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Background & aims Obesity is associated with non-alcoholic fatty liver (NAFL), which may progress towards non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma (HCC). Occult hepatitis B virus infection (OBI) may contribute to hepatic damage in patients with chronic liver disease of different aetiologies (eg HCV, alcohol). However, information on the prevalence and clinical impact of OBI in obese individuals is lacking. The aims of this study were to investigate NASH prevalence and risk factors in obese people who underwent bariatric surgery. Methods Two-hundred and twenty-six subjects (160 females; mean age 42.9 years ±10.8 SD) without evidence of any further cause of liver disease consecutively underwent bariatric surgery in two Italian liver centers. During surgery, all patients underwent liver biopsy for histological evaluation and molecular studies. Liver DNA extracts were tested for PNPLA3, TM6SF2, MBOAT7, IRGM polymorphisms and for OBI. Univariate and multivariate analyses were used to identify predictors of NASH. Results Histology showed NASH in 115 (50.9%) and NAFL in 111 cases (49.1%). Twenty-nine/226 (12.8%) cases had OBI, 24 (82.8%) of whom had NASH and 5 (17.2%) NAFL, whereas among the 197 OBI-negative cases, 91 (46.2%) had NASH and 106 (53.8%) NAFL (P = .0002). Multivariate analysis showed that older age (P = .03, OR 1.034), alanine aminotransferase values (P = .005, OR 1.023), insulin resistance/diabetes (P = .02, OR 2.257), TM6SF2 polymorphism (P = .04, OR 3.168) and OBI (P = .004, OR 5.503) were independent predictors of NASH. Conclusion NASH is highly prevalent in obese individuals undergoing bariatric surgery. OBI is one of the strongest risk factors of NASH in these patients.

Hepatitis B virus (HBV) infection is the main risk factor for hepatocellular carcinoma (HCC) worldwide. Integration of HBV DNA into the human genome has been found in >80% of HBV-related HCC cases. Some studies have, however, found similar integration patterns in tumorous and nontumorous tissues. Thus, the role of integrations for the development of HCC as well as the rate of integration in different stages of infection remain unclear. The aim of this study was to investigate integrations in patients without HCC, representing different stages of chronic HBV (CHB) infection. Extracted DNA in liver biopsies from 74 patients (one with 2 available biopsies) with CHB infection was analyzed by Alu-PCR. Amplicons were further analyzed by Sanger sequencing. Integration was detected in 39 biopsies (52%) as an amplicon containing both human and HBV sequences by Alu-PCR with one primer targeting a region in the HBV genome. Integrations were found in patients representing the different stages of CHB infection. A majority of the HBV sequences were located upstream or downstream of nucleotide position 1820, which previously has been identified as a common breakpoint in the HBV genome in integrated sequences. Approximately 60% of the HBV integrations were found in noncoding regions of the human genome. Integrations of HBV DNA into the human genome is an event frequently found in mild phases of chronic hepatitis.

SETTING:The number of Australians dying each year is predicted to double in the next 25 years and there is an urgent need to establish sustainable models for providing high quality end-of-life care. An innovative community care model (Bupa Palliative Care Choices Program or BPCCP) was developed and piloted with the purpose of supporting patients in achieving their choices surrounding end-of-life care. OBJECTIVES:This study evaluates whether BPCCP patients were more likely to die in their place of choice compared with patients receiving standard care. Additional aims were evaluating patient and carer satisfaction and insurer cost. DESIGN:This prospective, comparative cohort study comprises a clinical chart audit and survey of patient and carer experience. RESULTS:More BPCCP participants preferred to die at home (53% vs 31%). A lower proportion of BPCCP patients died in acute hospitals (10% vs 19%) and more of this cohort died at home (46% vs 26%). In both cohorts, nearly 90% of patients were able to die in their preferred location. Patient and carer satisfaction with the program was very high in the small cohort who responded to the survey. There was a decrease in average claims spend per patient enrolled in the program during the first 12-month period of implementation compared to historical claims spend for inpatients only. CONCLUSIONS:This evaluation of an innovative community palliative care intervention indicates that the extra services available to patients supports the choice of dying at home and the ability to do so while generating claims cost efficiencies. This article is protected by copyright. All rights reserved.

