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HIV-1 envelope glycoprotein (Env) interacts with cellular receptors and mediates virus entry into target cells. Blocking Env-receptor interactions represents an effective interventional strategy for developing HIV-1 entry inhibitors. We previously designed a panel of CD4-linker-DC-SIGN (CLD) constructs by fusing the extracellular CD4 and DC-SIGN domains with various linkers. Such CLDs produced by the prokaryotic system efficiently inhibited HIV-1 infection and dissemination in vitro and ex vivo. In this study, following the construction and identification of the most promising candidate with a linker of 8 Gly4Ser repeats (named CLD), we further designed an improved form (named CLDmut) by back mutating Cys to Ser at amino acid 60 of CD4. Both CLD and CLDmut were produced in mammalian (293F) cells for better protein translation and modification. The anti-HIV-1 activity of CLD and CLDmut was assessed against the infection of a range of HIV-1 isolates, including transmitted and founder (T/F) viruses. While both CLD and CLDmut efficiently neutralized the tested HIV-1 isolates, CLDmut demonstrated much higher neutralizing activity than CLD, with an IC50 up to one log lower. The neutralizing activity of CLDmut was close to or more potent than those of the highly effective HIV-1 broadly neutralizing antibodies (bNAbs) reported to date. Findings in this study indicate that mammalian cell-expressed CLDmut may have the potential to be used as prophylaxis or/and therapeutics against HIV-1 infection.

Cancer immunotherapy has greatly improved the prognosis of tumor-bearing patients. Nevertheless, cancer patients exhibit low response rates to current immunotherapy drugs, such as PD1 and PDL1 antibodies. Cyclic dinucleotide analogs are a promising class of immunotherapeutic agents. In this study, in situ autologous tumor vaccines, composed of bis-2'-F-cG S A S MP phosphonothioate isomers (FGA-di-pS-2 or FGA-di-pS-4) and cytidinyl/cationic lipids (Mix), were constructed. Intravenous and intratumoral injection of FGA-di-pS-2/Mix or FGA-di-pS-4/Mix enhanced the immunogenic cell death of tumor cells in vivo, leading to the exposure and presentation of whole tumor antigens, inhibiting tumor growth in both LLC and EO771 tumor in situ murine models and increasing their survival rates to 50% and 23%, respectively. Furthermore, the tumor-bearing mice after treatment showed potent immune memory efficacy and exhibited 100% protection against tumor rechallenge. Intravenous administration of FGA-di-pS-2/Mix potently promoted DC maturation, M1 macrophage polarization and CD8 + T cell activation and decreased the proportion of Treg cells in the tumor microenvironment. Notably, two doses of ICD-debris (generated by FGA-di-pS-2 or 4/Mix-treated LLC cells) protected 100% of mice from tumor growth. These tumor vaccines showed promising results and may serve as personalized cancer vaccinations in the future., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.)

Background: Vitamin D deficiency and insufficiency have become a common problem worldwide. Vitamin D has been associated with all causes of mortality in chronic diseases which are significantly associated with a longer hospital stay and poor outcome. Objectives: We aimed to investigate the role of empirical vitamin D supplementation in hospitalized patients and its relation to the length of stay and outcome of hospitalization. Study design: Case control study performed on eighty patients admitted to Internal Medicine Department at Ain Shams University Hospital, with acute deterioration of their chronic illness. Two groups of diseases were included, chronic liver diseases (CLD) and congestive heart failure (CHF). Methods: Twenty patients of each group were given vitamin D 200,000 IU IM within 3 days of admission (Intervention group) and 20 patients of each group (control group) did not receive vitamin D. Patients were sampled for their vitamin D, calcium and phosphorus levels on admission prior to intervention. Results: CLD and CHF Intervention groups had a non-significant correlation between vitamin D supplementation with length of hospital stay and mortality in comparison with control groups (P =1.000) (p=0.823) respectively. On the other hand, we found baseline vitamin D deficiency was an independent predictor of mortality (P value .018). Conclusions: Vitamin D deficiency is significantly associated with longer hospital stay and poor outcome of hospital admission. Beneficial effect of empirical vitamin D supplementation can't be achieved with single dose vitamin D (200,000 IU) on CHF and CLD hospitalized patients. [ABSTRACT FROM AUTHOR]

Background: Confronting a once-in-a-century pandemic with COVID-19, tremendous stress has been placed in all walks of life worldwide. Aims: In order to enhance scientific information interflow in the arena of liver diseases in Asia–Pacific region during this difficult time, Asian-Pacific Association for the Study of the Liver (APASL) has taken the initiative to form the APASL COVID-19 Taskforce to formulate a clinical practice guidance in Hepatology, liver-related oncology, transplantation and conduct of clinical trials. Methods: A taskforce with 22 key opinion leaders in Hepatology from 16 countries or administration regions in Asia–Pacific regions was formed and through intense interaction via webinar, this guidance was formulated. Based on scientific data and experiences, recommendations were made in the management of liver injury, liver transplantation, autoimmune diseases, chronic liver diseases, delivery of elective and emergency services and conduct of clinical trials. Conclusions: This is the first consensus clinical guidance synthesized by APASL for our hepatologist and their allied medical personal. [ABSTRACT FROM AUTHOR]

