Liver resection or combined chemoembolization and radiofrequency ablation improve survival in patients with hepatocellular carcinoma

Background/ Aims: To evaluate the long-term outcome of surgical and non-surgical local treatments of patients with hepatocellular carcinoma (HCC). Methods: We stratified a cohort of 278 HCC patients using six independent predictors of survival according to the Vienna survival model for HCC (VISUM- HCC). Results: Prior to therapy, 224 HCC patients presented with VISUM stage 1 (median survival 18 months) while 29 patients were classified as VISUM stage 2 (median survival 4 months) and 25 patients as VISUM stage 3 (median survival 3 months). A highly significant (p < 0.001) improved survival time was observed in VISUM stage 1 patients treated with liver resection ( n = 52; median survival 37 months) or chemoembolization (TACE) and subsequent radiofrequency ablation ( RFA) ( n = 44; median survival 45 months) as compared to patients receiving chemoembolization alone (n = 107; median survival 13 months) or patients treated by tamoxifen only (n = 21; median survival 6 months). Chemoembolization alone significantly (p <= 0.004) improved survival time in VISUM stage 1 - 2 patients but not (p = 0.341) in VISUM stage 3 patients in comparison to those treated by tamoxifen. Conclusion: Both liver resection or combined chemoembolization and RFA improve markedly the survival of patients with HCC

One-dimensional nature of the magnetic fluctuations in YBa2_2Cu3_3O6.6_{6.6}

There is increasing evidence that inhomogeneous distributions of charge and spin--so-called "striped phases"--play an important role in determining the properties of the high-temperature superconductors. For example, recent neutron-scattering measurements on the YBa$_2$Cu$_3$O$_{7-x}$ family of materials show both spin and charge fluctuations that are consistent with the striped-phase picture. But the fluctuations associated with a striped phase are expected to be one-dimensional, whereas the magnetic fluctuations observed to date appear to display two-dimensional symmetry. We show here that this apparent two-dimensionality results from measurements on twinned crystals, and that similar measurements on substantially detwinned crystals of YBa$_2$Cu$_3$O$_{6.6}$ reveal the one-dimensional character of the magnetic fluctuations, thus greatly strengthening the striped-phase interpretation. Moreover, our results also suggest that superconductivity originates in charge stripes that extend along the b crystal axis, where the superfluid density is found to be substantially larger than for the a direction.Comment: 3 pages, PDF onl

The activation of eco-driving mental models: can text messages prime drivers to use their existing knowledge and skills?

Eco-driving campaigns have traditionally assumed that drivers lack the necessary knowledge and skills and that this is something that needs rectifying. Therefore, many support systems have been designed to closely guide drivers and fine-tune their proficiency. However, research suggests that drivers already possess a substantial amount of the necessary knowledge and skills regarding eco-driving. In previous studies, participants used these effectively when they were explicitly asked to drive fuel-efficiently. In contrast, they used their safe driving skills when they were instructed to drive as they would normally. Hence, it is assumed that many drivers choose not to engage purposefully in eco-driving in their everyday lives. The aim of the current study was to investigate the effect of simple, periodic text messages (nine messages in 2 weeks) on drivers’ eco- and safe driving performance. It was hypothesised that provision of eco-driving primes and advice would encourage the activation of their eco-driving mental models and that comparable safety primes increase driving safety. For this purpose, a driving simulator experiment was conducted. All participants performed a pre-test drive and were then randomly divided into four groups, which received different interventions. For a period of 2 weeks, one group received text messages with eco-driving primes and another group received safety primes. A third group received advice messages on how to eco-drive. The fourth group were instructed by the experimenter to drive fuel-efficiently, immediately before driving, with no text message intervention. A post-test drive measured behavioural changes in scenarios deemed relevant to eco- and safe driving. The results suggest that the eco-driving prime and advice text messages did not have the desired effect. In comparison, asking drivers to drive fuel-efficiently led to eco-driving behaviours. These outcomes demonstrate the difficulty in changing ingrained habits. Future research is needed to strengthen such messages or activate existing knowledge and skills in other ways, so driver behaviour can be changed in cost-efficient ways