Background and Aims Serial evaluation of hepatitis B virus (HBV) DNA and aminotransferase values is required for identification of inactive HBV carriers (ICs). Recently, HBV surface antigen quantification (qHBsAg) and liver stiffness measurement (LSM) have been proposed as diagnostic tools in chronic HBV infection. The aim of this study was to evaluate the efficacy of HBV DNA quantification, qHBsAg and LSM in diagnosing ICs at a single time point. Methods Fifty-seven previously characterized ICs and 90 untreated HBsAg/anti-HBe positive patients [49 chronic hepatitis (CH), 41 cirrhosis] were enrolled. HBVDNA ≤2,000 IU/mL, LSM ≤6.2 kPa and qHBsAg ≤1,000 IU/mL were used as cut-offs to evaluate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA). Results Combined HBV DNA quantification and qHBsAg correctly identified 30/57 (52.6%) ICs showing 94% sensitivity, 96% specificity, 98% PPV, 87% NPV, 95% DA. HBV DNA coupled with LSM identified 40/57 (70.2%) ICs showing 97% sensitivity, 97% specificity, 98% PPV, 95% NPV, 97% DA. Combined LSM and qHBsAg identified 33/57 (57.9%) ICs showing 95% sensitivity, 78% specificity, 89% PPV, 89% NPV, 89% DA. The evaluation of the three parameters altogether allowed the identification of 23/57 (40.3%) ICs showing 100% specificity, 96% sensitivity, 100% PPV, 92% NPV, 97% DA. Similar results were obtained when either CH or cirrhotic patients were excluded from the analysis. Conclusions Combined evaluation of HBV DNA amount with LSM and/or qHBsAg is a highly reliable tool allowing the identification of a considerable number of HBV ICs at a single time point evaluation. This article is protected by copyright. All rights reserved.

Atmospheric pressure non-equilibrium plasma treatments of poly(vinylidene fluoride) (PVdF) solutions and electrospun Li-ion separators are implemented to improve fiber morphology and increase electrolyte uptake. Plasma pre-treatment of PVdF solutions increased the viscosity and induced a morphological change of polymer chains, enabling the production of defect-free mats with improved mechanical properties compared to those produced from non pre-treated solutions. The post-treatment of the electrospun separator induced a chemical modification of the PVdF surface and an increase of electrolyte uptake. A synergistic effect between the plasma treatments is reported: the electrolyte uptake of the pre&post-treated separators is about 1200%, ten times larger than that of commercial Celgard separators.

A single step process for the deposition of nanocomposite coatings with silver nanoparticles (AgNPs) embedded in a plasma-polymerized polyacrylic acid (pPAA) matrix and performed using a non-equilibrium atmospheric pressure plasma jet is presented. Acrylic acid (AA) and AgNPs dispersed in ethanol (EtOH) are used as precursors and are separately injected in the plasma region directly; Ar is used as plasma gas and also as carrier gas for both precursors. Scanning electron microscopy (SEM) and ATR-FTIR analysis show the deposition of a micrometric pPAA coating on the polyethylene (PE) film used as substrate; AgNPs embedded in the polymeric matrix are visible in SEM pictures and their presence is confirmed by XPS and EDS analysis. X-ray photoelectron spectroscopy (XPS) also highlights a high retention of carboxylic groups in the pPAA chemical structure and the surface oxidation of AgNPs. Preliminary results of the antibacterial activity of the co-deposited coatings are presented.

Successful plasma-polymerization of acrylic acid (AA), aimed at depositing plasma-polymerized polyacrylic acid (pPAA) coatings stable upon water contact with a high amount of carboxyl groups, using a non-equilibrium atmospheric pressure nanopulsed plasma jet is reported. Special attention is devoted to the surface chemical characterization of the pPAA coatings deposited on pristine and plasma pretreated polymeric substrates. The investigation of the pPAA chemical structure is performed by means of attenuated total reflectance-Fourier transform infrared and X-ray photoelectron spectroscopies. Insights on the morphological characteristics of the coatings are also provided by optical microscopy.

