The characteristics of viral hepatitis B and D co-infection are poorly documented in Chad. The aim of our study was to determine the prevalence of HBV/HDV co-infection and the characteristics of this co-infection. Mat...The characteristics of viral hepatitis B and D co-infection are poorly documented in Chad. The aim of our study was to determine the prevalence of HBV/HDV co-infection and the characteristics of this co-infection. Materials and Methods: This was a retrospective study including all patients with chronic HBsAg carriers referred in our department from January 2014 to December 2018. Non-inclusion criteria were: absence of anti-HDV testing, presence of anti-viral hepatitis C or Human Immunodeficiency Virus antibodies or excessive alcohol consumption. The variables studied were age, sex, blood transaminase level, HBV DNA level, HDV RNA level, and liver fibrosis and activity score (Actitest Fibrotest). The prevalence of HDV and the characteristics of HDV/HBV co-infection were determined. Results: During the study period, 403 patients were seen in these two hospitals for chronic HBsAg carriage. Of these, 378 (75%) had performed the anti HDV assay. Anti-HDV antibodies were positive in 53 patients (14%). In multivariate analysis, HBV/HDV co-infected patients were less frequently HBeAg positive (5.4% vs. 28.1%;p = 0.0001), older (35 years vs. 32 years;p = 0.001), and more frequently had significant necrotic-inflammatory activity (3.9% vs. 3.2%;p = 0.031) compared with mono infected patients. Neither gender (76.9% male vs. 77.4% male;p = ns), nor viral load (median 530 IU/ml vs. 195 IU/ml;p = ns), nor significant liver fibrosis (35.1% vs. 47.1%;p = ns), nor transaminases (median 26 vs. 32 IU/ml) were different with mono infected patients. Conclusion: VHD is common in Chad. It is associated with increased hepatic necrotic-inflammatory activity.展开更多
Nowadays, the number of cases in which malignant colorectal polyps are removed is increasing due to colorectal cancer screening programmes. Cancerous polyps are classified into non-invasive high grade neoplasia (NHGN)...Nowadays, the number of cases in which malignant colorectal polyps are removed is increasing due to colorectal cancer screening programmes. Cancerous polyps are classified into non-invasive high grade neoplasia (NHGN), when the cancer has not reached the muscularis mucosa, and malignant polyps, classed as T1, when they have invaded the submucosa. NHGN is considered cured with polypectomy, while the prognosis for malignant polyps depends on various morphological and histological factors. The prognostic factors include, sessile or pedunculated morphology of the polyp, whether partial or en bloc resection is carried out, the degree of differentiation of the carcinoma, vascular or lymphatic involvement, and whether the polypectomy resection margin is tumor free. A malignant polyp at T1 is considered cured with polypectomy ifit is a pedunculated polyp (Ip of the Paris classification), it has been completely resected, it is not poorly differentiated, the resection edge is not affected by the tumor and there is no vascular or lymphatic involvement. The sessile malignant polyp (Is of the Paris classification) at T1 is considered not cured with polypectomy. Only in some cases (e.g. older people with high surgical risk) local excision(polypectomy or endoscopic submucosal dissection or conventional endoscopic mucosal resection) is considered the definitive treatment.展开更多
BACKGROUND Coronary sinus(CS)imaging has recently gained importance due to increasing need for mapping and ablation of electrophysiological arrhythmias and left ventricular(LV)pacing during cardiac resynchronization t...BACKGROUND Coronary sinus(CS)imaging has recently gained importance due to increasing need for mapping and ablation of electrophysiological arrhythmias and left ventricular(LV)pacing during cardiac resynchronization therapy(CRT).Retrograde venogram is the current standard for imaging CS and its tributaries.AIM To evaluate CS anatomy during levophase of routine coronary angiography to aid LV lead implantation during