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Gamma-glutamyl transferase (GGT) has been predictive of chronic hepatitis C-related hepatocellular carcinoma (HCC) development. Its role in the risk of HCC in chronic hepatitis B (CHB) patients treated with nucleotide/nucleoside analogues (NAs) is elusive.A total of 2172 CHB patients from East Asia were randomized into development and validation groups in a 1:2 ratio. Serum GGT levels before and 6 months (M6) after initiating NAs and the potential risk factors were measured. The primary endpoint was HCC development 12 months after NA initiation.The annual incidence of HCC was 1.4/100 person-years in a follow-up period of 11 370.7 person-years. The strongest factor associated with HCC development was high M6-GGT levels (25 U/L; hazard ratio [HR]/95% confidence interval [CI]: 3.31/2.02-5.42, P .001), followed by cirrhosis (HR/CI: 2.06/1.39-3.06, P .001), male sex (HR/CI: 2.01/1.29-3.13, P = .002) and age (HR/CI: 1.05/1.03-1.17, P .001). Among cirrhotic patients, the incidence of HCC did not differ between those with high or low M6-GGT levels (P = .09). In contrast, among non-cirrhotic patients, the incidence of HCC was significantly higher for those with M6-GGT level25 U/L than for their counterparts (P .001). Cox regression analysis revealed that the strongest factor associated with HCC development in non-cirrhotic patients was high M6-GGT levels (HR/CI: 5.05/2.52-10.16, P .001), followed by age (HR/CI: 1.07/1.04-1.09, P .001). Non-cirrhotic elderly patients with high M6-GGT levels had a similarly high HCC risk as cirrhotic patients did (P = .29).On-treatment serum GGT levels strongly predicted HCC development in CHB patients, particularly non-cirrhotic patients, treated with NAs.

We aimed to compare the longitudinal changes in estimated glomerular filtration rate (eGFR) in chronic hepatitis B (CHB) patients treated with entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF). This is a retrospective study of 6189 adult treatment-naive CHB patients initiated therapy with TDF (n = 2482) or ETV (n = 3707) at 25 international centers using multivariable generalized linear modeling (GLM) to determine mean eGFR (mL/min/1.73 m2) and Kaplan–Meier method to estimate incidence of renal impairment (≥ 1 chronic kidney disease [CKD] stage worsening). We also examined above renal changes in matched ETV and TDF patients (via propensity score matching [PSM] on age, sex, diabetes mellitus [DM], hypertension [HTN], cirrhosis, baseline eGFR, and follow-up duration). In the overall cohort (mean age 49.7 years, 66.2% male), the baseline eGFR was higher for TDF vs. ETV group (75.9 vs. 74.0, p = 0.009). PSM yielded 1871 pairs of ETV or TDF patients with baseline eGFR ≥ 60 and 520 pairs for the eGFR

A series arc produces both light and heat, which results in a risk of fire. Hence, its prompt detection is very important. The series arc has different frequency characteristics depending on the operating conditions of the inverter and the line impedance. As a result, it is difficult to detect with conventional methods that use specific frequency bands. In this study, series arcs generated by three-phase pulse-width-modulated and three-phase model-predictive-control inverter loads, operating under various conditions, were detected using a deep-learning algorithm. To detect a series arc fault, the frequency characteristics were analyzed using all the frequency bands of a fast Fourier transform (FFT) result. To use all the frequency bands, a deep neural network (DNN), which is a deep-learning algorithm, was used. DNNs can learn quickly from large amounts of data and model complex nonlinear relationships. The DNN model proposed in this paper was designed to use all the frequency bands, and three cases were tested by changing the current magnitude and switching frequency. The arc current detection accuracy was calculated for three test cases and the obtained results were analyzed in detail based on the percentages of true/false and mean absolute error metrics. The analysis confirmed that the arc current was accurately detected, which validates the suitability of the DNN for series arc detection.

