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.
We prove that the loading composed by a finite sum of time-independent sources acting over a bounded plate can be uniquely identified by knowing the normal derivative of the displacement along a ...subset of the boundary or the displacement of the points in a certain set near the boundary. This is true even if these data correspond to an arbitrary small interval of time. The method used is to reduce the problem to another one for the wave equation.
Abstract
Background
Upper extremity musculoskeletal disorders negatively affect ability to perform activities of daily living, self-care and work. Therefore, outcome measurements that address muscle ...strength, fatigue resistance, functionality and work physical capacity must be defined to assess and plan specific actions to minimize them.
Objective
To investigate the association of upper extremity muscle strength with upper extremity fatigue resistance, work ability and upper extremity dysfunction in a sample of workers from a tertiary hospital.
Methods
Shoulder and elbow isokinetic strength were assessed by Biodex System 4™, isometric hand grip by JAMAR™, upper extremity fatigue resistance by Functional Impairment Test Hand and Neck/Shoulder/Arm (FIT-HaNSA), ability to work by the Work Ability Index and upper extremity dysfunction by the Quick-Disabilities of the Arm, Shoulder and Hand QuickDASH-Br questionnaire. The Nordic questionnaire and Numeric Pain Rating Scale (NPRS) were used for pain description. The associations were analysed by Spearman’s correlation coefficient (rho) (
p
< 0.05).
Results
Twenty-seven participants: 59.2% women; mean age 46 years old; 70.3% obese/overweight; 62.9% active with predominantly dynamic muscle contraction work. Besides predominance of good to moderate work ability (81.4%) and comorbidities (37%), all participants had symptoms of the upper extremities for at least 12 months, with a predominance of low-intensity in the shoulder (55.5%). In addition, 88.8% reported pain in other segments. Muscle strength of abduction (rho = 0.49), adduction (rho = 0.40), internal rotation (rho = 0.44) and hand grip (rho = 0.68) presented moderate correlation with FIT-HaNSA. Hand grip (rho = − 0.52) showed moderate correlation with upper extremity dysfunction.
Conclusions
The results of this preliminary study suggested the association of shoulder strength with fatigue resistance. Also, hand grip strength was associated with upper extremity dysfunction and fatigue resistance. No association was found with the Work Ability Index in this sample. So, it is suggested that hand grip and shoulder strength could be outcome measurements used for future interventions focused on upper extremity preventive exercises to improve strength and fatigue resistance of workers at risk for the development of musculoskeletal disorders. Other individual, psychosocial and organizational risk factors must also be considered as influences on upper extremity function.
Work-related musculoskeletal disorders (WRMDs) are often caused by inadequate use of the musculoskeletal system during work. Evidence suggests that multimodal intervention through exercises, massage, ...education, and ergonomic guidelines reduces pain and symptoms in the neck and upper extremities and help to prevent musculoskeletal disorders. The purpose of this study will be to assess the additive effectiveness of a specific and individualized workplace strengthening exercise program to an ergonomic guidance in reducing fatigue, pain and discomfort in the upper extremities and neck perceived by workers.
This trial was designed according to the Consolidated Standards of Reporting Trials - CONSORT guidelines. Participants will be employees of a tertiary hospital, with any complaints of pain or discomfort in the upper extremities during the past 12 months, without clinical musculoskeletal diagnosis. 166 participants will be randomized into parallels groups as control and workplace exercises. The primary outcomes will be Numerical Pain Scale, isokinetic muscle strength of abduction and isometric handgrip strength. Secondary outcomes on discomfort, fatigue, work capacity and dysfunction will be assessed by QuickDASH, Patient Specific Functional Scale, Neck Disability Index, Need for recovery, Work Ability Index self-report questionnaires and FIT-HANSA performance test. The Ergonomic Work Analysis will be done by Quick Expose Check, RULA, REBA, RARME, ROSA and HARM risk assessment ergonomic tools. We will analyze the difference between baseline and 12 weeks of intervention by T test of independent samples (95% confidence interval, p < 0.05). Clinical significance will be analyzed by the minimum clinically important difference and effect size by Cohen index. The association between the variables will be analyzed by construct validity with the hypothesis of correlations between pain and muscle strength, strength and functionality and strength and fatigue.
Although studies have shown promise outcomes for workplace exercises as an available therapeutic resource used to minimize complaints of pain and discomfort related to work, the results of this study aim to bring evidence about the benefit of a specific resistance exercise as an effective modality to facilitate mechanisms of neuromuscular adaptations, with gradual and posterior hypertrophy in the later phases.
