IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Recently, there have been multiple advances in the understanding of IgAN pathophysiology and therapeutic options. Despite the advent of new treatment options, individual risk stratification of the disease course and choosing the best treatment strategy for the patient remains challenging. A multitude of clinical trials is ongoing, opening multiple opportunities for enrollment. In this brief review we discuss the current approach to the management of IgAN and highlight the ongoing clinical trials.

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Introduction: Recent data suggest comparable diagnostic performance of cardiac specific troponin (cTn) in chronic kidney disease (CKD) compared to those without CKD, including when shorter time interval between tests is considered for high sensitivity (hs) assays. Objective: We performed a descriptive analysis of the adherence to recommended testing frequency across CKD stages in a large nationally representative dataset from the US Veterans Health Administration (VHA). Methods: The Loma Linda VA IRB approved the study under expedited review. Unique admissions for non-ST elevation myocardial infarction (NSTEMI) between 1999 and 2022in the VHA system with available cTn lab values (n=104, 390) were evaluated. ANOVA was utilized to compare time between first and second cTn values across CKD groups. After 2012, criteria for cTn interval reduced from 6-9 hours to 3-6 hours for hs-cTn. Criteria were considered met if time interval between cTn checks was &lt; 9 hours before 2012, &lt; 6 h after 2012. All analyses performed using R statistical software. Results: Troponin I was the assay utilized in 80% of the sample; high-sensitivity (hs) assays made up the minority (&lt;1%) and were primarily used after 2012. Average time interval between first and second cTn checks (across all assays over entire observation period) was 8.1, 8.4, 8.5, 9.3, 9.6, 7.9, 8.1 hours for CKD G1, G2, G3a, G3b, G4, G5, ESKD, respectively (p = 0.001, for trend) (Figure). When cardiac catheterization is performed, cTn criteria met was associated with shorter time to cardiac catheterization (48.5h vs. 52.4h, p < 0.001), irrespective of baseline CKD stage. Conclusions: Consistent application of guideline supported practices in NSTEMI care was noted across CKD stages in VHA hospitals, associated with timely diagnostic measures.

hepatology research in each year, its open access status and countries and journals the research is published in. METHODS: We used Web of Science database to search for articles and reviews published in the field of gastroenterology and hepatology in the years from January 1 st , 2000 to December 31 st , 2018. Among the variables we assessed, yearly trend, open access publications, countries, journals, and top cited articles. RESULTS: A total of 203,438 publications were retrieved by our search, of which 66,164 (32.5%) were open access publications. The yearly trend in total publication output showed a steady increase till 2015, followed by a steady decline. For country analyses, Japan has emerged to be the 2 nd highest country with research output in gastroenterology and hepatology. World Journal of gastroenterology remained to be the highest publishing journal in this field. CONCLUSION: The gastroenterology and hepatology field is rapidly expanding during the last two decades. This study provided an overall assessment of this field, taking the advantage of the advanced field indexing service by Web of Science database.

Background:: The recent report of The World Health Organization on diabetes has stressed on the burden of diabetes on low/middle income countries. Recent studies advocated the importance of funding more research on diabetes and insulin in these countries. Recently, the European Research Council advocated the importance of gold Open Access (OA) publishing, where the funded research should be immediately accessible. In this study, we aim to assess funding for insulin research, where we will compare the OA status between funded and unfunded research. Methods:: We used Scopus database to assess insulin research published from January 1st, 1999 to December 31st, 2018. Our bibliometric analysis consisted of three main sections: analysis of all publications on insulin, analysis of funded insulin publications, and analysis of unfunded insulin publications. Results:: We found a total of 388,202 publications, of which only 83,180 (21.4%) were funded. USA produced around 30.1% of the total publications, and the National Institute of Health (NIH) was the major funder with 18.6% of all publications. Of the funded publications, 29,143 (35%) were OA publications, compared to 97,347 (31.9%) of the unfunded publications. We didn’t find a significant difference in OA status between funded and unfunded research. Conclusion:: In concordance with the European Research Council’s decision to support gold OA publishing model, we found that only 35% of the funded and 31.9% of the unfunded insulin research were OA. Although the funded research is increasing in China, most of it is produced in high income countries. This highlights the importance of allocating more funds to low/middle income countries.