Prediction of liver disease in patients whose liver function tests have been checked in primary care : model development and validation using population-based observational cohorts

This work was supported by the UK National Health Service Research & Development Programme Health Technology Assessment Programme (project number 03/38/02) and also by the Backett Weir Russell Career Development Fellowship, University of Aberdeen.OBJECTIVE: To derive and validate a clinical prediction model to estimate the risk of liver disease diagnosis following liver function tests (LFTs) and to convert the model to a simplified scoring tool for use in primary care. DESIGN: Population-based observational cohort study of patients in Tayside Scotland identified as having their LFTs performed in primary care and followed for 2 years. Biochemistry data were linked to secondary care, prescriptions and mortality data to ascertain baseline characteristics of the derivation cohort. A separate validation cohort was obtained from 19 general practices across the rest of Scotland to externally validate the final model. SETTING: Primary care, Tayside, Scotland. PARTICIPANTS: Derivation cohort: LFT results from 310 511 patients. After exclusions (including: patients under 16 years, patients having initial LFTs measured in secondary care, bilirubin >35 μmol/L, liver complications within 6 weeks and history of a liver condition), the derivation cohort contained 95 977 patients with no clinically apparent liver condition. Validation cohort: after exclusions, this cohort contained 11 653 patients. PRIMARY AND SECONDARY OUTCOME MEASURES: Diagnosis of a liver condition within 2 years. RESULTS: From the derivation cohort (n=95 977), 481 (0.5%) were diagnosed with a liver disease. The model showed good discrimination (C-statistic=0.78). Given the low prevalence of liver disease, the negative predictive values were high. Positive predictive values were low but rose to 20-30% for high-risk patients. CONCLUSIONS: This study successfully developed and validated a clinical prediction model and subsequent scoring tool, the Algorithm for Liver Function Investigations (ALFI), which can predict liver disease risk in patients with no clinically obvious liver disease who had their initial LFTs taken in primary care. ALFI can help general practitioners focus referral on a small subset of patients with higher predicted risk while continuing to address modifiable liver disease risk factors in those at lower risk.Publisher PDFPeer reviewe

Mutual Information for the Detection of Crush

Fatal crush conditions occur in crowds with tragic frequency. Event organizers and architects are often criticised for failing to consider the causes and implications of crush, but the reality is that both the prediction and prevention of such conditions offer a significant technical challenge. Full treatment of physical force within crowd simulations is precise but often computationally expensive; the more common method of human interpretation of results is computationally “cheap” but subjective and time-consuming. This paper describes an alternative method for the analysis of crowd behaviour, which uses information theory to measure crowd disorder. We show how this technique may be easily incorporated into an existing simulation framework, and validate it against an historical event. Our results show that this method offers an effective and efficient route towards automatic detection of the onset of crush

VAST: An ASKAP Survey for Variables and Slow Transients

The Australian Square Kilometre Array Pathfinder (ASKAP) will give us an unprecedented opportunity to investigate the transient sky at radio wavelengths. In this paper we present VAST, an ASKAP survey for Variables and Slow Transients. VAST will exploit the wide-field survey capabilities of ASKAP to enable the discovery and investigation of variable and transient phenomena from the local to the cosmological, including flare stars, intermittent pulsars, X-ray binaries, magnetars, extreme scattering events, interstellar scintillation, radio supernovae and orphan afterglows of gamma ray bursts. In addition, it will allow us to probe unexplored regions of parameter space where new classes of transient sources may be detected. In this paper we review the known radio transient and variable populations and the current results from blind radio surveys. We outline a comprehensive program based on a multi-tiered survey strategy to characterise the radio transient sky through detection and monitoring of transient and variable sources on the ASKAP imaging timescales of five seconds and greater. We also present an analysis of the expected source populations that we will be able to detect with VAST.Comment: 29 pages, 8 figures. Submitted for publication in Pub. Astron. Soc. Australi

