19 research outputs found
Recent advances in NAFLD: current areas of contention
No full textThis brief review focuses on two contentious issues within the field of non-alcoholic fatty liver disease (NAFLD); the first is the recent effort to redefine NAFLD as metabolic (dysfunction)-associated fatty liver disease (MAFLD). The modification of “NAFLD” to “MAFLD” is expected to highlight the role of metabolic factors in the disease aetiology, which is hoped to improve patient understanding of the disease, facilitate patient-physician communication and highlight the importance of public health interventions in prevention and management. The diagnostic criteria for MAFLD allow it to coexist with other forms of liver disease, which recognises that metabolic dysfunction contributes towards disease progression in other liver pathologies, such as alcoholic liver disease. However, there remain concerns that renaming NAFLD may be premature without fully considering the broader implications, from diagnostic criteria to trial endpoints; therefore, the new definition has not yet been accepted by major societies. Another contentious issue within the field is the gap in our understanding of how patients undergoing therapeutic interventions should be monitored to assess amelioration/attenuation or the worsening of their liver disease. Biomarker scoring systems (such as the ELF test and FIB-4 test) and imaging techniques (such as transient elastography [TE] and magnetic resonance imaging [MRI] techniques) are proven to be reasonably accurate, and comparable with histology, in the diagnosis of NAFLD and evaluation of disease severity; however, their use in monitoring the response of disease to therapeutic interventions is not well established. Whilst biomarker scoring systems and TE are limited by poor diagnostic accuracy in detecting moderate fibrosis (e.g. F2 liver fibrosis defined by histology), more accurate MRI techniques are not practical for routine patient follow-up due to their expense and limited availability. More work is required to determine the most appropriate method by which therapeutic interventions for NAFLD should be monitored in clinical practice.<br/
The role of the gut microbiome and diet in the pathogenesis of non-alcoholic fatty liver disease
No full textNon-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, with a prevalence that is increasing in parallel with the global rise in obesity and type 2 diabetes mellitus. The pathogenesis of NAFLD is complex and multifactorial, involving environmental, genetic and metabolic factors. The role of the diet and the gut microbiome is gaining interest as a significant factor in NAFLD pathogenesis. Dietary factors induce alterations in the composition of the gut microbiome (dysbiosis), commonly reflected by a reduction of the beneficial species and an increase in pathogenic microbiota. Due to the close relationship between the gut and liver, altering the gut microbiome can affect liver functions; promoting hepatic steatosis and inflammation. This review summarises the current evidence supporting an association between NAFLD and the gut microbiome and dietary factors. The review also explores potential underlying mechanisms underpinning these associations and whether manipulation of the gut microbiome is a potential therapeutic strategy to prevent or treat NAFLD.</p
Diagnosis and management of non-alcoholic fatty liver disease
No full textNon-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western industrialised countries. The prevalence of NAFLD is increasing in parallel with the global rise in obesity and type 2 diabetes mellitus. NAFLD represents a spectrum of liver disease severity. NAFLD begins with accumulation of triacylglycerols in the liver (steatosis), and is defined by hepatic fatty infiltration amounting to greater than 5% by liver weight or the presence of over 5% of hepatocytes loaded with large fat vacuoles. In almost a quarter of affected individuals, steatosis progresses with the development of liver inflammation to non-alcoholic steatohepatitis (NASH). NASH is a potentially progressive liver condition and with ongoing liver injury and cell death can result in fibrosis. Progressive liver fibrosis may lead to the development of cirrhosis in a small proportion of patients. With the growing prevalence of NAFLD, there is an increasing need for a robust, accurate and non-invasive approach to diagnosing the different stages of this condition. This review will focus on (1) the biochemical tests and imaging techniques used to diagnose the different stages of NAFLD; and (2) a selection of the current management approaches focusing on lifestyle interventions and pharmacological therapies for NAFLD
Fourier transforms: and convolutions for the experimentalist
No full textFourier Transforms and Convolutions for the Experimentalist provides the experimentalist with a guide to the principles and practical uses of the Fourier transformation. It aims to bridge the gap between the more abstract account of a purely mathematical approach and the rule of thumb calculation and intuition of the practical worker. The monograph springs from a lecture course which the author has given in recent years and for which he has drawn upon a number of sources, including a set of notes compiled by the late Dr. I. C. Browne from a series of lectures given by Mr. J . A. Ratcliffe of
Village Roadshow Limited : commissioned history of Village Roadshow Corporation
No full textThis thesis was scanned from the print manuscript for digital preservation and is copyright the author.