Although universal vaccination has been administered to toddlers, South Korea has had periodic nationwide outbreaks of acute hepatitis A since the late 2000s. We examined the chronological changes in the seroprevalence of anti-hepatitis A virus (HAV) immunoglobulin G (IgG) over the past 15 years (2005-2019). We retrospectively collected data from 45,632 subjects who underwent anti-HAV IgG testing without evidence of acute HAV infection at four centers in the capital area of South Korea between January 2005 and December 2019. The seroprevalence of anti-HAV IgG was analyzed according to age and compared among seven age groups and five time periods. Additionally, age-period-cohort analyses were used to identify the age, period, and cohort effects of the seroprevalence of anti-HAV IgG. The mean age of the enrolled subjects was 39.2 ± 19.2 years, and the average anti-HAV IgG positivity rate was 66.4%. During the 15 years, the seroprevalence of anti-HAV IgG in people aged 0 to 19 years significantly increased over time (P .001). In people aged 20 to 29 years, the seroprevalence slightly decreased to that of the early 2010s (31.3% in 2005-2007 to 19.7% in 2011-2013) but rebounded to 39.5% in 2017 to 2019. In contrast, the seroprevalence of anti-HAV IgG in those aged 30 to 49 years decreased over time (P .001). The seroprevalence of anti-HAV IgG in those aged 20 to 39 years in 2017 to 2019 was still less than 40%. In addition, the seroprevalence of anti-HAV IgG in people aged 50 to 59 years has recently decreased. Since the introduction of the universal vaccination, the seroprevalence of anti-HAV IgG in children and young adults has gradually increased. However, the seroprevalence of anti-HAV IgG in people in their 20s remains low, and the seroprevalence of anti-HAV IgG in people in their 30s and 40s is gradually decreasing. Therefore, a new strategy for HAV vaccination is needed for those in their 20s to 40s.

Spent nuclear fuels (SNFs) are stored in stainless steel canisters at Independent Spent Fuel Storage Installations (ISFSIs) typically near the seashore. During long-term storage of these canisters in the dry cask storage system (DCSS), chloride-induced stress corrosion cracking (CISCC) could occur due to the deliquescence of concentrated salt deposits on the canister surface. To evaluate such flaws on the accessible exterior metallic portions of containment systems while in service, the ASME Section XI Code Case N-860 provides inservice inspection requirements for aging management of canisters manufactured with welded austenitic stainless steels. It is noteworthy that CISCC crack growth rate (CGR) model in Code Case N-860 consists of the constitutive equations with temperatures (canister surface temperatures, storage site yearly mean temperature, and ambient temperature measured at overpack inlet) and is independent of stress intensity factor or other environmental factors. In this work, the mean temperature effect of the local storage site on the CGR is analyzed based on the CISCC CGR model in Code Case N-860. The specified mean temperature in the Code Case is calculated yearly however, the crack growth by CISCC can be evaluated differently if the mean temperature of storage site with a large annual range of temperature such as South Korea is applied. In that case, the monthly mean temperature is adjusted as the yearly mean temperature so the effect of averaging range for calculating the mean temperature is analyzed. Firstly, climate data of some candidate sites for the storage in South Korea are measured from Korea Meteorological Administration (KMA). The climate data of the Diablo Canyon Power Plant located in California (United States) is obtained from National Weather Service (NWS) for comparison. Yearly data from 2012 to 2020 are applied and the crack growth is estimated for sites of different annual ranges.

Both entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are first-line therapies for chronic hepatitis B (CHB), but their comparative effectiveness with regards to hepatitis B surface antigen (HBsAg) seroclearance remains unclear.This international multicenter cohort study enrolled 7697 treatment-naïve CHB patients (median age 50 years; male 66.75%) initiated on either ETV (n = 5430) or TDF (n = 2267) without baseline malignancy or immunosuppression from 23 centers across 10 countries or regions. Patients were observed for HBsAg seroclearance until death, loss to follow-up, or treatment discontinuation or switching. The incidences of HBsAg seroclearance were adjusted for competing mortality and compared between ETV and TDF cohorts with inverse probability of treatment weighting (IPTW) and also by multivariable regression analysis.The study population was followed up for a median duration of 56.1 months with 36,929 11 person-years of observation. HBsAg seroclearance occurred in 70 ETV-treated and 21 TDF-treated patients, yielding 8-year cumulative incidence of 1.69% (95% confidence interval [CI] 1.32-2.17) for ETV and 1.34% (95% CI 0.85-2.10%), for TDF (p = 0.58). In the IPTW analysis with the two study cohorts more balanced in background covariates, the age-adjusted hazard ratio (HR) of TDF versus ETV for HBsAg seroclearance was 0.91 (95% CI 0.50-1.64; p = 0.75). Furthermore, there was no significant difference between the two medications in the multivariable competing risk regression model (adjusted sub-distributional HR 0.92 for TDF vs. ETV; 95% CI 0.56-1.53; p = 0.76).ETV and TDF did not differ significantly in the incidence of HBsAg seroclearance, which rarely occurred with either regimen.