Crop Updates 2006 - Katanning

This session covers sixteen papers from different authors 2006 SEASONAL OUTLOOK, David Stephens and Michael Meuleners, Department of Agriculture Review of climate model summaries reported in the Department of Agriculture’s growing season outlooks, Meredith Fairbanks, Department of Agriculture Farmers commodity outlook 2006, Thomas Schulz, Department of Agriculture Why is salinity such a difficult problem for plant breeders? T J Flowers, TD Colmer, University of Western Australia Matching nitrogen supply to wheat demand in 2005, Narelle Simpson, Ron McTaggart, Wal Anderson, Lionel Martin and Dave Allen, Department of Agriculture Wheat varieties in 2006, Brenda Shackley, Department of Agriculture Performance of dwarf potential milling oat varieties in Western Australian environments, Raj Malik and Kellie Winfield, Department of Agriculture Field pea lessons for 2006, Rodger Beermir, Department of Agriculture Better returns from Durum wheat, Shahahan Miyan, Department of Agriculture Summer weeds can reduce grain yield and protein, Dr. Abul Hashem, Department of Agriculture, Dr Shahab Pathan, Department of Agriculture, Vikki Osten, Queensland Department of Primary Industries and Fisheries Management of Summer Weeds, Alex Douglas, Department of Agriculture Frost or Friction, Garren Knell, Steve Curtin, Wade Longmuir, Consult Ag Pty Ltd PROFITING FROM MARGINAL LAND SEMINAR Producing Bio-Diesel and rubber from marginal land?? Dr Henry Brockman, Department of Agriculture SGSL Producer network – on ground implementation of saltbush based pastures, Justin Hardy, Arjen Ryder, John Paul Collins and Jessica Johns, Department of Agriculture Enhancing the profitability of “Edenia” using saltbush and perenials, SGSL Producer case study, John Pepall, Jinka’s Hill LCDC Investment in saltland pastures, Allan Herbert, Department of Agricultur

Mouse large-scale phenotyping initiatives: overview of the European Mouse Disease Clinic (EUMODIC) and of the Wellcome Trust Sanger Institute Mouse Genetics Project.

Two large-scale phenotyping efforts, the European Mouse Disease Clinic (EUMODIC) and the Wellcome Trust Sanger Institute Mouse Genetics Project (SANGER-MGP), started during the late 2000s with the aim to deliver a comprehensive assessment of phenotypes or to screen for robust indicators of diseases in mouse mutants. They both took advantage of available mouse mutant lines but predominantly of the embryonic stem (ES) cells resources derived from the European Conditional Mouse Mutagenesis programme (EUCOMM) and the Knockout Mouse Project (KOMP) to produce and study 799 mouse models that were systematically analysed with a comprehensive set of physiological and behavioural paradigms. They captured more than 400 variables and an additional panel of metadata describing the conditions of the tests. All the data are now available through EuroPhenome database (www.europhenome.org) and the WTSI mouse portal (http://www.sanger.ac.uk/mouseportal/), and the corresponding mouse lines are available through the European Mouse Mutant Archive (EMMA), the International Knockout Mouse Consortium (IKMC), or the Knockout Mouse Project (KOMP) Repository. Overall conclusions from both studies converged, with at least one phenotype scored in at least 80% of the mutant lines. In addition, 57% of the lines were viable, 13% subviable, 30% embryonic lethal, and 7% displayed fertility impairments. These efforts provide an important underpinning for a future global programme that will undertake the complete functional annotation of the mammalian genome in the mouse model

The mammalian gene function resource: The International Knockout Mouse Consortium

In 2007, the International Knockout Mouse Consortium (IKMC) made the ambitious promise to generate mutations in virtually every protein-coding gene of the mouse genome in a concerted worldwide action. Now, 5 years later, the IKMC members have developed highthroughput gene trapping and, in particular, gene-targeting pipelines and generated more than 17,400 mutant murine embryonic stem (ES) cell clones and more than 1,700 mutant mouse strains, most of them conditional. A common IKMC web portal (www.knockoutmouse.org) has been established, allowing easy access to this unparalleled biological resource. The IKMC materials considerably enhance functional gene annotation of the mammalian genome and will have a major impact on future biomedical research

Rethinking Human-Animal Relations: The Critical Role of Social Psychology

People deeply value their social bonds with companion animals, yet routinely devalue other animals, considering them mere commodities to satisfy human interests and desires. Despite the inherently social and intergroup nature of these complexities, social psychology is long overdue in integrating human-animal relations in its theoretical frameworks. The present body of work brings together social psychological research advancing our understanding of: 1) the factors shaping our perceptions and thinking about animals as social groups, 2) the complexities involved in valuing (caring) and devaluing (exploiting) animals, and 3) the implications and importance of human-animal relations for human intergroup relations. In this article, we survey the diversity of research paradigms and theoretical frameworks developed within the intergroup relations literature that are relevant, perchance critical, to the study of human-animal relations. Furthermore, we highlight how understanding and rethinking human-animal relations will eventually lead to a more comprehensive understanding of many human intergroup phenomena

The mammalian gene function resource: the International Knockout Mouse Consortium.

In 2007, the International Knockout Mouse Consortium (IKMC) made the ambitious promise to generate mutations in virtually every protein-coding gene of the mouse genome in a concerted worldwide action. Now, 5 years later, the IKMC members have developed high-throughput gene trapping and, in particular, gene-targeting pipelines and generated more than 17,400 mutant murine embryonic stem (ES) cell clones and more than 1,700 mutant mouse strains, most of them conditional. A common IKMC web portal (www.knockoutmouse.org) has been established, allowing easy access to this unparalleled biological resource. The IKMC materials considerably enhance functional gene annotation of the mammalian genome and will have a major impact on future biomedical research