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Background & aimsPatients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers.MethodsMembers of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey.ResultsSurveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was "fatty liver" (88% at least sometimes); "metabolic disease" or "MAFLD" were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between "NAFLD", "fatty liver disease (FLD)", "NASH", or "MAFLD". The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with "FLD" among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term "fatty" was stigmatizing, while 34% believed that "nonalcoholic" was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting "steatotic liver disease" as stigmatizing was low (14%).ConclusionsThe perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties.Impact and implicationsOver the past decades, efforts have been made to change the nomenclature of nonalcoholic fatty liver disease (NAFLD) to better align with its underlying pathogenetic pathways and remove any potential stigma associated with the name. Given the paucity of data related to stigma in NAFLD, we undertook this global comprehensive survey to assess stigma in NAFLD among patients and providers from around the world. We found there is a disconnect between physicians and patients related to stigma and related nomenclature. With this knowledge, educational programs can be developed to better target stigma in NAFLD among all stakeholders and to provide a better opportunity for the new nomenclature to address the issues of stigma.

Objective: To investigate the potential role of a novel m6A RNA regulator, Insulin-like Growth Factor-2 mRNA-binding protein 1 (IGF2BP1), in periodontal disease pathogenesis. Materials and methods: Gingival tissue samples from 60 periodontitis patients and 60 healthy individuals were analyzed for IGF2BP1 mRNA and protein expression via real-time quantitative PCR (RT-qPCR) and Western blotting. Additionally, Porphyromonas gingivalis Lipopolysaccharide (Pg-LPS) -induced human gingival fibroblasts (HGFs) were evaluated for IGF2BP1 and proinflammatory cytokine expression. In silico functional analysis further explored potential molecular mechanisms. Results: IGF2BP1 mRNA and protein levels were significantly higher in the periodontitis group compared to the healthy group. Functional analysis implicated IGF2BP1 in regulating the IL-17 signaling pathway, a key player in inflammation. Pg-LPS treatment upregulated IGF2BP1 and proinflammatory cytokines in HGFs, supporting this finding. Conclusion: Our study suggests that IGF2BP1 overexpression contributes to periodontitis pathogenesis, potentially through IL-17 signaling. Further research is needed to elucidate the precise molecular mechanisms and explore IGF2BP1 as a potential therapeutic target or biomarker for this common oral disease.

This research examines the synergistic effects of using CO2, spent fluid cracking catalyst (sFCC), and municipal solid wastes (MSW) for energy and chemical production. The effect of utilizing sFCC catalysts on syngas yield and its quality and energy yield is examined during CO2-assisted gasification of MSW components, pinewood, polyethylene terephthalate (PET), polystyrene, and waste tyres. The influence of catalyst position (in-situ and quasi-in-situ) and temperature were also investigated. In all cases, the sFCC catalyst resulted in doubling the yield of hydrogen and tripling methane which reveals that the spent FCC catalyst promoted the hydrocracking and CO2 reforming of hydrocarbons in the gas phase. As such the presence of sFCC in-situ catalytic CO2-assisted gasification increased the overall syngas yield by 62.5%, for PET, by 55% for waste tyres, 3.5 % for polystyrene and no change for wood when compared to their respective non-catalytic gasification cases. A comparison of quasi-in-situ gasification to in-situ catalytic gasification showed that quasi-in-situ gasification increased syngas yield and energy yields of pinewood by 21% and 22%, respectively. For PET, the quasi-in-situ catalytic gasification increased the syngas yield and energy by 27.5% and 23.8%, respectively. In the case of waste tyres, the syngas yield and energy yields increased by 24% and 23%, respectively. For polystyrene, the quasi-in-situ catalytic gasification increased the syngas yield and energy by 103.4% and 62.5% as compared to the in-situ catalytic gasification case. This implies that quasi-in-situ catalytic gasification is more efficient and effective at increasing the syngas yield. When comparing the carbonaceous sources, materials with higher volatile matter such as polystyrene had the highest overall syngas yield compared to other materials. Materials that have a higher tendency to form char had the least increase in syngas yield and energy due to soot and coke formation over the catalyst.

