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There is increasing evidence that early liver transplantation (eLT), performed within standardized protocols can improve survival in severe alcoholic hepatitis (sAH). The aim of the study was to assess outcomes after eLT for sAH in four Italian LT centers and to compare them with non-responders to medical therapy excluded from eLT. Patients admitted for sAH (2013–2019), according to NIAAA criteria, were included. Patients not responding to medical therapy were placed on the waiting list for eLT after a strict selection. Histological features of explanted livers were evaluated. Posttransplant survival and alcohol relapse were evaluated. Ninety-three patients with severe AH were evaluated (65.6% male, median [IQR] age: 47 [42–56] years). Forty-five of 93 patients received corticosteroids, 52 of 93 were non-responders and among these, 20 patients were waitlisted. Sixteen patients underwent LT. Overall, 6-, 12-, and 24-month survival rates were 100% significantly higher compared with non-responders to medical therapy who were denied LT (45%, 45%, and 36%; p&nbsp

Acute kidney injury (AKI) commonly occurs in patients with decompensated cirrhosis. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) could help discriminate between different etiologies of AKI. The aim of this study was to investigate the use of uNGAL in (1) the differential diagnosis of AKI, (2) predicting the response to terlipressin and albumin in patients with hepatorenal syndrome-AKI (HRS-AKI), and (3) predicting in-hospital mortality in patients with AKI.One hundred sixty-two consecutive patients with cirrhosis and AKI were included from 2015 to 2020 and followed until transplant, death, or 90 days. Standard urinary markers and uNGAL were measured. Data on treatment, type, and resolution of AKI were collected. Thirty-five patients (21.6%) had prerenal AKI, 64 (39.5%) HRS-AKI, 27 (16.7%) acute tubular necrosis-AKI (ATN-AKI), and 36 (22.2%) a mixed form of AKI. Mean values of uNGAL were significantly higher in ATN-AKI than in other types of AKI (1162 ng/ml [95% CI 423-2105 ng/ml] vs. 109 ng/ml [95% CI 52-192 ng/ml]; p 0.001). uNGAL showed a high discrimination ability in predicting ATN-AKI (area under the receiver operating characteristic curve, 0.854; 95% CI 0.767-0.941; p 0.001). The best-performing threshold was found to be 220 ng/ml (sensitivity, 89%; specificity, 78%). The same threshold was independently associated with a higher risk of nonresponse (adjusted OR [aOR], 6.17; 95% CI 1.41-27.03; p = 0.016). In multivariable analysis (adjusted for age, Model for End-Stage Liver Disease, acute-on-chronic liver failure, leukocytes, and type of AKI), uNGAL was an independent predictor of in-hospital mortality (aOR, 1.74; 95% CI 1.26-2.38; p = 0.001).uNGAL is an adequate biomarker for making a differential diagnosis of AKI in cirrhosis and predicting the response to terlipressin and albumin in patients with HRS-AKI. In addition, it is an independent predictor of in-hospital mortality.

There is growing evidence that liver transplantation (LT) is the most effective treatment for acute-on-chronic liver failure grade-3 (ACLF-3). This study examines whether and how this evidence translates into practice by analyzing the variability in intensive care unit (ICU) admissions, listing strategies, and LT activity for patients with ACLF-3 across transplantation centers in Europe. Consecutive patients who were admitted to the ICU with ACLF-3, whether or not they were listed and/or transplanted with ACLF-3, between 2018 and 2019 were included across 20 transplantation centers. A total of 351 patients with ACLF-3 were included: 33 had been listed prior to developing ACLF-3 and 318 had not been listed at the time of admission to the ICU. There was no correlation between the number of unlisted patients with ACLF-3 admitted to the ICU and the number listed or transplanted while in ACLF-3 across centers. By contrast, there was a correlation between the number of patients listed and the number transplanted while in ACLF-3. About 21% of patients who were listed while in ACLF-3 died on the waiting list or were delisted. The percentage of LT for patients with ACLF-3 varied from 0% to 29% for those transplanted with decompensated cirrhosis across centers (average = 8%), with an I(2) index of 68% (95% confidence interval, 49%-80%), showing substantial heterogeneity among centers. The 1-year survival for all patients with ACLF-3 was significantly higher in centers that listed and transplanted more patients with ACLF-3 (>10 patients) than in centers that listed and transplanted fewer: 36% versus 20%, respectively (p = 0.012). Patients with ACLF-3 face inequity of access to LT across Europe. Waitlisting strategies for patients with ACLF-3 influence their access to LT and, ultimately, their survival.

