Background & Aims Progressive fibrosis is a major cause of morbidity and mortality in chronic liver disease. To replace liver biopsy for disease staging, multiple serum markers are under evaluation ...with multiparametric panels yielding the most promising results. The Enhanced Liver Fibrosis (ELF) score is an ECM marker set consisting of tissue inhibitor of metalloproteinases 1 (TIMP-1), amino-terminal propeptide of type III procollagen (PIIINP) and hyaluronic acid (HA) showing good correlations with fibrosis stages in chronic liver disease. Methods The ELF score was measured in 400 healthy controls and 79 chronic hepatitis C patients using an ADVIA Centaur automated system. The ELF score was calculated using the published algorithm combining TIMP-1, PIIINP and HA values. Patients’ fibrosis stage was defined histologically. ROC analyses were performed to study marker validity. Reference values and influence factors for the ELF score were validated. Results ELF score reference values ranged from 6.7 to 9.8 and were significantly higher for men vs. women (7.0–9.9 vs. 6.6–9.3, respectively). Afternoon values were slightly higher than morning values (6.7–9.9 vs. 6.6–9.5, respectively). Age was a notable influence factor. We identified three cut-off values: 7.7 for a high sensitivity exclusion of fibrosis, 9.8 for a high specificity identification of fibrosis (sensitivity 69%, specificity 98% for moderate fibrosis), and 11.3 to discriminate cirrhosis (sensitivity 83%, specificity 97%). ELF score validity was superior to the results of the single tests. Conclusions The ELF score can predict moderate fibrosis and cirrhosis. However, influence factors such as gender and age need to be taken into account.
Receptivity to Instructional Computer-Based Feedback (RIF) Luca Bahr, J.; Höft, Lars; Meyer, Jennifer ...
European journal of psychological assessment : official organ of the European Association of Psychological Assessment,
05/2024
Journal Article
Recenzirano
Feedback can play a pivotal role in learning but is only effective when students use it. However, the use of feedback varies greatly from student to student and these differences must be explained. ...Hence, the construct receptivity to instructional feedback (RIF) was introduced to assess students’ attitudes towards and engagement with human-provided feedback in multiple English-speaking countries. However, RIF scales have not yet been used in computer-based assessment contexts nor in German-speaking countries; their application is thus limited. This study examined an adapted and translated RIF scale using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). We capitalized on data sets comprising German-speaking university ( N = 464) and secondary school ( N = 1,207) students. The bifactor-CFA model showed a good model fit and revealed a general receptivity factor alongside the four specific factors: experiential attitudes, instrumental attitudes, cognitive engagement, and behavioral engagement with feedback. Scalar measurement invariance allowed for cross-gender and educational level comparisons. The relationships with broader personality characteristics were consistent with other contexts, thus indicating discriminant validity. General receptivity, cognitive engagement, and experiential attitudes positively correlated with GPA, suggesting convergent validity. Results support the stability of the RIF scale’s adaptation and translation. Assessment implications are discussed.