Increasing hepatitis-related mortality has reignited interest to fulfill the World Health Organization’s goal of viral hepatitis elimination by 2030. However, economic barriers have enabled only 28% of countries to implement countermeasures. Given the high disease burden among Asians, we aimed to present age, sex, disease activity and treatment-specific annual progression rates among Asian chronic hepatitis B (CHB) patients to inform health economic modeling efforts and cost-effective public health interventions. We analyzed 18,056 CHB patients from 36 centers across the U.S. and seven countries/regions of Asia Pacific (9530 treated; 8526 untreated). We used Kaplan–Meier methods to estimate annual incidence of cirrhosis and hepatocellular carcinoma (HCC). Active disease was defined by meeting the APASL treatment guideline criteria. Over a median follow-up of 8.55 years, there were 1178 incidences of cirrhosis and 1212 incidences of HCC (297 without cirrhosis, 915 with cirrhosis). Among the 8526 untreated patients (7977 inactive, 549 active), the annual cirrhosis and HCC incidence ranged from 0.26% to 1.30% and 0.04% to 3.80% in inactive patients, and 0.55 to 4.05% and 0.19 to 6.03% in active patients, respectively. Of the 9530 treated patients, the annual HCC rates ranged 0.03–1.57% among noncirrhotic males and 2.57–6.93% among cirrhotic males, with lower rates for females. Generally, transition rates increased with age, male sex, the presence of fibrosis/cirrhosis, and active disease and/or antiviral treatment. Using data from a large and diverse real-world cohort of Asian CHB patients, the study provided detailed annual transition rates to inform practice, research and public health planning.

Background/Aims: We aimed to assess the role of vitamin D supplementation in the response to pegylated interferon-α (PEG-IFN-α) plus ribavirin (RBV) treat ment in patients with chronic hepatitis C (CHC). Methods: Our study was a multi-center, randomized controlled trial in 11 hos pitals. CHC patients were randomly assigned (1:1) to two groups namely, PEG-IFN-α plus RBV (control group) or PEG-IFN-α plus RBV + vitamin D (800 IU dai ly) (vitamin D group). The primary end-point was the rate of sustained virologic response (SVR). Results: One hundred forty eight CHC patients were randomly assigned to two groups. Seventy-one patients received the PEG-IFN-α plus RBV and 77 patients received the PEG-IFN-α plus RBV + vitamin D. A total of 105 patients complet ed the study (control group, 47 vs. vitamin D group, 58). Baseline characteristics were mostly similar in both the groups. There was a modest but non-significant increase in SVR in the vitamin D group compared to the control group with the intention to treat analysis (64.0% vs. 49.3 %, p = 0.071) as well as in the per protocol analysis (control group vs. vitamin D group: 74.5% vs. 84.5%, p = 0.202). Fifty-two patients (73.2%) in the control group and 63 patients (81.8%) in the vitamin D group experienced at least one adverse event. The drop-out rate due to adverse effects was not different between both groups (control group vs. vitamin D group: 19.7% vs. 10.4%, p = 0.111). Conclusions: Vitamin D supplement did not increase SVR in treatment naive pa tients with CHC irrespective of genotype.