Background and Aims Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) improves survival in patients with cirrhosis with refractory ascites and portal hypertensive bleeding. However, the indication for TIPS in older adult patients (greater than or equal to 70 years) is debated, and a specific prediction model developed in this particular setting is lacking. The aim of this study was to develop and validate a multivariable model for an accurate prediction of mortality in older adults. Approach and Results We prospectively enrolled 411 consecutive patients observed at four referral centers with de novo TIPS implantation for refractory ascites or secondary prophylaxis of variceal bleeding (derivation cohort) and an external cohort of 415 patients with similar indications for TIPS (validation cohort). Older adult patients in the two cohorts were 99 and 76, respectively. A cause-specific Cox competing risks model was used to predict liver-related mortality, with orthotopic liver transplant and death for extrahepatic causes as competing events. Age, alcoholic etiology, creatinine levels, and international normalized ratio in the overall cohort, and creatinine and sodium levels in older adults were independent risk factors for liver-related death by multivariable analysis. Conclusions After TIPS implantation, mortality is increased by aging, but TIPS placement should not be precluded in patients older than 70 years. In older adults, creatinine and sodium levels are useful predictors for decision making. Further efforts to update the prediction model with larger sample size are warranted.

Non-alcoholic fatty liver disease (NAFLD) is currently the fastest growing indication to liver transplantation (LT) in Western Countries, both for end stage liver disease and hepatocellular carcinoma. NAFLD/non-alcoholic steatohepatitis (NASH) is often expression of a systemic metabolic syndrome; therefore, NAFLD/NASH patients require a multidisciplinary approach for a proper pre-surgical evaluation, which is important to achieve a post-transplant outcome comparable to that of other indications to LT. NAFLD/NASH patients are also at higher risk of post-transplant cardiovascular events, diabetes, dyslipidemia, obesity, renal impairment and recurrent NASH. Lifestyle modifications, included diet and physical activity, are key to improve survival and quality of life after transplantation. A tailored immunosuppressive regimen may be proposed in selected patients. Development of new drugs for the treatment of recurrent NASH is awaited.

Mosquitoes are the major vectors of diseases such as malaria, dengue, filariasis e.t.c which led to the thousands of death yearly. World Health Organisation (WHO, 2005). In Nigeria, the repellent activity of ointments formulated with Occimum gratissimum oil has been reported against Ae. aegypti and Culex quinquefasiatus mosquito (Esimone et al., 2011). Mechanical aspirator will be use to catch the blood fed female Culex mosquito and it will be introduced into a mosquito rearing cage containing a transparent rubber filled with a distilled water for egg laying. Mouse pellet will be use to feed the Larvae i.e L1, L2 and L3.Two set ups both for Smoke and scent will be set with a control experiment in each. Analysis of variance will be to compare between the two set ups for the efficacy of Occimum gratissimum

The collection of nodes is termed as community in any network system that are tightly associated to the other nodes. In network investigation, identifying the community structure is crucial task, particularly for exposing connections between certain nodes. For community overlapping, network discovery, there are numerous methodologies described in the literature. Numerous scholars have recently focused on network embedding and feature learning techniques for node clustering. These techniques translate the network into a representation space with fewer dimensions. In this paper, a deep neural network-based model for learning graph representation and stacked auto-encoders are given a nonlinear embedding of the original graph to learn the model. In order to extract overlapping communities, an AEOCDSN algorithm is used. The efficiency of the suggested model is examined through experiments on real-world datasets of various sizes and accepted standards. The method outperforms various well-known community detection techniques, according to empirical findings.