Bacterial infections are a common complication in patients with decompensated liver cirrhosis. The complex landscape of cirrhosis, characterized by immune paralysis and an exhausted response to exogenous triggers, explains the higher prevalence of such infections, particularly in advanced disease stages. In clinical practice, the onset of a bacterial infection can lead to further deterioration of hepatic and extra-hepatic function, potentially resulting in acute decompensation or acute-on-chronic liver failure. This has significant clinical implications, particularly for patients awaiting a transplant. In this review, we will discuss the latest evidence on the diagnosis and therapy of bacterial infections in patients with decompensated cirrhosis. Additionally, we will analyze the impact of bacterial infections in the context of liver transplantation, discussing debated topics such as the timing of transplantation in patients with infections, potential implications for prioritization, effects on post-operative recovery, grafts, and patient survival.

A field trial was conducted to investigate the ‘Phytotoxicity of pendimethalin on the emergence of seedlings in direct seeded rice (DSR) across different concentrations’ during the Kharif season of 2022 at the experimental farm of the School of Agriculture, Lovely Professional University, Phagwara, Punjab. The experiment was conducted using a randomized block design with five treatments using different doses of pendimethalin (1600, 1800, 2000, and 2200 gram active ingredient per hectare (g ai per ha), and control (untreated)). Application of pendimethalin at 1600 g ai per ha resulted in a significantly higher number of seedlings than other treatment groups. The lowest number of seedlings was observed in the 2200 g ai per ha treatment group. The number of microbes present was optimal during the treatment with 1600 g ai per ha pendimethalin. With an increase in the dosage of pendimethalin, a decrease in the count of soil microbes was observed, with the lowest microbial count observed with the highest dose of pendimethalin, i.e., 2200 g ai per ha. No phytotoxic effect was observed in the DSR treated with pendimethalin at 1600 g ai per ha. Therefore the present study has to be obtain the appropriate use of dosage to inhibit the toxicity of herbicide as well as maintain the soil fertility and microbial growth.

Background & Aims: Patients with nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) face a multifaceted disease burden which includes impaired health-related quality of life (HRQL) and potential stigmatization. We aimed to assess the burden of liver disease in patients with NAFLD and the relationship between experience of stigma and HRQL. Methods: Members of the Global NASH Council created a survey about disease burden in NAFLD. Participants completed a 35-item questionnaire to assess liver disease burden (LDB) (seven domains), the 36-item CLDQ-NASH (six domains) survey to assess HRQL and reported their experience with stigmatization and discrimination. Results: A total of 2,117 patients with NAFLD from 24 countries completed the LDB survey (48% Middle East and North Africa, 18% Europe, 16% USA, 18% Asia) and 778 competed CLDQ-NASH. Of the study group, 9% reported stigma due to NAFLD and 26% due to obesity. Participants who reported stigmatization due to NAFLD had substantially lower CLDQ-NASH scores (all p

Distinguishing the direction of another person's eye gaze is extremely important in everyday social interaction, as it provides critical information about people's attention and, therefore, intentions. The temporal dynamics of gaze processing have been investigated using event-related potentials (ERPs) recorded with electroencephalography (EEG). However, the moment at which our brain distinguishes the gaze direction (GD), irrespectively of other facial cues, remains unclear. To solve this question, the present study aimed to investigate the time course of gaze direction processing, using an ERP decoding approach, based on the combination of a support vector machine and error-correcting output codes. We recorded EEG in young healthy subjects, 32 of them performing GD detection and 34 conducting face orientation tasks. Both tasks presented 3D realistic faces with five different head and gaze orientations each: 30°, 15° to the left or right, and 0°. While the classical ERP analyses did not show clear GD effects, ERP decoding analyses revealed that discrimination of GD, irrespective of head orientation, started at 140 ms in the GD task and at 120 ms in the face orientation task. GD decoding accuracy was higher in the GD task than in the face orientation task and was the highest for the direct gaze in both tasks. These findings suggest that the decoding of brain patterns is modified by task relevance, which changes the latency and the accuracy of GD decoding.

Cancers display significant heterogeneity with respect to tissue of origin, driver mutations, and other features of the surrounding tissue. It is likely that individual tumors engage common patterns of the immune system-here "archetypes"-creating prototypical non-destructive tumor immune microenvironments (TMEs) and modulating tumor-targeting. To discover the dominant immune system archetypes, the University of California, San Francisco (UCSF) Immunoprofiler Initiative (IPI) processed 364 individual tumors across 12 cancer types using standardized protocols. Computational clustering of flow cytometry and transcriptomic data obtained from cell sub-compartments uncovered dominant patterns of immune composition across cancers. These archetypes were profound insofar as they also differentiated tumors based upon unique immune and tumor gene-expression patterns. They also partitioned well-established classifications of tumor biology. The IPI resource provides a template for understanding cancer immunity as a collection of dominant patterns of immune organization and provides a rational path forward to learn how to modulate these to improve therapy.