CRT.METHODS In this prospective observational study,164 patients undergoing routine coronary angiography for various indications(Chronic stable angina-44.5%,acute coronary syndrome-39.5%,Dilated cardiomyopathy-11%,atypical chest pain-5%)were included.Venous phase(levophase)of left coronary injection was recorded in left anterior oblique-cranial and right anterior oblique-cranial views.Visibility of coronary veins,width and shape of CS ostium,angulations of proximal CS with body of CS were noted.Presence,size,take-off angle and tortuosity of posterolateral vein(PLV),anterior interventricular veins(AIV)and middle cardiac vein(MCV)were also noted.RESULTS During levophase,visibility grade(Muhlenbruch grade)for coronary veins was 3 in 74%and 2 in 26%of cases.Visibility of CS did not correlate with body mass index.The diameter of CS ostium was<10 mm,10-15 mm and>15 mm in 48%,42%and 10%of patients respectively.Proximal CS was tubular in 136(83%)patients and funnel-shaped in 28(17%)patients.Sharp take-off angulation between ostium and body of CS was seen in 16(10%)patients.Two or more PLV were present in 8 patients while PLV was absent in 52(32%)patients.Angle of take-off of PLV with body of CS was favourable(0°-45°)in 65(40%)patients.The angle was 45°-90°in 36 patients and difficult take-off angle(>90°)was seen in 8 patients.Length of PLV reached distal third of myocardium in 84 cases and middle third in 11 cases.There was no tortuosity in 79 cases,a single bend in 29 cases and more than 2 bends in 4 cases.Thirty nine(24%)patients had other veins supplying posterior/Lateral wall of LV.There was a single vein supplying lateral/posterior wall in 31(19%)patients.Diameter of MCV and AIV was significantly larger in patients with absent PLV as compared to patients with a PLV.CONCLUSION Levophase study of left coronary injection is effective in visualization of the CS in almost all patients undergoing coronary angiography and may be an effective alternative to retrograde venogram in patients with LV dysfunction or LBBB.展开更多
The rare earth elements and high-field-strength elements(REE-HFSE)exploration sector conducts most evaluations at deposit and smaller scales.It is not evident how the sector performs a preceding exploration stage—rat...The rare earth elements and high-field-strength elements(REE-HFSE)exploration sector conducts most evaluations at deposit and smaller scales.It is not evident how the sector performs a preceding exploration stage—rating and prioritising REE-HFSE mineralised provinces—to determine which provinces are prospective enough to warrant investment.Here we present an objective,repeatable,low-cost method to screen any REE-HFSE province,as a foundation for district-scale investigations or asset evaluations.It is original for REE-HFSE screening,and adapted from regional scale copper,cobalt and petroleum exploration,and CO2 storage,screening methods.It is centred upon a mineralised province’s favourability for potential value creation,and to identify:(a)its main information gaps;(b)its weakest links;(c)its exploration maturity and remaining potential category;(d)how it compares against other REE-HFSE provinces;and(e)if further investigation is justified.This method incorporates geoscience,strategy,economic and socio-environmental factors in a way that is understandable and directly usable across stakeholder groups.The workflow is systematic,yet flexible enough to accommodate organisationspecific criteria,and usable for other commodities.It provides the platform to build a global REE-HFSE province map and database consistently across national boundaries and organisations.Categories for the extent of province exploration maturity and remaining mineral potential are proposed.We illustrate the applicability of these methods using the Gardar REE-HFSE Province(GRHP)of south Greenland.We conclude that it is a moderate size,frontier province that is currently of questionable favourability for value creation.To move GRHP into a positive favourability class,its current weak links need strengthening by research,government policy and industry stakeholders:evaluate the mineral system;integrate all information geospatially and place it in the public domain;help the region improve some community health and safety issues;convert some mineral resources into an Ore Reserves category;commence mining and sales production.展开更多
