Elderly age is not a negative predictive factor for virological response to therapy with pegylated interferon-α and ribavirin in chronic hepatitis C virus patients.

BACKGROUND & AIMS: Age is frequently discussed as negative host factor to achieve a sustained virological response (SVR) to antiviral therapy of chronic hepatitis C. However, elderly patients often show advanced fibrosis/cirrhosis as known negative predictive factor. The aim of this study was to assess age as an independent predictive factor during antiviral therapy. METHODS: Overall, 516 hepatitis C patients were treated with pegylated interferon-α and ribavirin, thereof 66 patients ≥60 years. We analysed the impact of host factors (age, gender, fibrosis, haemoglobin, previous hepatitis C treatment) and viral factors (genotype, viral load) on SVR per therapy course by performing a generalized estimating equations (GEE) regression modelling, a matched pair analysis and a classification tree analysis. RESULTS: Overall, SVR per therapy course was 42.9 and 26.1%, respectively, in young and elderly patients with hepatitis C virus (HCV) genotypes 1/4/6. The corresponding figures for HCV genotypes 2/3 were 74.4 and 84%. In the GEE model, age had no significant influence on achieving SVR. In matched pair analysis, SVR was not different in young and elderly patients (54.2 and 55.9% respectively; P = 0.795 in binominal test). In classification tree analysis, age was not a relevant splitting variable. CONCLUSIONS: Age is not a significant predictive factor for achieving SVR, when relevant confounders are taken into account. As life expectancy in Western Europe at age 60 is more than 20 years, it is reasonable to treat chronic hepatitis C in selected elderly patients with relevant fibrosis or cirrhosis but without major concomitant diseases, as SVR improves survival and reduces carcinogenesis.

For better or worse: Associations between the experience of negative life events and positive and negative sibling relationship characteristics

Using Dutch data (N = 6630), this article examines how sibling relationships (including full biological, half- and adopted siblings) differed for persons who experienced a negative life event (divorce, physical illness, psychological problems, addiction, problems with the law, victimization of abuse or financial problems) and those who did not. Results showed that people who experienced serious negative life events in the past often had less active, less supportive and more strained sibling ties. The group that experienced a physical illness formed an exception, showing more supportive and active sibling ties, but also higher levels of conflict. Results suggest inequality between persons who have experienced negative life events and those who have not in terms of access to positive and supportive sibling relationships.

A Rotating black ring solution in five dimensions

The vacuum Einstein equations in five dimensions are shown to admit a solution describing a stationary asymptotically flat spacetime regular on and outside an event horizon of topology S1S2. It describes a rotating black ring. This is the first example of a stationary asymptotically flat vacuum solution with an event horizon of nonspherical topology. The existence of this solution implies that the uniqueness theorems valid in four dimensions do not have simple five-dimensional generalizations. It is suggested that increasing the spin of a spherical black hole beyond a critical value results in a transition to a black ring, which can have an arbitrarily large angular momentum for a given mass.

Holographic phase transitions with fundamental matter

The holographic dual of a finite-temperature gauge theory with a small number of flavors typically contains D-brane probes in a black hole background. At low temperature, the branes sit outside the black hole and the meson spectrum is discrete and possesses a mass gap. As the temperature increases, the branes approach a critical solution. Eventually, they fall into the horizon and a phase transition occurs. In the new phase, the meson spectrum is continuous and gapless. At large Nc and large't Hooft coupling, we show that this phase transition is always first order. In confining theories with heavy quarks, it occurs above the deconfinement transition for the glue.

Exact solution to the mean exit time problem for free inertial processes driven by Gaussian white noise

We obtain the exact analytical expression, up to a quadrature, for the mean exit time, T(x,v), of a free inertial process driven by Gaussian white noise from a region (0,L) in space. We obtain a completely explicit expression for T(x,0) and discuss the dependence of T(x,v) as a function of the size L of the region. We develop a new method that may be used to solve other exit time problems.