Using an Intelligent Intrusion Detection System (IIDS) instead of less effective firewalls and other intrusion detection systems can increase network security. The system's overall effectiveness is determined by the accuracy and speed of IIDS' categorization and training algorithms. According to research, Stabbing Intrusion Using Learning Framework (SILF) is an innovative and intelligent method of learning attack features and lowering dimensionality. To improve Enhanced Long Short-Term Memory (ELSTM) prediction accuracy while minimising testing and training time, an auto-encoder approach, which is an efficient learning methodology for feature generation in an unsupervised way is applied. Initial training samples are fed into the classifier to increase the predictability of incursion and classification accuracy. Thus, model efficacy may be achieved linearly while alternative classifier approaches such as conventional SVM, Random Forest (RF), and Naive Bayesian (NB) are investigated and compared. In this research, an efficient Intelligent Intrusion Detection System using Auto Encoder with Enhanced LSTM (IIDS-AE-ELSTM) is proposed for feature dimensionality reduction. Testing and training have shown that the proposed model is more efficient than existing systems in terms of performance measures such as accuracy, precision, recall, and F-measure. A new method to intrusion detection is presented, which increases detection of network intrusions with dimensionality reduction. The Python environment is used in the proposed model to create an efficient dimensionality reduction model for intrusion detection.

Peer reviewed: True, Funder: NIHR, (1) Background: Iron deficiency (ID) is an important adverse prognostic marker in patients with heart failure (HF); however, it is unclear whether intravenous iron replacement reduces cardiovascular mortality in this patient group. Here, we estimate the effect of intravenous iron replacement therapy on hard clinical outcomes following the publication of IRONMAN, the largest trial in this field. (2) Methods: In this systematic review and meta-analysis, prospectively registered with PROSPERO and reported according to PRISMA guidelines, we searched PubMed and Embase for randomized controlled trials investigating intravenous iron replacement in patients with HF and co-existing ID. The primary outcome was cardiovascular mortality and secondary outcomes were all-cause mortality, hospitalizations for HF and a combination of the primary outcome and hospitalizations for HF. (3) Results: A total of 1671 items were identified and after removal of duplicates we screened titles and abstracts of 1202 records. Some 31 studies were identified for full-text review and 12 studies were included in the final review. The odds ratio (OR) for cardiovascular death using a random effects model was 0.85 (95% CI 0.69 to 1.04) and for all-cause mortality it was 0.83 (95% CI 0.59 to 1.15). There was a significant reduction in hospitalizations for HF (OR 0.49, 95% CI 0.35 to 0.69) and the combination of hospitalizations for HF and cardiovascular death (OR 0.65, 95% CI 0.5 to 0.85). (4) Conclusions: This review supports the use of IV iron replacement reducing hospitalization rates for HF, however more research is required to determine the effect on cardiovascular mortality and to identify the patient population most likely to benefit.

This study explores how the evolutionary changes in urban administrative status from lowest (Town) to highest (City) ranks resulted in the Re-Emergence of Un – Ecological Quarantined Rural Satellite Towns and Rural Operations in Dodoma Tanzanian National Capital City. Under such circumstances, Un – ecological Rural operations and urbanisms become more prevalent in 28 newly emerged Quarantined Rural Satellite Towns in the City locality which enhances the disappearance and reappearance of Un - Ecological urban environment and land use land cover changes, land degradation in the City locality. The empirical evidence for this study was drawn from interviewing 443 respondents in 13 wards and 53 sub wards and through analyzing Landsat satellite images of 1998, 2008, 2018 and 2022 years by GIS. The study findings revealed that Local people are not relocated out of the city but instead urbanite at a rural scale into the City locality. Objectively, Un -Ecological Rural Operations in 28 Rural Satellite Towns in Dodoma City localities have contributed more to the Urban Ecological Environment degradation to a point that built-up land in the period of 24 years from 1998 to 2022 increased by 2221 ha, bare land by 15,737 ha and vegetation declined by 17,958 ha. If Dodoma City persists in the same way up to 2030 without Green Building Concepts and Design, New Urbanism and Ecological Modernization theories interventions it will lose the potential of being a resilient and habitable City. Sustainable development principles are recommended to be utilized in all the major development projects to be carried out in the city advert the situation.

