Correlation between Fibroscan and laboratory tests in non-alcoholic fatty liver disease/non-alcoholic steatohepatitis patients for assessing liver fibrosis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD) is a spectrum of disease ranging from simple steatosis to non-alcoholic steatohepatitis(NASH), through to advanced fibrosis and cirrhosis. Many patients with NAFLD remain undiagnosed and recognizing those at risk is very crucial. Although liver biopsy is the gold standard method for diagnosing and staging NAFLD, non-invasive imaging and lab modalities are also very promising in diagnosing these diseases.AIM To explore some of these non-invasive modalities in this context and assess how they hold up in terms of making a diagnosis while avoiding an invasive procedure like a liver biopsy.METHODS This study was conducted on NAFLD/NASH patients(n = 73) who underwent Fibroscan examinations at Saint George Hospital University Medical Center over 17 mo in order to assess liver fibrosis. Obtained Fibroscan results were correlated to laboratory tests and calculated aspartate transaminase(AST)/alanine transaminase(ALT) ratio, AST platelet ratio index(APRI) score and Fibrosis-4 score.RESULTS A significant age difference was observed across fibrosis stages of investigated patients. The mean stiffness score was 9.48 ± 11.77 KPa. A significant negative correlation was observed between ALT, AST, Albumin, gamma-glutamyl transferase, cholesterol, LDL, HDL, triglycerides, and ALP when compared across fibrosis stages. On the other hand, a significant positive correlation was found between Bilirubin, PT INR, partial thromboplastin time, glucose, and Platelet count when compared across fibrosis stages, in addition to AST/ALT ratio, APRI, and Fib-4 scores.CONCLUSION This study showed that Ultrasound alone is not efficient in the assessment of advancement of liver disease. Furthermore, the high positive relation between AST/ALT ratio, APRI and Fib-4 scores with fibrosis stages in NAFLD patients suggests that they could be used clinically in combination with Fibroscan to predict significant fibrosis and cirrhosis and to avoid liver biopsy.

Economic Improvement of Power Factor Correction: A Case Study

Power factor (PF) is simply an expression of energy efficiency, which is always expressed in terms of percentage. Technically, PF is a ratio of real power in Kilowatts to the apparent power, which is always expressed in kilovolts amperes. In AC power analysis, power is always expressed in three ways, the real power (P), reactive power (Q), and the apparent power (S). The real power is the work useful power, while the reactive power is the wasted power in the 3-phase AC system, and the apparent power is the vectorial sum of the two powers. The increase of reactive power will reduce the presence of real power, thus making the power to be more expensive. In this paper, we will analyze the importance of improving the power factor by applying a bank of capacitors to a case study in Lebanon. Analysis of the economic improvement in the application of power factor correction is carried out. The result shows a reduction of 12 percent in the total cost.

A Review on the Evolution of Europe＇s Methods to Exert Influence on The Palestinian-Israeli Peace Process

This review will assist to understand the evolution of Europe＇s methods to exert influence on the Palestinian-lsraeli peace process specifically from 1973 to 2015. Moreover, it was also noted that this will be essential in recognizing the evolution of European foreign policies. This study assists to understand the evolution of approaches agreed by the Europe since 1973 until present or 2015. This study focuses on the various approaches of actors from the civil society, private sector involved in the conflict between the Palestine and Israel. Moreover, this study will assist in understanding the evolution of Europe＇s methods and policies in the peace process between Israel and Palestine. Subsequently, this study focuses on the significance of non-state actors in the peace process between Palestine and Israel. This study clearly highlights the various strategies adopted by the Europe foreign policies in the conflict between Palestine and Israel. This study also highlights to what extent European foreign policy has assisted in the peace process between Israel and Palestine. This study would be useful to understand the effectiveness of European foreign policies in the peace process.