More-than-human participation: Design for sustainable smart city futures

In this forum we highlight innovative thought, design, and research in the area of interaction design and sustainability, illustrating the diversity of approaches across HCI communities. — Roy Bendor, Edito

Non-alcoholic fatty liver disease in women – current knowledge and emerging concepts

Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide, affecting up to 30% of adults. Progression to non-alcoholic steatohepatitis (NASH) is a key risk factor for cirrhosis, hepatocellular carcinoma and cardiovascular events. Alterations in reproductive hormones are linked to the development and/or progression of NAFLD/NASH in women. Women with Polycystic Ovary Syndrome (PCOS) and those with estrogen deficiency are at increased risk of NAFLD/NASH, with higher mortality rates in older women compared to men of similar ages. NAFLD/NASH is currently the leading indication for liver transplantation in women without hepatocellular carcinoma. Therefore, a better understanding of NAFLD in women is needed to improve outcomes. In this review, we discuss the hormonal and non-hormonal factors contributing to NAFLD development and progression in women. Furthermore, we highlight areas of focus for clinical practice and for future research

Metabolic profile reflects stages of fibrosis in patients with non-alcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide, with fibrosis stage being the main predictor for clinical outcomes. Here, we present the metabolic profile of NAFLD patients with regards to fibrosis progression. We included all consecutive new referrals for NAFLD services between 2011 and 2019. Demographic, anthropometric and clinical features and noninvasive markers of fibrosis were recorded at baseline and at follow-up. Significant and advanced fibrosis were defined using liver stiffness measurement (LSM) as LSM ≥ 8.1 kPa and LSM ≥ 12.1 kPa, respectively. Cirrhosis was diagnosed either histologically or clinically. Fast progressors of fibrosis were defined as those with delta stiffness ≥ 1.03 kPa/year (25% upper quartile of delta stiffness distribution). Targeted and untargeted metabolic profiles were analysed on fasting serum samples using Proton nuclear magnetic resonance (1H NMR). A total of 189 patients were included in the study; 111 (58.7%) underwent liver biopsy. Overall, 11.1% patients were diagnosed with cirrhosis, while 23.8% were classified as fast progressors. A combination of metabolites and lipoproteins could identify the fast fibrosis progressors (AUROC 0.788, 95% CI: 0.703–0.874, p < 0.001) and performed better than noninvasive markers. Specific metabolic profiles predict fibrosis progression in patients with nonalcoholic fatty liver disease. Algorithms combining metabolites and lipids could be integrated in the risk-stratification of these patients

Quantification of liver fibrosis—a comparative study

Liver disease has been targeted as the fifth most common cause of death worldwide and tends to steadily rise. In the last three decades, several publications focused on the quantification of liver fibrosis by means of the estimation of the collagen proportional area (CPA) in liver biopsies obtained from digital image analysis (DIA). In this paper, early and recent studies on this topic have been reviewed according to these research aims: the datasets used for the analysis, the employed image processing techniques, the obtained results, and the derived conclusions. The purpose is to identify the major strengths and “gray-areas” in the landscape of this topic

Identificación de ectoparásitos en Oso melero (Tamandua tetradactyla), Estado Lara, Venezuela

RESUMENObjetivo. Identificar especies de ectoparásitos encontrados parasitando naturalmente un Oso melero, el cual fue encontrado muriendo en una vía cercana al pueblo de Bobare, estado Lara, Venezuela. Materiales y métodos. Al ingresar el animal a la sala de anatomía del DCV-UCLA para ser sometido a la técnica de taxidermia, se procedió a revisar a través de la palpación toda la superficie corporal del Oso, con la finalidad de tomar muestras de ectoparásitos presentes en el hospedador; los especímenes encontrados fueron colocados en un envase de vidrio conservados en alcohol isopropílico y posteriormente fueron llevados al Laboratorio de Parasitología Veterinaria del DCV-UCLA para su identificación taxonómica. Los ectoparásitos fueron observados en lupa estereoscópica y clasificados con ayuda de claves taxonómicas. Resultados. Se identificaron dos especies de artrópodos infestando naturalmente el Oso Melero, de las cuales se encuentra una garrapata macho clasificada como Amblyomma nodosum; y una pulga hembra identificada como Pulex irritans. Conclusiones. Estos artrópodos se han reportado parasitando naturalmente algunas especies de mamíferos, dentro de los cuales el Oso Melero se ha visto afectado por la acción de estos ectoparásitos; en Venezuela es el primer reporte de Pulex irritans afectando esta especie animal

In-hospital mortality is associated with inflammatory response in NAFLD patients admitted for COVID-19

Background & aims Although metabolic risk factors are associated with more severe COVID-19, there is little evidence on outcomes in patients with non-alcoholic fatty liver disease (NAFLD). We here describe the clinical characteristics and outcomes of NAFLD patients in a cohort hospitalised for COVID-19. Methods This study included all consecutive patients admitted for COVID-19 between February and April 2020 at Imperial College Healthcare NHS Trust, with either imaging of the liver available dated within one year from the admission or a known diagnosis of NAFLD. Clinical data and early weaning score (EWS) were recorded. NAFLD diagnosis was based on imaging or past medical history and patients were stratified for Fibrosis-4 (FIB-4) index. Clinical endpoints were admission to intensive care unit (ICU)and in-hospital mortality. Results 561 patients were admitted. Overall, 193 patients were included in the study. Fifty nine patients (30%) died, 9 (5%) were still in hospital, and 125 (65%) were discharged. The NAFLD cohort (n = 61) was significantly younger (60 vs 70.5 years, p = 0.046) at presentation compared to the non-NAFLD (n = 132). NAFLD diagnosis was not associated with adverse outcomes. However, the NAFLD group had higher C reactive protein (CRP) (107 vs 91.2 mg/L, p = 0.05) compared to non-NAFLD(n = 132). Among NAFLD patients, male gender (p = 0.01), ferritin (p = 0.003) and EWS (p = 0.047) were associated with in-hospital mortality, while the presence of intermediate/high risk FIB-4 or liver cirrhosis was not. Conclusion The presence of NAFLD per se was not associated with worse outcomes in patients hospitalised for COVID-19. Though NAFLD patients were younger on admission, disease stage was not associated with clinical outcomes. Yet, mortality was associated with gender and a pronounced inflammatory response in the NAFLD group