BackgroundCOVID-19 vaccination rates are lower among historically marginalized populations, including Black/African American and Latinx populations, threatening to contribute to already high COVID-19 morbidity and mortality disparities for these groups. We conducted a community-based participatory research study using qualitative methods to explore knowledge and beliefs about COVID-19 vaccination among Black/African American, Latinx, and Chinese American residents of the San Francisco Bay Area and assess their views on vaccination outreach and delivery strategies.Methods and findingsData were collected from January 14, 2021, to February 24, 2021, with adult residents (N = 109 [Female: N = 76; 70%]) in San Francisco. Focus groups (N = 10) and in-depth interviews (N = 25) were conducted among Black/African Americans (N = 35), Latinx (N = 40), and Chinese Americans (n = 34) in English, Spanish, Cantonese, or Mandarin. Themes were identified using grounded field theory, and included misinformation, mistrust of government and health institutions, and linguistic and other barriers to vaccine access. All three racial/ethnic groups had experiences with vaccine misinformation and information overload. Many African American and Latinx participants cited structural and interpersonal racism, and anti-immigrant discrimination, as factors reducing their trust in government and public health disseminated information and their willingness to be vaccinated. Participants expressed trust in community-based organizations, including faith-based organizations and community-run clinics. Participants often experienced barriers to vaccine access, such as transportation to drive-in sites, with Latinx and Chinese American groups also frequently citing language barriers.ConclusionsVaccine outreach strategies must acknowledge how longstanding systemic, institutional, and structural racism contributes to mistrust in government and health institutions and engage with and support trusted messengers from the community to eliminate cultural, linguistic, and other barriers to vaccine access.

Despite global expansion, social disparities impact all phases of liver transplantation, from patient referral to post-transplant care. In pediatric populations, socioeconomic deprivation is associated with delayed referral, higher waitlist mortality, and reduced access to living donor transplantation. Children from socially deprived communities are twice as much less adherent to immunosuppression and have up to a 32% increased incidence of graft failure. Similarly, adult patients from deprived areas and racial minorities have a higher risk of not initiating the transplant evaluation, lower rates of waitlisting, and a 6% higher risk of not being transplanted. Social deprivation is racially segregated, and Black recipients have an increased risk of post-transplant mortality by up to 21%. The mechanisms linking social deprivation to inferior outcomes are not entirely elucidated, and powered studies are still lacking. We offer a review of the most recent evidence linking social deprivation and post-liver transplant outcomes in pediatric and adult populations, as well as a literature-derived theoretical background model for future research on this topic.

This paper addresses the issue of volatile organic compounds (VOCs), hazardous materials commonly present in paints, perfumes, petroleum and oil refineries, and plastic products, which can lead to health hazards. The detection of these toxic compounds has been a compelling subject for researchers. In this study, a novel approach is presented, involving the design of a sensor for VOC determination using a piezoresistive microcantilever. Microcantilevers have gained significant attention in electrochemical applications due to their enhanced sensitivity. The research explores various design factors, such as length, thickness, and material selection, to optimize the sensor’s response. Specifically, reducing the cantilever’s thickness is considered to improve the deflection sensitivity. To enhance the sensitivity of the piezoresistive sensor, particular emphasis is placed on developing the piezoresistive sensing layer to effectively address stress-induced changes. Experimental investigations involve exploring different cantilever shapes and piezolayer configurations to achieve the desired optimized condition. Ultimately, the rectangular cantilever shape is reshaped into a U-shape, which demonstrates enhanced sensitivity, offering promising possibilities for VOC detection. This study presents valuable insights into the design and optimization of piezoresistive microcantilever sensors for efficient VOC detection, its temperature effects, and monitoring applications.

