Summary
The aim of the EpiTer‐2 study was to analyse patient characteristics and their medication for HCV infection in Poland at the beginning of the interferon‐free era. Analysis of data of HCV ...infected patients treated during the initial period of availability of interferon‐free regimens in Poland, who started therapy after 1 July 2015 and had available an efficacy evaluation report before 30 June 2017 was undertaken. A total of 2879 patients with chronic hepatitis C were entered, including 46% with liver cirrhosis. The most common was genotype 1b (86.8%). The study population was gender balanced, the majority of patients were overweight or obese and 69% presented comorbidities, with the highest prevalence that for hypertension. More than half of patients were retreated due to failure of previous therapy with pegylated interferon and ribavirin. Almost two‐third of patients received current therapy with ombitasvir/paritaprevir/ritonavir±dasabuvir (OPrD) ±ribavirin. Other patients received mostly sofosbuvir‐based regimens including combination with ledipasvir and pegylated interferon and ribavirin for genotype 3‐infected patients. Efficacy of treatment in the whole study population measured as intent‐to‐treat analysis was 95%. The most frequent regimen, administered for patients infected with genotype 1b, was 12 weeks of OPrD, resulting in an SVR rate of 98%. At least one adverse event was reported in 38% of patients, and the death rate was 0.8%. In conclusion, data from the EpiTer‐2 study confirmed the excellent efficacy and safety profile of the real‐world experience with recently introduced therapeutic options for genotype 1 HCV infection, but demonstrated weakness of the current therapeutic programme regarding genotype 3 infections.
The fracture behaviour of high strength steels used in the manufacture of rolling element bearings has been investigated. The materials studied comprised two through-hardening steels and two ...case-hardening steels. The fracture behaviour of the steels has been characterised in terms of the plane strain stress intensity factor KIc, and has been related to the microstructure and heat treatment conditions of the steels. The fracture toughness of the through-hardening steels was determined as a function of hardening heat treatment and tempering temperature, and was found to obey the generally observed inverse relationship with hardness. Both steels showed a predominantly quasi-cleavage mode of failure in the quenched and tempered condition, which is interpreted in terms of primary carbide nucleated cleavage fracture. Tests on unnotched bars of the steels demonstrated the important role of primary carbides in fracture initiation. Increasingly fibrous fracture characteristics were observed with increasing tempering temperature, attributed to a decreasing matrix alloy content as secondary carbide precipitation proceeded. An increase in toughness was observed at the bearing operating temperature of 215oC, associated with a transition to a primary carbide nucleated microvoid coalescence mode of failure. In order to characterise the fracture behaviour of the case-hardened steels, the fracture toughness was determined as a function of carbon content for a series of through-carbonised samples produced to simulate the behaviour of the carburised steel at various depths below the surface. At low carbon contents, the fracture mode of one of the steels, a Ni-Cr-Mo low alloy steel, was manganese sulphide inclusion nucleated microvoid coalescence. The toughness of the uncarburised steel was found to depend on the secondary refining treatment, EFR steel showing inferior toughness to VAR and VIMVAR steel. With increasing carbon content, carbide precipitation on prior austenite grain boundaries promoted intergranular fracture. Above 0.8% carbon, fibrous fracture nucleated at microscopic carbide particles. The other case-hardening steel, a high alloy tungsten steel, was found to have low toughness even in the uncarburised condition. The low toughness was attributed to the presence of primary carbide particles and a high matrix alloy content, which make the steel susceptible to cleavage failure. The increasing volume fraction of primary carbide particles as carbon content increased promoted a transition in fracture mode from cleavage to carbide nucleated microvoid coalescence. In the case-carburised condition, the Ni-Cr-Mo steel showed crack arrest, as predicted from the behaviour of through-carburised material. By comparison, crack arrest did not occur in the case-carburised high alloy steel.
