Independent validation of the Enhanced Liver Fibrosis (ELF) score in the ANRS HC EP 23 Fibrostar cohort of patients with chronic hepatitis C

BACKGROUND: The Enhanced Liver Fibrosis (ELF) score combining serum hyaluronan, N-terminal peptide of type III procollagen and tissue inhibitor of metalloproteinase-1, was reported as relevant in predicting liver fibrosis in chronic liver disease and proposed as an alternative to liver biopsy. METHODS: We evaluated the ELF score in a cohort of chronic hepatitis C (CHC) patients included in a multicenter prospective study (ANRS HC EP 23 Fibrostar) using commercial reagents, different from those developed by the manufacturer of the Siemens ELF™ test. RESULTS: In 512 CHC, the ELF score, using ROC curves, showed good predictive performances for severe fibrosis [AUROC=0.82; 95% confidence interval (CI) 0.78-0.86]and for cirrhosis (AUROC=0.85; 95% CI 0.81-0.90), but slightly lower for significant fibrosis (AUROC=0.78; 95% CI 0.74-0.82). The Obuchowski measure (0.81) showed that the ELF score globally performed as a marker of liver fibrosis. The ELF score predicted significant fibrosis (cut-off=9.0) with a sensitivity of 0.86, a specificity of 0.62, a positive predictive value (PPV) of 0.80 and a negative predictive value (NPV) of 0.70. For extensive fibrosis (cut-off=9.33), sensitivity was 0.90, specificity was 0.63, PPV was 0.73 and NPV was 0.85. For cirrhosis (cut-off=9.35), sensitivity was 0.83, specificity was 0.75, PPV was 0.44 and NPV was 0.95. CONCLUSIONS: This study confirms the ELF score performance as an index to predict liver fibrosis or cirrhosis in CHC. The ELF test, using validated reagents, could be added to the health authorities approved non-invasive tests in assessing fibrosis as surrogate to liver biopsy

NN final-state interaction in two-nucleon knockout from 16O^{16}O

The influence of the mutual interaction between the two outgoing nucleons (NN-FSI) in electro- and photoinduced two-nucleon knockout from $^{16}O$ has been investigated perturbatively. It turns out that the effect of NN-FSI depends on the kinematics and on the type of reaction considered. The effect is generally larger in pp- than in pn-knockout and in electron induced than in photoinduced reactions. In superparallel kinematics NN-FSI leads in the $(e,e'pp)$ channel to a strong increase of the cross section, that is mainly due to a strong enhancement of the $\Delta$-current contribution. In pn-emission, however, this effect is partially cancelled by a destructive interference with the seagull current. For photoreactions NN-FSI is considerably reduced in superparallel kinematics and can be practically negligible in specific kinematics.Comment: 16 pages, 9 figure

Automated real-time collection of pathogen-specific diagnostic data: Syndromic infectious disease epidemiology

© Lindsay Meyers, Christine C Ginocchio, Aimie N Faucett, Frederick S Nolte, Per H Gesteland, Amy Leber, Diane Janowiak,. Background: Health care and public health professionals rely on accurate, real-time monitoring of infectious diseases for outbreak preparedness and response. Early detection of outbreaks is improved by systems that are comprehensive and specific with respect to the pathogen but are rapid in reporting the data. It has proven difficult to implement these requirements on a large scale while maintaining patient privacy. Objective: The aim of this study was to demonstrate the automated export, aggregation, and analysis of infectious disease diagnostic test results from clinical laboratories across the United States in a manner that protects patient confidentiality. We hypothesized that such a system could aid in monitoring the seasonal occurrence of respiratory pathogens and may have advantages with regard to scope and ease of reporting compared with existing surveillance systems. Methods: We describe a system, BioFire Syndromic Trends, for rapid disease reporting that is syndrome-based but pathogen-specific. Deidentified patient test results from the BioFire FilmArray multiplex molecular diagnostic system are sent directly to a cloud database. Summaries of these data are displayed in near real time on the Syndromic Trends public website. We studied this dataset for the prevalence, seasonality, and coinfections of the 20 respiratory pathogens detected in over 362,000 patient samples acquired as a standard-of-care testing over the last 4 years from 20 clinical laboratories in the United States. Results: The majority of pathogens show influenza-like seasonality, rhinovirus has fall and spring peaks, and adenovirus and the bacterial pathogens show constant detection over the year. The dataset can also be considered in an ecological framework; the viruses and bacteria detected by this test are parasites of a host (the human patient). Interestingly, the rate of pathogen codetections, on average 7.94% (28,741/362,101), matches predictions based on the relative abundance of organisms present. Conclusions: Syndromic Trends preserves patient privacy by removing or obfuscating patient identifiers while still collecting much useful information about the bacterial and viral pathogens that they harbor. Test results are uploaded to the database within a few hours of completion compared with delays of up to 10 days for other diagnostic-based reporting systems. This work shows that the barriers to establishing epidemiology systems are no longer scientific and technical but rather administrative, involving questions of patient privacy and data ownership. We have demonstrated here that these barriers can be overcome. This first look at the resulting data stream suggests that Syndromic Trends will be able to provide high-resolution analysis of circulating respiratory pathogens and may aid in the detection of new outbreaks

Genome-wide meta-analysis in alopecia areata resolves HLA associations and reveals two new susceptibility loci

