Australian tertiary care outcomes of entecavir monotherapy in treatment naive patients with chronic hepatitis B

Abstract AIM: To evaluate the long-term treatment outcomes of entecavir monotherapy in treatment naive patients in an Australian tertiary care setting. METHODS: A retrospective analysis of treatment naive patients receiving entecavir monotherapy through Westmead Hospital was performed. Patients were excluded if they had received previous treatment with another nucleoside or nucleotide analogue, were pregnant or less than 18 years old. RESULTS: Out of 336 patients, 163 patients fulfilled the selection criteria. Range of follow up was 3-46 mo (mean 26 mo). 134 patients (82.2%) had pre-treatment biopsies, with 26 patients (16.0 %) demonstrating F3-4 fibrosis. In total, 153 patients (93.9%) achieved at least Partial Virological Suppression (PVS), with 134 patients (82.2%) achieving complete virological suppression. The cumulative CVS and PVS rates at 36 mo were 82.1% and 96.4%, respectively. 3 patients (1.8%) failed to achieve PVS, while 5 patients (3.0%) developed virological rebound. 128 patients (78.5%) maintained CVS throughout follow up. Predictors of CVS included lower baseline DNA level (P = 0.001), hepatitis B virus e antigen negative status (P = 0.001) and increasing age at treatment (log rank 0.001). No significant adverse effects were reported necessitating cessation of entecavir. CONCLUSION: Entecavir monotherapy is efficacious and safe in an Australian tertiary care setting. Resistance and rebound rates are very low. This is similar to data from controlled and uncontrolled trials around the world

Analyse De La Variabilite Hydroclimatique Et Impacts Des Barrages Sur Le Regime Hydrologique D’une Riviere De Zone Semi-Aride : Le Sebou Au Maroc

The analysis and characterization of hydroclimatic variability over a long period of time is fundamental for understanding the impacts of climate change and vulnerability of hydrological regimes. The present work is a study of the spatial and temporal variability of the climatic and hydrological series in the Sebou river basin (Morocco) over the past sixty years using Hanning low-pass filter of second order and statistical tests of stationarity of climate and hydrological time series. These statistic testing methods were applied to analyze the spatial and temporal evolution to the hydroclimatologic data of the AzibEsSoltane, M'jara and MechraBelKsiri hydrometric stations, which are, respectively, located in the Middle Sebou, the Ouerrha Tributary of the Sebou and the Low Sebou. This analysis shows that climate variability has resulted particularly in strong interannual fluctuations in rainfall reflected by a succession of dry and wet periods between 1939 and 1979 and a general decrease in precipitation since 1980. The Water flow time series analysis are marked by ruptures detected mainly between 1972 and 1978 reflecting rainoff declines of about 50% in the Sebou downstream and 70% in the middle Sebou. Several decreases in water discharge (up to 90%) were also detected in the Ouerrhariver since 1996, when the Al Wahda dam started operating.The analysis of the relationships between rainfall and water discharge shows that the impacts of dams constructions are stronger than the climatic effect in the Ouerrha river. The results of this study are important indicators for the assessment of combined climate risks

Australian clinical practice guidelines for the diagnosis and management of Barrett's esophagus and early esophageal adenocarcinoma

Author version made available following 12 month embargo from date of publication according to publisher copyright policy.Barrett's esophagus (BE), a common condition, is the only known precursor to esophageal adenocarcinoma (EAC). There is uncertainty about the best way to manage BE as most people with BE never develop EAC and most patients diagnosed with EAC have no preceding diagnosis of BE. Moreover, there have been recent advances in knowledge and practice about the management of BE and early EAC. To aid clinical decision making in this rapidly moving field, Cancer Council Australia convened an expert working party to identify pertinent clinical questions. The questions covered a wide range of topics including endoscopic and histological definitions of BE and early EAC; prevalence, incidence, natural history, and risk factors for BE; and methods for managing BE and early EAC. The latter considered modification of lifestyle factors; screening and surveillance strategies; and medical, endoscopic, and surgical interventions. To answer each question, the working party systematically reviewed the literature and developed a set of recommendations through consensus. Evidence underpinning each recommendation was rated according to quality and applicability

Instrumentation de textiles par fibres optiques polymériques pour mesure in-situ de compression et de frottement