Continued fraction solution for the radiative transfer equation in three dimensions

Starting from the radiative transfer equation, we obtain an analytical solution for both the free propagator along one of the axes and an arbitrary phase function in the Fourier-Laplace domain. We also find the effective absorption parameter, which turns out to be very different from the one provided by the diffusion approximation. We finally present an analytical approximation procedure and obtain a differential equation that accurately reproduces the transport process. We test our approximations by means of simulations that use the Henyey-Greenstein phase function with very satisfactory results.

Solution to telegrapher's equation in the presence of reflecting and partly reflecting broundaries

We show that the reflecting boundary condition for a one-dimensional telegraphers equation is the same as that for the diffusion equation, in contrast to what is found for the absorbing boundary condition. The radiation boundary condition is found to have a quite complicated form. We also obtain exact solutions of the telegraphers equation in the presence of these boundaries.

EFFECT OF RICE STRAW AND NITRATE LEVELS IN SOIL SOLUTION ON NITROUS OXIDE EMISSION

Among the greenhouse gases, nitrous oxide (N2O) is considered important, in view of a global warming potential 296 times greater than that of carbon dioxide (CO2) and its dynamics strongly depend on the availability of C and mineral N in the soil. The understanding of the factors that define emissions is essential to develop mitigation strategies. This study evaluated the dynamics of N2O emissions after the application of different rice straw amounts and nitrate levels in soil solution. Pots containing soil treated with sodium nitrate rates (0, 50 and 100 g kg-1 of NO−3-N) and rice straw levels (0, 5 and 10 Mg ha-1), i.e., nine treatments, were subjected to anaerobic conditions. The results showed that N2O emissions were increased by the addition of greater NO−3 amounts and reduced by large straw quantities applied to the soil. On the 1st day after flooding (DAF), significantly different N2O emissions were observed between the treatments with and without NO−3 addition, when straw had no significant influence on N2O levels. Emissions peaked on the 4th DAF in the treatments with highest NO−3-N addition. At this moment, straw application negatively affected N2O emissions, probably due to NO−3 immobilization. There were also alterations in other soil electrochemical characteristics, e.g., higher straw levels raised the Fe, Mn and dissolved C contents. These results indicate that a lowering of NO−3 concentration in the soil and the increase of straw incorporation can decrease N2O emissions.

Outcome Prediction after Cardiac Arrest Treated with Hypothermia

Rationale: Clinical and electrophysiological prognostic markers of brain anoxia have been mostly evaluated in comatose survivors of out hospital cardiac arrest (OHCA) after standard resuscitation, but their predictive value in patients treated with mild induced hypothermia (IH) is unknown. The objective of this study was to identify a predictive score of independent clinical and electrophysiological variables in comatose OHCA survivors treated with IH, aiming at a maximal positive predictive value (PPV) and a high negative predictive value (NPV) for mortality. Methods: We prospectively studied consecutive adult comatose OHCA survivors from April 2006 to May 2009, treated with mild IH to 33-34_C for 24h at the intensive care unit of the Lausanne University Hospital, Switzerland. IH was applied using an external cooling method. As soon as subjects passively rewarmed (body temperature >35_C) they underwent EEG and SSEP recordings (off sedation), and were examined by experienced neurologists at least twice. Patients with status epilepticus were treated with AED for at least 24h. A multivariable logistic regression was performed to identify independent predictors of mortality at hospital discharge. These were used to formulate a predictive score. Results: 100 patients were studied; 61 died. Age, gender and OHCA etiology (cardiac vs. non-cardiac) did not differ among survivors and nonsurvivors. Cardiac arrest type (non-ventricular fibrillation vs. ventricular fibrillation), time to return of spontaneous circulation (ROSC) >25min, failure to recover all brainstem reflexes, extensor or no motor response to pain, myoclonus, presence of epileptiform discharges on EEG, EEG background unreactive to pain, and bilaterally absent N20 on SSEP, were all significantly associated with mortality. Absent N20 was the only variable showing no false positive results. Multivariable logistic regression identified four independent predictors (Table). These were used to construct the score, and its predictive values were calculated after a cut-off of 0-1 vs. 2-4 predictors. We found a PPV of 1.00 (95% CI: 0.93-1.00), a NPV of 0.81 (95% CI: 0.67-0.91) and an accuracy of 0.93 for mortality. Among 9 patients who were predicted to survive by the score but eventually died, only 1 had absent N20. Conclusions: Pending validation in a larger cohort, this simple score represents a promising tool to identify patients who will survive, and most subjects who will not, after OHCA and IH. Furthermore, while SSEP are 100% predictive of poor outcome but not available in most hospitals, this study identifies EEG background reactivity as an important predictor after OHCA. The score appears robust even without SSEP, suggesting that SSEP and other investigations (e.g., mismatch negativity, serum NSE) might be principally needed to enhance prognostication in the small subgroup of patients failing to improve despite a favorable score.

