; M2M: Machine-to-machine; MAS: Multi-agent system: a loosely coupled network of software agents that interact to solve problems that are beyond the individual capacities or knowledge of each problem solver; OR: Operations research; RFID: Radio frequency identification: a technology that uses electromagnetic fields to automatically identify and track tags attached to objects; RMS: Reconfigurable manufacturing system: a manufacturing system that can change and evolve rapidly in order to adjust its productivity capacity and functionality; OM: Operations management; T&T: Track and trace system; VCA: VOS viewer co-occurrence analysis: a software tool for visualising bibliometric networks; VMI: Vendor-managed inventory.
Targeting immune checkpoints is a novel approach in cancer therapy. This strategy may trigger immune related adverse events (irAE). We hypothesize that the incidence of irAE will be greater in ...patients receiving immune checkpoint inhibitors (ICI) targeting only immune cells compared to those that also target tumor cells (PD-L1). In addition, we compared the specific irAE profile and overall response rate (ORR) for each ICI by target(s).
We reviewed all ICI cancer clinical trials (90; 174 arms) that reported irAE and were published through MEDLINE. 114 arms from 73 trials were eligible for this meta-analysis (including 11,328 patients). We collected and compared arm-specific data including ICI target, number of patients with irAE of any grade, grade 3+ and grade 5, specific irAE, and ORR. The R package “meta” was used to conduct a meta-analysis to calculate and compare the percentage of patients with irAE and ORR.
The incidence (% of patients) of any grade irAE per ICI target was reported for 40 arms (3418 patients) treated with ICI. Most arms (80%) and patients (53%) studied were on phase 1/2 clinical trials. Patients were treated for solid malignancy on 39 arms (97%), mainly melanoma (40%). Two arms included ICI combinations. The incidence of any grade irAE was higher in patients who received ICI targeting CTLA-4 (53.8%) than PD-1 (26.5%) and PD-L1 ICI (17.1%) (P<0.001). Comparative specific irAE rates were calculated for each ICI target.
Our systematic review supported our mechanistic-driven hypothesis. We encourage investigators to report the incidence of irAE in future ICI combination trials.
More firms than ever before are disclosing the provenance of their products, results of product testing, and suppliers’ compliance with labor‐practice norms in their annual reports, sustainability ...reports, and press releases, besides making such information available on third‐party websites. However, collecting and disclosing such information is not only costly but also does not provide clear benefits. While the terminology is not yet standard in the literature, this study distinguishes supply chain transparency from visibility. Here, visibility refers to managers’ efforts to learn more about operations upstream in their supply chains. In contrast, by transparency, we mean a company disclosing information to consumers, investors, and other stakeholders about compliance with consumer‐expected norms in its supply chain operations and products. To motivate further research on supply chain transparency, we first report recent examples of companies providing supply chain transparency. Then we present potential benefits of supply chain visibility and supply chain transparency, respectively, for the company. Finally, we propose topics for research on supply chain transparency arranged by stakeholder.
Radiative and nonradiative electron spin-flip probabilities are analyzed in both plane wave and focused laser backgrounds. We provide a simple and physically transparent description of spin dynamics ...in plane waves, and demonstrate that there exists a kinematic regime in which the usual leading-order perturbative hierarchy of quantum electrodynamics is reversed, and nonradiative loop effects dominate over radiative tree-level spin flips. We show that while this loop dominance becomes suppressed in focused laser pulses due to a high sensitivity to field geometry, there is nevertheless a regime in which, in principle, loop effects on spin transitions can be discerned.
The topology of pure Bi is controversial because of its very small (∼10 meV) band gap. Here we perform high-resolution angle-resolved photoelectron spectroscopy measurements systematically on 14-202 ...bilayer Bi films. Using high-quality films, we succeed in observing quantized bulk bands with energy separations down to ∼10 meV. Detailed analyses on the phase shift of the confined wave functions precisely determine the surface and bulk electronic structures, which unambiguously show nontrivial topology. The present results not only prove the fundamental property of Bi but also introduce a capability of the quantum-confinement approach.