Smart textiles are increasingly present in the garment and connected wearable market. However, the integration of sensors into garments still requires removing technological but also scientific challenges, in particular when these sensors are optical fibres. Sensors based on polymeric optical fibres make it possible to measure disturbances by measuring the variation in irradiance at the fibre output. Empa is developing such fibres, one of which has the particularity of having a very low Young's modulus (a few MPa), so it is an excellent candidate for measuring deformations. The first part of this work was to optically and mechanically characterize this polymeric optical fibre. The results obtained showed that this fibre is little or not sensitive to traction and torsion, that it is sensitive to compression and bending. Its complex bending behaviour implied a particular strategy for integrating this optical fibre into the textile structure. The integration of this fibre in a structure using a knitting machine was carried out. The influence of the trajectory of the fibre in the knit and its structure has been studied in terms of sensitivity to friction and compression. Finally, a prototype including polymer optical fiber sensors was produced. It is an instrumented backpack for measuring parameters related to the runner¬backpack interaction.Les textiles intelligents sont de plus en plus présents sur le marché de l'habillement et des objets connectés. Cependant, l'intégration des capteurs dans les vêtements ou objets nécessite encore de lever des verrous technologiques mais également scientifiques, en particulier lorsque ces capteurs sont des fibres optiques. Les capteurs basés sur les fibres optiques polymériques permettent de mesurer des perturbations en mesurant la variation l’irradiance en sortie de fibre. L'Empa développe de telles fibres dont une a la particularité de présenter un module de Young très faible (quelques MPa), aussi elle est une excellente candidate pour mesurer des déformations. La première partie des présents travaux a consisté à caractériser optiquement et mécaniquement cette fibre optique polymérique. Les résultats obtenus ont montré que cette fibre est peu ou pas sensible à la traction et à la torsion, qu’elle est sensible à la compression et à la flexion. Son comportement complexe à la flexion a imposé une stratégie particulière d’intégration de cette fibre optique dans la structure textile. L’intégration de cette fibre dans une structure à l’aide d’une machine à tricoter a été réalisée. L’influence de la trajectoire de la fibre dans le tricot et la structure de celui-ci a été étudiée en termes de sensibilité au frottement et à la compression. Enfin, un prototype incluant des capteurs à fibre optique a été réalisé. Il s'agit d'un sac à dos instrumenté dont les mesures ont permis de suivre des paramètres relatifs à l’interaction entre le sac et le coureur en temps réel

Instrumentation de textiles par fibres optiques polymériques pour mesure in-situ de compression et de frottement

Les textiles intelligents sont de plus en plus présents sur le marché de l'habillement et des objets connectés. Cependant, l'intégration des capteurs dans les vêtements ou objets nécessite encore de lever des verrous technologiques mais également scientifiques, en particulier lorsque ces capteurs sont des fibres optiques. Les capteurs basés sur les fibres optiques polymériques permettent de mesurer des perturbations en mesurant la variation l’irradiance en sortie de fibre. L'Empa développe de telles fibres dont une a la particularité de présenter un module de Young très faible (quelques MPa), aussi elle est une excellente candidate pour mesurer des déformations. La première partie des présents travaux a consisté à caractériser optiquement et mécaniquement cette fibre optique polymérique. Les résultats obtenus ont montré que cette fibre est peu ou pas sensible à la traction et à la torsion, qu’elle est sensible à la compression et à la flexion. Son comportement complexe à la flexion a imposé une stratégie particulière d’intégration de cette fibre optique dans la structure textile. L’intégration de cette fibre dans une structure à l’aide d’une machine à tricoter a été réalisée. L’influence de la trajectoire de la fibre dans le tricot et la structure de celui-ci a été étudiée en termes de sensibilité au frottement et à la compression. Enfin, un prototype incluant des capteurs à fibre optique a été réalisé. Il s'agit d'un sac à dos instrumenté dont les mesures ont permis de suivre des paramètres relatifs à l’interaction entre le sac et le coureur en temps réel.Smart textiles are increasingly present in the garment and connected wearable market. However, the integration of sensors into garments still requires removing technological but also scientific challenges, in particular when these sensors are optical fibres. Sensors based on polymeric optical fibres make it possible to measure disturbances by measuring the variation in irradiance at the fibre output. Empa is developing such fibres, one of which has the particularity of having a very low Young's modulus (a few MPa), so it is an excellent candidate for measuring deformations. The first part of this work was to optically and mechanically characterize this polymeric optical fibre. The results obtained showed that this fibre is little or not sensitive to traction and torsion, that it is sensitive to compression and bending. Its complex bending behaviour implied a particular strategy for integrating this optical fibre into the textile structure. The integration of this fibre in a structure using a knitting machine was carried out. The influence of the trajectory of the fibre in the knit and its structure has been studied in terms of sensitivity to friction and compression. Finally, a prototype including polymer optical fiber sensors was produced. It is an instrumented backpack for measuring parameters related to the runner¬backpack interaction

