1,721,124 research outputs found
Derivation and validation of the BIMAST score for predicting the presence of fibrosis due to Metabolic dysfunction-associated steatotic liver disease among diabetic patients in the community
Get PDFBackground & aims
Current screening pathways, developed from tertiary care cohorts, underestimate the presence of Metabolic-dysfunction associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM) in the community. We developed, validated, and assessed cost-effectiveness of a new score for screening the presence of fibrosis due to MASLD in primary care.
Methods
Consecutive T2DM patients underwent screening for liver diseases with transient elastography (TE). Based on predictors of significant/advanced fibrosis, we generated the BIMAST score (based on aspartate aminotransferase (AST) and body mass index (BMI)) and validated it internally and externally (Royal Free Hospital, London and Palermo Hospital). For cost-effectiveness analysis, 6 screening strategies were compared against standard of care: BIMAST score, ultrasound plus abnormal liver function tests, FIB-4, NAFLD fibrosis score, ELF and transient elastography (TE). A Markov model was built based on fibrosis status. Cost per quality-adjusted life year (QALY) gained and the incremental cost-effectiveness ratio (ICER) were estimated over a lifetime.
Results
Among 300 patients enrolled, 64% (186) had MASLD and 10% (28) other causes of liver disease. In the whole population, patients with significant fibrosis, advanced fibrosis, and cirrhosis due to MASLD were 17% (50/287), 11% (31/287), and 3% (8/287), respectively. In primary care, BIMAST performed better than other non-invasive markers at predicting significant and advanced fibrosis. Moreover, BIMAST reduced false negatives from 54% (ELF) and 38% (FIB-4) to 10%. In both validation cohorts, BIMAST performance was as good as FIB-4. In the cost-utility analysis, ICER was £2,337.92/QALY for BIMAST.
Conclusion
The BIMAST predicts the presence of significant fibrosis in the community, reduces false negatives and is cost-effective. The BIMAST score should be included in the holistic assessment of diabetic patients
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
National clinical expert consensus statement: Coronavirus monoclonal antibodies as a prophylactic therapy against COVID-19 for immunocompromised groups
No full text- Novel long-acting coronavirus prophylactic monoclonal antibody
therapies have been shown to be effective in preventing COVID19 in immunocompromised individuals who are at increased risk
from SARS-CoV-2.
- Prophylactic antibody therapies should be made available in a
timely manner to give an antibody immunity boost to vulnerable
patients.
- Real world evaluations should be co-implemented to provide
confidence of ongoing effectiveness.
- Successful delivery of a coronavirus prophylactic antibody
therapy programme would deliver significant benefits to
healthcare systems, communities and immunocompromised
individuals
New agonists of the incretin/glucagon system for the treatment of metabolic dysfunction-associated steatohepatitis
No full textThe role of bile-metabolising enzymes in the pathogenesis of Clostridioides difficile infection, and the impact of faecal microbiota transplantation
Get PDFThe pathogenesis of Clostridioides difficile infection (CDI), and mechanisms of efficacy of faecal microbiota transplant (FMT) in treating recurrent CDI (rCDI), remain poorly-understood. Certain bile acids affect the ability of C. difficile to undergo germination or vegetative growth. Loss of gut microbiota-derived bile-metabolising enzymes may
predispose to CDI via perturbation of bile metabolism, and restitution of gut bile-metabolising functionality could mediate FMT’s efficacy. Initially, human samples were analysed, i.e.: 1) biofluids collected from rCDI patients pre- and post-FMT (and their donors), and 2) stool samples from primary CDI patients, including both
recurrers and non-recurrers. Analysis included: 16S rRNA gene sequencing; liquid chromatography-mass spectrometry for bile acid profiling; gas chromatography-mass spectrometry for short chain fatty acid (SCFA) quantification; bile salt hydrolase (BSH) enzyme activity; and qPCR of bsh/ baiCD genes involved in bile metabolism. Human results were validated in C. difficile batch cultures and a rCDI mouse model. A reduced proportion of the stool microbiota of rCDI patients pre-FMT contained BSH-producing bacteria compared to donors or post-FMT. Pre-FMT stool was enriched in
taurocholic acid (TCA; a potent trigger to C. difficile germination); TCA levels negatively correlated with bacterial genera containing BSH-producing organisms. Post-FMT stool demonstrated recovered BSH activity and microbial bsh/ baiCD gene copy number compared with pre-treatment (p<0.05), and recovery of SCFA including valerate (p<0.001).
Dynamics of stool bile acids/ BSH activity differed in primary CDI patients with and without disease
recurrence. In batch cultures, culture supernatant from engineered bsh-expressing E. coli reduced TCA-mediated C. difficile germination relative to supernatant from BSH-negative E. coli. C. difficile total viable counts were ~70% reduced in a rCDI mouse model after administration of BSH-expressing E. coli relative to mice receiving BSH-negative E. coli (p<0.05). These data demonstrate that gut microbiota BSH functionality is a key mechanism influencing vulnerability to CDI and efficacy of FMT.Open Acces
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