Biochemical Evaluation of Patients of Alcoholic Liver Disease and Non-alcoholic Liver Disease

Alcoholic liver disease (ALD) is due to excessive alcohol intake for long duration. Distinguishing ALD from non-ALD (non-alcoholic steatohepatitis, hepatitis of viral origin) is difficult as patient may deny alcohol abuse. Clinical examination, histology and serology may not differentiate these conditions. Accurate diagnosis is important as management of ALD differs from non-ALD patients. The aim of our study was (1) To evaluate the patients of ALD and non-ALD by biochemical parameters compared to controls, (2) To assess whether these parameters can differentiate ALD from non-ALD. Study was carried out on 50 patients of ALD in group I and 35 patients of NASH (non-alcoholic steatohepatitis) and acute viral hepatitis each in group II. Age matched healthy controls n = 50. Selection criteria—history of alcohol intake (amount and duration), clinical examination, sonography of abdomen, serum alanine transaminase (ALT) and bilirubin levels. Blood samples were analyzed for bilirubin, aspartate transaminase (AST), ALT, alkaline phosphatase (ALP), gamma glutamyl transferase (GGT) by kinetic method. Statistical analysis was done by Student unpaired ‘t’ test. Patients of ALD have raised AST/ALT ratio (De Ritis ratio) (>2), ALP and GGT compared to controls (P < 0.01).There is significant difference in AST/ALT ratio, serum GGT and ALP in ALD group compared to that in NASH and acute viral hepatitis (P < 0.05). This study suggests that De Ritis ratio >2 in ALD patients may be due to alcohol induced hepatic mitochondrial injury and pyridoxine deficiency. High GGT and ALP values may indicate enzyme induction by alcohol and mild cholestasis. Thus ALD patients have severe hepatic damage. De Ritis ratio <1 and normal to mild elevation in GGT level in NASH and acute viral hepatitis suggest mild hepatic injury of non-alcoholic origin. Our study concludes that ALD patients can be differentiated from NASH and acute viral hepatitis with certainty by measuring serum AST/ALT ratio, GGT and ALP. These biochemical parameters may help clinicians to support the diagnosis of ALD and non-ALD.     

Finite-time sliding mode flow control design via reduced model for a connection-oriented communication network

This paper addresses the flow control design of a connection-oriented communication network from the robust control theory perspective. Network is modelled as a nth order discrete system whose first order model is obtained using the two-time scale property associated with the process. The proposed scheme is characterised by an equivalent control based discrete sliding mode design for the first order model which is applied to nth order systems through aggregation. Besides its design simplicity, the proposed method exhibits finite time convergence property for the states while applied to the full order system emulating the characteristics of terminal sliding mode in a certain way. Simulation results via Matlab and ns-2 validate the efficacy of the proposed algorithm as an effective flow controller for connection-oriented networks.     

从白金预认证到三星级:中美绿色建筑分等评级程序的比较分析

2011年,作为全球最大能源使用国以及二氧化碳排放国,中美的建筑业所消耗的能源分别占到全国能源总消耗量的25%和40%。在建筑节能领域,绿色建筑的出现为消除建筑业所带来的对能源以及环境的负面影响提供了解决方法。为了促进绿色建筑的市场转型,推进设计和施工的差异化,中美均制定了国家绿色建筑分等评级程序以及配套政策。1998年,美国绿色建筑协会首次推出能源与环境先导设计(LEED),而中国政府则于2008年建立了中国绿色建筑评价标识(GBEL)。本文对美国LEED与中国GBEL评级程序、流程、评分系统以及扶持政策作了对比分析,研究发现,虽然两国所采用的绿色建筑设计以及操作评级程序的评分等级较为相似,它们在项目管理、评分要求和分配以及扶持政策类型等方面存在差异。美国能源与环境先导设计是由建筑产业利益相关者委员会制定并实施管理的。判断是否达到认证水平的灵活性更高。中国绿色建筑评价标识则是由政府操控的。判断是否达到评级水平的要求更为严格。但是,中国政府将在2014年下半年对中国绿色建筑评价标识的评级程序作出修正。本文对评级程序以及扶植政策的相似点以及差异是如何影响绿色建筑技术以及市场的发展作了分析,还讨论了绿色建筑未来发展可能面临的挑战以及政策导向意义。     

Association between self-reported health and physical and/or sexual abuse experienced before age 18

OBJECTIVE: The present study evaluated the association between women's health and physical and sexual abuse suffered before age 18. METHODS: A total of 3,568 randomly sampled insured women ages 18-64 completed a telephone interview to assess history of physical only, sexual only, or both physical and sexual abuse before age 18 (Behavioral Risk Factor Surveillance System); and current health (Short Form-36, Center for Epidemiologic Studies-Depression, Presence of Symptoms surveys). Adjusted analyses compared the health of women with physical abuse only, sexual abuse only, or physical and sexual abuse to the health of women without these abuse histories. RESULTS: Poorest health status was observed in women with a history of both physical and sexual child abuse compared to women without these abuse histories. In models that adjusted for age and income, women with both abuse types had increased prevalence of depression (prevalence ratio, 2.16), severe depression (PR, 2.84), physical symptoms (PR range, 1.33 for joint pain to 2.78 for nausea/vomiting), fair/poor health (PR, 1.84), and lower SF-36 scores (3.15-5.40 points lower). Women with physical abuse only or sexual abuse only also had higher prevalence of symptoms and lower SF-36 scores but the associations were not as strong. CONCLUSIONS: This study adds to the literature showing a graded association between multiple adverse events in childhood and adult health.     

The use of player physical and technical skill match activity profiles to predict position in the Australian Football League draft

This study investigated the extent to which position in the Australian Football League (AFL) national draft is associated with individual game performance metrics. Physical/technical skill performance metrics were collated from all participants in the 2014 national under 18 (U18) championships (18 games) drafted into the AFL (n = 65; 17.8 ± 0.5 y); 232 observations. Players were subdivided into draft position (ranked 1–65) and then draft round (1–4). Here, earlier draft selection (i.e., closer to 1) reflects a more desirable player. Microtechnology and a commercial provider facilitated the quantification of individual game performance metrics (n = 16). Linear mixed models were fitted to data, modelling the extent to which draft position was associated with these metrics. Draft position in the first/second round was negatively associated with “contested possessions” and “contested marks”, respectively. Physical performance metrics were positively associated with draft position in these rounds. Correlations weakened for the third/fourth rounds. Contested possessions/marks were associated with an earlier draft selection. Physical performance metrics were associated with a later draft selection. Recruiters change the type of U18 player they draft as the selection pool reduces. juniors with contested skill appear prioritised.