Aim/Purpose: This study was conducted to identify the marketing challenges faced by Zanzibar’s seaweed producers and to recommend suitable strategies. Methodology: A case study approach was adopted. The study combined semi-structured questionnaires and informal group discussions with the farmers as tools for primary data collection. A total of 592 seaweed farmers from both Unguja and Pemba participated in the study. The farmers were selected through multistage sampling. Analysis of challenges was done through the Garrett ranking method. Results: It was found that the leading marketing challenges for seaweed farmers are the absence of minimum selling price (MSP), limited buyers and the inability to set prices. The absence of MSP was linked to the absence of the industry’s supporting policies. At the same time, limited buyers emanated from the lack of the industry’s business strategy, limited linkage to the domestic market and lack of export differentiation. Farmers’ inability to set prices was found to be a result of exporters’ setting buying prices. Similarly, the study found that the farmers face intense competition due to limited production variety and being large in number. Farmers also were found to have limited marketing and promotional skills and lacked business strategies. Conclusion: Several interventions are required to support the seaweed farmers in Zanzibar. First, the creation of guiding industry’s business and marketing/product strategies. Further creation of the industry’s guiding and supporting policies is crucial. Second, establishing domestic demand and linking the industry to its potential users at individual and industrial levels is critical for the survival of Zanzibar’s seaweed industry. Third, the establishment of carrageenan extraction industries to establish export product differentiation. Capacity-building training is vital for farmers in agri-business and financial management areas. Government procurement and provision of storage facilities to minimise the offloading challenge are also needed to lessen the effect of same-time offloading, which exposes farmers to low prices. Lastly, financial assistance should also be provided to promote and upscale seaweed value-addition activities on the island. Originality/Value: Examination of marketing challenges faced by seaweed farmers in Zanzibar was conducted using the Garrett ranking technique, and suitable recommendations were proposed.

Aim: This study intended to analyse the Zanzibar seaweed industry’s (ZSI) profitability potential by adopting Porter’s five forces industry analysis framework. The objective was to identify factors in its structure contributing to the industry’s ongoing primary challenge of low returns. Methodology: The study was conducted on Zanzibar island in the United Republic of Tanzania. A case study design approach was adopted. The study’s sample consisted of seaweed farmers, exporters and officials from government institutions linked to the industry. Seaweed farmers were selected through multistage and quota sampling. Exporters were chosen based on experience, i.e. at least five years of operations and above. Government officials were selected through purposive and convenience sampling. The study utilised both primary and secondary data. A triangulation approach was adopted for data collection. Data analysis was done through thematic analysis, descriptive statistics and literature review. Results were adapted into Porter’s framework for further analysis. The threat level for each Porter’s force was determined by weighing their corresponding driving factors, and respondents rated the final results based on the perceived threat level. Results: The study found that the Zanzibar seaweed industry has low profitability potential. Threats emanate from the industry’s lack of entry barriers, several available cheap and high-performing substitutes, low switching costs and high bargaining power of buyers and suppliers. The government’s role in promoting the industry’s activities is almost non-existent. Similarly, the industry’s production methods were found to be still traditional. Innovative activities were found to be minimal. In terms of opportunities, the industry remains a viable economic alternative for the rural Zanzibarians due to its low capital entry requirements and short production cycles. The potential for increased income and improved health and nutrition exists if domestic markets are established. The growing global demand for carrageenan also signals the industry’s revenue and income growth potential. Similarly, the ZSI is also a source of economic gender empowerment for rural Zanzibari women. Conclusion: Zanzibar’s seaweed industry’s low profitability potential is a result of its structure, production system and the absent role of the Revolutionary Government of Zanzibar (RGoZ). Due to the unique nature of ZSI challenges, Porter’s generic strategies were found unsuitable. Hence, this study recommends creating a guiding industry business strategy and marketing plan to guide its activities. The industry’s customer base should also be diversified to expand buyer options and minimise risks associated with the global Rhodotypa market’s oligopolistic conditions. The creation of domestic and regional demand is also crucial. The Revolutionary Government of Zanzibar should also step in to give the necessary support, primarily through creating industry policy. Additionally, diversification of ZSI export products through establishing carrageenan extraction industries in Zanzibar is vital.

