Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection

Assessment of histological stage is an integral part of disease management in patients infected with the hepatitis C virus (HCV). The aim of this study was to develop a model incorporating objective clinical and laboratory parameters to estimate the probability of severe fibrosis ( i.e. , Ishak fibrosis ≥ 3) in previously untreated African American (AA) and Caucasian American (CA) patients with HCV genotype 1. The Ishak fibrosis scores of 205 CA and 194 AA patients enrolled in the Viral Resistance to Antiviral Therapy of Chronic Hepatitis C study (Virahep-C) were modeled using simple and multiple logistic regression. The model was then validated in an independent cohort of 461 previously untreated patients with HCV. The distribution of fibrosis scores was similar in the AA and CA patients as was the proportion of patients with severe fibrosis (35% vs. 39%, P = .47). After accounting for the number of portal areas in the biopsy, patient age, serum aspartate aminotransferase, alkaline phosphatase, and platelet count were independently associated with severe fibrosis in the overall cohort, and the relationship with fibrosis was similar in both the AA and CA subgroups. The area under the receiver operating characteristic curve (AUROC) of the Virahep-C model (0.837) was significantly better than in other published models ( P = .0003). The AUROC of the Virahep-C model was 0.851 in the validation population. In conclusion , a model consisting of widely available clinical and laboratory features predicted severe hepatic fibrosis equally well in AA and CA patients with HCV genotype 1 and was superior to other published models. The excellent performance of the Virahep-C model in an external validation cohort suggests the findings are replicable and potentially generalizable. (H EPATOLOGY 2006;44:925–935.)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55833/1/21335_ftp.pd

Digital supply chain management in the videogames industry: a systematic literature review

As industries mature, they rely more heavily on supply chain management (SCM) to ensure effective operations leading to greater levels of organisational performance. SCM has been widely covered in many industrial areas and, in line with other burgeoning sectors such as Tourism, an industry focus provides the opportunity to look in-depth at the context-based factors that affect SCM. Developments in digital distribution and rapid technological innovations have resulted in an increased focus on Digital Supply Chains (DSCs), which bring about significant changes to how consumers, customers, suppliers, and manufacturers interact, affecting supply chain design and processes. Through a systematic review of the Videogames Industry Supply Chain Management literature, which serves as a pertinent contextual example of a DSC, we look at how supply chains are affected by structural, market and technological change, such as increased platformisation, disintermediation and the proliferation of digital distribution. We distil these findings into a new research agenda, which identifies themes in line with extant DSC research, provides a series of relevant practice recommendations and identifies opportunities for future research

Exposure to risperidone versus other antipsychotics and risk of osteoporosis-related fractures : a population-based study

Objective Antipsychotics may increase serum prolactin, which has particularly been observed with risperidone. Further, hyperprolactinemia has been linked to osteoporosis-related fractures. Therefore, we investigated fracture risk in a nationwide cohort exposed to antipsychotics. Methods Swedish registers were used to identify adults with two consecutive dispensations of risperidone (n = 38 211), other atypical antipsychotics not including paliperidone (n = 60 691), or typical antipsychotics (n = 17 445) within three months between 2006 and 2013. An osteoporosis-related fracture was defined as a non-open hip/femur fracture in primary analyses. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Risperidone users were on average older (mean age of 68, 44, and 63 years for risperidone, other atypical antipsychotics, and typical antipsychotics respectively). Compared with other atypical antipsychotics, there was no association between risperidone and osteoporosis-related fractures in the overall (HR = 1.04, CI: 0.91-1.19) or age-stratified analyses. A significantly increased risk of typical antipsychotics (HR = 1.24, CI: 1.07-1.45) compared with other atypical antipsychotics remained for ages >45 years. Conclusion Risperidone does not appear to be associated with an increased risk of osteoporosis-related fracture compared with other atypical antipsychotic agents as a group. For typical antipsychotics, a moderately elevated risk of hip fractures was noted compared with other atypical antipsychotics, possibly because of residual confounding

Foreign direct investment and country risk: Further empirical evidence

Global political and economic changes over the last decade have resulted into massive capital inflows to developing countries, most of these flows are foreign direct investments. In light of threats of political instability in the forms of civil wars, illegal capital flight, financial market instability, and political corruption, etc., further assessment of country risk is warranted. We examine the relationship between FDI and political and economic risks for 26 countries for the years 1992, 1993, and 1994 by using regression analysis and cross section data. The results indicate a significant relationship between FDI and these risks. This study provides more reliable estimates by using a current and eclectic measurement of risks represented by Euromoney indexes of political and economic risks. In the previous studies the perception of risk was narrowly defined and also political instability events were mistakenly interpreted as political risks.