Der Kostendruck auf dem Markt der erneuerbaren Energien ist sehr hoch. Alle Akteure mussen von den Erfahrungen der Offshore-Windprojekte Gebrauch machen, um aktuelle und zukunftige Herausforderungen zu meistern. Die genauere Betrachtung der Erfahrungen der letzten Jahre wird vermeidbare Hindernisse und Kosten in das Bewusstsein rufen. Die vorhandenen technischen Regeln bieten dem Anwender eine gute Grundlage zur Entwicklung und Verbesserung der Produkte und Projekte. Die kombinierte Nutzung gewonnener Erfahrungen und des Fachwissens sind jedoch der Schlussel zum zukunftigen Erfolg. Deshalb sollten die Erfahrungen in der Industrie untereinander geteilt werden, um den Reifegrad der Offshore-Wind-Branche schneller zu erhohen. Zuverlassige Qualitat, stabiler Betrieb und ein gutes Risikomanagement helfen, wettbewerbsfahige erneuerbare Energie zu produzieren. Minimization of risks of wind power plants. The cost of energy pressure is high in the renewables power market. All actors must make use of the lessons learned from offshore wind power plant projects to face current and future challenges. Extracting experiences from projects over the last years will help to increase the awareness of avoidable obstacles and costs. The available technical standards provide the users a basis to improve their product and project developments. However, utilizing the experiences and know-how is key for future success. Therefore the lessons learned should be shared within the industry to enhance the maturity of offshore wind business. Reliable quality, stable operation and proper risk management will help to produce renewable power in a competitive energy sector.

Novel bio-based and biodegradable electrospun membranes, containing bactericidal ricinoleic acid (RA) units either by copolymerization with butylene succinate (BS) units or by blending PRA and PBS homopolymers, are characterized in their chemical, thermal, mechanical and surface properties. In the blends E. coli and S. aureus mortality rate increases with PRA amount, while the copolymer shows lower bactericidal activity compared to the blend with similar composition. XPS demonstrates that in the blends an enrichment of RA units at the fiber surface occurs during electrospinning due to phase separation, while in the copolymer RA units are homogeneously dispersed along fiber cross-section.

BACKGROUND Occult hepatitis B virus (HBV) infection frequently occurs in patients with HBV surface antigen (HBsAg)-negative chronic liver disease, and much evidence suggests that it is a risk factor for hepatocellular carcinoma (HCC) development. However, to the authors' knowledge, no follow-up study has been performed to date evaluating HCC occurrence over time in chronic hepatitis patients with or without occult HBV infection. METHODS A cohort of the 380 HBsAg-negative chronic hepatitis patients attending the study institution between 1991–2000 were evaluated and tested for occult HBV DNA by analysis of liver biopsy specimens. RESULTS There were 135 patients (35.5%) with occult HBV and 245 patients (64.5%) without occult HBV. Cirrhosis was significantly associated with occult HBV infection (P = 0.01). One hundred thirty-four of these patients were followed for a minimum of 50 months (median, 82.8 ± 32.6 mos). Fifty-three patients (39%) were occult HBV carriers and 81 (61%) were not. Nine patients developed HCC during the follow-up; eight were positive and one was negative for occult HBV (P = 0.002). CONCLUSIONS The current observational cohort study showed that, among the HBsAg-negative patients with chronic hepatitis, HCC develops for the most part in carriers of occult HBV. Therefore, the evaluation of HBV genomes in chronic hepatitis patients appears to be a powerful tool for the identification of individuals at higher risk of HCC development. Cancer 2006. © 2006 American Cancer Society.

The surface photochemistry of polystyrene is shown to exhibit features that distinguish it from the bulk and from the polymer in solution. We report on the use of medium- and high-resolution time-of-flight secondary ion mass spectrometry and X-ray photoelectron spectroscopy in an investigation of the changes that occur as a result of exposure to UV light from a ‘black lamp’ source. The experiment mimics closely the effects of natural sunlight. It is shown that there are substantial changes occurring in the surface molecular structure of polystyrene on irradiation, which correspond to loss of aromaticity, and that these changes precede any uptake of oxygen.

