Search

Evaluation of liver fibrosis stage is crucial in the assessment of chronic HCV patients, regarding decision to start treatment and during follow-up. Our aim was to assess the validity of the enhanced liver fibrosis (ELF) score in discrimination of advanced stage of liver fibrosis in naïve chronic HCV patients. We prospectively evaluated liver fibrosis stage in one hundred eighty-one naïve chronic HCV Egyptian patients by transient elastography (TE)-FibroScan. Patients were categorized into mild to moderate fibrosis (≤F2) group and advanced fibrosis (≥F3) group. The ELF score components, hyaluronic acid (HA), amino-terminal propeptide of type-III-procollagen (PIIINP) and tissue inhibitor of metalloproteinase type-1 (TIMP-1), were done using ELISA test. The mean values of ELF and its individual components significantly correlated with the hepatic fibrosis stage as measured by TE-FibroScan (P value 0.001). ELF cutoff value of 9.8 generated a sensitivity of 77.8%, specificity of 67.1%, area under the receiver operator characteristic curve (AUROC) of 0.76 with 95% confidence interval [CI] (0.68–0.83) for detecting advanced fibrosis (F ≥ 3). ELF panel is a good, reliable noninvasive test and showed comparable results to TE-FibroScan in detecting liver fibrosis stage in treatment naïve chronic HCV patients. [ABSTRACT FROM AUTHOR]

It is well known that hepatocellular carcinoma (HCC) develops as a consequence of hepatic fibrosis progression. In this study, we aimed to evaluate the inflammatory and fibrosis markers as predictors for HCC development among patients with hepatitis C virus (HCV) related chronic liver disease to help in early diagnosis and management of HCC. A total of 280 patients with chronic liver disease were included in this retrospective study, out of them 140 had liver cirrhosis with HCC and 140 had cirrhosis without HCC. Eight readily available blood indices King score, Fibro Q, AST-ALT ratio (AAR), APRI, LOK index, Goteborg University Cirrhosis Index (GUCI), fibro alpha, and Biotechnology Research Center (BRC) were constructed to compare the accuracies of these non invasive scores in predicting HCC development. All fibrosis scores except APRI were significantly higher in HCC. We found that Fibro alpha and BRC had superior diagnostic performance in prediction of HCC based on area under curve of 0.91 and 0.93, respectively compared to other scores with area under curve ranged from poor to failure (0.59-0.66). Almost all cirrhotic cases were secondary to HCV (93.6%), while HBV was detected in 2.1% of cases only. Anti-HCV positive was reported in 100% of HCC cases ( P = 0.002). Fibro alpha and BRC scores can be used for prediction of HCC. J. Med. Virol. 89:1062-1068, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

[Display omitted] Pressure sensors based on nitrogen-doped bamboo-shaped carbon nanotubes (N-BCNT) and carbon black (CB) as nanofillers, polyurethane foam (PU) as supporting substrate, and silicone rubber (SR) as a matrix were prepared. Dip coating was used to coat PU with 0.44 wt% nanofiller, including different mixing ratios of N-BCNT and CB (5:5; 6:4; 7:3; 8:2; 9:1). Then, the coated PU is impregnated in SR to fill the pores. Due to the higher aspect ratio of the N-BCNT, it contributes more to improving the electrical conductivity in the composites, while the CB fills the smaller gaps. The prepared sensors were tested in various applications, and it was found that the optimal mixing ratio of nanofillers was 7:3 N-BCNT:CB. Thus, a multifunctional pressure sensor has been developed successfully with excellent flexibility and good resilience, suitable for motion detection and finger touch applications. The pressure sensor showed high sensitivity, and the ability to detect a wide range of pressures. The sensor exhibited success in a range of applications, paving the way for its potential use in various fields in the future, such as wearable devices, prosthetics, robotic devices, and medical devices. [ABSTRACT FROM AUTHOR]