We aimed to compare the longitudinal changes in estimated glomerular filtration rate (eGFR) in chronic hepatitis B (CHB) patients treated with entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF).This is a retrospective study of 6189 adult treatment-naïve CHB patients initiated therapy with TDF (n = 2482) or ETV (n = 3707) at 25 international centers using multivariable generalized linear modeling (GLM) to determine mean eGFR (mL/min/1.73 mIn the overall cohort (mean age 49.7 years, 66.2% male), the baseline eGFR was higher for TDF vs. ETV group (75.9 vs. 74.0, p = 0.009). PSM yielded 1871 pairs of ETV or TDF patients with baseline eGFR ≥ 60 and 520 pairs for the eGFR 60 group. GLM analysis of the overall (unmatched) cohort and PSM cohorts revealed lower adjusted mean eGFRs in TDF (vs. ETV) patients (all p 0.01) during 10 years of follow-up. Among PSM eGFR ≥ 60 patients, the 5-year cumulative incidences of renal impairment were 42.64% for ETV and 48.03% for TDF (p = 0.0023). In multivariable Cox regression, TDF vs. ETV (adjusted HR 1.26, 95% CI 1.11-1.43) was associated with higher risk of worsening renal function.Over the 10-year study follow-up, compared to ETV, TDF was associated with a lower mean eGFR and higher incidence of renal impairment.

In this study, a corrosion pit test using notched bar specimens was conducted to investigate the effect of stress magnitude on the pit growth rate. To produce the notched bar specimens, 304 austenitic stainless steel was used, which is a material used for spent nuclear fuel canisters. Furthermore, three levels of stresses were generated using different notch radii. The corrosion pits were quantitatively measured through scanning electron microscopy and analyzed by finite element analysis. Based on experimental data, the pit growth rate model is suggested in terms of the stress and exposure time.

OBJECTIVE: We evaluated the prognostic impacts of body composition components measured by computed tomography (CT) in patients with liver cirrhosis. METHODS: A total of 160 cirrhotic patients who underwent CT and hepatic venous pressure gradient measurements were retrospectively enrolled. Cross-sectional areas of skeletal muscle, visceral and subcutaneous fat, and mean CT attenuation of trabecular bone of the fourth lumbar vertebral level (L4HU) were measured. RESULTS: Multivariate analysis showed model for end-stage liver disease score [hazard ratio (HR), 1.086; 95% confidence interval (CI), 1.020-1.156; P = 0.010], hepatic venous pressure gradient (HR, 1.076; 95% CI, 1.021-1.135; P = 0.006), sarcopenia (HR, 1.890; 95% CI, 1.032-3.462; P = 0.039), and L4HU (HR, 1.960 for L4HU

Introduction Although various clinical applications of geneX®ds have been reported, no study has reported the clinical application of geneX®ds in osteoporotic hip fracture. The present study aimed to identify the clinical effect of the application of geneX®ds in elderly patients with intertrochanteric fracture treated using proximal femoral nail antirotation (PFNA). Materials and methods From March 2014 to October 2017, 233 patients with intertrochanteric fracture (65 men and 168 women) were enrolled in this study. All patients received surgical treatment using PFNA. Patients were classified into two groups: those in whom geneX®ds which is synthetic osteoconductive bone graft substitute with the unique property of Zeta Potential Control (ZPC®), was use, and those in whom it was not. We compared the preoperative details and surgical outcomes, including radiologic outcome (postoperative reduction, tip apex distance, sliding distance of the helical blade, union, and union time) and clinical outcomes (Harris Hip Score and the walking ability at the last follow-up) between the groups. Results In patients with unstable fracture who achieved anatomical or extramedullary type of reduction, the average sliding distance at 1, 3, and 12 months was 4.9 mm, 7.5 mmm and 8.1 mm in the geneX®ds group and 7.5 mm, 10.8 mm, and 12.1 mm in the no geneX®ds group, respectively. There were significant differences in the sliding distance at 1, 3, and 12 months between these two groups. Conclusion The use of this synthetic osteoconductive bone graft substitute with zeta potential control may have positive effect on the controlled sliding of the helical blade and the healing of intertrochanteric fracture.

