Aliment Pharmacol Ther 2011; 33: 1104–1112
Summary
Background The role of anti‐viral therapy in prevention of hepatocellular carcinoma (HCC) recurrence is to be defined.
Aim To investigate the role ...of anti‐viral therapy in prevention of tumour recurrence after curative treatment of hepatitis B virus (HBV)‐related HCC.
Methods A systematic electronic search on keywords including HCC and different anti‐viral therapies was performed through eight electronic databases, including Medline, EMBASE and Cochrane Databases. The primary outcome was HCC recurrence after curative treatment of HBV‐related HCC. The secondary outcomes were mortality related to HCC, mortality related to liver failure and the overall mortality.
Results Nine cohort studies were included with a total number of 551 patients: 204 patients with anti‐viral treatment group and 347 patients without anti‐viral treatment (control group). There was significant difference in the incidence of HCC recurrence in favour of the anti‐viral treatment group (55% vs. 58%; odds risk (OR) = 0.59, 95% CI 0.35–0.97, P = 0.04). The risk of HCC was reduced by 41% in the anti‐viral treatment group. There were also significant differences in favour of anti‐viral treatment group in terms of liver‐related mortality (0% vs. 8%; OR = 0.13, 95% CI 0.02–0.69, P = 0.02) and overall mortality (38% vs. 42%; OR = 0.27, 95% CI 0.14–0.50, P < 0.001).
Conclusions Anti‐viral therapy has potential beneficial effects after the curative treatment of HBV‐related hepatocellular carcinoma in terms of tumour recurrence, liver‐related mortality and overall survival. Anti‐viral therapy should be considered after curative treatment of hepatocellular carcinoma.
For the explosion mechanism of Type Ia supernovae (SNe Ia), different scenarios have been suggested. In these, the propagation of the burning front through the exploding white dwarf (WD) star ...proceeds in different modes, and consequently imprints of the explosion model on the nucleosynthetic yields can be expected. The nucleosynthetic characteristics of various explosion mechanisms are explored based on three two-dimensional explosion simulations representing extreme cases: a pure turbulent deflagration, a delayed detonation following an approximately spherical ignition of the initial deflagration, and a delayed detonation arising from a highly asymmetric deflagration ignition. Apart from this initial condition, the deflagration stage is treated in a parameter-free approach. The detonation is initiated when the turbulent burning enters the distributed burning regime. This occurs at densities around 10{sup 7} g cm{sup -3}-relatively low as compared to existing nucleosynthesis studies for one-dimensional spherically symmetric models. The burning in these multidimensional models is different from that in one-dimensional simulations as the detonation wave propagates both into unburned material in the high-density region near the center of a WD and into the low-density region near the surface. Thus, the resulting yield is a mixture of different explosive burning products, from carbon-burning products at low densities to complete silicon-burning products at the highest densities, as well as electron-capture products synthesized at the deflagration stage. Detailed calculations of the nucleosynthesis in all three models are presented. In contrast to the deflagration model, the delayed detonations produce a characteristic layered structure and the yields largely satisfy constraints from Galactic chemical evolution. In the asymmetric delayed detonation model, the region filled with electron capture species (e.g., {sup 58}Ni, {sup 54}Fe) is within a shell, showing a large off-set, above the bulk of {sup 56}Ni distribution, while species produced by the detonation are distributed more spherically.
Summary
Background
Complementary and alternative medicine (CAM), particularly herbal therapy, is widely used by patients with inflammatory bowel disease (IBD) but controlled data are limited.
Aim
To ...systematically review the literature on the efficacy of herbal therapy in the treatment of ulcerative colitis (UC) and Crohn's disease (CD).
Methods
Publications in English and non‐English literatures (MEDLINE, EMBASE, EBM Reviews, AMED, Global Health) were searched from 1947 to 2013 for controlled clinical studies of herbal therapy in IBD. Outcome measures included response and remission rates.