Background: Circulating microRNAs (miRNAs) are endogenous, small (17–25 nucleotides) non-coding RNAs that are overexpressed in many human cancers including hepatocellular carcinoma (HCC). Moreover, circulating miRNAs can reflect the level of tissue miRNAs, so could be potential tumor markers. miRNA-21 regulates post-transcriptional expression of tumor suppressor gene; programed cell death 4 (PDCD4) gene which implies that miRNA-21 might be a novel diagnostic and/or prognostic marker for cancer. Objective: To evaluate the diagnostic and prognostic potential of circulating miRNA-21 and study the expression of PDCD4 gene as a target of miRNA-21 in HCC in Egyptian patients. Subjects and methods: This study was conducted on 30 HCC patients, 20 chronic liver disease (CLD) patients due to HCV infection and 20 healthy subjects. Serum alpha fetoprotein (AFP) was measured for all participants. The relative plasma expression of each of miRNA-21 and PDCD4 gene was determined in whole blood samples using real-time polymerase chain reaction. Results: The results revealed over expression of miRNA-21 and under expression of PDCD4 gene in HCC group (p

The study was carried out to determine the prevalence of H. pylori antibodies in patients with chronic liver disease (CLD), by detecting the presence of stool antigen (HpSA), serum, and salivary anti-H. pylori antibody using ELIZA and compared with Rapid Urease test (gold standard). A one hundred and seventy six endoscopy were carried out for patients with or without chronic liver disease. The result indicated that among 130 patients with (CLD), and 46 patients without CLD, the commonest endoscopy diagnosis by gastric biopsy was gastritis (22.72%), duodenal ulcer (17.61%), and Gastric ulcer (11.93%). The serum antibody positivity was higher (83.0%), followed, HpSA (74.4%), salivary antibody positivity (71.0%) and rapid urease test (RU) positivity (70.6%). In controls salivary antibody and rapid urease test positivity was higher than in CLD patients, while HpSA and serum antibody was higher in CLD patients. On the other hand, it was associated with sex and age. The sensitivity and specificity of HpSA were 94.6% and 91.6%, respectively.

Model Transformation (MT) has led the researchers to concentrate more in the field of software engineering. MT focuses mainly on transforming the input model to the target model to make it easily understandable. For the transformation, using optimal rules among a set of rules makes the design simpler. This paper proposes an algorithm, namely Whale Optimization integrated Adaptive Dragonfly (WOADF) algorithm, which integrates Adaptive Dragonfly (ADF) algorithm and Whale Optimization Algorithm (WOA), for transforming class diagrams (CLDs) to Relational Schema (RS). Further, the UML CLD is transformed into the RS model based on specific rules incorporated by the proposed WOADF algorithm. The fitness function of the proposed model is evaluated to select the optimal rule, by including the test cases to evaluate the optimal blocks. Then, the optimal blocks obtained from the proposed WOADF algorithm are used for achieving the transformation from CLD to the RS model. The effectiveness of the proposed WOADF algorithm is checked with Automatic Correctness (AC) and fitness values and is evaluated to be the best when compared to other existing techniques with maximum AC value measured to be 0.812 and fitness value to be 0.897, respectively. [ABSTRACT FROM AUTHOR]

We analyze a complex techno‐economic project of the Indian Bullet Train system, under construction via the High‐speed Rail lines in India, with an estimated speed of the train in 350 kmph and covering a distance of 500Km, the project is in collaboration with Japan and estimated cost is to be at Rs.1080 Billions. The groundwork for the Bullet Train Project started in December 2017 and the project dead line is set as August 2023 with land acquisition dead line to be completed by December 2018. The land requirement is 1400 Hectares which is divided into 7000 plots in 195 villages in Gujarat and 104 villages in Maharashtra. Despite location of bullet train project being in India's most economically and industrially developed states, the land acquisition got delayed. In this paper, we develop a systemigram to depict the whole problem. Based on the data available, CLD (Causal loop diagram) is created indicating cause and effect relation and feedback loops. On the application of system thinking approach, this study can be further explored for identifying archetypes. It was identified that the land acquisition process is more influenced by the coordination and interaction between policy makers and locals. It can be said that, if these two are on the same page with regards to the various terms and conditions such as conditions of compensation, then land acquisition will be done on time. [ABSTRACT FROM AUTHOR]