One-third of the global hepatitis C virus (HCV) burden is found in Asia. Real-world data from diverse East Asian cohorts remain limited. This study addressed the real-world status of direct-acting antiviral (DAA) therapy among patients from East Asia. Chronic hepatitis C (CHC) patients from clinical sites in Japan, Taiwan, South Korea, and Hong Kong were recruited in the REAL-C registry, an observational chart review registry. The primary outcome was sustained virologic response (SVR12, HCV RNA PCR

Background The main purpose of this study is to introduce our surgical technique and report surgical outcomes for percutaneous cable fixation in the treatment of subtrochanteric femoral fractures. Methods Between May 2013 and April 2017, 51 patients with subtrochanteric femoral fractures treated with closed intramedullary nailing and percutaneous cable fixation were enrolled in this study. Postoperative angulation, union rate, time from injury to union, and femoral shortening were also evaluated to assess radiologic outcomes. Clinical outcomes, including range of hip flexion, walking ability, and Harris hip score at the last follow-up were evaluated. Results Average coronal and sagittal angulation after surgery were 0.9 (range 0–5) and 0.3 (range 0–5), respectively. There was no postoperative angulation of more than 5°. Average shortening of the femur at 1-year follow-up was 2.7 mm (range 0–15). Bone union was achieved in 50 patients (98.0%) and average time to union was 18.6 weeks (range 12–48). Hip flexion, walking ability and Harris hip score at the last follow up were 115.6° (90–120), 7.9 (5–9), and 88.3 (65–100), respectively. Conclusion Percutaneous cerclage cable fixation can provide a greater likelihood of achieving anatomical reduction and increased stability of fracture, while preserving biology around the fracture site. Thus, percutaneous cerclage cable fixation can be an effective surgical technique for the treatment of complex subtrochanteric fractures.

Spent nuclear fuels are stored in dry storage canisters made of austenitic stainless steels. Canisters have a sensitivity to chloride-induced stress corrosion cracking since some storage facilities are located in coastal regions, and this environment could have a higher risk for pits and cracks to form on the surface of canisters. Hence, this paper suggests an experimental method of evaluating crack initiation for austenitic stainless steels. Notched bar specimens fabricated using AISI 304 and 304L stainless steels are designed to simulate loads corresponding to welding residual stresses on the surface of canisters. For testing to be conducted in chloride environments, the developed tester for evaluating CISCC is designed such that the notched bar specimens are immersed into the brine of 5% salinity and are loaded by tightening a spring to provide a constant load condition at 50 °C temperature. Also, initial load applied to each notched specimen is verified using finite element analysis as in the same experimental condition. As a result, the areas by pitting corrosion on notches are 1measured using the Image Analyzer program and the stress parameters obtained from the finite element analysis are used to correlate the effect of the pit formation.

Background & AIMS Antiviral treatment criteria are based on disease progression risk, and hepatocellular carcinoma (HCC) surveillance recommendations for patients with chronic hepatitis B (CHB) without cirrhosis is based on an annual incidence threshold of 0.2%. However, accurate and precise disease progression estimate data are limited. Thus, we aimed to determine rates of cirrhosis and HCC development stratified by age, sex, treatment status, and disease activity based on the 2018 American Association for the Study of Liver Diseases and 2017 European Association for the Study of the Liver guidelines. Methods We analyzed 18,338 patients (8914 treated, 9424 untreated) from 6 centers from the United States and 27 centers from Asia-Pacific countries. The Kaplan-Meier method was used to estimate annual progression rates to cirrhosis or HCC in person-years. Results The cohort was 63% male, with a mean age of 46.19 years, with baseline cirrhosis of 14.3% and median follow up of 9.60 years. By American Association for the Study of Liver Diseases criteria, depending on age, sex, and disease activity, annual incidence rates ranged from 0.07% to 3.94% for cirrhosis, from 0.04% to 2.19% for HCC in patients without cirrhosis, and from 0.40% to 8.83% for HCC in patients with cirrhosis. Several subgroups of patients without cirrhosis including males younger than 40 years of age and females younger than 50 years of age had annual HCC risk near or exceeding 0.2%. Similar results were found using European Association for the Study of the Liver criteria. Conclusion There is great variability in CHB disease progression rates even among “lower-risk” populations. Future CHB modeling studies, public health planning, and HCC surveillance recommendation should be based on more precise disease progression rates based on sex, age, and disease activity, plus treatment status.