Effects of Pig Slurry Application and Crops on Phosphorus Content in Soil and the Chemical Species in Solution

The application of pig slurry rates and plant cultivation can modify the soil phosphorus (P) content and distribution of chemical species in solution. The purpose of this study was to evaluate the total P, available P and P in solution, and the distribution of chemical P species in solution, in a soil under longstanding pig slurry applications and crop cultivation. The study was carried out in soil columns with undisturbed structure, collected in an experiment conducted for eight years in the experimental unit of the Universidade Federal de Santa Maria (UFSM), Santa Maria (RS). The soil was an Argissolo Vermelho distrófico arênico (Typic Hapludalf), subjected to applications of 0, 20, 40, and 80 m3 ha-1 pig slurry. Soil samples were collected from the layers 0-5, 5-10, 10-20, 20-30, 30-40, and 40-60 cm, before and after black oat and maize grown in a greenhouse, for the determination of available P, total P and P in the soil solution. In the solution, the concentration of the major cations, anions, dissolved organic carbon (DOC), and pH were determined. The distribution of chemical P species was determined by software Visual Minteq. The 21 pig slurry applications increased the total P content in the soil to a depth of 40 cm, and the P extracted by Mehlich-1 and from the solution to a depth of 30 cm. Successive applications of pig slurry changed the balance between the solid and liquid phases in the surface soil layers, increasing the proportion of the total amount of P present in the soil solution, aside from changing the chemical species in the solution, reducing the percentage complexed with Al and increasing the one complexed with Ca and Mg in the layers 0-5 and 5-10 cm. Black oat and maize cultivation increased pH in the solution, thereby increasing the proportion of HPO42- and reducing H2PO4- species.

Exact solution to the exit-time problem for an undamped free particle driven by Gaussian white noise

In a recent paper [Phys. Rev. Lett. 75, 189 (1995)] we have presented the exact analytical expression for the mean exit time, T(x,v), of a free inertial process driven by Gaussian white noise out of a region (0,L) in space. In this paper we give a detailed account of the method employed and present results on asymptotic properties and averages of T(x,v).

When telegrapher's equation furnishes a better approximation to transport equation than the difussion approximation

It has been suggested that a solution to the transport equation which includes anisotropic scattering can be approximated by the solution to a telegrapher's equation [A.J. Ishimaru, Appl. Opt. 28, 2210 (1989)]. We show that in one dimension the telegrapher's equation furnishes an exact solution to the transport equation. In two dimensions, we show that, since the solution can become negative, the telegrapher's equation will not furnish a usable approximation. A comparison between simulated data in three dimensions indicates that the solution to the telegrapher's equation is a good approximation to that of the full transport equation at the times at which the diffusion equation furnishes an equally good approximation.

Strong coupling solution to Schrödinger Equation: the mixing of states

In this paper we give some ideas that can be useful to solve Schrödinger equations in the case when the Hamiltonian contains a large term. We obtain an expansion of the solution in reciprocal powers of the large coupling constant. The procedure followed consists in considering that the small part of the Hamiltonian engenders a motion adiabatic to the motion generated by the large part of the same.

Negative and positive effects of trade on health.

Comment on: Blouin C, Chopra M, van der Hoeven R.Trade and social determinants of health. Lancet. 2009;373(9662):502-7. PMID: 19167058.