25,828 research outputs found

    A multisociety Delphi consensus statement on new fatty liver disease nomenclature

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    Abstract: The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventyfour percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms "nonalcoholic" and "fatty" were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction-associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction-associated steatotic liver disease, who consume greater amounts of alcohol per week (140-350 g/wk and 210-420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification. (c) 2023 American Association for the Study of Liver Diseases (AASLD), European Association for the Study of the Liver (EASL), and Fundacion Clinica Medica Sur, A.C. Published by Wolters Kluwer/Elsevier B.V/ Elsevier Espana, S. L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/

    Asynchrony in terrestrial insect abundance corresponds with species traits

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    Asynchrony in population abundance can buffer the effects of environmental change leading to greater community and ecosystem stability. Both environmental (abiotic) drivers and species functional (biotic) traits can influence population dynamics leading to asynchrony. However, empirical evidence linking dissimilarity in species traits to abundance asynchrony is limited, especially for understudied taxa such as insects. To fill this knowledge gap, we explored the relationship between pairwise species trait dissimilarity and asynchrony in interannual abundance change between pairs of species for 422 moth, butterfly, and bumblebee species in Great Britain. We also explored patterns differentiating traits that we assumed to capture ‘sensitivity to environmental variables’ (such as body mass), and traits that may reflect ‘diversity in exposure’ to environmental conditions and lead to niche partitioning (for example, habitat uses, and intra-annual emergence periods). As expected, species trait dissimilarity calculated overall and for many individual traits representing response and exposure was positively correlated with asynchrony in all three insect groups. We found that ‘exposure’ traits, especially those relating to the phenology of species, had the strongest relationship with abundance asynchrony from all tested traits. Positive relationships were not simply due to shared evolutionary history leading to similar life-history strategies: detected effects remained significant for most traits after accounting for phylogenetic relationships within models. Our results provide empirical support that dissimilarity in traits linked to species exposure and sensitivity to the environment could be important for temporal dissimilarity in insect abundance. Hence, we suggest that general trait diversity, but especially diversity in ‘exposure’ traits, could play a significant role in the resilience of insect communities to short-term environmental perturbations through driving asynchrony between species abundances

    A Readiness Level Assessment Framework for Zero Defect Manufacturing (ZDM)

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    In this study, a comprehensive framework for assessing the readiness of production systems for Zero Defect Manufacturing (ZDM) has been developed and presented. The framework includes four pillars of ZDM readiness, namely Personnel, Procedures, Infrastructure, and Company Culture, to help companies understand their level of readiness and plan for successful implementation of ZDM. We argue that a manufacturing company will be better equipped to embrace ZDM if it performs well in these four areas. We propose a tool that uses yes/no questionnaires to assess a manufacturing system’s readiness for ZDM. The results of the questionnaire will objectively show the true level of cultural readiness for ZDM adoption, and the level of investment required for implementation will depend on the level of readiness. This tool can help companies gain a clear understanding of their readiness and create a plan for implementing ZDM. Overall, our framework and tool can help manufacturers improve the quality of their products and be ready for ZDM adoption

    GWTC-2.1: Deep extended catalog of compact binary coalescences observed by LIGO and Virgo during the first half of the third observing run

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    International audienceThe second Gravitational-Wave Transient Catalog, GWTC-2, reported on 39 compact binary coalescences observed by the Advanced LIGO and Advanced Virgo detectors between 1 April 2019 15∶00 UTC and 1 October 2019 15∶00 UTC. Here, we present GWTC-2.1, which reports on a deeper list of candidate events observed over the same period. We analyze the final version of the strain data over this period with improved calibration and better subtraction of excess noise, which has been publicly released. We employ three matched-filter search pipelines for candidate identification, and estimate the probability of astrophysical origin for each candidate event. While GWTC-2 used a false alarm rate threshold of 2 per year, we include in GWTC-2.1, 1201 candidates that pass a false alarm rate threshold of 2 per day. We calculate the source properties of a subset of 44 high-significance candidates that have a probability of astrophysical origin greater than 0.5. Of these candidates, 36 have been reported in GWTC-2. We also calculate updated source properties for all binary black hole events previously reported in GWTC-1. If the eight additional high-significance candidates presented here are astrophysical, the mass range of events that are unambiguously identified as binary black holes (both objects ≄3M⊙) is increased compared to GWTC-2, with total masses from ∌14M⊙ for GW190924_021846 to ∌182M⊙ for GW190426_190642. Source properties calculated using our default prior suggest that the primary components of two new candidate events (GW190403_051519 and GW190426_190642) fall in the mass gap predicted by pair-instability supernova theory. We also expand the population of binaries with significantly asymmetric mass ratios reported in GWTC-2 by an additional two events (the mass ratio is less than 0.65 and 0.44 at 90% probability for GW190403_051519 and GW190917_114630 respectively), and find that two of the eight new events have effective inspiral spins χeff>0 (at 90% credibility), while no binary is consistent with χeff<0 at the same significance. We provide updated estimates for rates of binary black hole and binary neutron star coalescence in the local Universe

