Association between skirt size and chronic liver disease in post-menopausal women: a prospective cohort study within the United Kingdom Trial of Ovarian Cancer Screening (UKCTOCS)

BACKGROUND: We investigated the association between self-reported skirt size (SS) and change in SS, and incidence of chronic liver disease (CLD) in a prospective cohort study of women recruited to the UKCTOCS trial. METHODS: Women recruited to UKCTOCS in England without documented CLD self-reported their current UK SS during trial participation and were asked to recall their SS when aged in 20s (via completion of a questionnaire 3-5 years after recruitment). Participants were followed up via electronic health record linkage and hazard ratios (HR) calculated for incident liver-related events (LRE). RESULTS: Three hundred twenty-two (0.3%) of 94,124 women experienced a first LRE. Compared to SS ≤ 16, rates of LRE were higher in the SS ≥ 18 groups (both when aged in 20s and at questionnaire completion). Event rates were higher if there was no change in SS or an increase in SS, compared to a decrease in SS. In the models adjusted for potential confounders, HRs for LRE were higher in the groups of women reporting SS ≥ 18 both when aged in 20s (HR = 1.39 (95% CI; 0.87-2.23)) and at questionnaire completion (HR = 1.37 (95% CI; 1.07-1.75)). Compared to a decrease in SS, HRs were higher in the no change (HR = 1.78 (95% CI; 0.95-3.34)) and increase (HR = 1.80 (95% CI; 1.01-3.21)) groups. CONCLUSION: CLD is associated with high SS and an increase in SS over time. These data suggest SS can be used in simple public health messages about communicating the risk of liver disease. TRIAL REGISTRATION: UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978 . Registered 06/04/2000

Homozygosity Mapping and Genetic Analysis of Autosomal Recessive Retinal Dystrophies in 144 Consanguineous Pakistani Families.

PurposeThe Pakistan Punjab population has been a rich source for identifying genes causing or contributing to autosomal recessive retinal degenerations (arRD). This study was carried out to delineate the genetic architecture of arRD in the Pakistani population.MethodsThe genetic origin of arRD in a total of 144 families selected only for having consanguineous marriages and multiple members affected with arRD was examined. Of these, causative mutations had been identified in 62 families while only the locus had been identified for an additional 15. The remaining 67 families were subjected to homozygosity exclusion mapping by screening of closely flanking microsatellite markers at 180 known candidate genes/loci followed by sequencing of the candidate gene for pathogenic changes.ResultsOf these 67 families subjected to homozygosity mapping, 38 showed homozygosity for at least one of the 180 regions, and sequencing of the corresponding genes showed homozygous cosegregating mutations in 27 families. Overall, mutations were detected in approximately 61.8 % (89/144) of arRD families tested, with another 10.4% (15/144) being mapped to a locus but without a gene identified.ConclusionsThese results suggest the involvement of unmapped novel genes in the remaining 27.8% (40/144) of families. In addition, this study demonstrates that homozygosity mapping remains a powerful tool for identifying the genetic defect underlying genetically heterogeneous arRD disorders in consanguineous marriages for both research and clinical applications

Pulmonary Echinococcal Cyst with a Filamentous Fungus Co-Infection

Fungal infections are known to colonize the preexisting lung cavities formed as a result of diseases like tuberculosis, sarcoidosis, bronchiectasis and cavitatary neoplasia, mostly encountered in immunocompromised patients. Pulmonary echinococcal cysts have been reported coexistent with cryptococcosis and other saprophytic mycosis, but the coexistence of aspergillosis and echinococcal cyst is extremely rare and occasionally been reported in English literature. Active invasion and proliferation of the fungi in the laminated ectocyst of the echinococcal cyst is very unusual. We report a case of 60 years old immunocompetent female, presented with cough, chest pain and shortness of breath. The chest X- ray showed a large thick walled cavity in the lower and mid zone of right lung with positive water lily sign. Surgical enucleation of the echinococcal cyst revealed aspergilloma involving the cavity with massive invasion of laminated ectocyst by filamentous fungus, morphologically resembling an Aspergillus species and was further treated with Itraconazole for 3 months. This unique coexistence of active pulmonary echinococcosis and aspergillosis is being reported because of its rarity and clinical importance for its management.Keywords: Aspergillosis, echinococcosis, echinococcal cyst, pulmonary, mycosis

Successful Endoscopic Management of Bouveret's Syndrome in a Patient with Cholecystoduodenocolic Fistulae