Hispanic students participate in advanced programming at a much lower rate than their White peers. Although Advanced Placement (AP) can have a positive impact on future academic success and attainment of long-term goals, limited research has investigated factors that contribute to AP success for gifted Hispanic students. This study examined factors potentially predictive of success on AP exams for gifted Hispanic students. Contrary to prior literature, findings revealed that race/ethnicity was not a factor that significantly affected AP success for these gifted students. In addition, when examining the performance of all the Hispanic AP students, the only factor that significantly contributed to passing an AP exam was identification as gifted. Implications for practice and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Thrombopoietin-receptor agonists (TPO-RAs) are the only American Society of Hematology (ASH) guideline-advocated, second-line treatment for immune thrombocytopenia (ITP) that have been validated by randomized, controlled trials with a placebo comparator. Avatrombopag is a new candidate in this class that has been investigated as a treatment option for the treatment of ITP. Areas covered: In this Drug Profile, we provide a review of the clinical data of avatrombopag, which was approved in May 2018 by the United States Food and Drug Administration (FDA) for the treatment of thrombocytopenia in patients with chronic liver disease undergoing an invasive procedure, and an opinion of its potential place in the current evidence-based ITP treatment landscape. Expert commentary: Avatrombopag induces doubling of platelet counts, increasing them to above 50 X 109/L, and prevents the need for platelet transfusions while minimizing the need for rescue medications. Treatment-emergent adverse events (TEAEs) are comparable to placebo. Oral delivery, a 5-day dosing schedule and good tolerability (<1% discontinuation rate) with no clinically significant hepatoxicity make it a promising entrant as a potential second-line treatment for ITP. Further, data from a phase 3 study in patients with ITP supports its utility in the treatment of patients with ITP. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic liver disease (CLD) have a higher risk of mortality when infected with severe acute respiratory syndrome coronavirus 2. Although the fibrosis-4 (FIB-4) index, aspartate aminotransferase-to-platelet ratio index (APRI), and albumin-bilirubin grade (ALBI) score can predict mortality in CLD, their correlation with the clinical outcomes of CLD patients with coronavirus disease 2019 (COVID-19) is unclear. This study aimed to investigate the association between the liver severity and the mortality in hospitalized patients with non-cirrhotic CLD and COVID-19., Methods: This retrospective study analyzed 231 patients with non-cirrhotic CLD and COVID-19. Clinical characteristics, laboratory data, including liver status indices, and clinical outcomes were assessed to determine the correlation between liver status indices and the mortality among patients with non-cirrhotic CLD and COVID-19., Results: Non-survivors had higher levels of prothrombin time-international normalized ratio (PT-INR), alanine aminotransferase, aspartate aminotransferase, and high-sensitivity C-reactive protein (hs-CRP) and lower albumin levels. Multivariable analysis showed that ALBI grade 3 (odds ratio (OR): 22.80, 95% confidence interval (CI) [1.70-305.38], p = 0.018), FIB-4 index ≥ 3.25 (OR: 10.62, 95% CI [1.12-100.31], p = 0.039), PT-INR (OR: 19.81, 95% CI [1.31-299.49], p = 0.031), hs-CRP (OR: 1.02, 95% CI [1.01-1.02], p = 0.001), albumin level (OR: 0.08, 95% CI [0.02-0.39], p = 0.002), and use of vasopressors (OR: 4.98, 95% CI [1.27-19.46], p = 0.021) were associated with the mortality., Conclusion: The ALBI grade 3 and FIB-4 index ≥ 3.25, higher PT-INR, hsCRP levels and lower albumin levels could be associated with mortality in non-cirrhotic CLD patients with COVID-19. Clinicians could assess the ALBI grade, FIB-4 index, PT-INR, hs-CRP, and albumin levels of patients with non-cirrhotic CLD upon admission., Competing Interests: The authors declare that they have no competing interests., (© 2023 Wu et al.)

Depression is a complex and prevalent mental illness. Cherry leaf is a traditional Chinese herbal medicine, which has confirmed to exert a certain antidepressant effect, but its potential neural regulation mechanism is not clear. This paper aims to investigate the improved action of cherry leaf decoction (CLD) on chronic unpredictable mild stress (CUMS) rats and its potential neural regulation mechanism by verifying the role and function of NMDAR regulatory target α2δ-1 in depression due to CUMS. Male SD rats were subjected to random stressors persisting for 5 weeks to establish the CUMS depression rat model. CLD could effectively alleviate depression-like behaviors of CUMS rats in behavioral tests including sucrose preference test, forced swimming test, tail suspension test and open field test. After the administration of the CLD, the expression of corticotropic-releasing hormone (CRH) in the hypothalamus was inhibited. Moreover, the levels of CRH, adrenal cortical hormone (ACTH) and corticosterone (CORT) in serum also decreased significantly. CUMS upregulated the expressions of α2δ-1, N-methyl- d -aspartate receptor 1 (NR1), NR2A and NR2B, and enhanced the binding ability to of α2δ-1 and NR1, which were reversed by CLD. The results demonstrated that CLD could ameliorate depression-like behaviors due to CUMS, which was related to the fact that CLD down-regulated α2δ-1 level and interfered with α2δ-1 binding to NR1, thereby reducing NMDAR expression and ultimately inhibiting HPA axis activity., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

We present the Chinese Lexical Database (CLD): a large-scale lexical database for simplified Chinese. The CLD provides a wealth of lexical information for 3913 one-character words, 34,233 two-character words, 7143 three-character words, and 3355 four-character words, and is publicly available through http://www.chineselexicaldatabase.com. For each of the 48,644 words in the CLD, we provide a wide range of categorical predictors, as well as an extensive set of frequency measures, complexity measures, neighborhood density measures, orthography-phonology consistency measures, and information-theoretic measures. We evaluate the explanatory power of the lexical variables in the CLD in the context of experimental data through analyses of lexical decision latencies for one-character, two-character, three-character and four-character words, as well as word naming latencies for one-character and two-character words. The results of these analyses are discussed. [ABSTRACT FROM AUTHOR]