A polysiloxane diglycidyl ether was used as a comonomer of epoxy resins to obtain coatings through the ultraviolet curing technique. Notwithstanding its very low concentration (

Two commercially available epoxy-fluorinated monomers, 3-(perfluorooctyl)-1,2-propenoxide and 3-(1H, 1H, 9H-hexadecafluorononyloxyl)-1,2 propenoxide, were used as modifying additives for UV curable systems. These two fluorinated monomers were mixed, in small amounts (less than 1% w/w) with a hydrogenated epoxy monomer 1,4-cyclohexanedimethanol-diglycidyl ether. The mixtures were coated on glass substrate and UV-cured, giving rise to transparent films. Notwithstanding their very low concentrations, the fluorinated monomers caused a change in the surface properties of the films, without changing their curing conditions and their bulk properties. The air side of the coatings became highly hydrophobic, while the substrate side was unmodified. As shown by XPS measurements, the fluorinated monomers were able to concentrate selectively on the air side of the films, forming a fluorinated layer. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 89: 1524–1529, 2003

The tissue tropism and possible correlation with liver disease of the TT virus (TTV) as well as its prevalence and genotype distribution remain undefined. TTV-DNA was investigated in paired sera and tissue samples from 144 patients, and sera and cerebrospinal fluids (CSF) from additional six subjects. Of the 144 tissue samples, 128 were liver biopsy specimens from subjects with hepatic disease while 16 were surgically obtained nonliver specimens from patients with extrahepatic disease. TTV cloning, sequencing and genotype analyses were performed on isolates from sera, tissue specimens and peripheral blood mononuclear cells of two patients with hepatic and four patients with extrahepatic pathologies, as well as from sera and CSFs of two subjects. TTV was found in 100% of the examined tissues and in 60.1 and 50% of sera from patients with hepatic and extrahepatic pathologies, respectively. Moreover, TTV was detected in four of the six CSFs analysed but only in two correspondent sera. Genotyping revealed the coexistence of multiple TTV genotypes and genetic variants in each infected individual, and the analysis of TTV mRNA showed the presence of transcripts in all the six different tissues studied. These results indicate that the entire adult population in our area is more likely infected by TTV, although several subjects are not viraemic and that TTV infects many different human tissues and is able to invade the central nervous system.

In the preparation of polymer/montmorillonite (MMT) nanocomposites, the commonly used compatibilizers (cations of long carbon-chain alkyl ammonium salts) present the drawback of a poor thermal stability. During bulk processing of nanocomposites elevated temperatures are usually required and, if processing temperature is close to decomposition temperature of the surfactant, decomposition will occur altering the interface between filler and polymer. To solve this problem, organically modified MMTs with thermally stable imidazolium surfactants have been prepared. A series of nanocomposites were obtained by dispersing o-MMT in poly(methyl methacryate) (PMMA) matrix via an in situ free radical polymerization. The nanocomposites were characterized by X-ray diffraction, transmission electron microscopy, gel permeation chromatography, thermogravimetric analysis, dynamic mechanical analysis, and nanoindentation measurements. The results showed that nanocomposite thermal stability depended on both the kind of used surfactant and degree of exfoliation. Under the same values of molecular weight, the nanocomposites containing imidazolium cations showed a better thermal stability with respect to the nanocomposite obtained using a standard alkylammonium surfactant. Dynamic mechanical and Nanoindentation measurements showed an improvement of mechanical properties, such as modulus and hardness, with respect to pure PMMA. Solution blending treatments on these nanocomposites led to obtaining of further improvement of the thermal performance. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015, 132, 41393.