Fibrosis and steatosis are major histopathological alterations in chronic liver diseases. Despite various shortcomings, disease severity is generally determined by liver biopsy, emphasizing the need ...for simple noninvasive methods for assessing disease activity. Because hepatocyte cell death is considered a crucial pathogenic factor, we prospectively evaluated the utility of serum biomarkers of cell death to predict different stages of fibrosis and steatosis in 121 patients with chronic liver disease. We compared the M30 enzyme‐linked immunosorbent assay (ELISA), which detects a caspase‐cleaved cytokeratin‐18 (CK‐18) fragment and thereby apoptotic cell death, with the M65 ELISA, which detects both caspase‐cleaved and uncleaved CK‐18 and thereby overall cell death. Both biomarkers significantly discriminated patients with different fibrosis stages from healthy controls. However, whereas both markers differentiated low or moderate from advanced fibrosis, only the M65 antigen could discriminate even lower stages of fibrosis. The M65 assay also performed better in distinguishing low (≤10%) and higher (>10%) grades of steatosis. In a subgroup of patients, we evaluated the biomarkers for their power to predict nonalcoholic steatohepatitis (NASH). Importantly, both markers accurately differentiated healthy controls or simple steatosis from NASH. However, only serum levels of M65 antigen could differentiate simple steatosis from healthy controls. Conclusion: Cell death biomarkers are potentially useful to predict fibrosis, steatosis, or NASH. Compared with the widely used apoptosis marker M30, the M65 assay had a better diagnostic performance and even differentiated between lower fibrosis stages as well as between healthy individuals and patients with simple steatosis. (HEPATOLOGY 2012)
Order parameter symmetry is one of the basic characteristics of a superconductor. The heavy fermion compound UPt3 provides a rich system for studying the competition between superconductivity and ...other forms of electronic order and exhibits two distinct superconducting phases that are characterized by different symmetries. We fabricated a series of Josephson tunnel junctions on the as-grown surfaces of UPt3 single crystals spanning the a-b plane. By measuring their critical current, we mapped out the magnitude of the superconducting order parameter as a function of the momentum-space direction and temperature. In the high-temperature phase, we observed a sharp node in the superconducting gap at 45 degrees with respect to the a axis; an out-of-phase component appeared in the low-temperature phase, creating a complex order parameter.
The purpose of this research was to examine whether authoritative, authoritarian, indulgent, and neglectful parenting styles were associated with adolescent alcohol use and heavy drinking, after ...controlling for peer use, religiosity, and other relevant variables.
Structural equation modeling was used to estimate direct and indirect associations of parenting style with alcohol use and heavy drinking among 4,983 adolescents in Grades 7-12.
Adolescents whose parents were authoritative were less likely to drink heavily than adolescents from the other three parenting styles, and they were less likely to have close friends who used alcohol. In addition, religiosity was negatively associated with heavy drinking after controlling for other relevant variables.
Authoritative parenting appears to have both direct and indirect associations with the risk of heavy drinking among adolescents. Authoritative parenting, where monitoring and support are above average, might help deter adolescents from heavy alcohol use, even when adolescents have friends who drink. In addition, the data suggest that the adolescent's choice of friends may be an intervening variable that helps explain the negative association between authoritative parenting and adolescent heavy drinking.
The epidermal growth factor receptor (EGFR) is a member of the receptor tyrosine kinase family. Ligand (epidermal growth factor or EGF) binding to the EGFR results in the coordinated activation and ...integration of biochemical signaling events to mediate cell growth, migration, and differentiation. One mechanism the cell utilizes to orchestrate these events is ligand-mediated endocytosis through the canonical clathrin-mediated endocytic pathway. Identification of proteins that regulate the intracellular movement of the EGF·EGFR complex is an important first step in dissecting how specificity of EGFR signaling is conferred. We examined the role of the small molecular weight guanine nucleotide-binding protein (G-protein) rab7 as a regulator of the distal stages of the endocytic pathway. Through the transient expression of activating and inactivating mutants of rab7 in HeLa cells, we have determined that rab7 activity directly correlates with the rate of radiolabeled EGF and EGFR degradation. Furthermore, when inhibitory mutants of rab7 are expressed, the internalized EGF·EGFR complex accumulates in high-density endosomes that are characteristic of the late endocytic pathway. Thus, we conclude that rab7 regulates the endocytic trafficking of the EGF·EGFR complex by regulating its lysosomal degradation.
