Long-Term Survival in Gastroesophageal Junction Adenocarcinoma: Ramucirumab

We report a case of long-term survival with complete response of liver metastases within RAINBOW, a randomized, controlled trial of ramucirumab 8 mg/kg intravenously (days 1, 15) versus placebo, both plus paclitaxel 80 mg/m2 intravenously (days 1, 8, 15), every 4 weeks in patients with previously treated advanced gastroesophageal junction adenocarcinoma. A 64-year-old man with gastroesophageal junction adenocarcinoma and liver metastases received first-line folinic acid, 5-fluorouracil plus oxaliplatin (FOLFOX) following jejunostomy. On liver progression, he enrolled in RAINBOW (April 2012), receiving ramucirumab. In November 2013, positron emission tomography scan was consistent with complete metabolic response, confirmed by a follow-up scan in March 2016

Longitudinal liver stiffness assessment in patient with chronic hepatitis C undergoing antiviral therapy.

BACKGROUND/AIMS:Liver stiffness (LS) measurement by means of transient elastography (TE) is accurate to predict fibrosis stage. The effect of antiviral treatment and virologic response on LS was assessed and compared with untreated patients with chronic hepatitis C (CHC). METHODS: TE was performed at baseline, and at weeks 24, 48, and 72 in 515 patients with CHC. RESULTS: 323 treated (62.7%) and 192 untreated patients (37.3%) were assessed. LS experienced a significant decline in treated patients and remained stable in untreated patients at the end of study (P<0.0001). The decline was significant for patients with baseline LS ≥ 7.1 kPa (P<0.0001 and P 0.03, for LS ≥ 9.5 and ≥ 7.1 kPa vs lower values, respectively). Sustained virological responders and relapsers had a significant LS improvement whereas a trend was observed in nonresponders (mean percent change -16%, -10% and -2%, for SVR, RR and NR, respectively, P 0.03 for SVR vs NR). In multivariate analysis, high baseline LS (P<0.0001) and ALT levels, antiviral therapy and non-1 genotype were independent predictors of LS improvement. CONCLUSIONS: LS decreases during and after antiviral treatment in patients with CHC. The decrease is significant in sustained responders and relapsers (particularly in those with high baseline LS) and suggests an improvement in liver damage

Clinical phenotype of adult-onset systemic histiocytosis harboring <i>BRAF</i> in-frame deletions

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A national cross-sectional study among drug-users in France: epidemiology of HCV and highlight on practical and statistical aspects of the design

<p>Abstract</p> <p>Background</p> <p>Epidemiology of HCV infection among drug users (DUs) has been widely studied. Prevalence and sociobehavioural data among DUs are therefore available in most countries but no study has taken into account in the sampling weights one important aspect of the way of life of DUs, namely that they can use one or more specialized services during the study period. In 2004–2005, we conducted a national seroepidemiologic survey of DUs, based on a random sampling design using the Generalised Weight Share Method (GWSM) and on blood testing.</p> <p>Methods</p> <p>A cross-sectional multicenter survey was done among DUs having injected or snorted drugs at least once in their life. We conducted a two stage random survey of DUs selected to represent the diversity of drug use. The fact that DUs can use more than one structure during the study period has an impact on their inclusion probabilities. To calculate a correct sampling weight, we used the GWSM. A sociobehavioral questionnaire was administered by interviewers. Selected DUs were asked to self-collect a fingerprick blood sample on blotting paper.</p> <p>Results</p> <p>Of all DUs selected, 1462 (75%) accepted to participate. HCV seroprevalence was 59.8% [95% CI: 50.7–68.3]. Of DUs under 30 years, 28% were HCV seropositive. Of HCV-infected DUs, 27% were unaware of their status. In the month prior to interview, 13% of DUs shared a syringe, 38% other injection parapharnelia and 81% shared a crack pipe. In multivariate analysis, factors independently associated with HCV seropositivity were age over 30, HIV seropositivity, having ever injected drugs, opiate substitution treatment (OST), crack use, and precarious housing.</p> <p>Conclusion</p> <p>This is the first time that blood testing combined to GWSM is applied to a DUs population, which improve the estimate of HCV prevalence. HCV seroprevalence is high, indeed by the youngest DUs. And a large proportion of DUs are not aware of their status. Our multivariate analysis identifies risk factors such as crack consumption and unstable housing.</p