Transportation of drug through parental routes are conventionally followed through hypodermic injection methods, where hypodermic injections are administered into the human skin for drug release. However, there are some issues observed when these hypodermic needles are being used, there are instances where the needle is being inserted leaves some needle fractures in the skin. To cater to the issue scientific researchers are voraciously working on designing and developing polymeric type of microneedle structures for various medical diagnostic applications for glucose monitoring, drug delivery, and other applications. This article presents the structural design of a conicalshaped polymeric microneedle and the insertion force while being pierced into the skin. Simulations at different insertion angles on microneedle are analyzed by arriving with total needle displacements in the process of insertion. The von mises stress is also analyzed with applied force at different insertion angles resulted in incremental change in stress exerted by the microneedle. The resultant stress is below the yield stress which makes the microneedle pierce into the skin without breakage.

The purpose of the paper is to examine if gender is playing any role in the personality development of a child studying in a vernacular medium school. The authors collected the data from children studying in 6th, 7th and 8th classes at 10 vernacular medium i.e., Gujarati medium schools in Gandhinagar district of Gujarat. From each class, 20 students i.e., 60 students per school were randomly requested to fill in the core-self evaluation questionnaire. A total of 600 responses were collected. The impact of gender on personality development was tested using ANOVA (Analysis of variance). The findings show that gender differences do not exist in terms of personality development among school children studying in vernacular medium. The findings of this paper are in complete consonance with the numerous studies highlighting the little or no gender differences in personality development in children.

Background & Aims: Two recently developed composite models, the alpha-fetoprotein (AFP) score and Metroticket 2.0, could be used to select patients with hepatocellular carcinoma (HCC) who are candidates for liver transplantation (LT). The aim of this study was to compare the predictive performance of both models and to evaluate the net risk reclassification of post-LT recurrence between them using each model's original thresholds. Methods: This multicenter cohort study included 2,444 adult patients who underwent LT for HCC in 47 centers from Europe and Latin America. A competing risk regression analysis estimating sub-distribution hazard ratios (SHRs) and 95% CIs for recurrence was used (Fine and Gray method). Harrell's adapted c-statistics were estimated. The net reclassification index for recurrence was compared based on each model's original thresholds. Results: During a median follow-up of 3.8 years, there were 310 recurrences and 496 competing events (20.3%). Both models predicted recurrence, HCC survival and survival better than Milan criteria (p

Background: Management of infections due to carbapenemase-resistant Enterobacterales (CRE) in solid organ transplant (SOT) recipients remains a difficult challenge. The INCREMENT-SOT-CPE score has been specifically developed from SOT recipients to stratify mortality risk, but an external validation is lacking.Methods: Multicenter retrospective cohort study of liver transplant (LT) recipients colonized with CRE infection who developed infection after transplant over 7-year period. Primary endpoint was all-cause 30-day mortality from infection onset. A comparison between INCREMENT-SOT-CPE and other selected scores was performed. A two-level mixed effects logistic regression model with random effects for the center was fitted. Performance characteristics at optimal cut-point were calculated. Multivariable Cox regression analysis of risk factors for all-cause 30-day mortality was carried out.Results: Overall, 250 CRE carriers developed infection after LT and were analyzed. The median age was 55 years (interquartile range [IQR]: 46-62) and 157 were males (62.8%). All-cause 30-day mortality was 35.6%. A sequential organ failure assessment (SOFA) score >= 11 showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 69.7%, 76.4%, 62.0%, 82.0%, and 74.0%, respectively. An INCREMENT-SOT-CPE >= 11 reported a sensitivity, specificity, PPV, NPV, and accuracy of 73.0%, 62.1%, 51.6%, 80.6% and 66.0%, respectively. At multivariable analysis acute renal failure, prolonged mechanical ventilation, INCREMENT-SOT-CPE score >= 11 and SOFA score >= 11 were independently associated with all-cause 30-day mortality, while a tigecycline-based targeted regimen was found to be protective.Conclusions: Both INCREMENT-SOT-CPE >= 11 and SOFA >= 11 were identified as strong predictors of all-cause 30-day mortality in a large cohort of CRE carriers developing infection after LT.

