A Multicenter Retrospective Study on Clinical Characteristics, Treatment Patterns, and Outcome in Elderly Patients with Hepatocellular Carcinoma

Background. There is a paucity of information on the clinical presentation and outcome of elderly hepatocellular carcinoma (HCC) patients. We performed a multicenter retrospective comparative study to assess the impact of age on potential differences in clinical characteristics, treatment patterns, and outcome in HCC patients. Methods. We retrospectively analyzed HCC patients treated at two U.S. tertiary institutions from 1998 to 2008. Demographics, tumor parameters, etiology and severity of cirrhosis, treatment, and survival from diagnosis were collected and analyzed. After exclusion of transplanted patients, survival analyses were performed using the Kaplan-Meier method with log-rank tests and Cox proportional hazards models. Results. Three hundred thirty-five HCC patients were divided into two groups: “elderly” (95 patients, age ≥70 years) and “younger” (240 patients, aged <70 years). The male/female (M/F) ratio was 5.8:1 and 1.7:1 in the younger and elderly groups, respectively (p < .0001). Hepatitis C virus (HCV) infection rate was 48.3% in younger and 21.1% in elderly patients (p < .0001); Child class B and C cirrhosis accounted for 35.8% in younger and 25.3% in elderly patients (p = .063). Compared with younger patients, the elderly received transplant less frequently (19.6% versus 5.3%, p = .0002) and were more likely to receive supportive care only (22.9% versus 36.8%, p = .01). No significant differences between the two age groups were seen in tumor parameters or other treatments received. Overall (p = .47) and HCC-specific survival rates (p = .38) were similar in both age groups. Conclusions. Characteristics that distinguish elderly from younger HCC patients include lower M/F ratio, worse performance status, lower rate of HCV infection, and less advanced underlying cirrhosis. Elderly patients were less likely to have a liver transplant and more likely to receive supportive care only. However, overall and HCC-specific survival were similar between the two groups

Even moderate geomagnetic pulsations can cause fluctuations of foF2 frequency of the auroral ionosphere

Abstract The ionosonde at the Sodankylä Geophysical Observatory (SOD; 67∘ N, 27∘ E; Finland) routinely performs vertical sounding once per minute which enables the study of fast ionospheric variations at a frequency of the long-period geomagnetic pulsations Pc5–6/Pi3 (1–5 mHz). Using the ionosonde data from April 2014–December 2015 and colocated geomagnetic measurements, we have investigated a correspondence between the magnetic field pulsations and variations of the critical frequency of radio waves reflected from the ionospheric F2 layer (foF2). For this study, we have developed a technique for automated retrieval of the critical frequency of the F2 layer from ionograms. As a rule, the Pc5–6/Pi3 frequency band fluctuations in foF2 were observed at daytime during quiet or moderately disturbed space weather conditions. In most cases (about 80 %), the coherence between the foF2 variations and geomagnetic pulsations was low. However in some cases (specified as “coherent”) the coherence was as large as γ²≥0.5. The following conditions are favorable for the occurrence of coherent cases: enhanced auroral activity (6 h maximal auroral electrojet (AE) ≥800 nT), high solar wind speed (V>600 km/s), fluctuating solar wind pressure and northward interplanetary magnetic field. In the cases when the coherence was higher at shorter periods of oscillations, the magnetic pulsations demonstrated features typical for the Alfvén field line resonance

Monitoring of Geomagnetic and Telluric Field Disturbances in the Russian Arctic

The influence of space factors on technological systems in the Arctic (power transmission lines, oil/gas pipelines) has become critically important. To examine in depth these effects, an archive of digital 1 min data from Soviet/Russian magnetic stations deployed along the Arctic coast was created, starting from 1983 to the present. All data from various sources were converted to daily files in standard IAGA-2002 format and supplemented with quick-look magnetograms. Some of these data are included already in the existing world magnetic field databases, but not all. Examples of disturbances known to excite intense geomagnetically induced currents in power transmission lines were presented: irregular Pi3 pulsations and magnetic perturbation events. The database was augmented with the global 3D model of the Earth’s conductivity structure. The given example showed how the combined usage of the geomagnetic field database and the conductivity model enables one to synthesize the geoelectric field response to geomagnetic variations, and to assess the distortions of the pipeline-soil potential. To determine regions most susceptible to geomagnetic hazard, a map with normalized telluric fields was created for a uniform sinusoidally varying magnetic disturbance. This map showed that the largest electrotelluric potentials and field are induced in regions with a high resistivity (e.g., Kola Peninsula and Ural Mountains). This database can be also a useful support for space missions in the magnetosphere. The database is publicly available on the anonymous FTP site

Structural Characterization of the Dual Glycan Binding Adeno-Associated Virus Serotype 6▿ †

The three-dimensional structure of adeno-associated virus (AAV) serotype 6 (AAV6) was determined using cryo-electron microscopy and image reconstruction and using X-ray crystallography to 9.7- and 3.0-Å resolution, respectively. The AAV6 capsid contains a highly conserved, eight-stranded (βB to βI) β-barrel core and large loop regions between the strands which form the capsid surface, as observed in other AAV structures. The loops show conformational variation compared to other AAVs, consistent with previous reports that amino acids in these loop regions are involved in differentiating AAV receptor binding, transduction efficiency, and antigenicity properties. Toward structure-function annotation of AAV6 with respect to its unique dual glycan receptor (heparan sulfate and sialic acid) utilization for cellular recognition, and its enhanced lung epithelial transduction compared to other AAVs, the capsid structure was compared to that of AAV1, which binds sialic acid and differs from AAV6 in only 6 out of 736 amino acids. Five of these residues are located at or close to the icosahedral 3-fold axis of the capsid, thereby identifying this region as imparting important functions, such as receptor attachment and transduction phenotype. Two of the five observed amino acids are located in the capsid interior, suggesting that differential AAV infection properties are also controlled by postentry intracellular events. Density ordered inside the capsid, under the 3-fold axis in a previously reported, conserved AAV DNA binding pocket, was modeled as a nucleotide and a base, further implicating this capsid region in AAV genome recognition and/or stabilization