Liver cirrhosis is a common and growing public health problem globally.The diagnosis of cirrhosis portends an increased risk of morbidity and mortality.Liver biopsy is considered the gold standard for diagnosis of cir...Liver cirrhosis is a common and growing public health problem globally.The diagnosis of cirrhosis portends an increased risk of morbidity and mortality.Liver biopsy is considered the gold standard for diagnosis of cirrhosis and staging of fibrosis.However,despite its universal use,liver biopsy is an invasive and inaccurate gold standard with numerous drawbacks.In order to overcome the limitations of liver biopsy,a number of non-invasive techniques have been investigated for the assessment of cirrhosis.This review will focus on currently available non-invasive markers of cirrhosis.The evidence behind the use of these markers will be highlighted,along with an assessment of diagnostic accuracy and performance characteristics of each test.Non-invasive markers of cirrhosis can be radiologic or serum-based.Radiologic techniques based on ultrasound,magnetic resonance imaging and elastography have been used to assess liver fibrosis.Serum-based biomarkers of cirrhosis have also been developed.These are broadly classified into indirect and direct markers.Indirect biomarkers reflect liver function,which may decline with the onset of cirrhosis.Direct biomarkers,reflect extracellular matrix turnover,and include molecules involved in hepatic fibrogenesis.On the whole,radiologic and serum markers of fibrosis correlate well with biopsy scores,especially when excluding cirrhosis or excluding fibrosis.This feature is certainly clinically useful,and avoids liver biopsy in many cases.展开更多
This study links social capital with people’s health and well-being using data from the seventh wave of the World Value Survey,logistic regression,and path analysis.The study’s findings show that happiness and life ...This study links social capital with people’s health and well-being using data from the seventh wave of the World Value Survey,logistic regression,and path analysis.The study’s findings show that happiness and life satisfaction are two different measures of the same construct,or well-being.The determinants of each are also characterised differently:while life satisfaction is more of a stable and relative measure and is more strongly influenced by civic cooperation,social participation,and educational attainment,happiness is more of an unstable measure and is more strongly influenced by community belonging,trust and confidence aggregates,including employment and location of residence of an individual.Moreover,freedom of choice,financial satisfaction or social comparison,and state of health were the most important factors influencing happiness and life satisfaction.The findings also show that self-reported health(SRH)has a greater impact on happiness than a measure of life satisfaction.Path analysis shows out of the three other components of social capital—community belonging,civic engagement,and social participation—trust and confidence aggregates are the ones that have the biggest impact on increased social capital.For both well-being measures,SRH mediated the relationship.The life satisfaction measure had a higher level of mediation of SRH than happiness,but social capital had a smaller direct impact on life satisfaction than on happiness.SRH was found to be partially mediating this relationship for both happiness and life satisfaction measures,which means that people with higher social capital reported feeling better off.展开更多
文摘Liver cirrhosis is a common and growing public health problem globally.The diagnosis of cirrhosis portends an increased risk of morbidity and mortality.Liver biopsy is considered the gold standard for diagnosis of cirrhosis and staging of fibrosis.However,despite its universal use,liver biopsy is an invasive and inaccurate gold standard with numerous drawbacks.In order to overcome the limitations of liver biopsy,a number of non-invasive techniques have been investigated for the assessment of cirrhosis.This review will focus on currently available non-invasive markers of cirrhosis.The evidence behind the use of these markers will be highlighted,along with an assessment of diagnostic accuracy and performance characteristics of each test.Non-invasive markers of cirrhosis can be radiologic or serum-based.Radiologic techniques based on ultrasound,magnetic resonance imaging and elastography have been used to assess liver fibrosis.Serum-based biomarkers of cirrhosis have also been developed.These are broadly classified into indirect and direct markers.Indirect biomarkers reflect liver function,which may decline with the onset of cirrhosis.Direct biomarkers,reflect extracellular matrix turnover,and include molecules involved in hepatic fibrogenesis.On the whole,radiologic and serum markers of fibrosis correlate well with biopsy scores,especially when excluding cirrhosis or excluding fibrosis.This feature is certainly clinically useful,and avoids liver biopsy in many cases.
文摘This study links social capital with people’s health and well-being using data from the seventh wave of the World Value Survey,logistic regression,and path analysis.The study’s findings show that happiness and life satisfaction are two different measures of the same construct,or well-being.The determinants of each are also characterised differently:while life satisfaction is more of a stable and relative measure and is more strongly influenced by civic cooperation,social participation,and educational attainment,happiness is more of an unstable measure and is more strongly influenced by community belonging,trust and confidence aggregates,including employment and location of residence of an individual.Moreover,freedom of choice,financial satisfaction or social comparison,and state of health were the most important factors influencing happiness and life satisfaction.The findings also show that self-reported health(SRH)has a greater impact on happiness than a measure of life satisfaction.Path analysis shows out of the three other components of social capital—community belonging,civic engagement,and social participation—trust and confidence aggregates are the ones that have the biggest impact on increased social capital.For both well-being measures,SRH mediated the relationship.The life satisfaction measure had a higher level of mediation of SRH than happiness,but social capital had a smaller direct impact on life satisfaction than on happiness.SRH was found to be partially mediating this relationship for both happiness and life satisfaction measures,which means that people with higher social capital reported feeling better off.
