Multimodality Treatment with Conventional Transcatheter Arterial Chemoembolization and Radiofrequency Ablation for Unresectable Hepatocellular Carcinoma

Background/Aims: To evaluate the efficacy of multimodality treatment consisting of conventional transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) in patients with non-resectable and non-ablatable hepatocellular carcinoma (HCC). Methods: In this retrospective study, 85 consecutive patients with HCC (59 solitary, 29 multifocal HCC) received TACE followed by RFA between 2001 and 2010. The mean number of tumors per patient was 1.6 +/- 0.7 with a mean size of 3.0 +/- 0.9 cm. Both local efficacy and patient survival were evaluated. Results: Of 120 treated HCCs, 99 (82.5%) showed a complete response (CR), while in 21 HCCs (17.5%) a partial response was depicted. Patients with solitary HCC revealed CR in 91% (51/56); in patients with multifocal HCC (n = 29) CR was achieved in 75% (48 of 64 HCCs). The median survival for all patients was 25.5 months. The 1-, 2-, 3- and 5-year survival rates were 84.6, 58.7, 37.6 and 14.6%, respectively. Statistical analysis revealed a significant difference in survival between Barcelona Clinic Liver Cancer (BCLC) A (73.4 months) and B (50.3 months) patients, while analyses failed to show a difference for Child-Pugh score, Cancer of Liver Italian Program (CLIP) score and tumor distribution pattern. Conclusion: TACE combined with RFA provides an effective treatment approach with high local tumor control rates and promising survival data, especially for BCLC A patients. Randomized trials are needed to compare this multimodality approach with a single modality approach for early-stage HCC. Copyright (C) 2011 S. Karger AG, Base

Focal Cerebral Magnetic Resonance Changes Associated with Partial Status Epilepticus

We report 2 patients with transient abnormalities on magnetic resonance imaging (MRI) associated with partial status epilepticus (SE). A man with a 4-month history of partial seizures had complex partial SE for 9 days, with left temporal maximum on ictal EEG. Left temporal lobe T 2 signal was increased on MRI during SE, but cerebral MRI was normal 9 weeks later. A woman with “cryptogenic” temporal lobe epilepsy for 16 years had complex partial SE for 1 week, with right temporal maximum on ictal EEG. T 2 Signal was increased over the entire right temporal lobe, extending into the insula, without mass effect, on MRI 1 month after SE ended. Repeat MRI 1 month later showed marked decrease in volume of increased T 2 intensity, without gadolinium enhancement, but with mild mass effect over the right anteroinferomesial temporal areas. A gemistocytic astrocytoma was resected. Focal cerebral MRI abnormalities consistent with cerebral edema may be due to partial SE but also may indicate underlying glioma, even in long-standing partial epilepsy. Focal structural imaging changes consistent with neoplasm should be followed to full resolution after partial SE.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65221/1/j.1528-1157.1994.tb02909.x.pd

The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement

BACKGROUND: Three large new trials of unprecedented scale and cost, which included novel factorial designs, have found no effect of basic water, sanitation and hygiene (WASH) interventions on childhood stunting, and only mixed effects on childhood diarrhea. Arriving at the inception of the United Nations' Sustainable Development Goals, and the bold new target of safely managed water, sanitation and hygiene for all by 2030, these results warrant the attention of researchers, policy-makers and practitioners. MAIN BODY: Here we report the conclusions of an expert meeting convened by the World Health Organization and the Bill and Melinda Gates Foundation to discuss these findings, and present five key consensus messages as a basis for wider discussion and debate in the WASH and nutrition sectors. We judge these trials to have high internal validity, constituting good evidence that these specific interventions had no effect on childhood linear growth, and mixed effects on childhood diarrhea. These results suggest that, in settings such as these, more comprehensive or ambitious WASH interventions may be needed to achieve a major impact on child health. CONCLUSION: These results are important because such basic interventions are often deployed in low-income rural settings with the expectation of improving child health, although this is rarely the sole justification. Our view is that these three new trials do not show that WASH in general cannot influence child linear growth, but they do demonstrate that these specific interventions had no influence in settings where stunting remains an important public health challenge. We support a call for transformative WASH, in so much as it encapsulates the guiding principle that - in any context - a comprehensive package of WASH interventions is needed that is tailored to address the local exposure landscape and enteric disease burden