A combined estimator using TEC and b-value for large earthquake prediction

[EN] Ionospheric anomalies have been shown to occur a few days before several large earthquakes. The published works normally address examples limited in time (a single event or few of them) or space (a particular geographic area), so that a clear method based on these anomalies which consistently yields the place and magnitude of the forthcoming earthquake, anytime and anywhere on earth, has not been presented so far. The current research is aimed at prediction of large earthquakes, that is with magnitude M-w 7 or higher. It uses as data bank all significant earthquakes occurred worldwide in the period from January 1, 2011 to December 31, 2018. The first purpose of the research is to improve the use of ionospheric anomalies in the form of TEC grids for earthquake prediction. A space-time TEC variation estimator especially designed for earthquake prediction will show the advantages with respect to the use of simple TEC values. Further, taking advantage of the well-known predictive abilities of the Gutenberg-Richter law's b-value, a combined estimator based on both TEC anomalies and b-values will be designed and shown to improve prediction performance even more.Baselga Moreno, S. (2020). A combined estimator using TEC and b-value for large earthquake prediction. Acta Geodaetica et Geophysica Hungarica. 55(1):63-82. https://doi.org/10.1007/s40328-019-00281-5S6382551Abordán A, Szabó NP (2018) Metropolis algorithm driven factor analysis for lithological characterization of shallow marine sediments. Acta Geod Geophys 53:189–199. https://doi.org/10.1007/s40328-017-0210-zAkhoondzadeh M, Saradjian MR (2011) TEC variations analysis concerning Haiti (January 12, 2010) and Samoa (September 29, 2009) earthquakes. 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Acta Geod Geophys 53:579–606. https://doi.org/10.1007/s40328-018-0221-4Pulinets S, Boyarchuk K (2004) Ionospheric precursors of earthquakes. Springer, BerlinPulinets SA, Legen’ka AD, Gaivoronskaya TV, Depuev VKh (2003) Main phenomenological features of ionospheric precursors of strong earthquakes. J Atmos Sol Terr Phys 65:1337–1347. https://doi.org/10.1016/j.jastp.2003.07.011Reyes J, Morales-Esteban A, Martínez-Álvarez F (2013) Neural networks to predict earthquakes in Chile. Appl Soft Comput 13:1314–1328. https://doi.org/10.1016/j.asoc.2012.10.014Şentürk E, Çepni MS (2018a) A statistical analysis of seismo ionospheric TEC anomalies before 63 Mw ≥ 5.0 earthquakes in Turkey during 2003–2016. Acta Geophys 66:1495–1507. https://doi.org/10.1007/s11600-018-0214-2Şentürk E, Çepni MS (2018b) Ionospheric temporal variations over the region of Turkey: a study based on long-time TEC observations. 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Measurement of the inclusive and dijet cross-sections of b-jets in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

The inclusive and dijet production cross-sections have been measured for jets containing b-hadrons (b-jets) in proton-proton collisions at a centre-of-mass energy of sqrt(s) = 7 TeV, using the ATLAS detector at the LHC. The measurements use data corresponding to an integrated luminosity of 34 pb^-1. The b-jets are identified using either a lifetime-based method, where secondary decay vertices of b-hadrons in jets are reconstructed using information from the tracking detectors, or a muon-based method where the presence of a muon is used to identify semileptonic decays of b-hadrons inside jets. The inclusive b-jet cross-section is measured as a function of transverse momentum in the range 20 < pT < 400 GeV and rapidity in the range |y| < 2.1. The bbbar-dijet cross-section is measured as a function of the dijet invariant mass in the range 110 < m_jj < 760 GeV, the azimuthal angle difference between the two jets and the angular variable chi in two dijet mass regions. The results are compared with next-to-leading-order QCD predictions. Good agreement is observed between the measured cross-sections and the predictions obtained using POWHEG + Pythia. MC@NLO + Herwig shows good agreement with the measured bbbar-dijet cross-section. However, it does not reproduce the measured inclusive cross-section well, particularly for central b-jets with large transverse momenta.Comment: 10 pages plus author list (21 pages total), 8 figures, 1 table, final version published in European Physical Journal

Intra-gastric balloon as an adjunct to lifestyle support in severely obese adolescents; Impact on weight, physical activity, cardio-respiratory fitness and psychosocial wellbeing.

BACKGROUND: Severe adolescent obesity (BMI>99.6th centile) is a significant public health challenge. Current non-invasive treatments, including community-based lifestyle interventions, are often of limited effectiveness in this population, with NICE guidelines suggesting the use of bariatric surgery as the last line of treatment (NICE, 2013). Health professionals are understandably reluctant to commission bariatric surgery and as an alternative, the use of an intra-gastric balloon as an adjunct to a lifestyle programme might offer a reversible, potentially safer and less invasive option. OBJECTIVES: Explore the use of an intra-gastric balloon as an adjunct to a lifestyle support programme, to promote weight loss in severely obese adolescents. Outcomes included Weight loss, Waist and Hip measurements, psychosocial outcomes including health related quality of life and physical self-perceptions, physical activity and cardiorespiratory fitness. METHOD: Non-randomised pilot study. Results: 12 severely obese adolescents (5 males, 7 females; mean age 15yrs; BMI >3.5 s.d.; puberty stage 4 or more) and their families were recruited. Mean weight loss at 12 months (n=9) was 3.05 kg±14.69; d=0.002, P=0.550, and a BMI Z-score (n=12) change of 0.2 s.d.; d=0.7, P=0.002 was observed at 6 months with a large effect, but was not sustained at 12 months (mean change 0.1 s.d.; d=0.3, P=0.146 ) At 24 months (n=10) there was a weight gain from baseline of +9.9 kg±1.21 (d=0.4; P=0.433). Adolescent and parent HRQoL scores exceeded the minimal clinical important difference between baseline and 12 months for all domains but showed some decline at 24 months. CONCLUSION: An intra-gastric balloon as an adjunct to a lifestyle support programme represents a safe and well tolerated treatment approach in severely obese adolescents, with short-term effects on weight change. Improvements in psychosocial health, physical activity and cardiorespiratory fitness were maintained at 12 months, with varying results at 24 months

