1,720,987 research outputs found
Systematic analysis of funding awarded for viral hepatitis-related research to institutions in the United Kingdom, 1997-2010.
Full text linkViral hepatitis is responsible for great health, social and economic burden both globally and in the UK. This study aimed to assess the research funding awarded to UK institutions for viral hepatitis research and the relationship of funded research to clinical and public health burden of viral hepatitis. Databases and websites were systematically searched for information on infectious disease research studies funded for the period 1997-2010. Studies specifically related to viral hepatitis research were identified and categorized in terms of funding by pathogen, disease and by a research and development value chain describing the type of science. The overall data set included 6165 studies (total investment £2.6 billion) of which £76.9 million (3.0%) was directed towards viral hepatitis across 323 studies (5.2%). By pathogen, there were four studies specifically investigating hepatitis A (£3.8 million), 69 studies for hepatitis B (21.4%) with total investment of £14.7 million (19.1%) and 236 (73.1%) hepatitis C studies (£62.7 million, 81.5%). There were 4 studies investigating hepatitis G, and none specifying hepatitis D or E. By associated area, viral hepatitis and therapeutics research received £17.0 million, vaccinology £3.1 million and diagnostics £2.9 million. Preclinical research received £50.3 million (65.4%) across 173 studies, whilst implementation and operational research received £19.4 million (25.3%) across 128 studies. The UK is engaged in much hepatology research, but there are areas where the burden is great and may require greater focus, such as hepatitis E, development of a vaccine for hepatitis C, and further research into hepatitis-associated cancers. Private sector data, and funding information from other countries, would also be useful in priority setting
Targeted use of the Xpert® MTB/RIF diagnostic system in routine care alongside a clinical trial
No full textPositioning of the Xpert® MTB/RIF diagnostic system in a rural health system in KwaZulu-Natal, South Africa: primary health care clinic vs district hospital laboratory
No full textThe potential utility of Xpert® MTB/RIF for real-time surveillance of drug resistance in rural KwaZulu-Natal, South Africa
No full textBackground:The Xpert® MTB/RIF system is a molecular diagnostic for the detection of Mycobacterium tuberculosis and rifampicin resistance. Linkage of basic clinical information to the laboratory system could enhance real-time surveillance of drug resistance at a population level.Methods:A cluster randomised trial comparing two Xpert® MTB/RIF positioning strategies for adult pulmonary TB suspects. This preliminary analysis uses individual-level data across the trial arms combined from the first 30 weeks of enrolment and focuses on prevalence of rifampicin resistance in specific groups of suspects (current TB/previous TB/no previous TB). Current TB group includes participants suspected of MDR-TB (smear non-conversion or treatment failure on a standard TB treatment regimen). Results:558 submitted sputum specimens; 546 (98%) with valid Xpert® MTB/RIF result. Sensitivity and specificity for detection of multidrug resistance (against reference of line probe assay on culture isolate) were respectively 83.3% (95%CI 36.5–99.1) and 100% (95%CI 88.3–100). The Xpert® MTB/RIF results for the three groups are displayed in the table. Rifampicin resistance was defined most commonly by probes E (58%) and B (33%).Conclusions and recommendations:The detection of rifampicin resistance by the Xpert® MTB/RIF assay is a reliable indicator of multidrug resistance in this high burden setting. As expected, the prevalence of rifampicin resistance is higher among previously treated cases than among those not previously treated. As implementation is scaled up, incorporation of basic clinical data into Xpert® MTB/RIF laboratory systems could enhance the utility of this molecular diagnostic tool for real-time surveillance of drug resistance at a population level
Positioning of the Xpert® MTB/RIF diagnostic system in a rural health system in KwaZulu-Natal, South Africa: preliminary findings from a cluster randomised trial
No full textBackground: The Xpert® MTB/RIF system is a molecular diagnostic for the detection of Mycobacterium tuberculosis and rifampicin resistance. Data on diagnostic performance and clinical outcomes at different levels of the health system are required to inform scale-up within high burden countries.Methods:A cluster randomised trial comparing two Xpert® MTB/RIF positioning strategies for adult pulmonary TB suspects: point-of-care [POC] strategy (system positioned at primary health care clinic) vs. hospital laboratory [HL] strategy (system positioned at district hospital laboratory). Unit of randomisation S270 Abstract presentations, Friday, 16 November is two-week time block; participants recruited from single clinic if: age ? 18 yrs, current cough, HIV infection ± high risk of MDR-TB. This preliminary analysis incorporates first twelve randomisation blocks (7 POC, 5 HL) and focuses on diagnostic performance and retention in diagnostic pathway. Sensitivity and specificity for detection of M. tuberculosis were calculated with reference to a single MGIT culture.Results:486 individuals enrolled; 446 submitted specimens (266 POC, 180 HL). Xpert positivity was similar in both strategies (17.7% POC vs. 13.9% HL, P=0.29). Sensitivity for detection of M. tuberculosis was 80.0% (95%CI 63.9–90.4) at POC and 71.4% (95%CI 42.0–90.4) at HL. Specificity was 96.1% (95%CI 91.3–98.4) at POC and 91.4% (95%CI 84.3–95.6) at HL. The proportion of tests with invalid/error results was similar (3.4% POC vs. 4.4% HL, P=0.62). The proportion of participants who received their result within 30 days was 96.6% POC vs. 79.4% HL (P<0.001).Conclusions and recommendations:These preliminary results suggest that implementation of the Xpert® MTB/RIF system at primary health care clinic level produces comparable diagnostic performance to implementation within the normal laboratory system but reduces loss to follow-up within the diagnostic process. The ongoing trial will explore the impact on individual clinical outcomes
Operational feasibility and performance of the Xpert® MTB/RIF diagnostic system in a rural primary health care clinic: a preliminary analysis
No full textFalse negative rifampicin resistance result with the Xpert® MTB/RIF diagnostic system: case report and implications
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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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