Background/aims The C282Y mutation in the haemochromatosis gene (HFE) located on chromosome 6 has been identified as the main genetic basis of hereditary haemochromatosis (HH). Two more mutations of that gene, H63D and S65C, appear to be associated with milder forms of HH. A high allele frequency for C282Y and H63D mutations was reported in populations from North Europe, while incomplete information is available for individuals from the Mediterranean Basin where C282Y homozygotes comprise a smaller percentage of HH cases. In this study we investigated the allele frequency of HFE mutations and the association between HFE mutations and cases of HH in a population from the South of Italy (Sicily and Calabria). In addition, we evaluated a possible association between HFE mutations and either chronic liver disease or type II diabetes. Patients and methods Three hundred and twenty-seven individuals (654 chromosomes) were tested for C282Y, H63D and S65C mutations of the HFE gene by restriction fragment length polymorphism. Four had HH, 23 had hepatocellular carcinoma, 100 had chronic liver disease, 100 had type II diabetes, and 100 were healthy controls. Results Both C282Y and S65C mutations were each detected in one of the 654 chromosomes analysed (allele frequency=0.15%), while H63D change was found in 122 chromosomes (allele frequency=18.6%) and was equally distributed in all the categories examined. One healthy individual had compound heterozygosity for C282Y and H63D mutations. The frequency of C282Y in this Southern Italian sample was the lowest yet reported for a population of European origin. None of the four HH patients was either homozygous or heterozygous for C282Y. Conclusions In Mediterranean populations from Southern Italy the C282Y mutation occurs sporadically and HFE polymorphisms seem to have little diagnostic relevance.

2-Silyl five-membered sulfurated heterocycles can be efficiently accessed through reaction of bromo(methoxy)methyl trimethylsilane with suitable β-substituted mercaptans HS-CH2CH2-XH, leading to the formation of 2-silyl-1,3-dithiols, 2-silyl-1,3-thiazolidines, and 2-silyl-1,3-oxathiolanes. β-Mercaptoalcohols are obtained through regioselective ring opening of epoxides with bis(trimethylsilyl)sulfide (HMDST). In a similar way, thiiranes and aziridines react with HMDST, leading to the formation of 1,2-dithiols and β-aminothiols. Fluoride ion induced functionalization of the pentaatomic heterocycles smoothly affords the transfer of the heterocyclic ring on electrophiles, thus showing these silyl derivatives as a new class of acyl anion equivalents. When stereodefined compounds are reacted, the stereoinformation is transferred from the carbon–silicon to the newly formed carbon–carbon bond. © 2007 Wiley Periodicals, Inc. 18:516–526, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/hc.20345

Protodesilylaton of substituted silyl dithianes occurs with clean retention of configuration. In the case of the 2-phenyl derivative, epimerization of C-2 occurs. Selective functionalization of 2,2-bis trimethylsilyl derivatives can be efficiently obtained.

Background and Objectives The actual relationship between malignancy and secreting breast has not yet been extensively verified, mainly in patients with nipple discharge but without evidence of a breast lump. This study was carried out in 1,251 consecutive patients to evaluate the reliability of cytology combined with galactography in order to assess the relationship of malignant and premalignant lesions with discharge without the presence of a breast lump. Methods Those patients with bilateral discharge were approached endocrinologically, whereas the patients (433) with unilateral secretion were evaluated by cytology, mammography, fine needle biopsy, and galactography. Of 194 patients without a breast lump, 94 with positive cytology were surgically treated after mammogalactography. Surgical treatment included ductgalactophorectomy in 53, segmentectomy in 23, microdochectomy in 13, and mastectomy in 5 patients. Results Pathologic findings showed a solitary papilloma in 49 cases, minimal breast cancer in 20, fibrocystic disease in 11, papillomatosis in 7, lobular cancer in 5, and, finally, a duct ectasia in 2. Conclusions In the patients with secreting breast but without lump, cytological analysis in addition to galactography seems to be useful in identifying minimal breast cancer and in detecting premalignant lesions like papillomatosis. J. Surg. Oncol. 1999;71:235–238 © 1999 Wiley-Liss, Inc.

TBAF-catalyzed reaction of a range of substituted epoxides with hexamethyldisilathiane smoothly affords a direct and simple access to β-mercaptoalcohols in a highly regio- and stereoselective way.

