Summary
Background
Hepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from ...their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide.
Aim
To generate recommendations for the management of Asian Americans infected with HBV.
Methods
These guidelines are based on relevant data derived from medical reports on HBV from Asian countries as well as from studies in the HBsAg positive Asian Americans. The guidelines herein differ from other recommendations in the treatment of both HBeAg positive and negative chronic hepatitis B (CHB), in the approach to HCC surveillance, and in the management of HBV in pregnant women.
Results
Asian American patients, HBeAg positive or negative, with HBV DNA levels >2000 IU/mL (>104 copies/mL) and ALT values above normal are candidates for anti‐viral therapy. HBeAg negative patients with HBV DNA >2000 IU/mL and normal ALT levels but who have either serum albumin <3.5 g/dL or platelet count <130 000 mm3, basal core promoter (BCP) mutations, or who have first‐degree relatives with HCC should be offered treatment. Patients with cirrhosis and detectable HBV DNA must receive life‐long anti‐viral therapy. Indications for treatment include pregnant women with high viraemia, coinfected patients, and those requiring immunosuppressive therapy. In HBsAg positive patients with risk factors, life‐long surveillance for HCC with alpha‐fetoprotein (AFP) testing and abdominal ultrasound examination at 6‐month intervals is required. In CHB patients receiving HCC treatments, repeat imaging with contrast CT scan or MRI at 3‐month intervals is strongly recommended. These guidelines have been assigned to a Class (reflecting benefit vs. risk) and a Level (assessing strength or certainty) of evidence.
Conclusions
Application of the recommendations made based on a review of the relevant literature and the opinion of a panel of Asian American physicians with expertise in HBV treatment will inform physicians and improve patient outcomes.
Linked ContentThis article is linked to Ebel and Rosenthal, and Tong and Pan papers. To view these articles visit https://doi.org/10.1111/apt.14620 and https://doi.org/10.1111/apt.14662.
This study investigated the effect of n‐3 to n‐6 fatty acid ratios in broodstock diets on reproduction performance, fatty acid composition of eggs and gonads of tongue sole Cynoglossus semilaevis. ...Broodstock were fed five isonitrogenous and isoenergetic diets for 60 days. The supplemented lipids were prepared by a combination of fish oil and soybean oil inclusion FO (fish oil); FSO1 (fish oil: soybean oil = 7:1); FSO2 (fish oil: soybean oil = 2.2:1); FSO3 (fish oil: soybean oil = 1:1); FSO4 (fish oil: soybean oil = 1:4.3) as lipid sources with different n‐3 to n‐6 fatty acid ratios 10.40, 5.21, 2.81, 1.71 and 0.87. Results showed that relative fecundity, fertilization rate and survival rate of larvae at 7 days posthatching were all higher in broodstock fed FSO1 and FSO2 diet and significantly (P < 0.05) decreased in groups fed FSO3 and FSO4 diets. The best result in starvation tolerance test was obtained in FSO2 diet. The present study suggests that n‐3 and n‐6 PUFA ratio in broodstock diet has a considerable effect on spawning performance, egg and larval quality for C. semilaevis.
Exposure to Mycobacterium tuberculosis (Mtb) results in heterogeneous clinical outcomes including primary progressive tuberculosis and latent Mtb infection (LTBI). Mtb infection is identified using ...the tuberculin skin test and interferon-γ (IFN-γ) release assay IGRA, and a positive result may prompt chemoprophylaxis to prevent progression to tuberculosis. In the present study, we report on a cohort of Ugandan individuals who were household contacts of patients with TB. These individuals were highly exposed to Mtb but tested negative disease by IFN-γ release assay and tuberculin skin test, 'resisting' development of classic LTBI. We show that 'resisters' possess IgM, class-switched IgG antibody responses and non-IFN-γ T cell responses to the Mtb-specific proteins ESAT6 and CFP10, immunologic evidence of exposure to Mtb. Compared to subjects with classic LTBI, 'resisters' display enhanced antibody avidity and distinct Mtb-specific IgG Fc profiles. These data reveal a distinctive adaptive immune profile among Mtb-exposed subjects, supporting an expanded definition of the host response to Mtb exposure, with implications for public health and the design of clinical trials.
The aim of this study was to determine the association of inflammation and immune responses with the outcomes of patients at various stages, and to develop risk stratification for improving clinical ...practice and reducing mortality.
We included 77 patients with primary outcomes of either death or survival. Demographics, clinical features, comorbidities, and laboratory tests were compared. Linear, logistic, and Cox regression analyses were performed to determine prognostic factors.
The average age was 59 years (35-87 years). There were 12 moderate cases (16.2%), 42 severe cases (54.5%), and 23 critical cases (29.9%); and 41 were male (53.2%). Until March 20, 68 cases were discharged (88.3%), and nine critically ill males (11.7%) died. Interleukin-6 (IL-6) levels on the 1st day were compared with IL-6 values on the 14th day in the severe and the critically ill surviving patients (F=4.90, p=0.034, β=0.35, 95% CI: 0.00-0.10), and predicted death in the critically ill patients (p=0.028, β=0.05, OR: 1.05, 95% CI: 1.01-1.10). CD4+ T-cell counts at admission decreased the hazard ratio of death (p=0.039, β=-0.01, hazard ratio=0.99, 95% CI: 0.98-1.00, and median survival time 13.5 days).