Fresh frozen plasma (FFP) is widely used in liver diseases to rectify coagulation derangements. In this study we have analysed the pattern of FFP usage in liver diseases and its effect on International normalized ratio (INR). A retrospective study of liver disease patients who received FFP transfusions from January 2016 to June 2016 was done. FFP used for liver transplant surgeries and plasma exchange procedures were excluded from the study. A total of 1935 units of FFP were transfused to 576 patients. We found a high linear correlation between pre transfusion INR and change in INR per unit of FFP. Patients receiving 6 units or more FFP have shown significant INR improvement. Improvement was more in acute liver failure and acute on chronic liver failure cases compared to chronic liver disease. FFP is not effective in correcting mild to moderate coagulation defects in liver diseases. Large volumes are required to cause significant INR improvement. Considering the risks associated with FFP transfusion, decision of transfusion should be carefully weighed. Future prospective randomized control trails are required for understanding the risk benefit ratio better and formulating plasma transfusion guidelines in liver diseases. [ABSTRACT FROM AUTHOR]

In analysis of variance simultaneous component analysis, permutation testing is the standard way of assessing uncertainty of effect level estimates. This article introduces an analytical solution to the assessment of uncertainty through classical multivariate regression theory. We visualize the uncertainty as ellipsoids, contrasting these to data ellipsoids. This is further extended to multiple testing of effect level differences. Confirmatory and intuitive results are observed when applying the theory to previously published data and simulations. [ABSTRACT FROM AUTHOR]

Anniversaries offer a time for reflection, celebration, validation, and sometimes, simply a candid conversation on the current state of a field. In the field of learning disabilities, anniversaries offer a time to consider how far the field has come and just how far is left to go to understand what a learning disability is. Definitional understanding is foundational for moving forward. This column presents findings from a series of short conversations with past presidents of the Council for Learning Disabilities, individuals who are also leading experts in the field of learning disabilities. Results suggest four different thoughts about the definition of learning disabilities, two main themes regarding areas in which the field needs to focus, and two themes specific to where the field may be headed in the next 20 to 25 years. The column concludes with a discussion of implications for the future. [ABSTRACT FROM AUTHOR]

Background and aims Majority of the individuals with hepatitis C virus (HCV) infection in England are people who inject drugs, a vulnerable and disenfranchised cohort with poor engagement with secondary care. Our aim is to describe our experiences in setting up a successful nurse led HCV service at a substance misuse service (SMS).Methods We justify the need for a community HCV service and review the different community based models. Our experiences in engaging with stakeholders, obtaining funding, service set up, challenges faced and key recommendations are discussed. Finally, a summary of interim clinical outcomes is presented. Results A successful community based “one-stop” nurse led HCV service was set up in Dec 2013 at a large SMS. It provides all aspects of care (blood borne virus screening, non-invasive assessment of hepatic fibrosis, Hepatology input, HCV treatment, peer mentor, social and psychiatrist support, and opioid substitution) at one site. Interim clinical data indicate high service uptake with HCV treatment outcomes comparable to secondary care. Conclusions The advent of direct acting antivirals provides a unique opportunity for HCV elimination in England by 2030. Our “one-stop” integrated and multidisciplinary community HCV model suggests that HCV care can be successfully delivered outside of a hospital setting and warrants national adoption. [ABSTRACT FROM PUBLISHER]

Introduction. Chronic liver disease (CLD) is becoming a major cause of mortality in patients who are positive with human immunodeficiency virus (HIV). Our aim was to assess the prevalence of CLD in HIV+ individuals.Material and methods. We utilized the National Health and Nutrition Examination Survey (1999-2008) to assess the association of CLD with HIV infection. In eligible participants (18-49 years), HIV infection was defined as positive anti-HIV by enzyme immunoassay further confirmed by Western blot. The diagnosis of CLD included chronic hepatitis C (CH-C), alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Clinic-demographic and laboratory parameters were used to assess differences between those with and without HIV infection.Results. 14,685 adults were included. Of those, 0.43 ± 0.08% were HIV-positive and 13.8% had evidence of CLD, including 26.3% in HIV-positive individuals and 13.7% in HIV-negative controls (p = 0.0341). In the U.S. population, independent predictors of CLD included HIV positivity [OR = 1.96 (1.02-3.77), p = 0.04], older age [OR = 1.03 (1.02-1.03), p < 0.0001], male gender [OR = 2.15 (1.89-2.44), p < 0.0001] and obesity [OR = 2.10 (1.82-2.43), p < 0.0001], while African American race/ethnicity was associated with lower risk for CLD [OR = 0.68 (0.58-0.80), p < 0.0001].Conclusions. CLD is common in HIV positive individuals. With successful long term treatment of HIV, management of CLD will continue to remain very important in these patients.

