1,721,109 research outputs found
Corrigendum to "Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)" [Dig Liver Dis 54 (2022) 170-182]
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Is hepatocellular carcinoma risk impacted favorably or unfavorably by hepatitis C virus therapy with direct‐acting antivirals?
No full textCirrhosis is the strongest risk factor for hepatocellular carcinoma (HCC), with hepatitis C virus (HCV) being a major risk factor in the Western world and Japan. The advent of the new direct-acting antivirals (DAAs) revolutionized the treatment of HCV infection, with very high rates of sustained virologic response, very few contraindications, and low rate of adverse events. Hypothetically involved mechanisms regarding higher risk of HCC after DAA therapy focused on a loss of immune control owing to clearance of HCV-specific T-cells from the liver. The chapter aims to emulate a randomized trial using observational data and to establish a comparable index time for DAA-untreated patients. Studies showed that DAA treatment could improve liver function, reduce risk of decompensation, and reduce waitlist dropout due to HCC progression or death
Navigating the landscape of liver cancer management: Study designs in clinical trials and clinical practice
Full text link: Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer death worldwide and its prognosis is highly heterogeneous, being related not only to tumour burden but also to the severity of underlying chronic liver disease. Moreover, advances in systemic therapies for HCC have increased the complexity of patient management. Randomised-controlled trials represent the gold standard for evidence generation across all areas of medicine and especially in the oncology field, as they allow for unbiased estimates of treatment effect without confounders. Observational studies have many problems that could reduce their internal and external validity. However, large prospective (well-conducted) observational real-world studies can detect rare adverse events or monitor the occurrence of long-term adverse events. How best to harness real world data, which refers to data generated from the routine care of patients, and real-world 'evidence', which is the evidence generated from real-world data, represents an open challenge. In this review article, we aim to provide an overview of the benefits and limitations of different study designs, particularly focusing on randomised-controlled trials and observational studies, to address important and not fully resolved questions in HCC research
Adverse events in gastrointestinal endoscopy: Validation of the AGREE classification in a real-life 5-year setting
No full textBackground: The novel AGREE classification for adverse events (AEs) in gastrointestinal (GI) endoscopy has not yet been validated in a real-world setting.Aims: Our study aims to evaluate the correlation between the grades of AEs in the ASGE and AGREE classifications and to assess the interobserver agreement of the two classification systems.Methods: The correlation and association between the AE grades of the ASGE and AGREE classifications were analyzed using the Spearman rank correlation test and the chi-squared analysis, respectively. A weighted Cohen's kappa coefficient analysis was performed to determine the interobserver agreement of both classification systems.Results: We prospectively collected the AEs that occurred in our endoscopy unit over the past five years. A total of 226 AEs (226/84,863, 0.3%) occurred. There was a correlation between the ASGE and AGREE classifications ( & rho; = 0.61) and a moderately significant association ( p < 0.01, Cramer's V = 0.7). The interobserver agreement for the ASGE classification was fair (kappa 0.60, 95% confidence interval [CI]: 0.54, 0.67), whereas it was good for the AGREE classification (kappa 0.80, 95% CI: 0.62, 0.87).Conclusions: The AGREE classification was validated for the first time in a real-world setting and showed a positive correlation and higher interobserver agreement than the ASGE classification.& COPY; 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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