Results
Twenty‐one randomised controlled trials (14 UC; 7 CD) including a total of 1484 subjects (mean age 41, 50% female) were analysed. In UC, aloe vera gel, Triticum aestivum (wheat grass juice), Andrographis paniculata extract (HMPL‐004) and topical Xilei‐san were superior to placebo in inducing remission or response, and curcumin was superior to placebo in maintaining remission; Boswellia serrata gum resin and Plantago ovata seeds were as effective as mesalazine, whereas Oenothera biennis (evening primrose oil) had similar relapse rates as omega‐3 fatty acids in the treatment of UC. In CD, Artemisia absinthium (wormwood) and Tripterygium wilfordii were superior to placebo in inducing remission, and preventing clinical recurrence of post‐operative CD respectively.
Conclusions
Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous. Larger controlled studies with stricter endpoints and better‐defined patient groups are required to obtain more conclusive results on the use of CAM therapies in IBD.
We follow the long-term evolution of the dynamic ejecta of neutron star mergers for up to 100 years and over a density range of roughly 40 orders of magnitude. We include the nuclear energy input ...from the freshly synthesized, radioactively decaying nuclei in our simulations and study its effects on the remnant dynamics. Although the nuclear heating substantially alters the long-term evolution, we find that running nuclear networks over purely hydrodynamic simulations (i.e. without heating) yields actually acceptable nucleosynthesis results. The main dynamic effect of the radioactive heating is to quickly smooth out inhomogeneities in the initial mass distribution, subsequently the evolution proceeds self-similarly and after 100 years the remnant still carries the memory of the initial binary mass ratio. We also explore the nucleosynthetic yields for two mass ejection channels. The dynamic ejecta very robustly produce 'strong' r-process elements with A > 130 with a pattern that is essentially independent of the details of the merging system. From a simple model we find that neutrino-driven winds yield 'weak' r-process contributions with 50 < A < 130 whose abundance patterns vary substantially between different merger cases. This is because their electron fraction, set by the ratio of neutrino luminosities, varies considerably from case to case. Such winds do not produce any 56Ni, but a range of radioactive isotopes that are long-lived enough to produce a second, radioactively powered electromagnetic transient in addition to the 'macronova' from the dynamic ejecta. While our wind model is very simple, it nevertheless demonstrates the potential of such neutrino-driven winds for electromagnetic transients and it motivates further, more detailed neutrino-hydrodynamic studies. The properties of the mentioned transients are discussed in more detail in a companion paper.
For the origin of heavy rapid neutron capture process (r-process) elements, different sources have been proposed, e.g. core-collapse supernovae or neutron star mergers. Old metal-poor stars carry the ...signature of the astrophysical source(s). Among the elements dominantly made by the r-process, europium (Eu) is relatively easy to observe. In this work we simulate the evolution of Eu in our Galaxy with the inhomogeneous chemical evolution (ICE) model, and compare our results with spectroscopic observations. We test the most important parameters affecting the chemical evolution of Eu: (a) for neutron star mergers the coalescence time-scale of the merger (t
coal) and the probability to experience a neutron star merger event after two supernova explosions occurred and formed a double neutron star system (P
NSM) and (b) for the subclass of magnetorotationally driven supernovae (‘Jet-SNe’), their occurrence rate compared to standard supernovae (P
Jet-SN). We find that the observed Eu/Fe pattern in the Galaxy can be reproduced by a combination of neutron star mergers and Jet-SNe as r-process sources. While neutron star mergers alone seem to set in at too high metallicities, Jet-SNe provide a cure for this deficiency at low metallicities. Furthermore, we confirm that local inhomogeneities can explain the observed large spread in the Eu abundances at low metallicities. We also predict the evolution of O/Fe to test whether the spread in α-elements for inhomogeneous models agrees with observations and whether this provides constraints on supernova explosion models and their nucleosynthesis.
This is the first meta-analysis of the pooled prevalence of insomnia in the general population of China. A systematic literature search was conducted via the following databases: PubMed, PsycINFO, ...EMBASE and Chinese databases (China National Knowledge Interne (CNKI), WanFang Data and SinoMed). Statistical analyses were performed using the Comprehensive Meta-Analysis program. A total of 17 studies with 115,988 participants met the inclusion criteria for the analysis. The pooled prevalence of insomnia in China was 15.0% (95% Confidence interval CI: 12.1%-18.5%). No significant difference was found in the prevalence between genders or across time period. The pooled prevalence of insomnia in population with a mean age of 43.7 years and older (11.6%; 95% CI: 7.5%-17.6%) was significantly lower than in those with a mean age younger than 43.7 years (20.4%; 95% CI: 14.2%-28.2%). The prevalence of insomnia was significantly affected by the type of assessment tools (Q = 14.1, P = 0.001). The general population prevalence of insomnia in China is lower than those reported in Western countries but similar to those in Asian countries. Younger Chinese adults appear to suffer from more insomnia than older adults.