Phylodynamics and movement of Phycodnaviruses among aquatic environments

Phycodnaviruses have a significant role in modulating the dynamics of phytoplankton, thereby influencing community structure and succession, nutrient cycles and potentially atmospheric composition because phytoplankton fix about half the carbon dioxide (CO2) on the planet, and some algae release dimethylsulphoniopropionate when lysed by viruses. Despite their ecological importance and widespread distribution, relatively little is known about the evolutionary history, phylogenetic relationships and phylodynamics of the Phycodnaviruses from freshwater environments. Herein we provide novel data on Phycodnaviruses from the largest river system on earth—the Amazon Basin—that were compared with samples from different aquatic systems from several places around the world. Based on phylogenetic inference using DNA polymerase (pol) sequences we show the presence of distinct populations of Phycodnaviridae. Preliminary coarse-grained phylodynamics and phylogeographic inferences revealed a complex dynamics characterized by long-term fluctuations in viral population sizes, with a remarkable worldwide reduction of the effective population around 400 thousand years before the present (KYBP), followed by a recovery near to the present time. Moreover, we present evidence for significant viral gene flow between freshwater environments, but crucially almost none between freshwater and marine environments

Cognitive attraction and online misinformation

© The Author(s) 2019. The spread of online misinformation has gained mainstream attention in recent years. This paper approaches this phenomenon from a cultural evolution and cognitive anthropology perspective, focusing on the idea that some cultural traits can be successful because their content taps into general cognitive preferences. This research involves 260 articles from media outlets included in two authoritative lists of websites known for publishing hoaxes and ‘fake news’, tracking the presence of negative content, threat-related information, presence of sexually related material, elements associated to disgust, minimally counterintuitive elements (and a particular category of them, i.e., violations of essentialist beliefs), and social information, intended as presence of salient social interactions (e.g., gossip, cheating, formation of alliances), and as news about celebrities. The analysis shows that these features are, to a different degree, present in most texts, and thus that general cognitive inclinations may contribute to explain the success of online misinformation. This account can elucidate questions such as whether and why misinformation online is thriving more than accurate information, or the role of ‘fake news’ as a weapon of political propaganda. Online misinformation, while being an umbrella term covering many different phenomena, can be characterised, in this perspective, not as low-quality information that spreads because of the inefficiency of online communication, but as high-quality information that spreads because of its efficiency. The difference is that ‘quality’ is not equated to truthfulness but to psychological appeal.The Netherlands Organisation for Scientific Research (NWO VIDI-grant 016.144312)

Experimental Polymer Mechanochemistry and its Interpretational Frameworks

Polymer mechanochemistry is an emerging field at the interface of chemistry, materials science, physics and engineering. It aims at understanding and exploiting unique reactivities of polymer chains confined to highly non-equilibrium stretched geometries by interactions with their surroundings. Macromolecular chains or their segments become stretched in bulk polymers under mechanical loads or when polymer solutions are sonicated or flow rapidly through abrupt contractions. An increasing amount of empirical data suggests that mechanochemical phenomena are widespread wherever polymers are used. In the past decade, empirical mechanochemistry has progressed enormously, from studying fragmentations of commodity polymers by simple backbone homolysis to demonstrations of self-strengthening and stress-reporting materials and mechanochemical cascades using purposefully designed monomers. This progress has not yet been matched by the development of conceptual frameworks within which to rationalize, systematize and generalize empirical mechanochemical observations. As a result, mechanistic and/or quantitative understanding of mechanochemical phenomena remains, with few exceptions, tentative. In this review we aim at systematizing reported macroscopic manifestations of polymer mechanochemistry, and critically assessing the interpretational framework that underlies their molecular rationalizations from a physical chemist's perspective. We propose a hierarchy of mechanochemical phenomena which may guide the development of multiscale models of mechanochemical reactivity to match the breadth and utility of the Eyring equation of chemical kinetics. We discuss the limitations of the approaches to quantifying and validating mechanochemical reactivity, with particular focus on sonicated polymer solutions, in order to identify outstanding questions that need to be solved for polymer mechanochemistry to become a rigorous, quantitative field. We conclude by proposing 7 problems whose solution may have a disproportionate impact on the development of polymer mechanochemistry