Abstract Background Transient elastography is increasingly used for assessment of liver fibrosis. Acoustic radiation force impulse imaging (ARFI) is a new technology to perform liver elastography. ...Aims We evaluated the clinical feasibility, validity and accuracy of the ARFI method and compared it to Fibroscan® and liver histology. Methods Ultrasonographic elastography of the liver using ARFI was performed in 29 patients with liver cirrhosis, 70 patients with liver disease and 23 healthy controls. Results ARFI was feasible in all patients providing a mean propagation velocity of 1.65 ± 0.93 m/s. ARFI results of the right and left liver lobes were comparable ( p < 0.001). In cirrhotic patients, ARFI gave significantly higher values than in the other patients ( p < 0.001). Rate of invalid measurements was lower in ARFI than in Fibroscan® ( p < 0.04). Both elastography methods were highly correlated to each other ( p < 0.001). Furthermore, ARFI correlated to histological grading of liver fibrosis ( p < 0.001) and to inflammatory activity ( p < 0.05). Liver steatosis had no statistical influence on ARFI results ( p = 0.2) in contrast to Fibroscan® ( p < 0.05). Conclusions The new ultrasonographic method of ARFI elastography allows valid, accurate and flexible evaluation of liver stiffness. It seems more feasible in patients with liver cirrhosis than Fibroscan® . ARFI elastography of the left liver lobe is also possible. Liver steatosis does not seem to influence ARFI elastography.
Background: Extended dialysis is an increasingly used modality of renal replacement therapy that theoretically offers advantages of both intermittent and continuous therapies in the intensive care ...unit (ICU). Methods: We randomly treated 39 ventilated critically ill patients with oliguric acute renal failure with either continuous venovenous hemofiltration (CVVH; n = 19; age, 50.1 ± 3.2 years; Acute Physiology and Chronic Health Assessment II APACHE II score, 32.3 ± 1.2; 79% sepsis) and a substitution fluid rate of at least 30 mL/kg/h for 24 hours or with extended dialysis for 12 hours (n = 20; age, 50.8 ± 3.6 years; APACHE II score, 33.6 ± 1.0; 85% sepsis). The latter was performed using an easy-to-handle, single-pass, batch dialysis system. All hemodynamic parameters were monitored invasively by means of an indwelling arterial catheter. Results: Average mean arterial blood pressure, heart rate, cardiac output, systemic vascular resistance, and catecholamine dose were not significantly different in both therapies. Urea reduction rate was similar with extended dialysis compared with CVVH therapy (53% ± 2% versus 52% ± 3%; P = not significant) despite an average rate of substitution fluid with the latter of 3.2 ± 0.1 L/h. This was corroborated by the finding of similar amounts of urea eliminated in the collected spent total hemofiltration and dialysis fluid. Correction of acidosis was accomplished faster with extended dialysis than CVVH, and the amount of heparin used was significantly lower with extended dialysis (P < 0.01). Conclusion: Extended dialysis combines excellent detoxification with cardiovascular tolerability, even in severely ill patients in the ICU. The technically simple dialysis system used offers flexibility of treatment time.
Background/Aims: Extracorporeal detoxification systems for supportive therapy of liver failure have recently gained much interest. We herein report results from the first clinical application of ...Prometheus
®, a new liver support system in which albumin-bound substances are directly removed from blood by special adsorber. In a simultaneous step, high-flux hemodialysis is performed. We assessed safety, adsorber efficiency and clinical efficacy of the Prometheus
® system.
Methods: Eleven patients with acute-on-chronic liver failure and accompanying renal failure were treated with Prometheus
® on 2 consecutive days for >4 h.
Results: Prometheus
® treatment significantly improved serum levels of conjugated bilirubin, bile acids, ammonia, cholinesterase, creatinine, urea and blood pH. There were no significant changes in hemoglobin and platelet levels, whereas leucocytes increased without signs of systemic infection. No treatment-related complications except a blood pressure drop in two patients with systemic infection were noted. In one patient (Child-Pugh score: 15) Prometheus
® treatment could not be completed due to onset of uncontrolled bleeding 16 h after dialysis.
Conclusions: Prometheus
® is a safe supportive therapy for patients with liver failure. A significant improvement of the biochemical milieu was observed already after two treatments. Prospective controlled studies with the Prometheus
® system are necessary to evaluate hard clinical end-points.
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