Underrecognition and Suboptimal Quality of Care for Nonalcoholic Fatty Liver Disease Cirrhosis in Primary Care Patients with Diabetes Mellitus.

Background: Nonalcoholic fatty liver disease (NAFLD) is a leading cause of cirrhosis but is underrecognized in primary care. Cirrhosis management requires complex monitoring, and the quality of care (QoC) for NAFLD cirrhosis patients in primary care may be inadequate.

Methods: In this retrospective-prospective cohort study of primary care patients with diabetes mellitus, we identified patients with NAFLD cirrhosis by 1) evidence of cirrhosis from abdominal imaging identified by natural language processing, or 2) existence of International Classification of Diseases code for cirrhosis.

Prospective study of a case-finding algorithm to detect NAFLD with advanced fibrosis in primary care patients.

Background And Aims: Primary care providers need strategies to identify NAFLD patients and select for specialty referral, but proposed algorithms have only been studied in established NAFLD patients.

Methods: We implemented an algorithm for all adults with diabetes mellitus in a large primary care practice and excluded hepatitis B and C or alcohol use. Applying annual Fibrosis-4 Index and NAFLD Fibrosis Score for 5 years, we categorized patients as low-risk, indeterminate-risk, or high-risk for advanced fibrosis.

Primary Care Providers and Nonalcoholic Fatty Liver Disease: A Needs Assessment Survey.

Background: Primary care providers (PCPs) face increasing numbers of patients at risk for NAFLD and are responsible for the detection of NAFLD and the decision on referral to specialists. We conducted a PCP needs assessment to ascertain the barriers and desired supports for NAFLD in primary care.

Methods: We designed a cross-sectional study of PCPs at a large diverse health system and surveyed faculty, residents, and nurse practitioners.

Circadian and ultradian rhythms in normal mice and in a mouse model of Huntington's disease.

Circadian rhythms in core body temperature (CBT) have been widely studied, but fewer studies have explored higher-frequency (ultradian) rhythms in detail. We analyzed CBT recordings from young and middle-aged wild-type mice as well as from the Q175 model of Huntington's disease (HD), at sufficient temporal resolution to address the question of ultradian rhythms. We used model selection methods to show that the overall circadian pattern was better fit by a square wave than a sine wave.