Low Cost Flux Switching Linear Hybrid Actuator

International audienceIt's now possible to better satisfy the need for direct linear actuators. In particular, the household applications represent an expanding market. The principal constraints are the cost and the noise. We propose, in this paper, a new electromagnetic structure in which the rail is passive (without permanent magnets and without conductors) and where the mobile part (primary) has ferromagnetic pieces, permanent magnets and coils with simple forms very easy to build. The presence of permanent magnets permits obtaining good performances with high efficiency even for smaller sizes. Moreover the performances are not very sensitive to the airgap length. In comprison with induction and switched reluctance motors. Yhis last characteristic is important in order to have easy guiding. The present structure I cellular and works on the principle of permanent magnet flux switching during movment. We describe its principle, and we perform an analysis of the significant dimensional parametric influence. The electromagnetic phenomena is basically 3D, but to simplify the understanding, the analysis is based initially on an analytic modelling in linear mode and then on a numerical computation by 2D finite element method. We then show an experimental structure for which we compare the theoretical results and the measurements of static effort. We also provide a synthesis of the experimental results obtained with many types of permanent magnets and with several numbers of cells. Finally, we show the results of the dynamic operation when the actuator is supplied by an electronic inverter and self-driving system with indirect position sensors

Analyse des possibilités de fonctionnement en régime des désexcitation des moteurs à aimants permanents

In this paper, we study the extending of speed range of motors (or generators) with permanent magnet inductor and supplied by electronic converter. The amplitude of phase voltage and current waveforms are limited by electronics supply. The aim of this study is to achieve a maximum power near of the base speed one on an extended speed range. This require an airgap flux weakening so called “flux weakening” above base speed. A parametric analysis of motor electromagnetic characteristics is made to show the influence of armature reaction and magnetic saliency on speed range. We show that exists an ideal condition to obtain a constant power speed range theoretically unlimited. Magnetic saliency permits to enhance the power factor especially when $L_{\rm d}> L_{\rm q}$. As main hypotheses, we consider no saturation, e.m.f. and current sine waveforms and a sinusoidal airgap flux density. Finally, we recapitulate the permanent magnet rotor structures able to obtain a flux-weakening operation.Cet article traite de l'extension de la plage de vitesse des moteurs (ou alternateurs) à excitation par aimants permanents et alimentés par convertisseur électronique. La tension et le courant sont limités en amplitude par l'alimentation électronique.L'objectif est d'obtenir une puissance proche de celle correspondant au régime de base sur une plage de vitesse étendue. Ceci nécessite une réduction de flux d'entrefer ou “désexition” au delà de la vitesse de base. Une analyse paramétrique des caractéristiques du moteur est effectuée pour mettre en évidence l'influence de la réaction d'induit et de la saillance magnétique. Nous montrons qu'il existe une condition idéale pour obtenir une plage de fonctionnement à puissance constante théoriquement illimitée. La saillance magnétique permet d'accroître le facteur de puissance surtout lorsque $L_{\rm d}> L_{\rm q}$. Les principales hypothèses de cette étude sont l'absence de saturation, des f.e.m. et des courants sinusoïdaux et une induction spatiale sinusoïdale dans l'entrefer. Enfin, nous effectuons un bilan des structures de rotors permettant un fonctionnement en régime de désexcitation

Switching flux permanent magnet polyphased synchronous machines

International audienceThis paper present original structures of a permanent magnet synchronous polyphased machine based on the switching flux principle