Reduced healthcare utilisation following successful HCV treatment in HIV co-infected patients with mild liver disease

New direct-acting antivirals (DAA) for hepatitis C virus (HCV) infection have achieved high cure rates in many patient groups previously considered difficult-to-treat, including those HIV/HCV co-infected. The high price of these medications is likely to limit access to treatment, at least in the short term. Early treatment priority is likely to be given to those with advanced disease, but a more detailed understanding of the potential benefits in treating those with mild disease is needed. We hypothesized that successful HCV treatment within a co-infected population with mild liver disease would lead to a reduction in the use and costs of healthcare services in the 5 years following treatment completion. We performed a retrospective cohort study of HIV/HCV-co-infected patients without evidence of fibrosis/cirrhosis who received a course of HCV therapy between 2004 and 2013. Detailed analysis of healthcare utilization up to 5 years following treatment for each patient using clinical and electronic records was used to estimate healthcare costs. Sixty-three patients were investigated, of whom 48 of 63 (76.2%) achieved sustained virological response 12 weeks following completion of therapy (SVR12). Individuals achieving SVR12 incurred lower health utilization costs (£5000 per-patient) compared to (£10 775 per-patient) non-SVR patients in the 5 years after treatment. Healthcare utilization rates and costs in the immediate 5 years following treatment were significantly higher in co-infected patients with mild disease that failed to achieve SVR12. These data suggest additional value to achieving cure beyond the prevention of complications of disease

Pacific Hake, Merluccius productus, Autecology: A Timely Review

Pacific hake, Merluccius productus, the most abundant groundfish in the California Current Large Marine Ecosystem (CCLME), is a species of both commercial significance, supporting a large international fishery, and ecological importance, connecting other species as both predator and prey. Coastal Pacific hake migrations are characterized by movements between northern summer feeding areas and southern winter spawning areas, with variations in annual abundance, distribution, and the extent of these movements associated with varying climate-ocean conditions. In general, warm (cool) years with enhanced (reduced) stratification and poleward (equatorward) transport are often related to good (poor) recruitment, increased (decreased) northward distribution, and reduced (enhanced) growth. However, the classic periodic pattern of annual migration and distribution may no longer be fully representative. Based on recent advances in the understanding of climate-ocean variability off the U.S. west coast, we hypothesize that the annual movements of Pacific hake are more responsive to climate-ocean variability than previously thought, and further, that changes observed in Pacific hake distributions may reflect long-term changes in climate-ocean conditions in the CCLME. Therefore, an updated model of these relations is key to effective monitoring and management of this stock, as well as to devising scenarios of future change in the CCLME as a result of climate variations. The current state of knowledge of the relationship between the Pacific hake and its environment is reviewed, highlighting emerging ideas compared to those of the past, and priorities for future research are suggested

The 2016 Perseids

The Perseid meteor shower has been observed since ancient times. One of the most prolific annual showers, the Perseids have also been known to outburst. At least two spacecraft have suffered anomalies potentially caused by meteoroid impacts during Perseid outbursts. Olympus, an ESA telecommunications satellite, was likely impacted by a Perseid meteoroid during the 1993 outburst that ultimately led to the termination of the spacecraft's mission. Landsat-5, an imaging satellite jointly managed by NASA and the USGS, lost gyro stability during the peak of the Perseids in 2009. The Perseid meteor shower is expected to outburst again in 2016. Stream model predictions place the peak activity on the night of August 11-12 (UT) as the Earth passes through several old debris trails from parent comet 109P/Swift-Tuttle. Observing geometry favors Europe at the onset, but increased activity for about half a day means that North America is also well-placed for observations. A call for observations to characterize the stream and constrain numerical models is made. Modeling results, observing geometry, and spacecraft risk during the 2016 Perseids will be discussed

Recommendations for HER2 testing in the UK

Determining the HER2 status of breast carcinomas is a prerequisite for the use of the monoclonal antibody trastuzumab (Herceptin(R)), which has recently been licensed for the treatment of metastatic disease. This necessitates a test based on archival material. The preferred analyses are immunohistochemistry with fluorescent in situ hybridisation (FISH) as a follow up test for ambiguous results. Guidelines have been developed for standardised, well controlled procedures for the provision of reliable results. A group of three reference laboratories has been established to provide advice, quality assurance, and materials, where needed

