Bankruptcy prediction model using cost-sensitive extreme gradient boosting in the context of imbalanced datasets

In the process of bankruptcy prediction models, a class imbalanced problem has occurred which limits the performance of the models. Most prior research addressed the problem by applying resampling methods such as the synthetic minority oversampling technique (SMOTE). However, resampling methods lead to other issues, e.g., increasing noisy data and training time during the process. To improve the bankruptcy prediction model, we propose cost-sensitive extreme gradient boosting (CS-XGB) to address the class imbalanced problem without requiring any resampling method. The proposed method’s effectiveness is evaluated on six real-world datasets, i.e., the LendingClub, and five Polish companies’ bankruptcy. This research compares the performance of CS-XGB with other ensemble methods, including SMOTE-XGB which applies SMOTE to the training set before the learning process. The experimental results show that i) based on LendingClub, the CS-XGB improves the performance of XGBoost and SMOTE-XGB by more than 50% and 33% on bankruptcy detection rate (BDR) and geometric mean (GM), respectively, and ii) the CS-XGB model outperforms random forest (RF), Bagging, AdaBoost, XGBoost, and SMOTE-XGB in terms of BDR, GM, and the area under a receiver operating characteristic curve (AUC) based on the five Polish datasets. Besides, the CS-XGB model achieves good overall prediction results

Lifestyle Behavior Change in Patients With Nonalcoholic Fatty Liver Disease:A Qualitative Study of Clinical Practice

Nonalcoholic fatty liver disease (NAFLD) is the most common liver condition worldwide and is linked largely to obesity and inactivity. Lifestyle modification is the primary treatment for NAFLD targeting dietary change, physical activity, and exercise to facilitate weight loss and weight loss maintenance. This has been shown to reduce steatosis and ameliorate steatohepatitis. European Clinical Practice Guidelines for the management of NAFLD highlight the importance of targeting lifestyle behavior change in all patients with NAFLD regardless of disease severity. These guidelines recommend combining dietary restriction and a progressive increase in aerobic exercise and resistance training with a focus on tailoring interventions to the individual patient. Practice guidelines published by the American Association for the Study of Liver Diseases recommend weight loss of at least 3% to 5% of body weight via hypocaloric diet or diet combined with increased physical activity but state that these lifestyle interventions should target patients with nonalcoholic steatohepatitis. Given the benefits of lifestyle behavior change, this study explored the perceptions surrounding clinical care as currently offered to patients with NAFLD. The aim of this study was to establish whether current provision of lifestyle behavior change support is sufficient, whether health care professionals believe they have the tools to target lifestyle behavior changes effectively, and how targeting diet and physical activity/exercise to facilitate weight loss and weight loss maintenance in practice can be improved from the perspective of health care professionals and patients

ผลการจัดการเรียนรู้วิชาเคมีด้วยรูปแบบฟาร์ไกด์ที่มีต่อผลสัมฤทธิ์ทางการเรียนและความคงทนในการเรียนรู้ - ของนักเรียนมัธยมศึกษาตอนปลาย

This study was quasi-experimental research. The purposes of this research were to 1) compare the learning achievement of students who learned chemistry through FAR guide model and students who learned chemistry through conventional teaching method and 2) compare the learning retention of students who learned chemistry through FAR guide model and students who learned chemistry through conventional teaching method. The samples were 75 tenth grade students of secondary school in the office of the basic education commission, selected by purposive sampling from two classrooms of tenth grade students of a school in Nonthaburi. One class of 37 students was randomly assigned to the experimental group and another class of 38 students was randomly assigned to the controlled group. The research duration took 6 weeks through 10 times of instruction. The research instrument was FAR guide model lesson plans, traditional model lesson plans and achievement tests. The collected data were analysed by arithmetic mean, standard deviation, independent-samples t-test, pairedsamples t-test and analysis of covariance (ANCOVA). The research findings were summarized as follows: 1) Students who learned chemistry through FAR guide model had higher mean scores of learning achievement than students who learn chemistry through conventional teaching method at .05 level of significance and 2) Both students who learned chemistry through FAR guide model and students who learn chemistry through conventional teaching method had no learning retention and had no difference of mean scores of learning retention at .05 level of significance

Projected increase in obesity and non‐alcoholic‐steatohepatitis–related liver transplantation waitlist additions in the United States

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151250/1/hep29473-sup-0001-suppinfo.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151250/2/hep29473.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151250/3/hep29473_am.pd

Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation

BACKGROUND: Liver biopsy is the reference standard for diagnosing the extent of fibrosis in chronic liver disease; however, it is invasive, with the potential for serious complications. Alternatives to biopsy include non-invasive liver tests (NILTs); however, the cost-effectiveness of these needs to be established. OBJECTIVE: To assess the diagnostic accuracy and cost-effectiveness of NILTs in patients with chronic liver disease. DATA SOURCES: We searched various databases from 1998 to April 2012, recent conference proceedings and reference lists. METHODS: We included studies that assessed the diagnostic accuracy of NILTs using liver biopsy as the reference standard. Diagnostic studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-analysis was conducted using the bivariate random-effects model with correlation between sensitivity and specificity (whenever possible). Decision models were used to evaluate the cost-effectiveness of the NILTs. Expected costs were estimated using a NHS perspective and health outcomes were measured as quality-adjusted life-years (QALYs). Markov models were developed to estimate long-term costs and QALYs following testing, and antiviral treatment where indicated, for chronic hepatitis B (HBV) and chronic hepatitis C (HCV). NILTs were compared with each other, sequential testing strategies, biopsy and strategies including no testing. For alcoholic liver disease (ALD), we assessed the cost-effectiveness of NILTs in the context of potentially increasing abstinence from alcohol. Owing to a lack of data and treatments specifically for fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), the analysis was limited to an incremental cost per correct diagnosis. An analysis of NILTs to identify patients with cirrhosis for increased monitoring was also conducted. RESULTS: Given a cost-effectiveness threshold of £20,000 per QALY, treating everyone with HCV without prior testing was cost-effective with an incremental cost-effectiveness ratio (ICER) of £9204. This was robust in most sensitivity analyses but sensitive to the extent of treatment benefit for patients with mild fibrosis. For HBV [hepatitis B e antigen (HBeAg)-negative)] this strategy had an ICER of £28,137, which was cost-effective only if the upper bound of the standard UK cost-effectiveness threshold range (£30,000) is acceptable. For HBeAg-positive disease, two NILTs applied sequentially (hyaluronic acid and magnetic resonance elastography) were cost-effective at a £20,000 threshold (ICER: £19,612); however, the results were highly uncertain, with several test strategies having similar expected outcomes and costs. For patients with ALD, liver biopsy was the cost-effective strategy, with an ICER of £822. LIMITATIONS: A substantial number of tests had only one study from which diagnostic accuracy was derived; therefore, there is a high risk of bias. Most NILTs did not have validated cut-offs for diagnosis of specific fibrosis stages. The findings of the ALD model were dependent on assuptions about abstinence rates assumptions and the modelling approach for NAFLD was hindered by the lack of evidence on clinically effective treatments. CONCLUSIONS: Treating everyone without NILTs is cost-effective for patients with HCV, but only for HBeAg-negative if the higher cost-effectiveness threshold is appropriate. For HBeAg-positive, two NILTs applied sequentially were cost-effective but highly uncertain. Further evidence for treatment effectiveness is required for ALD and NAFLD. STUDY REGISTRATION: This study is registered as PROSPERO CRD42011001561. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Impact of a structured lifestyle programme on patients with metabolic syndrome complicated by non‐alcoholic fatty liver disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147867/1/apt15063.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147867/2/apt15063_am.pd

The role of lifestyle changes in the management of chronic liver disease

The prevalence of obesity worldwide has dramatically increased during the last three decades. With obesity comes a variety of adverse health outcomes which are grouped under the umbrella of metabolic syndrome. The liver in particular seems to be significantly impacted by fat deposition in the presence of obesity. In this article we discuss several liver conditions which are directly affected by overweight and obese status, including non-alcoholic fatty liver disease, chronic infection with hepatitis C virus and post-liver transplant status. The deleterious effects of obesity on liver disease and overall health can be significantly impacted by a culture that fosters sustained nutritional improvement and regular physical activity. Here we summarize the current evidence supporting non-pharmacological, lifestyle interventions that lead to weight reduction, improved physical activity and better nutrition as part of the management and treatment of these liver conditions

Activation of Peroxisome Proliferator-Activated Receptor Gamma by Rosiglitazone Increases Sirt6 Expression and Ameliorates Hepatic Steatosis in Rats

Sirt6 has been implicated in the regulation of hepatic lipid metabolism and the development of hepatic steatosis. The aim of this study was to address the potential role of Sirt6 in the protective effects of rosiglitazone (RGZ) on hepatic steatosis.) by stomach gavage for 6 weeks. The involvement of Sirt6 in the RGZ's regulation was evaluated by Sirt6 knockdown in AML12 mouse hepatocytes.RGZ treatment ameliorated hepatic lipid accumulation and increased expression of Sirt6, peroxisome proliferator-activated receptor gamma coactivtor-1-α (Ppargc1a/PGC1-α) and Forkhead box O1 (Foxo1) in rat livers. AMP-activated protein kinase (AMPK) phosphorylation was also increased by RGZ, accompanied by alterations in phosphorylation of LKB1. Interestingly, in free fatty acid-treated cells, Sirt6 knockdown increased hepatocyte lipid accumulation measured as increased triglyceride contents (p = 0.035), suggesting that Sirt6 may be beneficial in reducing hepatic fat accumulation. In addition, Sirt6 knockdown abolished the effects of RGZ on hepatocyte fat accumulation, mRNA and protein expression of Ppargc1a/PGC1-α and Foxo1, and phosphorylation levels of LKB1 and AMPK, suggesting that Sirt6 is involved in RGZ-mediated metabolic effects.Our results demonstrate that RGZ significantly decreased hepatic lipid accumulation, and that this process appeared to be mediated by the activation of the Sirt6-AMPK pathway. We propose Sirt6 as a possible therapeutic target for hepatic steatosis

Energy determinants GAPDH and NDPK act as genetic modifiers for hepatocyte inclusion formation

Differential expression and activity of the cellular energy regulators GAPDH and NDPK underlie reactive oxygen species–induced damage in the mouse liver and may contribute to human liver disease progression