CRD 42016043620.
During school closures forced by the COVID-19 pandemic, remote/online learning has been adopted to help students continue to learn. Student engagement, which is energized by motivation as explained ...by self-determination theory (SDT), is a prerequisite for learning. Therefore, this study investigated how the three perceived psychological needs in SDT affected student engagement in online learning using pre- and post-questionnaires completed by 1201 Grade 8 and 9 students within 6 weeks of partaking in online learning. The results suggested that digital support strategies better satisfied students' needs, that all of the needs were predictors of the level of engagement, and that relatedness support was very important.
Upper gastrointestinal bleeding (UGIB), especially peptic ulcer bleeding, remains one of the most important cause of hospitalisation and mortality world wide. In Asia, with a high prevalence of ...Helicobacter pylori infection, a potential difference in drug metabolism, and a difference in clinical management of UGIB due to variable socioeconomic environments, it is considered necessary to re-examine the International Consensus of Non-variceal Upper Gastrointestinal Bleeding with emphasis on data generated from the region. The working group, which comprised experts from 12 countries from Asia, recommended the use of the Blatchford score for selection of patients who require endoscopic intervention and which would allow early discharge of patients at low risk. Patients' comorbid conditions should be included in risk assessment. A pre-endoscopy proton pump inhibitor (PPI) is recommended as a stop-gap treatment when endoscopy within 24 h is not available. An adherent clot on a peptic ulcer should be treated with endoscopy combined with a PPI if the clot cannot be removed. Routine repeated endoscopy is not recommended. High-dose intravenous and oral PPIs are recommended but low-dose intravenous PPIs should be avoided. COX-2 selective non-steroidal anti-inflammatory drugs combined with a PPI are recommended for patients with very high risk of UGIB. Aspirin should be resumed soon after stabilisation and clopidogrel alone is no safer than aspirin plus a PPI. When dual antiplatelet agents are used, prophylactic use of a PPI reduces the risk of adverse gastrointestinal events.
Magnetic resonance imaging is a key diagnostic tool in modern healthcare, yet it can be cost-prohibitive given the high installation, maintenance and operation costs of the machinery. There are ...approximately seven scanners per million inhabitants and over 90% are concentrated in high-income countries. We describe an ultra-low-field brain MRI scanner that operates using a standard AC power outlet and is low cost to build. Using a permanent 0.055 Tesla Samarium-cobalt magnet and deep learning for cancellation of electromagnetic interference, it requires neither magnetic nor radiofrequency shielding cages. The scanner is compact, mobile, and acoustically quiet during scanning. We implement four standard clinical neuroimaging protocols (T1- and T2-weighted, fluid-attenuated inversion recovery like, and diffusion-weighted imaging) on this system, and demonstrate preliminary feasibility in diagnosing brain tumor and stroke. Such technology has the potential to meet clinical needs at point of care or in low and middle income countries.
The existence of neutron star mergers has been supported since the discovery of the binary pulsar and the observation of its orbital energy loss, consistent with General Relativity. They are ...considered nucleosynthesis sites of the rapid neutron-capture process (r-process), which is responsible for creating approximately half of all heavy elements beyond Fe and is the only source of elements beyond Pb and Bi. Detailed nucleosynthesis calculations based on the decompression of neutron star matter are consistent with solar r-process abundances of heavy nuclei. Neutron star mergers have also been identified with short-duration
-ray bursts via their IR afterglow. The high neutron densities in ejected matter permit a violent r-process, leading to fission cycling of the heaviest nuclei in regions far from (nuclear) stability. Uncertainties in several nuclear properties affect the abundance distributions. The modeling of astrophysical events also depends on the hydrodynamic treatment, the occurrence of a neutrino wind after the merger and before the
possible emergence of a black hole, and the properties of black hole accretion disks. We discuss the effect of nuclear and modeling uncertainties and conclude that binary compact mergers are probably a (or the) dominant site of the production of r-process nuclei in our Galaxy.
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