Synthetic Observations of Simulated Radio Galaxies I: Radio and X-ray Analysis

We present an extensive synthetic observational analysis of numerically- simulated radio galaxies designed to explore the effectiveness of conventional observational analyses at recovering physical source properties. These are the first numerical simulations with sufficient physical detail to allow such a study. The present paper focuses on extraction of magnetic field properties from nonthermal intensity information. Synchrotron and inverse-Compton intensities provided meaningful information about distributions and strengths of magnetic fields, although considerable care was called for. Correlations between radio and X-ray surface brightness correctly revealed useful dynamical relationships between particles and fields. Magnetic field strength estimates derived from the ratio of X-ray to radio intensity were mostly within about a factor of two of the RMS field strength along a given line of sight. When emissions along a given line of sight were dominated by regions close to the minimum energy/equipartition condition, the field strengths derived from the standard power-law-spectrum minimum energy calculation were also reasonably close to actual field strengths, except when spectral aging was evident. Otherwise, biases in the minimum- energy magnetic field estimation mirrored actual differences from equipartition. The ratio of the inverse-Compton magnetic field to the minimum-energy magnetic field provided a rough measure of the actual total energy in particles and fields in most instances, within an order of magnitude. This may provide a practical limit to the accuracy with which one may be able to establish the internal energy density or pressure of optically thin synchrotron sources.Comment: 43 pages, 14 figures; accepted for publication in ApJ, v601 n2 February 1, 200

SU(3) breaking in hyperon transition vector form factors

We present a calculation of the SU(3)-breaking corrections to the hyperon transition vector form factors to $\mathcal{O}(p^4)$ in heavy baryon chiral perturbation theory with finite-range regularisation. Both octet and decuplet degrees of freedom are included. We formulate a chiral expansion at the kinematic point $Q^2=-(M_{B_1}-M_{B_2})^2$, which can be conveniently accessed in lattice QCD. The two unknown low-energy constants at this point are constrained by lattice QCD simulation results for the $\Sigma^-\rightarrow n$ and $\Xi^0\rightarrow \Sigma^+$ transition form factors. Hence we determine lattice-informed values of $f_1$ at the physical point. This work constitutes progress towards the precise determination of $|V_{us}|$ from hyperon semileptonic decays

Spacecraft Risk Posed by the 2016 Perseid Outburst

The Perseids are one of the more prolific annual showers, known for high rates and for producing bright meteors. Outbursts of this shower have been noted in the 1860s, the early 1990s, 2004, and 2009, with the 1993 outburst being especially active (peak ZHR above 300). The 1993 Perseids also affected the space-faring nations, as the launch of the STS-51 mission was delayed by NASA until after the shower maximum due to an inability to predict the shower intensity, and the ESA telecommunications satellite Olympus suffered a mission-ending anomaly attributed to a static discharge caused by a Perseid impact [1]. Rates were again high (peak ZHR around 200) in 2009, when the NASA/USGS imaging satellite Landsat-5 experienced a gyro anomaly just before the shower peak; however in this case, the satellite was recovered and normal operations resumed one week later [2]. It is interesting to note that both spacecraft anomalies were not what is typically expected from meteoroid strikes, i.e., physical damage or an attitude displacement due to transfer of momentum. It would appear that the very fast Perseids (59 km s(sup -1) have a marked ability to produce plasma upon impact, which can then serve as a conductive path for discharge currents. The shower is expected to outburst again in 2016, and we present the results from the MSFC Meteoroid Stream Model [4], which predicts enhanced activity on a level similar to that of 2009 as the Earth passes through several debris trails on the night of August 11-12 (UT). We then compare our results to those of other modelers

An Exponential Luminous Efficiency Model for Hypervelocity Impact into Regolith

The flash of thermal radiation produced as part of the impact-crater forming process can be used to determine the energy of the impact if the luminous efficiency is known. From this energy the mass and, ultimately, the mass flux of similar impactors can be deduced. The luminous efficiency, eta, is a unique function of velocity with an extremely large variation in the laboratory range of under 6 km/s but a necessarily small variation with velocity in the meteoric range of 20 to 70 km/s. Impacts into granular or powdery regolith, such as that on the moon, differ from impacts into solid materials in that the energy is deposited via a serial impact process which affects the rate of deposition of internal (thermal) energy. An exponential model of the process is developed which differs from the usual polynomial models of crater formation. The model is valid for the early time portion of the process and focuses on the deposition of internal energy into the regolith. The model is successfully compared with experimental luminous efficiency data from both laboratory impacts and from lunar impact observations. Further work is proposed to clarify the effects of mass and density upon the luminous efficiency scaling factors. Keywords hypervelocity impact impact flash luminous efficiency lunar impact meteoroid

Field experiments on concentrated organic nitrogen fertilizers

RESP-395