Abstract 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, Mdn age = 68, SD age = 5.39) in a Structural Equation Modeling. In early life, the experience of hunger predicted lower delayed recall (β = − 0.10, p

Biological aging is defined as a progressive decline in tissue function that eventually results in cell death. Accelerated biologic aging results when the telomere length is shortened prematurely secondary to damage from biological or environmental stressors, leading to a defective reparative mechanism. Stem cells therapy may have a potential role in influencing (counteract/ameliorate) biological aging and maintaining the function of the organism. Mesenchymal stem cells, also called mesenchymal stromal cells (MSCs) are multipotent stem cells of mesodermal origin that can differentiate into other types of cells, such as adipocytes, chondrocytes, and osteocytes. MSCs influence resident cells through the secretion of paracrine bioactive components such as cytokines and extracellular vesicles (EVs). This review examines the changes in telomere length, cellular senescence, and normal biological age, as well as the factors contributing to telomere shortening and accelerated biological aging. The role of MSCs—especially those derived from gestational tissues—in prevention of telomere shortening (TS) and accelerated biological aging is explored. In addition, the strategies to prevent MSC senescence and improve the antiaging therapeutic application of MSCs and MSC-derived EVs in influencing telomere length and cellular senescence are reviewed.

Venolymphatic malformations occur due to dysplasia of lymphatic and venous vessel structures. These tumour-like lesions cause tissue abnormality with impaired function and have aesthetic importance when involving the craniofacial region. Vascular lesions are classified as haemangiomas and other vascular malformations. They are named after the vessels involved in malformation like arterial, venous, lymphatic, or mixed types. Present study represents a rare case report of a 23-year-old patient who presented to our hospital with swelling over the left elbow and a lump over the left breast, which was diagnosed as venolymphatic malformation involving the left breast and left elbow joint, which is an unusually affected anatomical region by this congenital anomaly. Ultrasonography (USG), the primary tool for diagnosis, was performed. Later, the patient underwent Magnetic Resonance Imaging (MRI) for confirmation and to determine the extent of the lesion. Excision of the lesion was done over left elbow completely with a wide margin. Histopathology confirmed the final diagnosis. Venous malformations (VM) are the most common among these congenital malformations, with an incidence of over 50%. Lymphatic malformations (LM) have a much lower incidence than venous malformations, but the combination of venous and LM has a very low incidence.

FOG computing enhances communication efficiency by processing data at the network’s edge. In many critical infrastructure (CI) networks, user entities outsource data to the FOG server, but the reliability of the data is a concern. To avoid incorrect decision-making due to corrupt data, a data auditing process is mandatory. Further, a group of user entities in a CI network generate data onto a common file and outsource the file to the FOG server. Auditing such shared group data creates additional complexities. Existing shared group data auditing schemes using public key infrastructure (PKI) or identity-based cryptography (IBC) face challenges such as certificate management or key escrow problems respectively. While, certificateless cryptography (CLC) offers better security and efficiency, but many CLC-based shared group data auditing schemes lack protection against key generation center compromise. The key generation process in many of the existing shared group data auditing schemes is centralized and does not support flexible user entity admission. This paper proposes a distributed and decentralized cryptography approach to enhance the security of key generation for group members. The scheme offers flexible user admission, allowing for full or semi-membership. The proposed scheme provides efficient and secure shared group data auditing against public key replacement, metadata forgery, and integrity attacks, as shown by performance evaluation and security analysis.

Background & Aims: Bacterial infections are frequent in patients with cirrhosis and increase the risk of death and drop-out from liver transplant (LT) waiting list. In patients with bacterial infections, LT is frequently delayed because of the fear of poor outcomes. We evaluated the impact of pre-LT infections on post-LT complications and survival. Methods: From 2012 to 2018, consecutive patients transplanted at the Hospital of Padua were identified and classified in two groups: patients surviving an episode of bacterial infection within 3 months before LT (study group) and patients without infections before LT (control group). Post-LT outcomes (complications, new infections, survival) were collected. Results: A total of 466 LT recipients were identified (study group n = 108; control group n = 358). After LT, the study group had a higher incidence of new bacterial (57% vs. 20%, p

