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

Rhetoric But Whose Reality? The Influence of Employability Messages on Employee Mobility Tactics and Work Group Identification

Over the last decade, employability has been presented by its advocates as the solution to employment uncertainty, and by its critics as a management rhetoric possessing little relevance to the experiences of most workers. This article suggests that while employability has failed to develop into a key research area, a deeper probing of its message is warranted. In particular, it is suggested that employability may have resonance with employees as workers rather than as employees of their immediate employing organisation. This demands a slightly different approach to studying employability than some other related phenomena such as employee commitment which has resonance only in relation to the employing organization. In adopting a social identity approach, the significance of the employability message is shown not only to lie in employees’ willingness to disassociate from their existing work groups and pursue individual mobility, but also in its capacity to undermine workers’ collective responses to grievances and unwanted organizational changes. A future research agenda is presented which highlights the need to address recent attempts to develop employability expectations among graduate career entrants, and for a closer critical engagement with management writings that attempt to justify the unnecessary espousal of the self development message

A Developmental Perspective on Community Service in Adolescence

A substantial number of U.S. adolescents currently participate in community service and there is increased national interest in service programs. This article assesses the assumption of developmental benefits to service participants by critically reviewing 44 empirical studies. It offers a theoretical framework for understanding the findings by connecting them to identity development and delineating three pertinent concepts: agency, social relatedness, and moral-political awareness. These concepts are applied to studies that investigate: ( 1) the characteristics and motivations of participants, ( 2) the effects of service, and ( 3) the process of service. The findings support the conclusion that service activities which provide opportunities for intense experiences and social interactions are often associated with prosocial development. The findings also point to the need for more studies focused on particular service programs and on relationships between service providers and those served

Folic Acid Exposure Rescues Spina Bifida Aperta Phenotypes in Human Induced Pluripotent Stem Cell Model

Neural tube defects (NTDs) are severe congenital abnormalities, caused by failed closure of neural tube during early embryonic development. Periconceptional folic acid (FA) supplementation greatly reduces the risk of NTDs. However, the molecular mechanisms behind NTDs and the preventive role of FA remain unclear. Here, we use human induced pluripotent stem cells (iPSCs) derived from fetuses with spina bifida aperta (SBA) to study the pathophysiology of NTDs and explore the effects of FA exposure. We report that FA exposure in SBA model is necessary for the proper formation and maturation of neural tube structures and robust differentiation of mesodermal derivatives. Additionally, we show that the folate antagonist methotrexate dramatically affects the formation of neural tube structures and FA partially reverts this aberrant phenotype. In conclusion, we present a novel model for human NTDs and provide evidence that it is a powerful tool to investigate the molecular mechanisms underlying NTDs, test drugs for therapeutic approaches