Bouveret's syndrome, first described in 1896 by Léon Bouveret, is rare, limited to approximately 200 published case reports to date [Ariche et al.: Scand J Gastroenterol 2000;35:781–783]. It is a subgroup of gallstone ileus in which a cholecystoduodenal fistula allows the passage of a gallstone that obstructs the duodenum, causing gastric outlet obstruction. This case is unique as it describes Bouveret's syndrome in a patient with combined cholecystoduodenocolic fistulae. Gastric outlet obstruction was successfully managed endoscopically with lithotripsy. Both fistulae were subsequently managed conservatively without any complications

Investigation of vacuum evaporated SnTe thin films for their structural, electrical and thermoelectric properties

Remarkable enhancement in figure-of-merit (ZT) value of p-type Tin Telluride (SnTe) thin films is reported in the present investigations. Under high vacuum conditions, all thin films deposited on the glass substrate by using thermal evaporation technique. Thickness of the thin films were kept 55 and 33 nm. Morphological features and the elemental composition of the thin film were investigated using scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) technique respectively. High-resolution transmission electron microscopy (HRTEM) with selected area electron diffraction (SAED) pattern was used to investigate the microstructure of these thin films. For the identification of crystalline features, phase, and nano-crystallites size in all the thin films, the X-ray diffraction (XRD) technique had played a dominant role. The analysis of the XRD data results in a single-phase cubic structure. Atomic force microscopy (AFM) analysis revealed the 2D and 3D view of variable size grains formed on the glass substrate. Four probes method was used to determine the electrical conductivity of these thin films. Electrical measurements revealed the semi-metallic nature of the SnTe thin films. The thermoelectric measurement analysis revealed that the ZT of the thin films was found to be increased as the thickness of the film enhanced. The maximum value of ZT similar to 1.0 was obtained at room temperature for the film of thickness 55 nm

Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C

At present chronic liver disease (CLD), the third commonest cause of premature death in the United Kingdom is detected late, when interventions are ineffective, resulting in considerable morbidity and mortality. Injury to the liver, the largest solid organ in the body, leads to a cascade of inflammatory events. Chronic inflammation leads to the activation of hepatic stellate cells that undergo trans-differentiation to become myofibroblasts, the main extra-cellular matrix producing cells in the liver; over time increased extra-cellular matrix production results in the formation of liver fibrosis. Although fibrogenesis may be viewed as having evolved as a “wound healing” process that preserves tissue integrity, sustained chronic fibrosis can become pathogenic culminating in CLD, cirrhosis and its associated complications. As the reference standard for detecting liver fibrosis, liver biopsy, is invasive and has an associated morbidity, the diagnostic assessment of CLD by non-invasive testing is attractive. Accordingly, in this review the mechanisms by which liver inflammation and fibrosis develop in chronic liver diseases are explored to identify appropriate and meaningful diagnostic targets for clinical practice. Due to differing disease prevalence and treatment efficacy, disease specific diagnostic targets are required to optimally manage individual CLDs such as non-alcoholic fatty liver disease and chronic hepatitis C infection. To facilitate this, a review of the pathogenesis of both conditions is also conducted. Finally, the evidence for hepatic fibrosis regression and the mechanisms by which this occurs are discussed, including the current use of antifibrotic therapy

Case law on standard essential patents in Europe

In Europe disputes over SEPs are frequently litigated. In Huawei v ZTE, the CJEU gave a landmark judgement where it established guidelines to balance the interests of SEP owners and those of implementers. In this paper we will cover that case as well as other important SEP-related decisions from courts in the UK, Germany, France, Netherland and Italy

SECURITY AND OTHER VULNERABILITY PREDICTION USING NOVEL DEEP REPRESENTATION OF SOURCE CODE WITH ACTIVE FEEDBACK LOOP

Since the cost of fixing vulnerabilities can be thirty times greater after an application has been deployed, it is recognized that properly-written code can yield potentially large savings. Accordingly, approaches presented herein apply machine learning and Artificial Intelligence (AI) techniques to improve developer experience by enabling developers to avoid introducing potential bugs and/or vulnerabilities while coding. Billions of lines of source code, which have already been written, are utilized as examples of how to write functional and secure code that is easy to read and to debug. By leveraging this wealth of available data, which is complemented with state-of-art machine learning models, enterprise-level software solutions can be developed that have a high standard of coding and are potentially bug-free