IntroductionThe study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e., in non-vaccinated patients, COVID-19 prevalence of infection, mortality, and lethality in liver transplant recipients (LTRs), using non-liver solid transplant recipients (NL-SOTRs) and the Italian general population (GP) as comparators.MethodsCase collection started from February 21 to June 22, 2020, using the data from the National Institute of Health and National Transplant Center, whereas the data analysis was performed on September 30, 2020.To compare the sex- and age-adjusted distribution of infection, mortality, and lethality in LTRs, NL-SOTRs, and Italian GP we applied an indirect standardization method to determine the standardized rate.ResultsAmong the 43,983 Italian SOTRs with a functioning graft, LTRs accounted for 14,168 patients, of whom 89 were SARS-CoV-2 infected. In the 29,815 NL-SOTRs, 361 cases of SARS-CoV-2 infection were observed. The geographical distribution of the disease was highly variable across the different Italian regions. The standardized rate of infection, mortality, and lethality rates in LTRs resulted lower compared to NL-SOTRs [1.02 (95%CI 0.81-1.23) vs. 2.01 (95%CI 1.8-2.2); 1.0 (95%CI 0.5-1.5) vs. 4.5 (95%CI 3.6-5.3); 1.6 (95%CI 0.7-2.4) vs. 2.8 (95%CI 2.2-3.3), respectively] and comparable to the Italian GP.DiscussionAccording to the most recent studies on SOTRs and SARS-CoV-2 infection, our data strongly suggest that, in contrast to what was observed in NL-SOTRs receiving a similar immunosuppressive therapy, LTRs have the same risk of SARS-CoV-2 infection, mortality, and lethality observed in the general population. These results suggest an immune response to SARS-CoV-2 infection in LTRS that is different from NL-SOTRs, probably related to the ability of the grafted liver to induce immunotolerance.

Liver transplantation (LT) has significantly transformed the prognosis of patients with end-stage liver disease and hepatocellular carcinoma (HCC). The traditional epidemiology of liver diseases has undergone a remarkable shift in indications for LT, marked by a decline in viral hepatitis and an increase in metabolic dysfunction-associated steatotic liver disease (MASLD), along with expanded indications for HCC. Recent advancements in surgical techniques, organ preservation and post-transplant patients’ management have opened new possibilities for LT. Conditions that were historically considered absolute contraindications have emerged as potential new indications, demonstrating promising results in terms of patient survival. While these expanding indications provide newfound hope, the ethical dilemma of organ scarcity persists. Addressing this requires careful consideration and international collaboration to ensure equitable access to LT. Multidisciplinary approaches and ongoing research efforts are crucial to navigate the evolving landscape of LT. This review aims to offer a current overview of the primary emerging indications for LT, focusing on acute-on-chronic liver failure (ACLF), acute alcoholic hepatitis (AH), intrahepatic and perihilar cholangiocarcinoma (i- and p-CCA), colorectal liver metastasis (CRLM), and neuroendocrine tumor (NET) liver metastases.

Abstract With different countries facing multiple waves, with some SARS-CoV-2 variants more deadly and virulent, the COVID-19 pandemic is becoming more dangerous by the day and the world is facing an even more dreadful extended pandemic with exponential positive cases and increasing death rates. There is an urgent need for more efficient and faster methods of vaccine development against SARS-CoV-2. Compared to experimental protocols, the opportunities to innovate are very high in immunoinformatics/in silico approaches, especially with the recent adoption of structural bioinformatics in peptide vaccine design. In recent times, multi-epitope-based peptide vaccine candidates (MEBPVCs) have shown extraordinarily high humoral and cellular responses to immunization. Most of the publications claim that respective reported MEBPVC(s) assembled using a set of in silico predicted epitopes, to be the computationally validated potent vaccine candidate(s) ready for experimental validation. However, in this article, for a given set of predicted epitopes, it is shown that the published MEBPVC is one among the many possible variants and there is high likelihood of finding more potent MEBPVCs than the published candidates. To test the same, a methodology is developed where novel MEBP variants are derived by changing the epitope order of the published MEBPVC. Further, to overcome the limitations of current qualitative methods of assessment of MEBPVC, to enable quantitative comparison and ranking for the discovery of more potent MEBPVCs, novel predictors, Percent Epitope Accessibility (PEA), Receptor specific MEBP vaccine potency (RMVP), MEBP vaccine potency (MVP) are introduced. The MEBP variants indeed showed varied MVP scores indicating varied immunogenicity. Further, the MEBP variants with IDs, SPVC_446 and SPVC_537, had the highest MVP scores indicating these variants to be more potent MEBPVCs than the published MEBPVC and hence should be preferred candidates for immediate experimental testing and validation. The method enables quicker selection and high throughput experimental validation of vaccine candidates. This study also opens the opportunity to develop new software tools for designing more potent MEBPVCs in less time.