Background Hepatitis C virus is a worldwide problem. Noninvasive methods for liver fi brosis assessment as ultrasound-based approaches have emerged to replace liver biopsy. the aim of this study was to evaluate the diagnostic accuracy of real-time elastography (RTE) in the assessment of liver fi brosis in patients with chronic hepatitis C (CHC), compared with transient elastography and liver biopsy. Methods RTE, FibroScan and liver biopsy were performed in 50 CHC patients. In addition, aspartate aminotransferase to platelet ratio index (APRI) and routine laboratory values were included in the analysis. Results RTE was able to diagnose signifi cant hepatic fi brosis (F ⩾2) according to METAVIR scoring system at cut-off value of 2.49 with sensitivity 100%, specifi city 66%, and area under the receiver-operating characteristics (AUROC) 0.8. FibroScan was able to predict signifi cant fi brosis at cut-off value 7.5 KPa with sensitivity 88%, specifi city 100%, and AUROC 0.94. APRI was able to predict signifi cant hepatic fi brosis (F ⩾2) with sensitivity 54%, specifi city 80%, and AUROC 0.69. there was a signifi cant positive correlation between the FibroScan score and RTE score (r=0.6, P=0.001). Conclusions Although FibroScan is superior in determining signifi cant hepatic fi brosis, our data suggest that RTE may be a useful and promising noninvasive method for liver fi brosis assessment in CHC patients especially in cases with technical limitations for FibroScan. [ABSTRACT FROM AUTHOR]

Background and aims: Role of acoustic radiation force impulse (ARFI) elastography, in transplant setting, is not well established. We aimed to define the normal mean values of the liver stiffness by ARFI Elastography in healthy liver donors and to evaluate ARFI elastography as predictor of graft fibrosis post living donor liver transplant (LDLT) in comparison to other non-invasive methods (transient elastography [TE], APRI and FIB4).Patients and methods: A total of 100 subjects (70 recipients and 30 donors) were recruited. APRI and FIB4 scores were calculated for all recipients. TE and ARFI elastography (Siemens Acuson S2000 Ultrasound System, Germany) were performed to all subjects. All donors and only 30 recipients had liver biopsy. Significant fibrosis was defined as ≥ F2.Results: The mean ARFI velocity among the donors was 1.05 ± 0.09 m/s. Regarding the recipients: mean age was 49.5 ± 8.49 years, 85.7% males, fibrosis stages < F2 were the most frequent stages by liver biopsy (86.7%) and TE (67.1%). ARFI median was significantly correlated with TE median, APRI and FIB-4 (r = 0.888, p = 0.000; r = 0.62, p = 0.000, and r = 0.585, p = 0.000, respectively). ARFI performed well in discriminating patients with ≥ F2 (AUROC = 0.93, 95% CI 0.86-0.99, p < 0.01) with best cutoff median value of 1.34 m/s (sensitivity 90%, specificity 82%).Conclusion: ARFI can be used as a reliable method in assessment of significant fibrosis post-LDLT. [ABSTRACT FROM AUTHOR]

Given their non-invasiveness and demonstrated effectiveness, power analysis attacks (PAAs) are concerning and to be accounted for in modern circuit design. That is especially relevant for technology-dependent verification of PAA countermeasure implementations. Prior art proposed various countermeasures against PAAs, including masking and hiding, voltage switching, noise injection, etc. Aside from the proven working principles of such countermeasures, it is important to understand that their effectiveness is primarily technology- and implementation-dependent. Hence, before deployment, especially for integrated circuits, such countermeasures require accurate circuit-level studies. This work investigates an industrial-grade 14 nm fin field-effect transistor (FinFET) technology at design-time in the context of PAAs. We leverage device-level measurement data from Intel high-volume manufacturing processes, build up accordingly well-characterized standard-cell libraries, and utilize a commercial-grade computer-aided design (CAD) flow for PAA evaluation at design-time. Our study is focused on (1) the effectiveness of voltage switching as a countermeasure, (2) the advanced encryption standard (AES) cipher as a representative circuit, and (3) the correlation power analysis (CPA) as an attack framework. We show that, to improve the resilience against the CPA attack in particular and to lower information leakage in general, specific voltage configurations are more promising than others for the 14 nm FinFET technology. • We study design-time technology evaluation for power side-channel attacks (PSCAs). • We focus on industrial-grade 14 nm fin field-effect transistor (FinFET) technology. • We use device-level measurement data from Intel high-volume manufacturing nodes. • We build up accordingly well-characterized standard-cell libraries. • We utilize a commercial-grade computer-aided design flow for PSCA evaluation. • We study voltage switching as countermeasure against correlation power analysis (CPA). • Resilience against CPA increases the more we switch, the larger the voltage difference. • But, information leakage is increasing for such configurations as well. • Thus, careful study of voltage differences, switching ratios is required. • Such study requires technology-accurate design-time evaluation, as proposed here. • Our findings are robust: we conduct batches of randomized-but-reproducible CPA runs. • Our findings are conservative: we use technology-accurate, zero-delay simulations. • Our findings serve as guidelines for secure design, e.g., for key refresh rates. [ABSTRACT FROM AUTHOR]

