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Background Oral lichen planus (OLP) and hyposalivation have been reported as extrahepatic manifestations of hepatitis C virus (HCV) infection. Our study evaluated the effect of direct antiviral agents (DAAs) on OLP and hyposalivation in convicts with chronic hepatitis C, examining patients before, during and after the antiviral treatment period with direct acting antiviral agents (DAAs). Methods We screened 198 inmates for the presence of the HCV antibody. Patients found to be positive underwent a quantitative HCV-RNA test and HCV genotype typing, as well as an oral cavity examination using a scoring system for OLP (REU score) and the clinical oral dryness score (CODS). Subsequently, all patients underwent DAA therapy and a systematic physical examination of the oral cavity at 1, 3 and 6 months from the beginning of treatment. Results Fifty patients (25.25%) had a positive HCV-RNA test. At baseline, OLP was detected in 4 patients (8%), with a mean REU score of 10.13±4, and different degrees of hyposalivation were seen in 17 patients (34%), with a mean CODS score of 4.71±1.72. Six months after the start of DAA therapy, we observed resolution of OLP in 3 patients (75%) and improvement in the remaining subject with a significantly lower mean REU score (2±4). Hyposalivation disappeared in 5 patients, improved in 10, and remained unchanged in 2 patients with a significantly lower mean CODS score (0.06±0.24). Conclusion This study demonstrated the effectiveness of DAAs in the treatment of OLP and hyposalivation.

The electron cyclotron (EC) heating and current drive (H&CD) system developed for the ITER is made of 12 sets of high-voltage power supplies feeding 24 gyrotrons connected through 24 transmission lines (TL), to five launchers, four located in upper ports and one at the equatorial level. Nearly all procurements are in-kind, following general ITER philosophy, and will come from Europe, India, Japan, Russia and the USA. The full system is designed to couple to the plasma 20MW among the 24MW generated power, at the frequency of 170GHz, for various physics applications such as plasma start-up, central H&CD and magnetohydrodynamic (MHD) activity control. The design takes present day technology and extends toward high-power continuous operation, which represents a large step forward as compared to the present state of the art. The ITER EC system will be a stepping stone to future EC systems for DEMO and beyond. The development of the EC system is facing significant challenges, which includes not only an advanced microwave system but also compliance with stringent requirements associated with nuclear safety as ITER became the first fusion device licensed as basic nuclear installations as of 9 November 2012. Since the conceptual design of the EC system was established in 2007, the EC system has progressed to a preliminary design stage in 2012 and is now moving forward toward a final design.

The authors carried out many functional tests on the naso-pharyngo-tubal district in a group of patients affected with cystic fibrosis. The research has included: a clinical otolaryngological examination, Rx study of the paranasal sinuses, rhinomanometric study, mucocialiary nasal test, valuation of the tubal function and impedentiometry. The results have shown a poor correlation between the pathology of the nasal fossae and functionality of the Eustachian tube and middle ear. In order to verify the reliability of the data obtained, the same functional tests have been carried out on a control group of patients suffering from nasal atopy.

The Mirror one Lower (LM1) is part of the in-vessel quasi-optical beam propagation system for the ITER Electro Cyclotron (EC) Upper Launcher (UL), where eight beams are reflected through four mirrors during its passage to the plasma. The mirrors are grouped into two rows of four beams each and the mirror LM1 refers to a four mirror set. High power millimeter (mm) waves are generated by the gyrotrons and delivered to the in-vessel components via corrugated wave-guides. The design of the LM1 shall guarantee the optimal propagation of the beams during their transmission through the optical system taking into consideration 1) the shape of the reflecting surfaces, 2) loads coming from the beams themselves, the plasma and nuclear reactions as well as off-normal events and 3) the port plug space restrictions. This paper reports the Ohmic loss assessment at LM1 as function of frequency, surface roughness and resistivity using the most suitable material and the power input (1.31 MW at 170 GHz). It describes the design investigation of the cooling solutions for the normal scenario via computational fluid dynamic analyses, based on the ITER Primary Heat Transfer System (PHTS) cooling boundary conditions, needed to remove similar to 20 kW of power deposition on the mirror surface. Finite element analyses are performed to guide the design choices in an effort to minimize the maximum mirror surface temperature and thus diminishing the deformation of the reflecting surfaces. The conclusion of this study will provide a feasible design solution for the LM1 and Upper Mirror 1 (UM1).

