The Australasian hepatology association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

© 2016 Richmond et al. Background: Hepatitis C is a blood-borne virus primarily spread through sharing of drug-injecting equipment. Approximately 150 million people worldwide and 230,000 Australians are living with chronic hepatitis C infection. In March 2016, the Australian government began subsidizing direct acting antivirals (DAAs) for the treatment of hepatitis C, which are highly effective (95% cure rate) and have few side effects. However, there is limited evidence to inform the provision of adherence support to people with hepatitis C on DAAs including the level of medication adherence required to achieve a cure. Methodology: In February 2016, a steering committee comprising four authors convened an expert panel consisting of six hepatology nurses, a hepatologist, a pharmacist, a consumer with hepatitis C and treatment experience, and a consumer advocate. The expert panel focused on the following criteria: barriers and enablers to DAA adherence; assessment and monitoring of DAA adherence; components of a patient-centered approach to DAA adherence; patients that may require additional adherence support; and interventions to support DAA adherence. The resultant guidelines underwent three rounds of consultation with the expert panel, Australasian Hepatology Association (AHA) members (n=12), and key stakeholders (n=7) in June 2016. Feedback was considered by the steering committee and incorporated if consensus was achieved. Results: Twenty-four guidelines emerged from the evidence synthesis and expert panel discussion. The guidelines focus on the pretreatment assessment and education, assessment of treatment readiness, and monitoring of medication adherence. The guidelines are embedded in a patient-centered approach which highlights that all patients are at risk of nonadherence. The guidelines recommend implementing interventions focused on identifying patients’ memory triggers and hooks; use of nonconfrontational and nonjudgmental language by health professionals; and objectively monitoring adherence. Conclusion: These are the first guidelines to support patients and health professionals in the delivery of clinical care by identifying practical adherence support interventions for patients taking DAAs

Unified analysis of switched-capacitor resonant converters

Author name used in this publication: Y. P. Benny YeungAuthor name used in this publication: K. W. E. ChengAuthor name used in this publication: S. L. HoAuthor name used in this publication: K. K. Law2004-2005 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Non-Gaussian states for continuous variable quantum computation via Gaussian maps

We investigate non-Gaussian states of light as ancillary inputs for generating nonlinear transformations required for quantum computing with continuous variables. We consider a recent proposal for preparing a cubic phase state, find the exact form of the prepared state and perform a detailed comparison to the ideal cubic phase state. We thereby identify the main challenges to preparing an ideal cubic phase state and describe the gates implemented with the non-ideal prepared state. We also find the general form of operations that can be implemented with ancilla Fock states, together with Gaussian input states, linear optics and squeezing transformations, and homodyne detection with feed forward, and discuss the feasibility of continuous variable quantum computing using ancilla Fock states.Comment: 8 pages, 6 figure

Agglomeration of celecoxib by quasi emulsion solvent diffusion method: effect of stabilizer

Purpose: The quasi-emulsion solvent diffusion (QESD) has evolved into an effective technique to manufacture agglomerates of API crystals. Although, the proposed technique showed benefits, such as cost effectiveness, that is considerably sensitive to the choice of a stabilizer, which agonizes from a absence of systemic understanding in this field. In the present study, the combination of different solvents and stabilizers were compared to investigate any connections between the solvents and stabilizers. Methods: Agglomerates of celecoxib were prepared by QESD method using four different stabilizers (Tween 80, HPMC, PVP and SLS) and three different solvents (methyl acetate, ethyl acetate and isopropyl acetate). The solid state of obtained particles was investigated by differential scanning calorimetry (DSC) and Fourier transform infrared (FT-IR) spectroscopy. The agglomerated were also evaluated in term of production yield, distribution of particles and dissolution behavior. Results: The results showed that the effectiveness of stabilizer in terms of particle size and particle size distribution is specific to each solvent candidate. A stabilizer with a lower HLB value is preferred which actually increased its effectiveness with the solvent candidates with higher lipophilicity. HPMC appeared to be the most versatile stabilizer because it showed a better stabilizing effect compared to other stabilizers in all solvents used. Conclusion: This study demonstrated that the efficiency of stabilizers in forming the celecoxib agglomerates by QESD was influenced by the HLB of the stabilizer and lipophilicity of the solvents

Esophagectomy without mortality: What can surgeons do?