Increasing hepatitis-related mortality has reignited interest to fulfill the World Health Organization's goal of viral hepatitis elimination by 2030. However, economic barriers have enabled only 28% of countries to implement countermeasures. Given the high disease burden among Asians, we aimed to present age, sex, disease activity and treatment-specific annual progression rates among Asian chronic hepatitis B (CHB) patients to inform health economic modeling efforts and cost-effective public health interventions.We analyzed 18,056 CHB patients from 36 centers across the U.S. and seven countries/regions of Asia Pacific (9530 treated; 8526 untreated). We used Kaplan-Meier methods to estimate annual incidence of cirrhosis and hepatocellular carcinoma (HCC). Active disease was defined by meeting the APASL treatment guideline criteria.Over a median follow-up of 8.55 years, there were 1178 incidences of cirrhosis and 1212 incidences of HCC (297 without cirrhosis, 915 with cirrhosis). Among the 8526 untreated patients (7977 inactive, 549 active), the annual cirrhosis and HCC incidence ranged from 0.26% to 1.30% and 0.04% to 3.80% in inactive patients, and 0.55 to 4.05% and 0.19 to 6.03% in active patients, respectively. Of the 9530 treated patients, the annual HCC rates ranged 0.03-1.57% among noncirrhotic males and 2.57-6.93% among cirrhotic males, with lower rates for females. Generally, transition rates increased with age, male sex, the presence of fibrosis/cirrhosis, and active disease and/or antiviral treatment.Using data from a large and diverse real-world cohort of Asian CHB patients, the study provided detailed annual transition rates to inform practice, research and public health planning.

Surgical treatment of AO/OTA type 33-C fractures is a therapeutic challenge despite advances in surgical instruments and techniques. We introduce a novel surgical technique named transient retrograde interfragmentary compression (TRIC) to help intraarticular fragment reduction in AO/OTA type 33-C fracture. We inserted a partial threaded 7.0-cannulated screw with a washer along the transepicondylar axis from the medial femoral epicondyle during the articular block reduction process of AO/OTA type 33-C fractures to strengthen the compressive force between the condylar fragments and to enhance the handling of the articular block fragment in the alignmental correction stage. Following the provisional reduction and fixation using lateral distal femur locking compression plate, TRIC screw was removed. Fifteen AO/OTA type 33-C distal femoral intraarticular fractures of thirteen patients were surgically treated using the TRIC technique. We analyzed the radiographic result of the patients by measuring the horizontal gap and vertical step-off in the postoperative radiographs. Mean horizontal fracture gap was 0.34 mm and mean vertical step-off between bicondylar fragments was 0.63 mm. The median value of the horizontal fracture gap and vertical step off was 0 and 0.46 mm, respectively. Mean time to union in the bicondylar fracture fragment was 9 week. TRIC is considered to be a valuable surgical reduction technique in the treatment of the AO/OTA 33-C type fractures.

OBJECTIVES To investigate the success rate of spleen stiffness measurement and factors that affect measurement success and to determine the spleen stiffness value of normal individuals by 2-dimensional shear wave elastography. METHODS The spleen and liver stiffnesses of 313 consecutive patients were measured with SWE. The body mass index, abdominal wall thickness, spleen size, and liver stiffness of the patients were evaluated to identify factors associated with successful measurement of spleen stiffness. Patients were grouped by body mass index, spleen size, and liver stiffness, and the success rates and mean spleen stiffness values of the groups were compared. Independent predictors for successful spleen stiffness measurement and their cutoff values were evaluated. The mean spleen stiffness values of patients considered to have normal spleen stiffness were investigated. RESULTS The overall success rate of spleen stiffness measurement was 52.9%. It was significantly higher in nonobese than in obese patients and in patients with splenomegaly and liver cirrhosis. The spleen stiffness value was higher in the splenomegaly group than the nonsplenomegaly group (P

