1,721,066 research outputs found
Are the opportunities to prevent alcohol related liver deaths in the UK in primary or secondary care? A retrospective clinical review and prospective interview study
No full textBackground
Deaths from liver cirrhosis have increased at least 8 fold since the 1970's in the UK and further increases are anticipated, whereas in the rest of Europe liver deaths are decreasing. In the UK, we urgently need strategies to detect those who misuse alcohol and are at risk of developing alcoholic liver disease before they get to that point. One potential strategy is to screen admissions to hospital with alcohol related conditions for evidence of alcohol misuse.Surprisingly, there has been no research into the important question of where the opportunities are to detect those who misuse alcohol – primary or secondary care. We attempted to answer this firstly by conducting a retrospective analysis of the medical notes of 94 patients diagnosed with alcohol induced liver cirrhosis between 1st January 1995 and 31st December 2000 at Southampton General Hospital with the purpose of identifying admissions to hospital prior to a diagnosis of alcoholic liver disease. In the second part of the study, we interviewed patients with alcoholic liver disease about their contact with health services.Results
Before diagnosis of alcoholic liver disease, 33% (31/94) of the patients had had an admission to hospital for an alcohol related condition. There was a mean of 7 years and 1 month (SD 6 years 3 months) between the first alcohol-related admission and presentation with alcoholic liver disease (in those who had had admissions). The commonest reason for alcohol related admission was falls/fractures/injuries, followed by non-variceal gastro-intestinal bleeds. Patients with alcoholic liver disease who were interviewed had seen their General Practitioner on average at least 2 times per year.Conclusion
Most patients who develop alcohol-induced cirrhosis do not have an admission to hospital with an alcohol related condition before developing alcoholic liver disease. Therefore, if we screen patients admitted to hospital with alcohol related conditions for evidence of alcohol misuse, we could potentially detect around a third of those at risk of developing cirrhosis. Although secondary care has an important role to play in detecting those at risk, the main opportunity for detection is in primary care
Organotypic liver culture in a fluid-air interface using slices of neonatal rat and adult human tissue - a model of fibrosis in vitro
No full textIntroduction: Fibrosis is the common end stage of most liver disease but there is no effective treatment currently available. We hypothesised that if viability of liver tissue slice culture could be improved, it should be possible to develop a model of liver fibrosis in vitro that could advance the development of antifibrotic therapy while at the same time reducing the need to use in vivo models. We have adapted a slice culture technique developed originally for organotypic culture of neural tissue to the liver.Methods: slices of neonatal rat or adult human liver, 100–400-?m thick, were cut and cultured on nitrocellulose inserts at the air/fluid interface for up to 28 days.Results: Hepatocytes expressed albumin by immunocytochemistry for up to 10 days and were viable for up to 21 days during which time new structures appeared, including cytokeratin 19 positive bile ductular structures and bands of smooth muscle actin positive stellate cells associated with new reticulin positive matrix. Smooth muscle actin expression by stellate cells could be pharmacologically inhibited by SDZ-RAD (everolimus).Discussion: In conclusion, we have successfully developed a novel model of liver culture, which may prove useful in both studies of the mechanisms of liver fibrosis and in developing therapeutic strategies
Sudden unexpected death in alcohol misuse – an unrecognized public health issue?
No full textSudden arrhythmic cardiac death can occur in chronic misusers of alcohol. The only findings at post mortem are fatty liver and a negative or low blood alcohol. This is an under-recognized entity. Coroner‘s post mortems in a typical UK city were studied. Seven out of 1,292 (0.5%) post mortems were deemed to have died of alcohol associated arrhythmic death. Applying this study to the UK as a whole, alcohol related arrhythmic death or as we have termed it SUDAM (Sudden Unexpected Death in Alcohol Misuse) probably accounts for around 1,000 deaths, many of which are misattributed to other cause
A novel quantitative representation of the morphology of prostate cancer and a novel automated tool for advance requesting of immunohistochemistry
No full textProstate cancer is a disease affecting growing numbers of people, which can form metastases and cause death. The risk of mortality and complications from prostate cancer is assessed by visual inspection of tumour morphology in Haematoxylin & Eosin-stained tissue samples. The morphology of prostate cancer is highly heterogeneous: during tumorigenesis, the normal glands that traverse and branch through the prostate lose their structural organisation, and develop a range of aberrant morphological characteristics, such as smaller size, larger nuclei and loss of the layer of basal epithelial cells found in normal glands. Depending on the level of structural loss, and of dedifferentiation of the glands, tissue samples are assigned a Gleason Score from 4 to 10. A higher Gleason Score is indicative of increased clinical risk for patients, and it guides the decision on what type of treatment patients should receive. The Gleason Score suffers from considerable shortcomings, including a poor reproducibility that is due to its qualitative definition. In this work, we design an algorithm to extract a quantitative representation of the morphology of prostate cancer, based on the segmentation and morphological measurement of prostate glands. We validate the use of the representation by showing it automatically captures clinically relevant morphological classes, it is predictive of the Gleason Score, and it can be used to characterise different tissue specimen types used in prostate cancer diagnosis. The morphology of glands is used to diagnose prostate cancer. In some cases, the morphology may appear abnormal, but not to an extent to make a confident cancer diagnosis possible. Immunohistochemistry is then used to detect the lack of basal cells in glands, which is indicative of prostate cancer. We design an automated tool for advance requesting immunohistochemistry for such cases of ambiguous prostate morphology, and we estimate the temporal and monetary savings of introducing the tool into the clinical workflow
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
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe 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
Barriers to the release of human tissue for clinical trials research in the UK: a national survey of cellular pathology laboratories on behalf of the National Cancer Research Institute's Cellular Molecular Pathology (CM-Path) initiative
Full text linkAim: To survey UK cellular pathology departments regarding their attitudes and practices relating to release of human tissue from their diagnostic archives for use in clinical trial research. Methods: A 30-item questionnaire was circulated to the National Cancer Research Institute's Cellular Molecular Pathology initiative and Confederation of Cancer Biobanks mailing lists. Responses were collected over a 10-month period from November 2016 to August 2017. Results: 38 departments responded to the survey, the majority of which regularly receive requests for tissue for research purposes. Most requests come from academia and financial support to facilitate tissue release comes from a variety of sources. A range of practices were reported in relation to selection of the most appropriate sample to release, consent checking, costing and governance frameworks. Conclusions: This survey demonstrates wide variation in practice across the UK and identifies barriers to release of human tissue for clinical trial research. Until we can overcome these obstacles, patient samples will remain inaccessible to research. Therefore, this study highlights the urgent need for clear and coordinated national guidance on this issue.</p
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe 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
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