Introduction: Surgical resection remains the mainstay treatment for patients with localized esophageal cancer. It is, however, a complex procedure. Mortality rate used to be high, but in recent years, death rate has been reduced to below 5% in specialized centers. Methods: Outcome of esophagectomy can be improved by paying attention to (1) appropriate patient section, (2) choice of surgical techniques and their execution, and (3) optimizing perioperative care. A volume-outcome relationship is also evident. Surgeons can perform esophagectomy without mortality, but a multi-disciplinary team management is essential to achieve this goal. © 2009 The Society for Surgery of the Alimentary Tract.postprin

Spin-Nematic Squeezed Vacuum in a Quantum Gas

Using squeezed states it is possible to surpass the standard quantum limit of measurement uncertainty by reducing the measurement uncertainty of one property at the expense of another complementary property. Squeezed states were first demonstrated in optical fields and later with ensembles of pseudo spin-1/2 atoms using non-linear atom-light interactions. Recently, collisional interactions in ultracold atomic gases have been used to generate a large degree of quadrature spin squeezing in two-component Bose condensates. For pseudo spin-1/2 systems, the complementary properties are the different components of the total spin vector , which fully characterize the state on an SU(2) Bloch sphere. Here, we measure squeezing in a spin-1 Bose condensate, an SU(3) system, which requires measurement of the rank-2 nematic or quadrupole tensor as well to fully characterize the state. Following a quench through a nematic to ferromagnetic quantum phase transition, squeezing is observed in the variance of the quadratures up to -8.3(-0.7 +0.6) dB (-10.3(-0.9 +0.7) dB corrected for detection noise) below the standard quantum limit. This spin-nematic squeezing is observed for negligible occupation of the squeezed modes and is analogous to optical two-mode vacuum squeezing. This work has potential applications to continuous variable quantum information and quantum-enhanced magnetometry

Behavioural and Cognitive Associations of Short Stature at 5 Years

Objectives To determine the extent to which childhood short stature is associated with cognitive, behavioural and chronic health problems, and whether these problems could be attributed to recognized adverse biological, psychosocial or psychological factors. Methodology At their first antenatal session, 8556 women were enrolled in a prospective study of pregnancy. When their children were 4 and 6 years of age, mothers completed a detailed questionnaire concerning their child's health and behaviour. A Peabody Picture Vocabulary Test-Revised (PPVT-R) was completed by the child at 5 years of age. Z scores were used to categorize height measurements in 3986 children. The relationship of these height categories with the child's health, and behavioural and cognitive problems was then examined. Results No association was found between height and symptoms of chronic disease or behaviour problems in boys or girls. On the unadjusted analysis, mean PPVT-R scores were significantly lower in boys with heights < 3 percentile and 3-10 percentile compared with study children between 10 to 90 percentile (P < 0.01). Scores were similarly significantly lower in girls with heights < 3 percentile and 3-10 percentile (P = 0.01). Even after adjusting for psychosocial and biological confounders, short stature remained a significant predictor for lower PPVT-R scores in both boys and girls, although height only accounted for 1.1% of the variance in scores in boys and 0.5% of the variance in PPVT-R scores in girls. Psychosocial factors had a greater role than height in determining PPVT-R scores at 5 years of age. Conclusions These findings suggest a significant, though small, association between height and PPVT-R scores at 5 years of age, independent of psychosocial disadvantage and known biological risk factors

Low-Energy Signals from Kinetic Mixing with a Warped Abelian Hidden Sector

We investigate the detailed phenomenology of a light Abelian hidden sector in the Randall-Sundrum framework. Relative to other works with light hidden sectors, the main new feature is a tower of hidden Kaluza-Klein vectors that kinetically mix with the Standard Model photon and Z. We investigate the decay properties of the hidden sector fields in some detail, and develop an approach for calculating processes initiated on the ultraviolet brane of a warped space with large injection momentum relative to the infrared scale. Using these results, we determine the detailed bounds on the light warped hidden sector from precision electroweak measurements and low-energy experiments. We find viable regions of parameter space that lead to significant production rates for several of the hidden Kaluza-Klein vectors in meson factories and fixed-target experiments. This offers the possibility of exploring the structure of an extra spacetime dimension with lower-energy probes.Comment: (1+32) Pages, 13 Figures. v2: JHEP version (minor modifications, results unchanged

How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations? : a study in polish primary care

Background: Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women. Methods: A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual’s CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects’ self-care behavior was examined. Results: We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important. Conclusions: Different predictors of acquisition of health behavior are encountered in men and women. Our results suggest that gender-adjusted motivation models influencing the recognition process need to be considered to optimize compliance in patients with CVR

A mutation in the viral sensor 2'-5'-oligoadenylate synthetase 2 causes failure of lactation.

We identified a non-synonymous mutation in Oas2 (I405N), a sensor of viral double-stranded RNA, from an ENU-mutagenesis screen designed to discover new genes involved in mammary development. The mutation caused post-partum failure of lactation in healthy mice with otherwise normally developed mammary glands, characterized by greatly reduced milk protein synthesis coupled with epithelial cell death, inhibition of proliferation and a robust interferon response. Expression of mutant but not wild type Oas2 in cultured HC-11 or T47D mammary cells recapitulated the phenotypic and transcriptional effects observed in the mouse. The mutation activates the OAS2 pathway, demonstrated by a 34-fold increase in RNase L activity, and its effects were dependent on expression of RNase L and IRF7, proximal and distal pathway members. This is the first report of a viral recognition pathway regulating lactation