Background & Aims Studies to evaluate risks of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection treated with the nucelos(t)ide analogues entecavir or tenofovir have produced contradictory results. These differences are likely to be the result of censored data, insufficient observation periods, and different observation periods for patients treated with different drugs. We aimed to compare the incidence of HCC development between patients treated with oral entecavir or tenofovir and followed up for the same time periods. Methods We performed a retrospective study, collecting data from 1560 treatment-naive patients with chronic HBV infection who were first treated with entecavir (n = 753) or tenofovir (n = 807) from 2011 through 2015 at 9 academic hospitals in Korea. Clinical outcomes were recorded over a mean time period of 4.7 ± 1.0 years, from 92.4% of patients treated with tenofovir and 92.7% of patients treated with entecavir. Results Thirty-four patients in the entecavir group (4.5%) and 45 patients in the tenofovir group (5.6%) developed HCC during the follow-up period. The incidence of HCC did not differ significantly between groups, even in a 516-pair propensity score–matched population. Conclusions In a retrospective study of 1560 treatment-naive patients with chronic HBV infection, the incidence of HCC did not differ significantly between patients treated with entecavir vs tenofovir over the same observation period. Clinical trial: KCT0003487.

This paper presents a new test method for assessing chloride induced stress corrosion cracking occurred in metal canisters used for storing spent nuclear fuels. The material applied to experiment is austenitic stainless steel, SS304 similarly used on manufacturing canisters and the experiment is carried out with immersing a compact tension specimen to chloride solution made up with artificial sea salt. Constant displacement condition using bolt tightening is applied to the test and a load is measured as a function of time using a load cell. Five specimens are used for the experiment at temperature of 50 °C for several months and stress intensity factor is calculated through the measured relaxed load and crack length on fractured surface of the specimen. Crack growth rate is presented in terms of test periods and consequently this apparatus suggests a method for evaluating structural integrity of chloride stress corrosion cracking.

Stress corrosion cracking may occur when chloride-bearing salts deposit and deliquesce on the external surface of stainless steel spent nuclear fuel storage canisters at weld regions with high residual stresses. Although it has not yet been observed, this phenomenon leads to a confinement concern for these canisters due to its potential for radioactive materials breaching through the containment system boundary provided by the canister wall during extended storage. The tests for crack growth rate have been conducted on bolt-load compact tension specimens in a setup designed to allow initially dried salt deposits to deliquesce and infuse to the crack front under conditions relevant to the canister storage environments (e.g., temperature and humidity). The test and characterization protocols are performed to provide bounding conditions in which cracking will occur. The results after 2- and 6-month exposure are examined in relation to previous studies in condensed brine and compared with other experimental data in the open literature. The knowledge gained from bolt-load compact tension testing is being applied to a large plate cut from a mockup commercial spent nuclear fuel canister to demonstrate the crack growth behavior induced from starter cracks machined in regions where the welding residual stress is expected. All these tests are conducted to support the technical basis for ASME Boiler and Pressure Vessel Section XI Code Case N-860.

The burden of minimal hepatic encephalopathy (MHE) is significant, but no universal criteria for diagnosis have been established. We aimed to validate the Korean Stroop Test for MHE screening. Chronic hepatitis B-related liver cirrhosis patients were recruited prospectively from 13 centers. The Korean Stroop Test consisted of two Stroop-off states (color and word) and two Stroop-on states (inhibition and switching). Accuracy adjusted psychomotor speed (rate correct score) of these tests were analyzed. Sex- and age- adjusted rate correct scores of these tests were rated as the Korean Stroop Score (K-Stroop score). MHE was diagnosed when Portosystemic Encephalopathy Syndrome Test (PHES) scores were below −4. A total of 220 liver cirrhosis patients and 376 healthy controls were enrolled. Prevalence of MHE was 20.6% in cirrhosis patients. Rate correct scores and the K-Stroop score showed significant differences between healthy controls, cirrhosis patients without MHE, and cirrhosis patients with MHE. The rate correct score of the K-Stroop score was 0.74 (95% Confidence Interval: 0.66–0.83, P

In this paper, a new experimental tester was designed to improve the stability in load measurement and imposed environment for chloride-induced stress corrosion cracking (CISCC) testing of austenitic stainless steels that are used to construct spent nuclear fuel dry storage canisters. By fabricating compact tension specimens using the UNS S30400 stainless steel, the test is conducted by immersing the specimen in 5 % salinity artificial seawater at 50°C. From the measured load, the stress intensity factor is calculated and the crack length is measured by an optical microscope. The present experimental data confirm the existing findings that the CISCC growth rate is insensitive to the stress intensity factor but is dominantly affected by the specimen surface temperature. The crack growth rate also confirms the existing model.