Researchers can access this thesis by asking their local university, institution or public library to
make a request on their behalf. Monash staff and postgraduate students can use the link in the References field
Computer and information technologies resources for the postsecondary education of students with disabilities : final report to the Office of learning technologies
No full textComprend des références bibliographiques."Results of an empirical study investigating the views and concerns about computer and adaptive computer
technologies of postsecondary disability service providers are presented. The study was carried out in both
French and English in the spring of 2000. Based on structured interviews with 156 Canadians who provide
disability related services to students, the responses represent an 80% participation rate. Key findings in the
following areas are highlighted: characteristics of postsecondary disability service providers; presence of
students with disabilities on campus, availability and accessibility of campus computers to students with
disabilities, important factors in meeting the computer related needs of students with disabilities, and the
presence and needs of postsecondary faculty and staff with disabilities. An extensive listing of useful
resources is provided and recommendations are made to guide decision making to ensure that Canadian
colleges and universities are technologically welcoming of the whole campus community." -- Provided by author
Socio-economic inequality in small area use of elective total hip replacement in the English NHS in 1991 and 2001
No full textInternational evidence suggests that there are substantial socio-economic inequalities in the delivery of specialist health services, even in the UK and other high-income countries with publicly funded health systems (Goddard and Smith 2001, Dixon et al. 2003, Van Doorslaer, Koolman and Jones 2004, Van Doorslaer et al. 2000). Studies of total hip replacement in the English NHS have yielded particularly striking examples, given that hip replacement is such a common, effective and longestablished health technology. Administrative data show that people living in deprived areas are less likely to receive hip replacement (Chaturvedi and Ben-Shlomo 1995, Dixon et al. 2004) while survey data suggest they may be more likely to need it (Milner et al. 2004). However, previous studies have not examined change in inequality over time. This paper presents evidence on the change in socio-economic inequality in small area use of elective total hip replacement in the English NHS, comparing 1991 with 2001. This was a period of important large-scale health care reform in England, involving at least two significant reforms that might potentially have influenced socio-economic inequality in health care delivery: (1) the introduction and subsequent abolition of the Conservative “internal market” 1991-7, and (2) the introduction in 1995 of a revised NHS resource allocation formula designed to reduce geographical inequalities in health care delivery. Two datasets, for 1991 and 2001, were assembled from routine NHS data sources: Hospital Episode Statistics (HES) on hospital utilisation in England and the corresponding decennial National Censuses in 1991 and 2001. Both datasets contain information on over 8,000 electoral wards in England (over 95% of the total). To improve comparability, a common geography of frozen 1991 wards was adopted. The Townsend deprivation score was employed as an indicator of socio-economic status. Inequality was analysed in two ways. First, for comparability with previous small area studies of hip replacement, by using simple range measures based on indirectly age-sex standardised utilisation ratios (SURs) by deprivation quintile groups. Second, using concentration indices of deprivationrelated inequality in use based on indirectly age-sex standardised utilisation ratios for each individual small area. Each SUR is the observed use divided by the expected use, if each age and sex group in the study population had the same rates of use as the national population.
Multi-dimensional key generation of ICMetrics for cloud computing
No full textDespite the rapid expansion and uptake of cloud based services, lack of trust in the provenance of such services represents a significant inhibiting factor in the further expansion of such service. This paper explores an approach to assure trust and provenance in cloud based services via the generation of digital signatures using properties or features derived from their own construction and software behaviour. The resulting system removes the need for a server to store a private key in a typical Public/Private-Key Infrastructure for data sources. Rather, keys are generated at run-time by features obtained as service execution proceeds. In this paper we investigate several potential software features for suitability during the employment of a cloud service identification system. The generation of stable and unique digital identity from features in Cloud computing is challenging because of the unstable operation environments that implies the features employed are likely to vary under normal operating conditions. To address this, we introduce a multi-dimensional key generation technology which maps from multi-dimensional feature space directly to a key space. Subsequently, a smooth entropy algorithm is developed to evaluate the entropy of key space
Author Correction: Discovery of drug–omics associations in type 2 diabetes with generative deep-learning models (<em>Nature Biotechnology</em>, (2023), 41, 3, (399-408), 10.1038/s41587-022-01520-x)
No full text\ua9 2023, The Author(s).In the version of this article initially published, Cristina Leal Rodr\uedguez (Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) was omitted from the author list. The error has been corrected in the HTML and PDF versions of the article
Costs and Treatment Pathways for Type 2 Diabetes in the UK:A Mastermind Cohort Study
No full textIntroduction: Medication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time.Methods: Prescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989-2013. Average follow-up was 10 years. Individuals were prescribed on average 2.4 (SD: 1.2) drugs with average annual costs of £241. We calculated summary statistics for first- and second-line therapies. Linear regression models were used to estimate associations between therapy characteristics and baseline patient characteristics.Results: Average time from diagnosis to first prescription was 3 years (SD: 4.0 years). Almost all first-line therapy (98%) was monotherapy, with average annual cost of £83 (SD: £204) for 3.8 (SD: 3.5) years. Second-line therapy was initiated in 73% of all individuals, at an average annual cost of £219 (SD: £305). Therapies involving insulin were markedly more expensive than other common therapies. Baseline HbA1c was unrelated to future therapy costs, but higher average HbA1c levels over time were associated with higher costs.Conclusions: Medication therapy has undergone substantial changes during the period covered in this study. For example, therapy is initiated earlier and is less expensive than in the past. The data provided in this study will prove useful for future modelling studies, e.g. of stratified treatment approaches.</p