Alopecia areata (AA) is a prevalent autoimmune disease with 10 known susceptibility loci. Here we perform the first meta-analysis of research on AA by combining data from two genome-wide association studies (GWAS), and replication with supplemented ImmunoChip data for a total of 3,253 cases and 7,543 controls. The strongest region of association is the major histocompatibility complex, where we fine-map four independent effects, all implicating human leukocyte antigen-DR as a key aetiologic driver. Outside the major histocompatibility complex, we identify two novel loci that exceed the threshold of statistical significance, containing ACOXL/BCL2L11(BIM) (2q13); GARP (LRRC32) (11q13.5), as well as a third nominally significant region SH2B3(LNK)/ATXN2 (12q24.12). Candidate susceptibility gene expression analysis in these regions demonstrates expression in relevant immune cells and the hair follicle. We integrate our results with data from seven other autoimmune diseases and provide insight into the alignment of AA within these disorders. Our findings uncover new molecular pathways disrupted in AA, including autophagy/apoptosis, transforming growth factor beta/Tregs and JAK kinase signalling, and support the causal role of aberrant immune processes in AA

Including osteoprotegerin and collagen IV in a score-based blood test for liver fibrosis increases diagnostic accuracy

BACKGROUND: Noninvasive methods for liver fibrosis evaluation in chronic liver diseases have been recently developed, i.e. transient elastography (Fibroscan™) and blood tests (Fibrometer®, Fibrotest®, and Hepascore®). In this study, we aimed to design a new score in chronic hepatitis C (CHC) by selecting blood markers in a large panel and we compared its diagnostic performance with those of other noninvasive methods. METHODS: Sixteen blood tests were performed in 306 untreated CHC patients included in a multicenter prospective study (ANRS HC EP 23 Fibrostar) using METAVIR histological fibrosis stage as reference. The new score was constructed by non linear regression using the most accurate biomarkers. RESULTS: Five markers (alpha-2-macroglobulin, apolipoprotein-A1, AST, collagen IV and osteoprotegerin) were included in the new function called Coopscore©. Using the Obuchowski Index, Coopscore© shows higher diagnostic performances than for Fibrometer®, Fibrotest®, Hepascore® and Fibroscan™ in CHC. Association between Fibroscan™ and Coopscore© might avoid 68% of liver biopsies for the diagnosis of significant fibrosis. CONCLUSION: Coopscore© provides higher accuracy than other noninvasive methods for the diagnosis of liver fibrosis in CHC. The association of Coopscore© with Fibroscan™ increases its predictive value

Relaxation time for a dimer covering with height representation

This paper considers the Monte Carlo dynamics of random dimer coverings of the square lattice, which can be mapped to a rough interface model. Two kinds of slow modes are identified, associated respectively with long-wavelength fluctuations of the interface height, and with slow drift (in time) of the system-wide mean height. Within a continuum theory, the longest relaxation time for either kind of mode scales as the system size N. For the real, discrete model, an exact lower bound of O(N) is placed on the relaxation time, using variational eigenfunctions corresponding to the two kinds of continuum modes.Comment: 12 pages, LaTeX; 1 figure in PostScript file; to appear, J. Stat. Phys. Sections and subsections were reshuffled to improve presentation, some text added on quantum-dimer model, fully-frustrated Ising model, and application to general class of "height" model

España. Historia. Edad Antigua. (19--)

Copia Digital. Real Academia de la Historia : 2010Forma de ingreso: Legado. Fuente de ingreso: Gonzalo Menéndez-Pidal y Goyri (Madrid). Fecha de ingreso: 29 de febrero de 2003Nota: "Los nombres subrayados son cabeza de convento jurídico". Signos convencionales indicando los límites de provincia, conventos jurídicos y tribus, y las colonias y municipiosMapa diseñado por Gonzalo Menéndez-Pidal y Goyri para ilustrar sus librosManuscrito sobre papel grueso en tinta china. Rotulación con plantilla. Notas a lápiz fuera de la línea de enmarque para corregir en el original definitiv

Empoderamento negro para transformação da economia

O evento Empoderamento negro para transformação da economia aconteceu no dia 23 de maio de 2023, no Teatro BNDES, no Rio de Janeiro. Celebrando o Dia Mundial da África, o BNDES e a Open Society Foundations (OSF) promoveram o seminário com o objetivo de discutir os impactos positivos da diversidade étnico-racial nos setores financeiro e empresarial do Brasil.Painel 1. Da lei de cotas ao engajamento corporativo voluntário: a experiência brasileira / Tatiana Dias Silva, Liel Miranda, Luiza Helena Trajano ; Moderação: Estela do Espírito Santo -- keynote speaker / Flávia Oliveira -- Painel 2. Capital a serviço da diversidade: experiência no setor financeiro / Alan Soares, Helio Santos, Selma Moreira, Cida Bento ; Moderação: Marcos Aurélio do Nascimento de Lima -- Painel 3. Como avançar? A política de Black Economic Empowerment da África do Sul / Vusumuzi W. Mavimbela, Khutso Manthata, Sheila Motsepe ; Moderação: Natália Dias -- Encerramento: Marcelo Calero, Margareth Menezes, Aloizio Mercadante, Anielle Franco e João Jorge Rodrigues