The accuracy of diagnostic indicators for coeliac disease: A systematic review and meta-analysis

Background: The prevalence of coeliac disease (CD) is around 1%, but diagnosis is challenged by varied presentation and non-specific symptoms and signs. This study aimed to identify diagnostic indicators that may help identify patients at a higher risk of CD in whom further testing is warranted. // Methods: International guidance for systematic review methods were followed and the review was registered at PROSPERO (CRD42020170766). Six databases were searched until April 2021. Studies investigating diagnostic indicators, such as symptoms or risk conditions, in people with and without CD were eligible for inclusion. Risk of bias was assessed using the QUADAS-2 tool. Summary sensitivity, specificity, and positive predictive values were estimated for each diagnostic indicator by fitting bivariate random effects meta-analyses. // Findings: 191 studies reporting on 26 diagnostic indicators were included in the meta-analyses. We found large variation in diagnostic accuracy estimates between studies and most studies were at high risk of bias. We found strong evidence that people with dermatitis herpetiformis, migraine, family history of CD, HLA DQ2/8 risk genotype, anaemia, type 1 diabetes, osteoporosis, or chronic liver disease are more likely than the general population to have CD. Symptoms, psoriasis, epilepsy, inflammatory bowel disease, systemic lupus erythematosus, fractures, type 2 diabetes, and multiple sclerosis showed poor diagnostic ability. A sensitivity analysis revealed a 3-fold higher risk of CD in first-degree relatives of CD patients. // Conclusions: Targeted testing of individuals with dermatitis herpetiformis, migraine, family history of CD, HLA DQ2/8 risk genotype, anaemia, type 1 diabetes, osteoporosis, or chronic liver disease could improve case-finding for CD, therefore expediting appropriate treatment and reducing adverse consequences. Migraine and chronic liver disease are not yet included as a risk factor in all CD guidelines, but it may be appropriate for these to be added. Future research should establish the diagnostic value of combining indicators

Challenges of adapting English médium instruction into the Spanish university curricula and some novel solutions

The integration of the Spanish university system in the European Higher Education Area (EHEA) demands a series of concrete proposals. As we advance in the implementation of the process of Bologna, it is necessary to contemplate a new paradigm of teaching/learning. Central to this new paradigm is the adaptation of the curricula into the English language medium (EMI). Among many strategies for internationalization of the Universidad Politécnica de Madrid (UPM) under adoption, this university has funded a project TechEnglish intends to facilitate the conversion of subjects and eventually degree programs into the delivery in the English Language. This paper details a work in progress and describes the collaboration between content teachers and applied linguistics. The three collaborative actions are currently underway: observation of classes by applied linguists, seminar delivery on topics requested by the content teachers, and materials development with the help of teaching assistants. We are convinced that this collaboration is the necessary ingredient to promote teaching and learning through English at our university

Tipping Bucket Rain Gauges in Hydrological Research: Summary on Measurement Uncertainties, Calibration, and Error Reduction Strategies

Tipping bucket rain gauges (TBRs) continue to be one of the most widely used pieces of equipment for rainfall monitoring; they are frequently used for the calibration, validation, and downscaling of radar and remote sensing data, due to their major advantages—low cost, simplicity and low-energy consumption. Thus, many works have focused and continue to focus on their main disadvantage—measurement biases (mainly in wind and mechanical underestimations). However, despite arduous scientific effort, calibration methodologies are not frequently implemented by monitoring networks’ operators or data users, propagating bias in databases and in the different applications of such data, causing uncertainty in the modeling, management, and forecasting in hydrological research, mainly due to a lack of knowledge. Within this context, this work presents a review of the scientific advances in TBR measurement uncertainties, calibration, and error reduction strategies from a hydrological point of view, by describing different rainfall monitoring techniques, summarizing TBR measurement uncertainties, focusing on calibration and error reduction strategies, discussing the state of the art and providing future perspectives of the technology

Producción legislativa y representaciones políticas de la élite parlamentaria brasileña

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