The chemokine receptor CXCR5 is pivotal for ectopic mucosa-associated lymphoid tissue neogenesis in chronic Helicobacter pylori-induced inflammation

Ectopic lymphoid follicles are a key feature of chronic inflammatory autoimmune and infectious diseases, such as rheumatoid arthritis, Sjögren's syndrome, and Helicobacter pylori-induced gastritis. Homeostatic chemokines are considered to be involved in the formation of such tertiary lymphoid tissue. High expression of CXCL13 and its receptor, CXCR5, has been associated with the formation of ectopic lymphoid follicles in chronic infectious diseases. Here, we defined the role of CXCR5 in the development of mucosal tertiary lymphoid tissue and gastric inflammation in a mouse model of chronic H. pylori infection. CXCR5-deficient mice failed to develop organized gastric lymphoid follicles despite similar bacterial colonization density as infected wild-type mice. CXCR5 deficiency altered Th17 responses but not Th1-type cellular immune responses to H. pylori infection. Furthermore, CXCR5-deficient mice exhibited lower H. pylori-specific serum IgG and IgA levels and an overall decrease in chronic gastric immune responses. In conclusion, the development of mucosal tertiary ectopic follicles during chronic H. pylori infection is strongly dependent on the CXCL13/CXCR5 signaling axis, and lack of de novo lymphoid tissue formation attenuates chronic immune responses

Gray zones around diffuse large B cell lymphoma. Conclusions based on the workshop of the XIV meeting of the European Association for Hematopathology and the Society of Hematopathology in Bordeaux, France

The term “gray-zone” lymphoma has been used to denote a group of lymphomas with overlapping histological, biological, and clinical features between various types of lymphomas. It has been used in the context of Hodgkin lymphomas (HL) and non-Hodgkin lymphomas (NHL), including classical HL (CHL), and primary mediastinal large B cell lymphoma, cases with overlapping features between nodular lymphocyte predominant Hodgkin lymphoma and T-cell/histiocyte-rich large B cell lymphoma, CHL, and Epstein–Barr-virus-positive lymphoproliferative disorders, and peripheral T cell lymphomas simulating CHL. A second group of gray-zone lymphomas includes B cell NHL with intermediate features between diffuse large B cell lymphoma and classical Burkitt lymphoma. In order to review controversial issues in gray-zone lymphomas, a joint Workshop of the European Association for Hematopathology and the Society for Hematopathology was held in Bordeaux, France, in September 2008. The panel members reviewed and discussed 145 submitted cases and reached consensus diagnoses. This Workshop summary is focused on the most controversial aspects of gray-zone lymphomas and describes the panel’s proposals regarding diagnostic criteria, terminology, and new prognostic and diagnostic parameters

Challenges and Pitfalls in the Management of Parathyroid Carcinoma: 17-Year Follow-Up of a Case and Review of the Literature

A 29-year-old man presented to his primary care physician with nausea, severe weight loss and muscle weakness. He had a hard, fixed neck swelling. He was severely hypercalcaemic with 10-fold increased parathyroid hormone (PTH) concentrations. A diagnosis of primary hyperparathyroidism was established and the patient was referred for parathyroidectomy. At neck exploration, an enlarged parathyroid gland with invasive growth into the thyroid gland was found and removed, lymph nodes were cleared and hemithyroidectomy was performed. A suspected diagnosis of parathyroid carcinoma was confirmed histologically. Serum calcium and PTH levels normalised post-operatively, but hyperparathyroidism recurred within 3 years of surgery. Over the following 17 years, control of hypercalcaemia represented the most difficult challenge despite variable success achieved with repeated surgical interventions, embolisations, radiofrequency ablation of metastases and treatment with calcimimetics, bisphosphonates and haemodialysis using low-dialysate calcium. In this paper, we report the challenges and pitfalls we encountered in the management of our patient over nearly two decades of follow-up and review recent literature on the topic