    Transition of young people from children’s into adults’ services: what works for whom and in what circumstances – protocol for a realist synthesis

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    Introduction The process of transitioning young people from children’s or adolescents’ health services into adults’ services is a crucial time in the lives and health of young people and has been reported to be disjointed rather than a process of preparation in which they are involved. Such transitions not only fail to meet the needs of young people and families at this time of significant change, but they may also result in a deterioration in health, or disengagement with services, which can have deleterious long-term consequences. Despite the wealth of literature on this topic, there has yet to be a focus on what works for whom, in what circumstances, how and why, in relation to all young people transitioning from children’s into adults’ services, which this realist synthesis aims to address. Methods and analysis This realist synthesis will be undertaken in six stages: (1) the scope of the review will be defined; (2) initial programme theories (IPTs) developed; (3) evidence searched; (4) selection and appraisal; (5) data extraction and synthesis; and (6) finally, refine/confirm programme theory. A theory-driven, iterative approach using the ‘On Your Own Feet Ahead’ theoretical framework, will be combined with an evidence search including a review of national transition policy documents, supplemented by citation tracking, snowballing and stakeholder feedback to develop IPTs. Searches of EMBASE, EMCARE, Medline, CINAHL, Cochrane Library, Web of Science, Scopus, APA PsycINFO and AMED will be conducted from 2014 to present, supplemented with grey literature, free-text searching (title, abstract and keywords) and citation tracking. Data selection will be based on relevance and rigour and extracted and synthesised iteratively with the aim of identifying and exploring causal links between contexts, mechanisms and outcomes. Results will be reported according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards Quality and Publication Standards. Ethics and dissemination This realist synthesis forms part of the National Transition Evaluation Study, which has received ethical and regulatory approval (IRAS ID: 313576). Results will be disseminated through peer-review publication, conference presentations and working with healthcare organisations, stakeholder groups and charities

    GWTC-2.1: Deep extended catalog of compact binary coalescences observed by LIGO and Virgo during the first half of the third observing run

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    International audienceThe second Gravitational-Wave Transient Catalog, GWTC-2, reported on 39 compact binary coalescences observed by the Advanced LIGO and Advanced Virgo detectors between 1 April 2019 15∶00 UTC and 1 October 2019 15∶00 UTC. Here, we present GWTC-2.1, which reports on a deeper list of candidate events observed over the same period. We analyze the final version of the strain data over this period with improved calibration and better subtraction of excess noise, which has been publicly released. We employ three matched-filter search pipelines for candidate identification, and estimate the probability of astrophysical origin for each candidate event. While GWTC-2 used a false alarm rate threshold of 2 per year, we include in GWTC-2.1, 1201 candidates that pass a false alarm rate threshold of 2 per day. We calculate the source properties of a subset of 44 high-significance candidates that have a probability of astrophysical origin greater than 0.5. Of these candidates, 36 have been reported in GWTC-2. We also calculate updated source properties for all binary black hole events previously reported in GWTC-1. If the eight additional high-significance candidates presented here are astrophysical, the mass range of events that are unambiguously identified as binary black holes (both objects ≄3M⊙) is increased compared to GWTC-2, with total masses from ∌14M⊙ for GW190924_021846 to ∌182M⊙ for GW190426_190642. Source properties calculated using our default prior suggest that the primary components of two new candidate events (GW190403_051519 and GW190426_190642) fall in the mass gap predicted by pair-instability supernova theory. We also expand the population of binaries with significantly asymmetric mass ratios reported in GWTC-2 by an additional two events (the mass ratio is less than 0.65 and 0.44 at 90% probability for GW190403_051519 and GW190917_114630 respectively), and find that two of the eight new events have effective inspiral spins χeff>0 (at 90% credibility), while no binary is consistent with χeff<0 at the same significance. We provide updated estimates for rates of binary black hole and binary neutron star coalescence in the local Universe

    Accelarated immune ageing is associated with COVID-19 disease severity