The present study demonstrated that IL-6 levels and CD4+ T-cell count at admission played key roles of predictors in the prognosis, especially for critically ill patients. High levels of IL-6 and impaired CD4+t cells are seen in severe and critically ill patients with COVID-19.
Nanocomposite Al–Sn-based bearing alloys produced by mechanical alloying (MA) exhibit high hardness; however, their poor sintering density and ductility limit their wide spread application. Here, we ...present a strategy to produce a dual-scale structure in an Al–Sn–Si alloy consisting of coarse and ultrafine grains through a combination of conventional powder sintering and thermomechanical treatment. We found that severe deformation and the presence of an Al–Si eutectic mixture for sample induced abnormal grain growth of Al to create the dual-scale Al–Sn–Si alloy through annealing treatment. An optimum matching of ductility and strength, and optimum wear performance were achieved at annealing temperatures of 500 and 550°C. Detailed investigation of the wear mechanism revealed that the combination of high strength and high ductility provided by the dual-scale structure is a key factor for the improvement of the wear properties.
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•The dual-scale Al-Sn-Si alloy was prepared by thermomechanical treatment.•An optimum mechanical property was achieved at the annealing between 500 and 550°C.•Wear performance was determined by the hardness–ductility matching.•The monolithic RT-rolling alloy exhibited delamination wear due to poor ductility.
The absorption and accumulation of Cd
2+, Fe
3+, Zn
2+, Mn
2+, Cu
2+ and Mg
2+ in the roots and leaves of 20 rice cultivars (
Oryza sativa L.) with different genotypes under cadmium (Cd) stress were ...investigated with pot experiments. The results showed that there existed significant differences among the rice cultivars in the contents of six mineral elements in both roots and leaves at both heading and ripening periods. The statistical analysis showed that, for their contents in roots, significant and positive correlations between Cd
2+ and Fe
3+, Cd
2+ and Zn
2+, Cd
2+ and Mn
2+, Cd
2+ and Cu
2+ existed, but no significant correlation between Cd
2+ and Mg
2+, at the two periods. In the leaves, Cd also showed significant and positive correlations with Fe
3+, Zn
2+ and Cu
2+ at the both periods, but a significant and negative correlation with Mn
2+ and no significant correlation with Mg
2+ at heading, a significant and positive correlation with Mg
2+ and no significant correlation with Mn
2+ at ripening. These results suggested that there were cooperative absorption between Cd
2+ and Fe
3+, Mn
2+, Cu
2+, Mn
2+ in rice plants. Genotypic differences in Cd uptake and translocation among the rice cultivars suggested that paddy field of some rice cultivars may be irrigated with partially treated sewage water.
We report findings of strong anomalies in both mutual inductance and inelastic Raman spectroscopy measurements of single-unit-cell FeSe film grown on Nb-doped SrTiO3, which occur near the temperature ...where the superconductinglike energy gap opens. Analysis suggests that the anomaly is associated with a broadened ferroelectric transition in a thin layer near the FeSe/SrTiO3 interface. The coincidence of the ferroelectric transition and gap-opening temperatures adds credence to the central role played by the film-substrate interaction on the strong Cooper pairing in this system. We discuss scenarios that could explain such a coincidence.
An in situ displacement reaction was used to prepare an Al–12 wt% Sn nanocomposite alloy from mechanically alloyed Al–SnO
2
–MgH
2
. The nanoscaled Sn phase was mostly 30–50 nm in size and was ...distributed uniformly in the Al matrix. The wear properties of the Al–SnO
2
–MgH
2
composite were enhanced significantly compared to those of an Al–Sn–MgH
2
composite. These improvements stemmed from the high-strength and nanoconfined Sn-phase lubrication, which moved the peak stress far below the surface, released strain localization at the uppermost sliding surface layer, and suppressed cracking and surface roughening. The dispersion strengthening of the Al–SnO
2
–MgH
2
composite favored the maintenance of a stable tribolayer, which resulted in an integrated worn surface and an excellent wear performance.
•A surface acoustic wave ammonia sensor based on ZnO/SiO2 composite film.•The sensor demonstrates good sensitivity and selectivity to NH3.•The dangling Si bands on the surface of the film enhance the ...sensitivity to NH3.•The reactions on the surface of the film improve the sensor's selectivity to NH3.
A surface acoustic wave (SAW) resonator with ZnO/SiO2 (ZS) composite film was used as an ammonia sensor in this study. ZS composite films were deposited on the surface of SAW devices using the sol–gel method, and were characterized using SEM, AFM, and XRD. The performance of the sensors under ammonia gas was optimized by adjusting the molar ratio of ZnO:SiO2 to 1:1, 1:2 and 1:3, and the sensor with the ratio of ZnO to SiO2 equaling to 1:2 was found to have the best performance. The response of sensor was 1.132kHz under 10ppm NH3, which was much higher than that of the sensor based on a pristine ZnO film. Moreover, the sensor has good selectivity, reversibility and stability at room temperature. These can be attributed to the enhanced absorption of ammonia and unique surface reaction on composite films due to the existence of silica.
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