In the present work, we find that both diffusion activation energy Ea(D) and Ea(S^ex) increase linearly with pressure and have the same slope (0.022±0.001 eV/GPa) for liquid Al. The temperature and pressure...In the present work, we find that both diffusion activation energy Ea(D) and Ea(S^ex) increase linearly with pressure and have the same slope (0.022±0.001 eV/GPa) for liquid Al. The temperature and pressure dependence of excess entropy is well fitted by the expression -S^ex (T, P)/kB = a(P)+ b(P)T + c(P) exp(Ef/kBT), which together with the small ratio of Ef/kB T leads to the relationship of excess entropy to temperature and pressure, i.e. Sex ~ -cEf/T, where c is about 12 and Ef (= △E - P△V) is the favourable energy. Therefore, there exists a simple relation between Ea(S^ex) and Ef, i.e. Ea(S^ex) ≈ cEf.展开更多
文摘The characteristics of viral hepatitis B and D co-infection are poorly documented in Chad. The aim of our study was to determine the prevalence of HBV/HDV co-infection and the characteristics of this co-infection. Materials and Methods: This was a retrospective study including all patients with chronic HBsAg carriers referred in our department from January 2014 to December 2018. Non-inclusion criteria were: absence of anti-HDV testing, presence of anti-viral hepatitis C or Human Immunodeficiency Virus antibodies or excessive alcohol consumption. The variables studied were age, sex, blood transaminase level, HBV DNA level, HDV RNA level, and liver fibrosis and activity score (Actitest Fibrotest). The prevalence of HDV and the characteristics of HDV/HBV co-infection were determined. Results: During the study period, 403 patients were seen in these two hospitals for chronic HBsAg carriage. Of these, 378 (75%) had performed the anti HDV assay. Anti-HDV antibodies were positive in 53 patients (14%). In multivariate analysis, HBV/HDV co-infected patients were less frequently HBeAg positive (5.4% vs. 28.1%;p = 0.0001), older (35 years vs. 32 years;p = 0.001), and more frequently had significant necrotic-inflammatory activity (3.9% vs. 3.2%;p = 0.031) compared with mono infected patients. Neither gender (76.9% male vs. 77.4% male;p = ns), nor viral load (median 530 IU/ml vs. 195 IU/ml;p = ns), nor significant liver fibrosis (35.1% vs. 47.1%;p = ns), nor transaminases (median 26 vs. 32 IU/ml) were different with mono infected patients. Conclusion: VHD is common in Chad. It is associated with increased hepatic necrotic-inflammatory activity.
文摘Nowadays, the number of cases in which malignant colorectal polyps are removed is increasing due to colorectal cancer screening programmes. Cancerous polyps are classified into non-invasive high grade neoplasia (NHGN), when the cancer has not reached the muscularis mucosa, and malignant polyps, classed as T1, when they have invaded the submucosa. NHGN is considered cured with polypectomy, while the prognosis for malignant polyps depends on various morphological and histological factors. The prognostic factors include, sessile or pedunculated morphology of the polyp, whether partial or en bloc resection is carried out, the degree of differentiation of the carcinoma, vascular or lymphatic involvement, and whether the polypectomy resection margin is tumor free. A malignant polyp at T1 is considered cured with polypectomy ifit is a pedunculated polyp (Ip of the Paris classification), it has been completely resected, it is not poorly differentiated, the resection edge is not affected by the tumor and there is no vascular or lymphatic involvement. The sessile malignant polyp (Is of the Paris classification) at T1 is considered not cured with polypectomy. Only in some cases (e.g. older people with high surgical risk) local excision(polypectomy or endoscopic submucosal dissection or conventional endoscopic mucosal resection) is considered the definitive treatment.
