1,720,956 research outputs found
Identifying advanced liver disease in asymptomatic patients in primary care: an evaluation of patient outcomes 24 months after implementing a primary care liver pathway and community liver service
No full textBackground and aimsIn 2019, Southampton Clinical Commissioning Group implemented a liver guidance pathway and community liver service to help early detection and reduce the number of deaths from liver disease. The liver guidance pathwaysupports primary care clinicians identify patients at risk of liver disease to access early intervention before developing to advanced liver disease. The community liver service provides vibration controlled transient elastography (VCTE) assessment to patients who, after following the liver guidance pathway, have been identified as having severe liver fibrosis. This study aims to evaluate the patient outcomes 24 months after implementing the liver pathway and VCTEservice.MethodAll patients referred to the Southampton community liver service between January 2019 and December 2020. Demographics recorded included: Age, sex, body mass index (BMI), alcohol consumption (high or low), VCTE reading (kPa), diagnosis (alcohol related liver disease, non-alcoholic fatty liver disease or both) and patient outcomes (stay in primary care or refer to secondary care for clinical management).Results527/632 patients referred to the community liver service received a VCTE assessment.16.6% (n = 105) did not attend their appointment and for 0.9% (n = 5), no valid VCTE reading was obtained. The median (IQR) age of patients was 58 (46–65) years, 58.6% were male; median (IQR) BMI was 30.5 (27.1–35.1) kg/m² and alcohol consumption in 23.9% (n = 126) was graded as high (defined as drinking more than the UK recommended alcohol guidelines). Mean (SD) VCTE was 9.5 (9.2) kPa, of whom 8% (n = 42) had a reading of >20.0 kPa. 77.4% (n = 408) were diagnosed with non-alcoholic fatty liver disease (NAFLD); 15.7% (n = 83) with alcohol related liver disease (ARLD) and 6.8% (n = 36) with both NAFLD and ARLD. 27.9% (n = 147) of patients were found to have a liver fibrosis stage of F3/F4 (9.7 kPa–13.5 kPa/>13.6 kPa) and were referred to secondary care. 71.0% (n =374) had a liver fibrosis stage of F0-F2 (between 3.0 kPa and 9.6 kPa)and were referred back to primary care for repeat VCTE assessment in 3 years time
The risk of liver disease in patients with type 2 diabetes needs to be taken seriously: A real-world study located in a new community-based liver scanning service
No full textAim: To evaluate risk of liver fibrosis in patients with type 2 diabetes referred to a primary care liver assessment service.Methods: A retrospective evaluation of adults referred for liver assessment using vibration controlled transient elastography (VCTE) between January-December 2020. Data recorded at the time of assessment included: age, sex, ethnicity, body mass index (BMI), VCTE (kPa) reading, alcohol consumption and diabetes status. Binary logistic regression was used to examine whether type 2 diabetes, BMI, sex, age and ethnicity were associated with F2/F3 liver fibrosis.Results: 350 patients received a liver assessment. Median (IQR) age was 58 (47-64) years, 56% were male; 24.6% identified as Black, Asian and Minority Ethnic (BAME); median (IQR) BMI 30.8 (27.3-35.3) kg/m2, mean (±SD) VCTE 9.0 kPa (±7.6), and 35.4% had type 2 diabetes. Moderate/severe liver fibrosis (F2/F3) occurred in 59.3% of patients with type 2 diabetes and 25% without diabetes (control) (p < 0.001). Cirrhosis (F4) was found in 28.5% of patients with type 2 diabetes and 8% of control (p < 0.001). Type 2 diabetes, BMI and BAME were all associated with F2/F3 fibrosis (odds ratio (OR) 3.69, 95% confidence interval (CI) 2.19-6.22; 1.14, (1.09-1.20) and 2.04 (1.06-3.94) respectively). Alcohol consumption was not significantly different between type 2 diabetes and control cohort.Conclusion: Patients with type 2 diabetes referred for liver assessment are at markedly increased risk of liver fibrosis, known to be a cause of end stage liver disease and hepatocellular carcinoma. We recommend that patients with type 2 diabetes should be assessed for liver fibrosis
Performance of the enhanced liver fibrosis score, comparison with vibration-controlled transient elastography data, and development of a simple algorithm to predict significant liver fibrosis in a community-based liver service: a retrospective evaluation
No full textBackground and aims: liver fibrosis is a key risk factor for cirrhosis, hepatocellular carcinoma and end stage liver failure. The National Institute for Health and Care Excellence guidelines for assessment for advanced (≥F3) liver fibrosis in people with non-alcoholic fatty liver disease recommend the use of enhanced liver fibrosis (ELF) test, followed by vibration controlled transient elastography (VCTE). Performance of ELF at predicting significant (≥F2) fibrosis in real-world practice is uncertain.To assess the accuracy of ELF using VCTE; investigate the optimum ELF cut-off value to identify ≥F2 and ≥F3; and develop a simple algorithm, with and without ELF score, for detecting ≥F2.Methods: retrospective evaluation of patients referred to a Community Liver Service for VCTE, Jan-Dec 2020. Assessment included: body mass index (BMI), diabetes status, alanine aminotransferase (ALT) levels, ELF score and biopsy-validated fibrosis stages according to VCTE.Results: data from 273 patients were available. N=110 patients had diabetes. ELF showed fair performance for ≥F2 and ≥F3, area under the curve (AUC)=0.70, 95% confidence interval (CI) 0.64-0.76 and AUC=0.72, 95% CI 0.65-0.79 respectively. For ≥F2 Youden’s Index for ELF=9.85 and for ≥F3, ELF=9.95. Combining ALT, BMI and HbA1c (ALBA algorithm) to predict ≥F2 showed good performance (AUC=0.80, 95% CI 0.69-0.92), adding ALBA to ELF improved performance (AUC=0.82, 95% CI 0.77-0.88). Results were independently validated.Conclusion: optimal ELF cut-off for ≥F2 is 9.85 and 9.95 for ≥F3. ALT, BMI and HbA1c (ALBA algorithm) can be used to stratify patients at risk of ≥F2. ELF performance is improved by adding ALBA
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Get PDF“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
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
- …