Background: Etiology of nearly 30% cases of chronic viral hepatitis remains undetected. Occult HBV infection (OBI) has emerged as an important clinical entity in this scenario. Apart from prevalence and clinical outcome of OBI patients genotype was determined in northern region of India. Materials and Methods: A total of 847 patients with chronic liver disease (CLD) were screened for common viral etiologies and others serological markers of HBV. Amplification of surface, precore and polymerase genes of HBV was performed in patients negative for other etiologies. Genotyping and sequencing of the precore region was performed for OBI cases. Results: Twenty-nine (7.61%) cases of OBI were identifiedof which 9 had chronic liver disease (CHD), 11 liver cirrhosis (LC) and 9 hepatocellular carcinoma (HCC). Majority of OBI cases were detected by amplification of surface gene 26 (89.6%), followed by pre-core gene 12 (41.3%). Their liver functions tests were significantly deranged in comparison to overt HBV cases. IgG anti HBc was present in 8 (27.6%) OBI cases. Mutation was observed in 8 (32%) in pre-core region at nt. 1896 of overt HBV cases. Genotype D was the predominant genotype. In conclusion: OBI in our study was characterized by predominance of genotype D and more severe clinical and biochemical profile in comparison to overt HBV. IgG anti HBc positivity could be utilized as a marker of OBI. We recommend use of sensitive nested PCR for diagnosis of OBI, amplifying at least surface and precore gene.

Research suggests that culturally and linguistically diverse (CLD) youths are underserved by mental health systems; CLD youths are less likely to receive mental health services and more likely to receive services that are inappropriate or inadequate. The lack of well-established treatments for CLD youths has been cited as one contributing factor to this problem. Consequently, it has been suggested that therapists should incorporate cultural awareness frameworks into their practice and adapt interventions in order to best serve youths from this population. The purpose of this literature review is to present established models that incorporate principles of cultural awareness and systematic intervention adaptation. Related studies that describe the applications of these models are also reviewed. Commonalities between different culturally responsive adaptation models are discussed, and implications for school-based practice are explored. [ABSTRACT FROM AUTHOR]

In crystallization studies, newly developed technologies, such as Focused Beam Reflectance Measurement (FBRM) and Particle Vision and Measurement (PVM) are applied for determining on-line monitoring of a representation of the Chord Length Distribution (CLD) and observe the photographs of crystals respectively; moreover recently they are widely used. Properly installed, the FBRM ensures on-line determination of the CLD, which is statistically associated to the Crystal Size Distribution (CSD). In industrial crystallization, CSD and mean crystal size as well as external habit and internal structure are important characteristics for further use of the crystals. In this paper, the effect of residence time, stirring speed, feeding rate, supersaturation level and the polyelectrolytes such as anionic polyacrylamide (APAM) and non-ionic polyacrylamide (NPAM) on the CLD as well as the shape of boric acid crystals were investigated by using the FBRM G600 and the PVM V819 probes respectively in an MSMPR (Mixed Suspension Mixed Product Removal) crystallizer. The CSD and kinetic data were determined experimentally using continuous MSMPR crystallizer running at steady state. The population density of nuclei, the nucleation rate and the growth rate were determined from the experimental population balance distribution when the steady state was reached. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of sexual dysfunction in the patients suffering from chronic liver disease. Period: 1 year from June 2013 to May 2014. Study Design: An observational study. Setting: Asian Institute of Medical Sciences. Methodology: 150 cases of chronic liver disease including patients of both genders at Asian Institute of medical sciences who had suggestive history and signs /symptoms of sexual dysfunction. Results: Study found 51.3% of total patients were suffering with sexual dysfunction. Out of all participating females, 52.2% were affected and among the total male patients 51% males were suffering from sexual dysfunction. Hepatitis C virus (HCV) and Hepatitis B virus (HBV) were positive in 76.7% and 11.3%, respectively. Conclusion: Sexual dysfunction is a common complication in the patients suffering from chronic liver disease. [ABSTRACT FROM AUTHOR]

Increasing environmental awareness has contributed to the shift of mindset among the Malaysian construction industry stakeholders. The Malaysian government has put an effort to prioritize the importance of managing construction and demolition (C&D) wastes to mitigate environmental impacts, but the recycling rate is still as low as 15%. This study was conducted to identify key principles and strategies in developing an integrated management of C&D waste via survey questionnaire sent to government agencies, developers, consultants and contractors. The final version of the survey involved 52 questions and it was sent to 480 construction actors. The results reveal that it is crucial that the process of managing the generation of C&D waste starts at the planning and designing stage so that the volume of generated waste could be decreased during the construction cycle. Suitable strategies for each stage of the construction cycle have been identified: among others, waste management plan and construction methods in the planning and designing stage; awareness and awards and regulations enhancement during procurement phase; and effective management during the stages of construction and demolition. A causal-loop diagram (CLD) for managing C&D waste was developed according to the findings. [ABSTRACT FROM AUTHOR]