文摘BACKGROUND Coronary sinus(CS)imaging has recently gained importance due to increasing need for mapping and ablation of electrophysiological arrhythmias and left ventricular(LV)pacing during cardiac resynchronization therapy(CRT).Retrograde venogram is the current standard for imaging CS and its tributaries.AIM To evaluate CS anatomy during levophase of routine coronary angiography to aid LV lead implantation during CRT.METHODS In this prospective observational study,164 patients undergoing routine coronary angiography for various indications(Chronic stable angina-44.5%,acute coronary syndrome-39.5%,Dilated cardiomyopathy-11%,atypical chest pain-5%)were included.Venous phase(levophase)of left coronary injection was recorded in left anterior oblique-cranial and right anterior oblique-cranial views.Visibility of coronary veins,width and shape of CS ostium,angulations of proximal CS with body of CS were noted.Presence,size,take-off angle and tortuosity of posterolateral vein(PLV),anterior interventricular veins(AIV)and middle cardiac vein(MCV)were also noted.RESULTS During levophase,visibility grade(Muhlenbruch grade)for coronary veins was 3 in 74%and 2 in 26%of cases.Visibility of CS did not correlate with body mass index.The diameter of CS ostium was<10 mm,10-15 mm and>15 mm in 48%,42%and 10%of patients respectively.Proximal CS was tubular in 136(83%)patients and funnel-shaped in 28(17%)patients.Sharp take-off angulation between ostium and body of CS was seen in 16(10%)patients.Two or more PLV were present in 8 patients while PLV was absent in 52(32%)patients.Angle of take-off of PLV with body of CS was favourable(0°-45°)in 65(40%)patients.The angle was 45°-90°in 36 patients and difficult take-off angle(>90°)was seen in 8 patients.Length of PLV reached distal third of myocardium in 84 cases and middle third in 11 cases.There was no tortuosity in 79 cases,a single bend in 29 cases and more than 2 bends in 4 cases.Thirty nine(24%)patients had other veins supplying posterior/Lateral wall of LV.There was a single vein supplying lateral/posterior wall in 31(19%)patients.Diameter of MCV and AIV was significantly larger in patients with absent PLV as compared to patients with a PLV.CONCLUSION Levophase study of left coronary injection is effective in visualization of the CS in almost all patients undergoing coronary angiography and may be an effective alternative to retrograde venogram in patients with LV dysfunction or LBBB.
基金This research,and the costs to prepare this document for open access publication,was part of the HiTech Alk Carb project,under the European Union Horizon 2020 research and innovation programme,grant agreement number[689909]。
文摘The rare earth elements and high-field-strength elements(REE-HFSE)exploration sector conducts most evaluations at deposit and smaller scales.It is not evident how the sector performs a preceding exploration stage—rating and prioritising REE-HFSE mineralised provinces—to determine which provinces are prospective enough to warrant investment.Here we present an objective,repeatable,low-cost method to screen any REE-HFSE province,as a foundation for district-scale investigations or asset evaluations.It is original for REE-HFSE screening,and adapted from regional scale copper,cobalt and petroleum exploration,and CO2 storage,screening methods.It is centred upon a mineralised province’s favourability for potential value creation,and to identify:(a)its main information gaps;(b)its weakest links;(c)its exploration maturity and remaining potential category;(d)how it compares against other REE-HFSE provinces;and(e)if further investigation is justified.This method incorporates geoscience,strategy,economic and socio-environmental factors in a way that is understandable and directly usable across stakeholder groups.The workflow is systematic,yet flexible enough to accommodate organisationspecific criteria,and usable for other commodities.It provides the platform to build a global REE-HFSE province map and database consistently across national boundaries and organisations.Categories for the extent of province exploration maturity and remaining mineral potential are proposed.We illustrate the applicability of these methods using the Gardar REE-HFSE Province(GRHP)of south Greenland.We conclude that it is a moderate size,frontier province that is currently of questionable favourability for value creation.To move GRHP into a positive favourability class,its current weak links need strengthening by research,government policy and industry stakeholders:evaluate the mineral system;integrate all information geospatially and place it in the public domain;help the region improve some community health and safety issues;convert some mineral resources into an Ore Reserves category;commence mining and sales production.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.10674135,10874182 and 50803066)the Foundation of the Education Committee of Anhui Province,China(Grant Nos.KJ2010A031 and KJ2010A012)the Funds from the Centre of Computational Science,Hefei Institutes of Physical Sciences
文摘In the present work, we find that both diffusion activation energy Ea(D) and Ea(S^ex) increase linearly with pressure and have the same slope (0.022±0.001 eV/GPa) for liquid Al. The temperature and pressure dependence of excess entropy is well fitted by the expression -S^ex (T, P)/kB = a(P)+ b(P)T + c(P) exp(Ef/kBT), which together with the small ratio of Ef/kB T leads to the relationship of excess entropy to temperature and pressure, i.e. Sex ~ -cEf/T, where c is about 12 and Ef (= △E - P△V) is the favourable energy. Therefore, there exists a simple relation between Ea(S^ex) and Ef, i.e. Ea(S^ex) ≈ cEf.