Fire effects on cultural resources in Grand Canyon National Park

Fire archaeology is a relatively new discipline that is underrepresented in anthropological literature. The purpose of this study is to quantify how fire affects cultural resources found on the north and south rims of Grand Canyon National Park. The primary objective of this analysis is to determine whether certain fire or archaeological variables indicate more severe impact on cultural resources from fire events. Twenty-eight pre-contact, multi-component, and historical archaeological sites from both the north rim and south rim of Grand Canyon National Park were visited over the course of the summer and fall of 2022. Standardized post-fire assessment forms and post-fire monitoring forms make up the dataset for this study, producing variables including fire type, site type, fire severity, and level of impact to site integrity. Each of these 28 sites were burned over by either wildland fires or prescribed fires of differing severities over the past several decades. Results produced using IBM SPSS statistics software suggest no statistically significant correlations between fire type, site type, fire severity, and impact to site. These results imply a sense of resilience that certain archaeological artifacts can have in response to fire. It is important for fire managers and fireline resource advisors (READs) to understand these implications, as fire personnel can be assigned to areas they are needed most when there is an understanding of what resources can burn during an incident, and which cannot. Keywords: fire archaeology, IBM SPSS Statistics, cultural resources and fire, Grand Canyon National Par

Optimising outcomes of endoscopic resection of neoplastic gastrointestinal lesions

Barrett’s oesophagus (BE), a known complication of gastroesophageal reflux disease, is characterised replacement of the squamous lining of the distal esophagus by columnar epithelium containing specialized intestinal metaplasia (IM). BE is the only known precursor to oesophageal adenocarcinoma (EAC). EAC incidence has outstripped all other solid organ malignancy and increased almost 6-fold over the past 3 decades 1 2. It has a survival rate of less than 20% at 5 years 3. Most people with BE never develop EAC and most patients diagnosed with EAC have no preceding diagnosis of BE. Progression from BE to EAC occurs in a stepwise manner based on the degree of dysplasia, which is the best marker for predicting progression in patients with BE 4. Histologic progression is noted in a predictable manner starting with low-grade dysplasia (LGD), followed by high-grade dysplasia (HGD), and lastly EAC (superficial or invasive). Superficial EAC comprises the histological tumour classification of T1a (invasion into the mucosa; also known as intramucosal cancer (IMC)) and T1b (invasion into the submucosal but not the muscularis propria) 5. HGD and IMC are often grouped together as Barrett’s Early Neoplasia (BEN). The progression of non-dysplastic BE to BEN ranges from 1.2 to 3.3 per 1000 patient years 6 7. The incidence rate of BEN was 13.4% per patient per year for patients in whom the diagnosis of LGD was confirmed by an academic centre histopathologist 8. This pathologic stepwise progression provides an opportunity for early intervention to prevent development of EAC or eradicate EAC, and thus avoid morbidity and mortality related to this lethal cancer. Endoscopic eradication therapy (EET) for patients at increased risk of progression to EACis endorsed by multiple gastroenterological society guidelines 9-11. Given its efficacy and safety profile, EET as a first line therapy for BEN has ever increasingly replaced oesophagectomy, which has a 30 day mortality of up to 6% 12. The rationale for oesophagectomy for BEN is the concern for synchronous occult invasive carcinoma, which in the surgical series is between 8% and 12% 13-15. Systemic review data of 1350 EAC cases that underwent oesophagectomy noted lymph node metastasis in 1.9% of IMC cases [95% confidence interval (CI), 1.1%-2.6%] and 0% in HGD cases. Considering that the risk of lymph node metastasis in T1a disease is similar or lower than the mortality of oesophagectomy, even at high-volume centers, there is a convincing argument for EET. The management paradigm of BEN centers around resection of all visible lesions which are usually harbingers of the highest grade of dysplasia and subsequent BE eradication of the remaining BE to reduce the risk of metachronous neoplasia (up to 30%) 16. Subsequently patients are enrolled into a surveillance program to identify and treat any possible recurrent neoplasia. Complete BE eradication (CBE) can be achieved through endoscopic resection (ER), endoscopic ablation (EA) or a combination of the two approaches (hybrid therapy). Endoscopic resection can be achieved by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). EA techniques include radiofrequency ablation (RFA), cryotherapy or photodynamic therapy. The most common practiced EET modalities are EMR and RFA