Preeclampsia, a complex multisystem disorder predominantly impacting the kidneys and liver, manifests through hypertension and organ dysfunction in expectant mothers. Preeclampsia can also cause ocular signs, but they are uncommon. Exudative retinal detachment (ERD) is one such unusual but dangerous consequence. A thorough clinical description and therapy of a patient who experienced exudative retinal detachment while experiencing preeclampsia are provided in this study. A 28-year-old Saudi female, with no medical or surgical history, underwent an emergency cesarean section (CS) due to severe preeclampsia and failed induction of labor. The patient complained of painless blurry vision, with central dark spot and decreased vision starting from labor daytime. The patient was admitted to the hospital for blood pressure monitoring and further investigations. The patient was started on hydralazine intravenous (IV) and labetalol PO to control BP. The patient was delivered by cesarean section for preeclampsia with severe features after the failure of labor induction, and she had improved her vision by four weeks postpartum. Retinal detachment as a consequence of preeclampsia is conservatively managed, with a generally favorable prognosis. Previous studies have consistently emphasized the critical importance of a multidisciplinary approach that fosters collaboration between obstetricians and ophthalmologists. This collaborative strategy not only ensures comprehensive care but also facilitates early detection, timely intervention, and improved management outcomes for conditions affecting both maternal health and ophthalmic well-being during pregnancy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alsamaan et al.)

The objective was to assess the knowledge, attitudes, and practices of nurses toward the prevention of falls in older hospitalized patients. A cross-sectional study employing a 54-item questionnaire was conducted on 370 nurses at a tertiary care referral center. The mean age of the study population was 36.3 ± 7.7 years, with the majority being females (282; 76.8%). Most of them had attended fall prevention training (335; 90.5%). More than 98% knew fall prevention policies and safety goals, according to their response to a fall and risk assessment, but were less aware of the risk factors of falls, such as recurrent falls (61%), depression (44%), and lower-extremity numbness (40.5%). Similarly, 99% had positive attitudes toward risk assessment, fall prevention intervention, and response to a fall. Around 55% thought they were responsible for patients' falls, and 96% felt the need to undergo more training on fall prevention. Furthermore, 92% strictly followed fall prevention policies and 85.4% followed the color-coding system for high-risk patients. Despite the preventive measures in place, 33% encountered patient falls, and 82.2% experienced unwitnessed patient fall incidents in their units. Although the nurses had higher levels of knowledge about the policies, they lacked information on the risk factors. There is a significant scope that warrants great attention concerning the adherence to guidelines and the provision of fall prevention training programs, with a focus on the intrinsic causative factors of falls.

In this work, three different polyurethane (PU) foams were prepared by mixing commonly used isocyanate and polyol with different isocyanate indices (1.0:0.8, 1.0:1.0, 1.0:1.1). Then, the prepared polyurethane foam samples were coated by dip-coating with a fixed ratio of nitrogen-doped, bamboo-shaped carbon nanotubes (N-BCNTs) to obtain pressure sensor systems. The effect of the isocyanate index on the initial resistance, pressure sensitivity, gauge factor (GF), and repeatability of the N-BCNT/PU pressure sensor systems was studied. The pore volume was crucial in finetuning the PU-foam-based sensors ability to detect large strain. Furthermore, large pore volume provides suitable spatial pores for elastic deformation. Sensors with large pore volume can detect pressure of less than 3 kPa, which could be related to their sensitivity in the high range. Moreover, by increasing the pore volume, the electrical percolation threshold can be achieved with a minimal addition of nanofillers. On the other hand, PU with a smaller pore volume is more suitable to detect pressure above 3 kPa. The developed sensors have been successfully applied in many applications, such as motion monitoring and vibration detection.