The degradation of PK99 was studied by heating the polymer in both isothermal and dynamic conditions under nitrogen flow and in a static air atmosphere. In both environments this polymer's thermal stability exceeded that of PEEK. The dynamic experiments showed that in both nitrogen and air atmospheres the polymer degraded in two stages with formation of the same residue, which was quite stable under nitrogen, while almost completely burned in air. Good agreement was observed with the isothermal experiments. Apparent activation energy values were evaluated. The double linear relationships obtained by the Kissinger equation suggested a complex degradation process.

The surface properties of acrylic films, obtained through UV curing of bisphenol-A-dihydroxyethyl diacrylate (BHEDA) mixed with fluorinated acrylic monomers, were investigated. Three fluorinated acrylates were selected in order to vary the film composition, namely: 2-(n-perfluorooctylsulphonamido-N-butyl)ethyl acrylate, 2-(n-perfluorooctylsulphonamido-N-ethyl)ethyl acrylate and 2-(n-perfluorooctyl)ethyl acrylate. They were used at concentrations ranging from 0.01 to 1% w/w. The bulk of the films obtained after UV curing was not influenced by the additive as far as the thermal and mechanical properties are concerned. In contrast, the surface properties, examined by measuring the advancing and the receding contact angle with different solvents and evaluating the surface tension, were deeply modified notwithstanding the low concentration of the additive. The change was found to be dependent on the type of monomer and its concentration. Moreover, a clear influence of the substrate in contact with the polymeric film was pointed out. The following substrates were examined: glass, high-density polyethylene and polytetrafluoroethylene; it was shown that the substrate polarity strongly influences the surface properties of the films. X-ray photoelectron spectroscopy analyses allowed the obtaining of the surface composition of the films prepared in the different conditions and could provide a clear interpretation of the previous results.

A preliminary X-ray photoelectron spectroscopic (XPS) investigation on poly[4,4′-isopropylidenebis(1,4-phenyleneoxyethylene) diacrylate] samples obtained by photocuring on several substrates in the presence of a fluorine containing acrylic monomer is reported. Quantitative calculations based on F1s/C1s area ratios and C1s peak fitting show a noticeable fluorine surface enrichment that ranges, depending on the substrate, from 17 wt.-% to 59 wt.-% of fluorine containing moiety. The calculations also reveal the presence of a concentration gradient at the surface.

A series of new poly(arylene ether)s, containing naphthalene, pyridine, and quinoline units have been prepared by solution condensation polymerization. The synthesis involves nucleophilic displacement of aromatic dihalides with aromatic potassium bisphenates in an anhydrous dipolar aprotic solvent at elevated temperatures. The polymers, having inherent viscosity from 0.24 to 1.32 dL/g, were obtained in quantitative yield, have excellent thermal stability as shown by 10% weight loss temperatures in nitrogen and air (above 450 and 430°C, respectively) and high glass transition temperatures (in the range of 150–220°C). The introduction of quinoline moieties in the polymer backbone positively influences the thermal properties, such as high Tg/Tm ratios. © 1995 John Wiley & Sons, Inc.

A new approach to additions of silicon nucleophiles to imines was developed. The method is based on the phase-transfer of phenoxides by ammonium catalysts, overcoming the inability of amide adducts in promoting the reactions.

A suitably positioned (1, 2-, 1, 4-, and 1, 5-) intramolecular sulfide interferes with the iodotrimethylsilane-promoted iodine for hydroxyl substitution, as well as the related alcohol deprotection procedure (regioselective cleavage of methyl ethers). The outcome may be a cyclic sulfonium salt or an iodide arising from cleavage of a sulfonium intermediate. Cyclization is especially favored with secondary and tertiary alcohols or ethers, and with an aliphatic more than an aromatic sulfide function. A transannular version of the reaction results in the facile ring contraction of a 7- to a 5-membered cyclic sulfide. The trimethyliodosilane-promoted iodine for hydroxyl substitution, as well as the related methyl ether cleavage reaction, fail for substrates where a sulfide function is suitably positioned relative to the oxygen function. The outcome may be either a cyclic sul fonium iodide or a rearranged sulfide arising from cleavage of a sulfonium intermediate as in the case of 4-methoxy thiepane Download : Download full-size image