Background: Circulating microRNAs (miRNAs) are endogenous, small (17-25 nucleotides) non-coding RNAs that are overexpressed in many human cancers including hepatocellular carcinoma (HCC). Moreover, circulating miRNAs can reflect the level of tissue miRNAs, so could be potential tumor markers. miRNA-21 regulates post-transcriptional expression of tumor suppressor gene; programed cell death 4 (PDCD4) gene which implies that miRNA-21 might be a novel diagnostic and/or prognostic marker for cancer. Objective: To evaluate the diagnostic and prognostic potential of circulating miRNA-21 and study the expression of PDCD4 gene as a target of miRNA-21 in HCC in Egyptian patients. Subjects and methods: This study was conducted on 30 HCC patients, 20 chronic liver disease (CLD) patients due to HCV infection and 20 healthy subjects. Serum alpha fetoprotein (AFP) was measured for all participants. The relative plasma expression of each of miRNA-21 and PDCD4 gene was determined in whole blood samples using real-time polymerase chain reaction. Results: The results revealed over expression of miRNA-21 and under expression of PDCD4 gene in HCC group (p< 0.05) compared to both CLD and healthy subjects, while no significant change was detected between CLD and healthy subjects. miRNA-21 expression was negatively correlated with PDCD4 gene expression. miRNA-21 expression increased significantly with presence of cirrhosis, increased number of focal lesions, larger size of tumor, advanced tumor stage and presence of vascular invasion. Receiver Operator of Characteristics (ROC) curve analysis of plasma miRNA-21 revealed that, at a cut-off value of 3.93 (fold expression), the sensitivity and specificity for differentiation of HCC cases were 93% and 90%, respectively. Conclusion: Circulating miRNA-21 could be a novel early diagnostic and prognostic biomarker for detection of HCC. Approaches interfering with the miRNA-21/PDCD4-axis, or releasing PDCD4 expression, may have a strong basis for therapeutic uses in cancer in the future. [ABSTRACT FROM AUTHOR]

The former use of chlordecone (CLD) in the French West Indies has resulted in long-term pollution of soils. CLD is known to be potentially transferred towards animal products of animals reared outdoors, mainly through accidental soil ingestion. Several studies indicate that soil bound CLD is bioavailable when administered to farm animals. Currently there is a need to quantify the level of CLD absorption and its toxicokinetic characteristics in the ruminant and particularly in the goat. These are considered as important farm species in the French West Indies. The objective of this study was to evaluate the absorption rate and the half-life of CLD in the non-lactating goat. The goats were administered either intravenously (i.v., n = 6) or orally (p.o., n = 6) one dose (1 mg kg −1 body weight) of CLD. Blood samples were collected at defined times up to 160 days post-dosing. CLD was analyzed in serum by high-resolution gas chromatography. A comparison of the area under the serum concentration-time curves (AUC) showed that the i.v. route is equivalent to the oral route. Thus, CLD is considered almost completely absorbed after p.o. administration, as shown by the mean absolute bioavailability. The comparison between the pharmacokinetic profiles of CLD following oral and intravenous dose showed a difference during the first 14 days and a similar kinetic after this period. The half-life of CLD in serum was close to 20 days. These results highlight a possible strategy of decontamination due to the short half-life of CLD, obtained in dry goats that did not excrete fat matter. [ABSTRACT FROM AUTHOR]

Objective: To determine the association of hyponatremia in chronic liver disease patients with presentation of hepatic encephalopathy (HE) at Isra university Hospital Hyderabad. Methods: This study was cross sectional and carried out at medicine and gastroenterology department of Isra university Hospital Hyderabad and MMC Mirpur-Khas. Study duration was from September 2015 to March 2016. All the cases with age more than 25 years, both genders after diagnosis of chronic liver disease with sign and symptoms of Hepatic Encephalopathy were selected in this study. Blood sample for serum sodium level, was send to diagnostic laboratory of the hospital. Hyponatremia was classified as: 130-135 mEqL (mild), 125-130 mEq/L (moderate) and < 125 mEq/L (severe). Hepatic encephalopathy was categorized according to the West Haven classification (4 grades). Results: Total number of cases was 80. Mean age was 48 + 8.5 years. 55 (68.5%) patients were male. Majority of cases, 55 (68.5%) patients were infected with HCV. 40% patients had normal level of sodium, 25% had mild, 20% had moderate while 15% patients had severe hyponatremia. On the grading of encephalopathy, 30 (37.5%) patients had grade 1 encephalopathy while 25/(31.2%) patients had grade 2, 15/(18.8%) had grade 3 while 10 (12.5%) patients hade grade 4. The serum sodium levels significantly decreased with increasing severity of hepatic encephalopathy (P = 0.001). Conclusion: We concluded that the hyponatremia is significantly linked with Hepatic Encephalopathy (HE) in patients having chronic liver disease (CLD). [ABSTRACT FROM AUTHOR]

Background: We describe the proportion of children with compensated cirrhosis who develop decompensation in Ontario, Canada over the past two decades., Methods: This is a retrospective population-based cohort study using routinely collected health care data from Ontario, Canada held at ICES during 1997-2017. Diagnosis of cirrhosis was made using validated ICES definition, and decompensation events were defined according to validated coding. Rates of decompensation, type of decompensation, and incidence of liver transplantation after decompensation were analyzed. Databases were linked at the individual level and analyzed at ICES-Queen's., Results: A total of 2,755 children with compensated cirrhosis were included and 9% (253) developed decompensation over a median follow-up of 7 years. Children most likely to suffer decompensation were younger (median age 10 versus 4 years, p < 0.001) and female (45% versus 52%, p = 0.03). Ascites (137/253, 54%) was the most frequent complication. 199/2755 (7%) of children with cirrhosis received liver transplantation, of which 64% (128/199) occurred after a decompensation event. Overall, a total of 132 (4.7%) deaths occurred during the study period, with 55 deaths following a decompensating event., Conclusion: We present the first study to describe rates of decompensation, type, and rate of liver transplantation after decompensation in pediatric cirrhosis at the population level. To improve the care of children with liver disease, early detection of liver disease, early initiation of specific treatments as well as identification of children who are at risk of becoming decompensated are crucial., Competing Interests: JA Flemming consulted on the development of an educational conference for Gilead Sciences. M Kehar received consulting fees from Roche Canada. The other authors have nothing to disclose., (© Canadian Association for the Study of the Liver, 2023.)