Attachment theory suggests that interindividual differences in attachment security versus insecurity (anxiety and avoidance) contribute to the ways in which people perceive social emotional signals, particularly from the human face. Among different facial features, eye gaze conveys crucial information for social interaction, with a straight gaze triggering different cognitive and emotional processes as compared to an averted gaze. It remains unknown, however, how interindividual differences in attachment associate with early face encoding in the context of a straight versus averted gaze. Using electroencephalography (EEG) and recording event-related potentials (ERPs), specifically the N170 component, the present study (

Sarcopenia, defined as progressive and generalized loss of muscle mass and strength, is common in chronic liver disease. It significantly impacts the quality of life and increases the risk of liver-related complications and mortality in cirrhotic patients. Moreover, recent studies showed a negative impact of sarcopenia on patients awaiting liver transplantation (LT), on post-LT outcomes, and on response to hepatocellular carcinoma therapies. Data about the influence of sex on the incidence, prevalence, diagnosis and treatment of sarcopenia in chronic liver diseases are poor and conflicting. The aims of this review of the literature are to define sex differences in sarcopenic cirrhotic patients and to highlight the necessity of a sex stratified analysis in future studies. This analysis of the literature showed that most of the studies are retrospective, with a higher prevalence of sarcopenia in males, probably due to anatomical differences between the sexes. Moreover, diagnostic criteria for sarcopenia are different between studies, as there is not a defined cut-off and, as a consequence, no comparable results. In conclusion, sex seems to have an impact on sarcopenia, and future studies must accurately investigate its role in identifying and treating high-risk patients, reducing the negative impact of sarcopenia on the survival and quality of life of cirrhotic patients.

Alternative splicing shapes the transcriptome and contributes to each cell's unique identity, but single-cell RNA sequencing (scRNA-seq) has struggled to capture the impact of alternative splicing. We previously showed that low recovery of mRNAs from single cells led to erroneous conclusions about the cell-to-cell variability of alternative splicing. Here, we present a method, Psix, to confidently identify splicing that changes across a landscape of single cells, using a probabilistic model that is robust against the data limitations of scRNA-seq. Its autocorrelation-inspired approach finds patterns of alternative splicing that correspond to patterns of cell identity, such as cell type or developmental stage, without the need for explicit cell clustering, labeling, or trajectory inference. Applying Psix to data that follow the trajectory of mouse brain development, we identify exons whose alternative splicing patterns cluster into modules of coregulation. We show that the exons in these modules are enriched for binding by distinct neuronal splicing factors and that their changes in splicing correspond to changes in expression of these splicing factors. Thus, Psix reveals cell type–dependent splicing patterns and the wiring of the splicing regulatory networks that control them. Our new method will enable scRNA-seq analysis to go beyond transcription to understand the roles of post-transcriptional regulation in determining cell identity.

This study set out to examine the role of different adversities experienced at different life course stages on cognitive aging (i.e., level and change). Data from the longitudinal study: Survey of Health, Ageing, and Retirement in Europe (SHARE) with the selection of participants over 60 years were used (N = 2662, Mdnage = 68, SDage = 5.39) in a Structural Equation Modeling. In early life, the experience of hunger predicted lower delayed recall (β = − 0.10, p p = 0.001) performance in older age, whereas financial hardship predicted lower verbal fluency (β = − 0.06, p = 0.005) performance and steeper decline in delayed recall (β = − 0.11, p p = 0.001; stress: β = 0.07, p = 0.003) and verbal fluency performance (financial hardship: β = 0.08, p = 0.001; stress β = 0.10, p p = 0.048). This study highlights the importance of disentangling the period effect from the specific effect of the adversity experienced in the association between adversity and cognition in older age. Moreover, differential results for delayed recall and verbal fluency measures suggest that it is also important to consider the cognitive outcome domains examined.