The presence of water greatly influences time-dependent rock deformation. An understanding of how water can affect the time-dependent mechanical behavior of rock is important when assessing the ...long-term stability of geotechnical projects. While the previous studies have performed brittle creep experiments on oven-dry or fully-saturated rocks, we report here on a study designed to better understand brittle creep at different levels of saturation. We performed brittle creep experiments on oven-dry samples of red sandstone (Hunan province, China) and samples of the sandstone pre-immersed in water for different durations (from 2 to 8 days). These samples were deformed at a constant stress in one of either two conditions: dry or submerged in water. Before performing creep experiments, we first performed a series of water absorption and constant stress rate experiments to guide the stresses required for our creep tests and to assist with their interpretation. Our creep experiments show that immersion in water greatly increased the minimum creep strain rate and greatly shortened the time-to-failure when compared to the dry state. In detail, the minimum creep strain rate and time-to-failure increased and decreased, respectively, as pre-immersion duration increased from 4 to 6 days, but did not change as the duration was further increased to 8 days. We attribute this to the saturation of microcracks between 4 and 6 days (i.e., water imbibition was complete, or close to completion, following 6 days). We also show that oven-dry samples deformed at a constant stress underwater fail at stresses much lower than oven-dry samples deformed under dry conditions, due to the imbibition of water during deformation. Samples pre-immersed in water, but deformed in the dry condition were characterized by lower strain rates and longer time-to-failure than those pre-immersed in water and deformed underwater. Our explanation for this is that, due to the availability of water, crack tips can remain hydrated when the sample is deformed underwater, thus increasing the efficacy of stress corrosion cracking. The relationships and data provided herein inform on the long-term stability of engineering structures.
In response to the globally escalating number of language learners tasked with learning science through a foreign language, this review seeks to bring new perspectives by reframing research findings, ...still dominated by historical language assumptions, through a contemporary language lens. We aim to unearth, amalgamate and expose the potentials of non-linguistic modes described by the theory of multiliteracies that appear sporadic and fragmentary within studies due to their linguistic focus, as we surmise they offer language learners alternative avenues for meaning-making. 40 peer-reviewed empirical studies published between 1995 and 2019 were systematically found and examined using theoretical thematic analysis to expand our understandings. We conjectured findings that appeared contingent upon non-linguistic modes but did not prominently feature in the reported results. In doing so, we used a multimodal and translanguaging lens from which three themes and educational implications emerged. The integration of non-linguistic modes in science: (1) aided language learners' science discourse, provided they had access to multiple modes and agency over expression; (2) facilitated multicultural learning communities validating each learner as a sense maker; and (3) promoted authentic and equitable learning experiences. Other noteworthy findings, such as the influence of the tactile mode, are discussed. Recommendations to future researchers include adopting epistemologies of language fitting to our century and developing transdisciplinary approaches to research.
We detail a method to produce a GeV-photon source with polarisation degree exceeding 91% and 78% (corresponding to a 96% and 89% fraction of the photons) for linear and circular polarised photons ...respectively and with a brilliance of the order of 1021photons/(smm2mrad20.1%BW). Using currently available multi-GeV electron bunches and laser pulses of moderately relativistic intensities, we show how the weakly nonlinear regime can produce photons polarised mainly parallel to the laser field. We demonstrate the robustness of this scheme by considering electron bunches of various emissivities colliding with linearly and circularly-polarised laser pulses at a range of angles.
A humidity diffusion based numerical model is proposed to simulate the floor heave processes of swelling rock tunnel when it exposed to high humidity. The phenomenon of swelling in tunneling is ...treated as a humidity–mechanical coupled process, i.e. the stress redistribution as well the water vapor diffusion around the tunnel is taken into account. This allows one to model the observed floor heaves realistically without considering the complex chemical processes induced by water–rock interaction. Furthermore, the development of heave and pressure over the course of time can be studied. The swelling rock is considered as an elasto-plastic material with damage threshold, which allows one to predict the large heaves of a tunnel floor that are often observed in-situ. The relationship between the mechanical damage and humidity diffusion are discussed at the mesoscopic level. By studying the influence of parameters in the numerical model on the floor heave behavior, the time-dependent deformation and failure processes of tunnel under high humid condition are discussed in detail. The deformations at the floor level are larger than that of sidewalls interpreted here as a consequence of different humid boundary conditions. The numerical results provide a better understanding of time-dependent behavior of floor heave of tunnel under the high humid condition.
► A humidity diffusion based model is proposed to simulate the floor heave of tunnel. ► The floor heave is greatly depending on the degradation by humidity corrosion. ► The floor heave is sensitive to the lateral pressure and the swelling coefficient. ► The time-dependent deformation is caused by stress and environmental corrosion.
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