During the last several decades, there has been a dramatic increase in the number of English language learners (ELLs) entering American educational settings. One result in the changing demographics of K-12 settings is the stark contrast between the backgrounds of learners found in the classroom settings and their educators. This has resulted in many pre-service teachers being inadequately prepared to meet the unique learning needs of their future learners (Eisenhardt, Besnoy, & Steel, 2012). Therefore, the purpose of this research was to develop an understanding of pre-service teachers’ beliefs in regards to their abilities to effectively teach ELLs. Analyses of this research revealed significant differences between pre-service teachers who have and have not completed English for Speakers of Other Languages (ESOL) coursework. Pre-service teachers also reported linguistic barriers as the greatest challenge faced when educating ELLs.

Aim: The main aim of the study is to study the clinical profile of disorders of the liver and hepatobiliary system in paediatric patients and to correlate the histopathology findings of liver biopsy in chronic liver disease. Another aim being to assess the prognosis and to know the outcome and the effects of treatment in chronic liver diseases in paediatric age group. Materials and Methods: It was a prospective study, included the clinical profile of Chronic Liver Diseases (CLD) in children and the histopathological correlation. A total of 55 children were thoroughly investigated by doing relevant investigations and liver biopsy. Observations and Results: A male predominance (60%) was noted with maximum incidence in the age group of 6-12 years. The incidence of CLD was 1.1% of total admissions. The most common presenting complaint was jaundice and abdominal distension. Hepatic encephalopathy was noted in 29% patients. Hepatomegaly was seen in 63% patients and spleenomegaly was seen in 60% patients. The incidence of cirrhosis on liver biopsy was 42% (23cases) in CLD patients. The most common diagnosis on histopathology was Wilson’s disease (22%), followed by hepatitis and autoimmune hepatitis. The predominant spectrum of CLD was metabolic liver disease and also the predominant cause of death. Conclusion: As the incidence of CLD is quite low, a very high index of suspicion is required for its diagnosis. Some uncommon causes of CLD in children were seen in our study like neutral lipid storage disease, α1-Antitrypsin deficiency disease, lupus hepatitis, Alagille syndrome and Budd-Chiari syndrome. A patient of CLD with jaundice and hepatomegaly should be treated aggressively as those are the poor prognostic indicators of the disease. Hepatic encephalopathy and cirrhosis are also associated with poor outcome in patients with CLD. Liver biopsy histopathology by an expert and its correlation with laboratory investigations plays an important role in the diagnosis of CLD. The major cause of deaths in patients with CLD is due to end stage liver disease and fulminant hepatic failure and the only way to prevent and treat these patients is by liver transplantation.

A simple model is presented to extract the particle size distribution (PSD) from the chord length distribution measured using a focused beam reflectance measurement probe. The model can be implemented using simple spread sheeting tools and does not require the description of additional parameters as opposed to previous models. The model was validated for two systems consisting of spherical ceramic beads by comparing model predicted PSD against the PSD obtained through image analysis (IA). Then, the model was evaluated by considering various systems consisting of irregularly shaped particles (sand/zinc dust/plasma alumina). Model predictions accurately predicted the mean but over-predicted the variance of the PSD in comparison with the PSD obtained from IA. However, overall, a reasonable agreement was observed. Finally, the model was shown to be accurate in predicting PSD in comparison with the measured PSD for systems of practical relevance such as for paracetamol and p-aminophenol crystals. © 2016 American Institute of Chemical Engineers AIChE J, 62: 4215-4228, 2016 [ABSTRACT FROM AUTHOR]

Background: Noninvasive markers are needed to identify esophageal varices (EV) in patients with chronic liver disease (CLD). Recently, liver stiffness (LS)-spleen size-to-platelet ratio risk score (LSPS) has been shown to predict EV in patients with chronic hepatitis C. The aim of this study was to validate the clinical value of LSPS for EV detection and identification of high risk EV in Japanese patients with CLD. Methods: A total of 230 patients with CLD who had undergone endoscopy, LS measurement, and ultrasonography between 2013 and 2015 were enrolled. The relationships between clinical data and LSPS were compared with those for other noninvasive markers (aspartate aminotransferase-to-platelet ratio, FIB-4 index, and platelet-to-spleen ratio), along with platelet count, spleen size, and LS. Diagnostic and prognostic abilities were assessed by the area under the receiver operating characteristic curve (AUC) and multivariate logistic regression. Results: LSPS correlated significantly with EV grade ( P < 0.001) and was superior to the other noninvasive indices for determination of EV and high risk EV. Furthermore, LSPS was independently associated with the presence of EV ( P < 0.001) and elevated EV risk ( P = 0.013) by multivariate logistic regression analysis. The optimal cutoff values of LSPS for EV and high risk EV were 1.1 and 2.2, respectively, at which AUC, negative predictive value, and accuracy were 0.821 [95 % confidence interval (CI) 0.743-0.899], 91.9, and 84.3 % and 0.859 (95 % CI 0.736-0.981), 95.5, and 76.9 %, respectively. Conclusions: LSPS represents a useful, noninvasive, accurate method to detect EV and a high EV risk in Japanese patients with CLD. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to record the incidence of portal biliopathy in cases of chronic liver diseases (CLD) with portal hypertension, that presented to a tertiary care hospital over a period of 2 years. METH ODS: A retrospective, cross-sectional study was performed on data collected from computerized records and CT scan images of cases of CLD. The data was collected from 30th September 2013 to 30th September 2015. The study center was the Department of Radiology, at Liaquat National Hospital, Karachi, Pakistan. RESULTS: A total of 294 patients presented to Liaquat National Hospital, Department of Radiology with the history of chronic liver disease over a period of 2 years. The median age of presentation was 54.50 years. The sample consisted of 160 males (54.42%) and 134 females (45.57%). 264 patients were found to have portal hypertension with varices. Only 03 female patients were found to have cavernous transformation of portal vein with portal biliopathy. Portal vein thrombosis was seen in 42 patients. Regenerating nodules were seen in 36 patients and hepatomas in 98 patients. CONCLUSION: The incidence of portal biliopathy is rare and is very low, but not uncommon in patients of chronic liver disease with portal hypertension and cannot be disregarded. Timely diagnosis and management will be useful to lower morbidity and mortality. [ABSTRACT FROM AUTHOR]