IntroductionHepatic encephalopathy (HE) affects the survival and quality of life of patients with cirrhosis. However, longitudinal data on the clinical course after hospitalization for HE are lacking. The aim was to estimate mortality and risk for hospital readmission of cirrhotic patients hospitalized for HE.MethodsWe prospectively enrolled 112 consecutive cirrhotic patients hospitalized for HE (HE group) at 25 Italian referral centers. A cohort of 256 patients hospitalized for decompensated cirrhosis without HE served as controls (no HE group). After hospitalization for HE, patients were followed-up for 12 months until death or liver transplant (LT).ResultsDuring follow-up, 34 patients (30.4%) died and 15 patients (13.4%) underwent LT in the HE group, while 60 patients (23.4%) died and 50 patients (19.5%) underwent LT in the no HE group. In the whole cohort, age (HR 1.03, 95% CI 1.01–1.06), HE (HR 1.67, 95% CI 1.08–2.56), ascites (HR 2.56, 95% CI 1.55–4.23), and sodium levels (HR 0.94, 95% CI 0.90–0.99) were significant risk factors for mortality. In the HE group, ascites (HR 5.07, 95% CI 1.39–18.49) and BMI (HR 0.86, 95% CI 0.75–0.98) were risk factors for mortality, and HE recurrence was the first cause of hospital readmission.ConclusionIn patients hospitalized for decompensated cirrhosis, HE is an independent risk factor for mortality and the most common cause of hospital readmission compared with other decompensation events. Patients hospitalized for HE should be evaluated as candidates for LT.

Healthy soil is critical to the growth of nutritious food and to farmers’ livelihoods. However, one-third of global soil is already affected by moderate to severe degradation by diverse processes. The reduction of soil degradation is one of the most important policy objectives, but policymakers and local planners require guidance in choosing the most effective interventions, both scientifically and economically, to reduce soil degradation. The complex interconnections between agriculture, the natural environment, and social well-being increase the need of researchers to access and use comprehensive soil data sets. Our ability to manage and support soil depends on the data we collect and the information and knowledge that we generate from them. Nevertheless, soil data accessibility and sharing are currently low and represent one of the major barriers to making better decisions in agriculture. A critical first step to capitalize on the opportunities offered by agriculture science and technologies is thus the standardization, organization, and the making of the multitude of specialty datasets generated by studies and projects publicly available to the global community. To address this challenge, Varda is creating an interactive soil digital platform that allows surfacing and comparing existing soil data across the globe in order to facilitate soil data sharing and interoperability. Moreover, the platform highlights soil data gaps across regions through a soil data gap index, and particularly soil health data gap through another ad hoc index developed by Varda and Aberdeen University. Such indexes will allow multilateral organizations, governments, and agribusiness stakeholders to fill some of these data gaps through ad-hoc soil sampling and data collection campaigns.

This study explores how the evolutionary changes in Dodoma's urban administrative status from lowest to highest ranks in Tanzania have resulted in the emergence of Un - ecological urban land use and land cover changes, urban land degradation, and un-ecological urban villages in the locality of the newly established Dodoma National Capital City. The empirical evidence for this study has been drawn from interviewing 443 respondents in 17 wards and 56 sub-wards and through analysing Landsat satellite images of 1998, 2008, 2018 and 2022 years by semi-automatic classification plug-in (SCP) in Quantum Geographical information system (QGIS) software (version 3.12.3). The findings of this study revealed that built-up land hectares have increased by 60%, bare land hectares decreased by 23%, vegetation hectares decreased by 13%, and water hectares decreased by 1% between 1998 and 2022. If Dodoma City persists in the same way up to 2030 without green building concepts and design, New urbanism and ecological modernization theories interventions it will lose the potential of being a resilient and liveable National Capital City. Sustainable development principles are recommended to be utilized in all the major development projects to be carried out in the city advert the situation.

The fate of sulfur and conversion of metals during the co-gasification of municipal solid waste (MSW) and gypsum is examined here using aspen plus combined with Thermo-Calc for the process model development. The effect of air ratio, temperature, and MSW-to-gypsum feed mass ratio on the syngas evolution, sulfur transformation, and mineral speciation behavior is investigated. The results showed prevention of gypsum sulfur transformation to sulfur dioxide at temperatures below 1050 °C, air ratio < 0.4, and MSW-to-CaSO4 feed mass ratio < 33 wt%. Approximately 90 wt% of feed was transformed into gas products comprising 22% CO and 19% H2. At approximately 900 °C, major minerals formed were CaS (alabandite), melilite, anorthite, rankinite, nepheline, and wollastonite. Melilite, a calcium silicate of aluminum and magnesium, dominated over all other silicates. At temperatures >1000 °C, these minerals transformed into a more stable calcium orthosilicate (CaSiO4) and molten oxysulfide. At temperatures higher than 1200 °C, all metals in MSW were transformed into molten oxides. The results show that syngas and minerals can be recovered during the co-gasification of MSW and gypsum to directly reveal the synergetic benefits of co-processing MSW and gypsum low-value waste materials.