(NCT04047056, https://clinicaltrials.gov/ct2/show/NCT04047056?term=NCT04047056&draw=2&rank=1 ) on Dec 03, 2020.
Abstract
A feature of digital 3D urban models is that they provide semantic information on various objects in urban space. This paper proposes a basic framework for obtaining visual information about ...the external conditions of a building to be designed using a 3D urban model. Ray emission and collision detection are used in a game engine to identify the type and distance of objects surrounding the building in the 3D urban model. Tagging the objects with their semantics identifies their type such as sky, building, road, greenery and so on. This paper also proposes setting two different viewpoints at the façade and the interior to consider the building design and the indoor visual environment design from both aspects of the whole building and individual rooms.
Abstract
Greenery is a key element of quality window views. This study aims to clarify the quantitative effect of greenery on view satisfaction in urban offices. Green view factor (GVF) is proposed ...to measure greenery visible through windows. Subjective evaluation experiments were conducted using a virtual reality system for different GVFs between 0% and 100%. It was found that greenery increases view satisfaction by up to 20 to 30 points on a 100-point scale. But the view satisfaction does not simply depend on the GVF. The layout and spacing of greenery are important. Greenery occupying about 50% of the window width at intervals maximizes the view satisfaction in the case of full-window walls.
The total cross sections were measured for coherent double neutral-pion photoproduction on the deuteron at incident energies below 0.9 GeV for the first time. No clear resonance-like behavior is ...observed in the excitation function for Wγd=2.38–2.61 GeV, where the d⁎(2380) dibaryon resonance observed at COSY is expected to appear. The measured excitation function is consistent with the existing theoretical calculation for this reaction. The upper limit of the total cross section is found to be 0.034 μb for the dibaryon resonance at Wγd=2.37 GeV (90% confidence level) in the γd→π0π0d reaction.
Balancing immunosuppression to prevent rejection while minimizing infection or drug toxicity risk is a major challenge in heart transplantation. Therapeutic drug monitoring alone is inadequate to ...measure the immune response. An immune monitoring (IM) assay (ImmuKnow; Cylex, Columbia, MD) performed on peripheral blood measures adenosine triphosphatase (ATP) release from activated lymphocytes and may predict the immune state. Therefore, we sought to determine the utility of IM in heart transplant recipients.
Between November 2005 and July 2008, 296 heart transplant recipients had a total of 864 IM assays performed at 2 weeks to 10 years post-transplant and were correlated with infection and rejection events that occurred within 1 month after IM testing. All patients received standard triple-drug immunosuppressive therapy with tacrolimus, mycophenolate mofetil and corticosteroids, without induction therapy.
There were 38 infectious episodes and 8 rejection episodes. The average IM score was significantly lower during infection than steady state (187 vs 280 ng ATP/ml, p < 0.001). The average IM score was not significantly different during rejection when compared with steady state (327 vs 280 ng ATP/ml, p = 0.35). Interestingly, 3 of 8 rejection episodes were antibody-mediated rejections and had hemodynamic compromise and, for these, the mean IM score was significantly higher than for steady-state patients (491 vs 280 ng ATP/ml, p < 0.001).
The non-invasive IM test appears to predict infectious risk in heart transplant patients. The association between high IM scores and rejection risk is inconclusive due to the small number of rejection episodes. Further studies with larger sample sizes for rejection episodes are required.
The FOREST detector for meson photoproduction experiments at ELPH Ishikawa, T.; Fujimura, H.; Fukasawa, H. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
10/2016, Letnik:
832
Journal Article
Recenzirano
An electromagnetic calorimeter complex, FOREST, has been constructed for meson photoproduction experiments at the Research Center for Electron Photon Science, Tohoku University. It consists of three ...types of calorimeters, which are made of pure cesium-iodide crystals, lead scintillating-fiber modules, and lead glass Cherenkov counters. Each calorimeter is equipped with a plastic scintillator hodoscope to identify charged particles. The design and performance of FOREST are described. The energy responses of test calorimeters have been investigated by using 100–800MeV positron beams. The energy resolutions of the three calorimeters are found to be approximately 3%, 7%, and 5% for 1-GeV photons, respectively. A cryogenic hydrogen/deuterium target system fitted to the FOREST experiments and a newly developed data acquisition system are also presented.
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