Four EC H&CD (Electron Cyclotron Heating and Current Drive) launchers will be installed into the upper ports #12, #13, #15 and #16 in ITER. Beside plasma heating their main purpose is to counteract plasma instabilities by injecting up to 20 MW of microwave power at a frequency of 170 GHz at dedicated positions into the plasma. The microwave power is generated in 24 Gyrotrons outside the Tokamak and transmitted into the dedicated ports by 8 waveguide lines per launcher. After passing a CVD (Chemical Vapor Deposition) diamond window and another section of circular waveguides, the microwaves are quasi-optically guided into the plasma by an adjusted set of mirrors. These mirrors and also the foremost segments of the waveguides are mounted into the Upper Port Plug, which is a massive steel structure capable to dissipate up to 800 kW heat and to withstand heavy mechanical loads induced mainly from plasma disruptions. This paper presents the most recent status of the design of the EC H&CD Upper Port Plug (UPP), featuring the construction of the supporting structure and the BSM (Blanket Shield Module) with its plasma facing First Wall, the PHTS (Primary Heat Transfer System) water cooling layout, the shielding components engineering, the microwave system integration and comprehensive manufacturing strategies. Also correlated computational analyses to prove the final design of the launchers structural system are given.

Background Obese patients (Ob) with a binge eating disorders (BED) behavior pattern have a higher prevalence of postprandial distress syndrome (PDS) compared to Ob without a BED behavior pattern, while an increase of PDS has been described in Ob after sleeve gastrectomy (SG). Hedonic response to a meal is dissociable from satiation in healthy subjects. Anhedonia is the lowered ability to experience pleasure. There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms. Aim To assess the relationship among anhedonia, BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG. Methods Eighty-one Ob without SG, 45 Ob with SG and 55 healthy controls (HC) were studied. All subjects fulfilled the binge eating scale (BES) to investigate BED, the validated 14 items Snaith-Hamilton pleasure scale (SHAPS) to assess Anhedonia as well as the Beck Depression Inventory-II (BDI II) and State Trait Anxiety Inventory (STAI) questionnaires to screen for depression and anxiety. All patients underwent a standardized questionnaire investigating the intensity-frequency scores (0-6) of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia (FD) and its subtypes according to ROME IV criteria. Results Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED (OR: 4.7; 95.0%CI 1.23-18.24; P = 0.02). STAI-Y2 scores were significantly higher in Ob without SG positive for BED (42.2 ± 1.5 vs Ob negative for BED: 39.6 ± 1 .0, P = 0.04), while SHAPS scores and BDI II did not differ in the two groups (1.16 ± 1.30 vs 0.89 ± 1.02, P = 0.49). A lower prevalence of BED (BES > 17: 11.4% vs 40.7%, P = 0.001) and BDI-II (6.8 ± 1.2 vs 13.8 ± 1.9, P = 0.005) was reported in Ob with SG than Ob without SG, on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG. Thirty-five percent of Ob with SG fulfilled the diagnosis of FD. SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups (18.2 vs 8.1%, P = 0.2). Fifty-four percent of Ob with SG achieved surgical success excess weight loss > 50%. Excess weight loss was negatively related to SHAPS total mean scores [adjusted B: -7. 099 (95%CI: -13.91 to -0.29), P = 0.04]. Conclusion Ob without SG showed a higher prevalence of PDS, mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior, whereas no differences were found in SHAPS score. Ob with SG showed a higher prevalence of PDS compared to Ob without SG. Concerning psychological aspect, BED and depression are less frequent in the Ob with SG, while both state and trait anxiety are significantly higher. Moreover, the more an Ob with SG is anhedonic, less surgical success was achieved.