Klinewesth9870

The real-world virological efficacy and safety of interferon-free direct-acting antiviral (DAA) therapy with ledipasvir (LDV) plus sofosbuvir (SOF) were assessed in patients who were chronically infected with hepatitis C virus (HCV) genotype 2.

A total of 126 patients with chronic hepatitis C due to HCV genotype 2 infection who were treated with the LDV/SOF regimen were enrolled. The sustained virological response (SVR) rate and safety were analyzed. SVR was assessed in the intention-to-treat (ITT) population as well as in the modified intention-to-treat (mITT) population, which excluded patients with non-virological failure, including those who dropped out before the SVR assessment.

The overall SVR rates of the ITT and mITT populations were 87.3% (95% confidence interval [CI] 80.2-92.6) (110/126) and 97.3% (95% CI 92.4-99.4) (110/113), respectively. In the mITT population, the percentages of patients with undetectable HCV RNA at 4, 8, and 12weeks after the start of therapy were 92.9% (95% CI 86.5-96.9) (105/113), 99.1% (95% CI 95.2-100.0) (112/113), and 100.0% (95% CI 97.4-100.0) (113/113), respectively. Subgroup analyses of the mITT population showed no significant differences in SVR rates according to age, sex, HCV genotype (subtype), history of interferon-based therapy, baseline FIB-4 index, or baseline estimated glomerular filtration rate. In all subpopulations, the SVR rates were > 90%. There were no severe adverse events associated with the treatment.

The LDV/SOF regimen showed high virological efficacy and acceptable safety in patients with HCV genotype 2 infection.

UMIN registration no. 000038604.

UMIN registration no. 000038604.The ocean provides benefits to coastal communities around the world, however, the depth and complexity of people's interactions with marine ecosystems are not well represented in many marine management initiatives. Many fisheries are managed to maximize provisioning value, which is readily quantified, while ignoring cultural values. An ecosystem services approach that includes both provisioning and cultural services will enable managers to better account for the diverse values marine fisheries provide to coastal communities. In this study, we assess community values related to a top fished species, the Mexican chocolate clam, Megapitaria squalida, in Loreto, Baja California Sur, Mexico. We conducted an exploratory analysis based on 42 household surveys, and found that community members perceive multiple provisioning and cultural benefits from the clam, including community economic, historical, and identity values. Despite reporting infrequent harvest and consumption of clams, participants perceive the species as an important part of community identity, highlighting the role of Mexican chocolate clams as a cultural keystone species in the Loreto region. Fisheries management that recognizes the full range of ecosystem services a species contributes to coastal communities will be better equipped to sustain these diverse values into the future.

The number of elderly patients in Japan with breast cancer has been gradually increasing. The aim of this study was to determine the efficacy of radiotherapy (RT) after breast-conserving surgery (BCS) for elderly patients with early breast cancer who were restaged according to the 8th Edition Breast Cancer Staging System.

We reviewed patients age ≥ 65years who received BCS and adjuvant RT or BCS alone for breast cancer between 2010 and 2015 in our institution and restaged those patients using the AJCC 8th edition pathological prognostic staging system. We compared relapse-free survival (RFS) and overall survival (OS) rates in the RT group and no RT group.

A total of 170 patients were eligible for analysis 94 (55.3%) were treated with RT and 76 (44.7%) were treated without RT. Age (p < 0.01) was associated with the use of RT. Adjuvant RT significantly improved RFS (95.75% vs 84.21%, p = 0.02). There was no significant difference between the OS rates in the two groups. Univariate analysis showed that pathologic T stage and N stage were significantly associated with both RFS and OS and that histologic grade, chemotherapy, HER2, and RT were significantly associated with RFS, but not with OS. GSK429286A in vitro RT reduced the risk of recurrence (HR=0.56, 95% CI=0.19-0.96, p = 0.04).

RT was associated with significantly improved RFS, but had no significant impact on OS in elderly patients with breast cancer after BCS. Adjuvant RT should be performed even for elderly patients with early breast cancer.

RT was associated with significantly improved RFS, but had no significant impact on OS in elderly patients with breast cancer after BCS. Adjuvant RT should be performed even for elderly patients with early breast cancer.

After coronary artery bypass grafting (CABG), healthcare utilisation is high and is partly unplanned. eHealth applications have been proposed to reduce healthcare consumption and to enable patients to get actively involved in their recovery. This way, healthcare expenses can be reduced and the quality of care can be improved.

We aim to evaluate whether the use of an eHealth programme can reduce unplanned healthcare utilisation and improve mental and physical health in the first 6weeks after discharge in patients who underwent CABG. In addition, patient satisfaction and use of the eHealth programme will be evaluated.

For this single-centre randomised controlled trial, at least 280patients referred for CABG will be included at the preoperative outpatient clinic and randomised to an intervention or control group. The intervention group will have access to an eHealth programme, which consists of online educational videos developed by the Dutch Heart Foundation and postoperative video consultations with aphysician. The control group will receive standard care and will not have access to the eHealth programme. The primary endpoint is healthcare utilisation; other endpoints include anxiety, duration of recovery, quality of life and patient satisfaction. Participants will complete several questionnaires at 6time points during the study.

Patient enrolment started in February 2020 and completion of the follow-up period is expected in August 2021.

This randomised trial was initiated to test the hypothesis that patients who are partaking in our eHealth programme use less unplanned care and experience abetter quality of life, less anxiety and afaster recovery than controls.

This randomised trial was initiated to test the hypothesis that patients who are partaking in our eHealth programme use less unplanned care and experience a better quality of life, less anxiety and a faster recovery than controls.