Abstract As the US population ages, more elderly patients may need liver transplantation. Our aim was to assess recent trends among elderly individuals requiring liver transplant in the United States. Scientific Registry of Transplant Recipients data (2002–2020) were used to select elderly (≥65 years) liver transplant candidates and assess on‐list and posttransplant outcomes. During the study period, 31,209 liver transplant candidates ≥65 years were wait listed. Common etiologies included nonalcoholic steatohepatitis (NASH; 31%), hepatitis C (23%), and alcoholic liver disease (18%); 30% also had hepatocellular carcinoma (HCC). Over time, the proportion of patients ≥65 years among all adult liver transplant candidates increased from 9% (2002–2005) to 23% (2018–2020) (trend, p

يهدف هذا البحث عبر فصولهِ إلى اختبار علاقة تأثير الشفافية التنظيمية كمتغير مستقل في الرقابة الإدارية كمتغير مستجيب في هيئة النزاهة الاتحادية أحد الهيئات الرقابية والتحقيقية المهمة في العراق، اذ يتجسد البحث في تشخيص طبيعة هذه العلاقة والتعرف على دور كل منهما، وتم طرح المشكلة البحث الرئيسية (هل استطاعت هيئة النزاهة من استثمار شفافيتها في تحسين رقابتها الادارية؟)، وللإجابة على هذا السؤال تم طرح فرضيتين رئيستين للبحث تحمل كل منها أبعادها، فالفرضية الأولى توجد علاقة ارتباط ذات دلالة معنوية بين الشفافية التنظيمية والرقابة الادارية في هيئة النزاهة، أما الفرضية الثانية يوجد تأثير ذات دلالة معنوية للشفافية التنظيمية في الرقابة الادارية بأبعادها في هيئة النزاهة، وكانت الاجابة عن هذه الفرضيات بوجود علاقة ارتباط ذات دلالة معنوية لكل من الفرضيتين، واستناداً إلى ملاءمة موضوع الدراسة في المؤسسات العامة ذات التوجه الإشرافي، وقيمة المنظمة المدروسة بالنسبة للمجتمع، فقد تم استخدام الأسلوب التحليلي الوصفي في إتمام البحث، وتضمن البحث عينة من قيادات الهيئة، وجمعت البيانات من (83) مستجيبا يمثلون عينة البحث من أصل (100) يمثلون مجتمع البحث، والمتمثل (بالمديرين العامين، معاونو المديرين العامين، رؤساء الأقسام، مسؤولي الشعب) اعتمادا على الاستبانة التي تضمنت (32) فقرة، لقد جمعهم باستخدام المقابلات الشخصية والملاحظات على الأرض لاختبار فرضياتها، استخدمت هذه الدراسة البرنامجين Smart V.3.4 وSPSS V.28، فضلا عن تقنيات الإحصاء الوصفي، أما أبرز النتائج التي توصل إليها البحث فكانت قدرة هيئة النزاهة الاتحادية على توظيف شفافيتها التنظيمية في تحسين رقابتها الإدارية من خلال اعتمادها على تبين استثمار هيئة النزاهة شفافيتها التنظيمية في تحسين رقابتها الإدارية بشكل جيد، لاسيما وأنها اعتمدت الوضوح في الإجراءات والإفصاح عن المعلومات والاتصال بشكل مجتمع في تحسينها، فيما وضعت توجها لتحسين فاعلية رقابتها الإدارية بتوظيف الوضوح في الإجراءات، بينما حقق أهداف الرقابة الإدارية من خلال أبعاد الشفافية التنظيمية الثلاث، فضلاً عن تحسينها وسائل الرقابة الإدارية من خلال تبني الوضوح في الإجراءات والإفصاح عن المعلومات، واخيراً اعتمدت الهيئة على الوضوح في الإجراءات والاتصال لتحسين مستوى أنشطتها الرقابية، وفي نهاية البحث حاول الباحث بالخروج بمجموعة من الاقتراحات التي تساعد على تحسين الرقابة الإدارية للهيئة المدروسة، منها ضرورة اهتمام هيئة النزاهة بوضوح اجراءاتها وبما يسهم في تعزيز شفافيتها بتوضيح اجراءات العمل واعتماد اساليب توضيح تكسب مهامها، وكذلك ينبغي على هيئة النزاهة بالإفصاح عن المعلومات بالإفصاح عن المعلومات وبما يحسن من شفافيتها من خلال تبني معايير افصاح تحافظ من خلالها على ميزاتها التنظيمية، واشاعة ثقافة التشارك المعرفي والمعلوماتي.

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.