Surfaces of nano-sized ZSM-5 zeolites have been passivated by a chemical liquid deposition (CLD) technique using tetraethylorthosilicate (TEOS). The impact of this post-synthesis treatment has been evaluated in the methanol-to-olefins (MTO) reaction. A two-step surface passivation led to enhanced selectivity towards C 2 –C 4 light olefins, between 10 and 30% in relative, at nearly complete methanol conversion when compared with pristine zeolites. However, these post-treated zeolites exhibited a significant loss in stability. To rationalize these results and establish structure-activity relationships, zeolite catalysts have been thoroughly characterized by nitrogen adsorption–desorption, SEM, XRF, XRD and FTIR techniques. ZSM-5 zeolite (Si/Al = 27) in the form of well-arranged rectangular nanocrystals behave in MTO after silylation as a commercial ZSM-5 zeolite having a Si/Al = 52. [ABSTRACT FROM AUTHOR]

Background: Infants with chronic lung disease tend to be difficult to care for due to the heterogeneous nature of both their disease and the treatments required. Multiple types of medications, treatments, and nursing interventions are often needed to attain clinical success, and it is frequently difficult to discern which are effective versus the ones that offer no benefit. This article presents a case study that chronicles the care of an infant with chronic lung disease treated with albuterol. An innovative form of ventilation with monitoring of the electrical activity of the diaphragm with a special sensor-embedded catheter is used to assess the effectiveness of albuterol administration.Purpose: This case study presents the monitoring of the effectiveness of albuterol in an infant with chronic lung disease measuring the electrical activity of the diaphragm catheter (Edi) and the various monitoring systems on the Servo-i ventilator in Neurally Adjusted Ventilatory Assist (NAVA) Mode.Case Findings/results: The clinicians followed various respiratory trends monitored by the Servo-i ventilator after albuterol dosing to document the clinical utility of using albuterol in this infant. The monitoring provided by NAVA showed an improvement in both lung mechanics and clinical condition immediately after albuterol administration.Implications For Practice: The infant had a positive response to albuterol dosing that subsequently led to reduced length of stay, reduced costs, and reduced family anxiety. This type of monitoring could help nurses and clinicians discern whether a given treatment or medication was effective.Implications For Research: This method of clinical monitoring could provide a means to assess clinical utility of respiratory medications, treatments, and nursing interventions in certain populations of neonates and infants. The impact of objective monitoring on required sedation, weight gain, ventilator days, length of hospitalization, and overall hospital costs are other possible areas for future research. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study to detect the vitamin D deficiency associated to different risk factors in the patients with CLD. Study Design: Descriptive study. Setting: MMC Mirpur Khas and LUH Jamshoro / Hyderabad. Period: Nov 2013 to Apr 2014. Patients and Methods: All the cases with chronic liver disease and cirrhosis were included in the study after diagnosis. All the patients with HCC, diabetes and with renal failure were excluded from the study. Assessment of CLD causes was carried out by routine investigation, ultrasound of abdomen and patient's personal history. Furthermore to assessment of vitamin D status, by measuring serum concentration level as 25(OH) of the vitamin D. Blood sample of all the cases were send to the Diagnostic and research Laboratory of LUMHS. Results: Male were found in the majority 60.0% and female 40.0%, with the mean age of (mean±SD=49.8±6.5). Deficiency of the vitamin D was calculated according to different causes in according Vitamin D classification as; (Mild class 20-31 ng/ml), (Moderate class 7-19 ng/ml) and (Severe class \7 ng/ml). In the mild class HBV infected patients 78.95% were most common. In moderate class HBV +HCV infected patients were most common 52.94%. Patients with history of alcohol were found in majority with severe deficiency of vitamin D 57.14%. Conclusion: In this study we concluded that vitamin D deficiency increases with increases of liver severity, it's mostly found in the HCV infected and alcoholic liver disease, these patients should take vitamin D regularly, and food which contains rich source of Vitamin D. [ABSTRACT FROM AUTHOR]