BackgroundThe COVID-19 pandemic is the deadliest threat to humankind caused by the SARS-COV-2 virus in recent times. The gold standard for its detection, quantitative Real-Time Polymerase Chain Reaction (qRT-PCR), has several limitations regarding experimental handling, expense, and time. While the hematochemical values of routine blood tests have been reported as a faster and cheaper alternative, the external validity of the model on a diverse population has yet to be thoroughly investigated. Here we studied the external validity of machine learning-based prediction scores from hematological parameters recorded in Brazil, Italy, and Western Europe.Methods and FindingsThe publicly available hematological records (raw sample size (n) = 195554) from hospitals of three different territories, Brazil, Italy, and Western Europe, were preprocessed to develop the training, testing, and prediction cohorts for ML models. A total of eight (sub)datasets were trained on seven different ML classifiers. The XGBoost classifier performed consistently better on all the datasets producing eight different models. The working models include a set of either four or fourteen hematological parameters. The internal performances of the XGBoost models (AUC scores range from 84% to 97%) were superior to the ML models reported in the literature for a few datasets (AUC scores range from 84% to 87%). The external performance (AUC score) was 86% when the model was trained and tested on fourteen hematological parameters obtained from the same country (Brazil) but on independent datasets. However, the external performances were reduced when tested across the populations; 69% when trained on datasets from Italy (n=1736) and tested on datasets from Brazil (n=602)) and 65%, when trained on datasets from Italy and tested on datasets from Western Europe (n=1587)) respectively.ConclusionFor the first time, this report showed that the models trained and tested on the same population but on separate records produced reasonably accurate results. The study promises the confidence of these models trained and tested within the same populations and has the potential application to extend those to other demographic locations. Both four- and fourteen-parameter models are publicly available;https://covipred.bits-hyderabad.ac.in/homeAuthor SummaryCOVID-19 has posed the deadliest threat to the human population in the 21stcentury. Timely detection of the disease could save more lives. The RT-PCR test is considered the gold standard for COVID-19 detection. However, there are several limitations of the technique that suggests developing an alternate detection protocol that would be efficient, fast, and cheap. Among several other alternate detection techniques, hematology based Machine-Learning (ML) prediction is one. All the hematology-based predictions reported so far in the literature were only internally validated. Considering the need to develop an alternate protocol for rapid, near-accurate, and cheaper COVID-19 detection techniques, we aim to externally validate the hematology-based ML prediction. Here external validation indicates use of two independent datasets for model training and testing, in contrast to internal validation where the same dataset splits into train and test sets. We have integrated published clinical records from Brazil, Italy, and West Europe hospitals. Internal ML model performances are superior compared to those reported in literature. The external model performances were equivalent to the internal performances when trained and tested on the same population. However, the external performances were inferior when train and test sets were from different populations. The results promise the utility of these models on the same populations. However, it also warns to train the model on one population and test it on another. The outcome of this work has the potential for an initial screen of COVID-19 based on hematological parameters before qRT-PCR tests.

The co-thermal chemical conversion of biomass and waste tires is an important direction for the utilization of waste resources to produce renewable energy. In this study, the product distribution and synergistic effects during the co-pyrolysis of agricultural residues and waste tire were analyzed by a pyrolyzer coupled with a gas chromatograph/mass spectrometer (Py-GC/MS). Pyrolysis and co-pyrolysis products were analyzed at 550 °C and 650 °C for maize stalk (MS), wheat straw (WS), waste tire (WT) feedstocks, as well as mixtures of wheat straw-waste tire (WS:WT mass ratio of 1:1), and maize stalk-waste tire (MS:WT mass ratio of 1:1). The results showed that the co-pyrolysis of agricultural residues and waste tire promoted the release of phenols, aldehydes, and ketone derivatives, and reduced the formation of H2 and H2O. In addition, a relatively high content of aromatic hydrocarbons was obtained at 650 °C temperature, while 550 °C was optimal when considering the formation of ketones. The results showed a synergistic effect in the co-pyrolysis of biomass and waste tire.