Background : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a decrease of ≥ 4% after change from supine to upright position) to detect hypoxia and ortheodeoxia.Result : Eleven of thirty patients (36.6%) with chronic liver disease and portal hypertension were found to have contrast echocardiographic evidence of intrapulmonary right-to-left shunting. Arterial oxygen desaturation was present in 3 patients (27.3%) of those with intra-pulmonary right-to-left shunting ,they were considered as clinically significant HPS ,the remaining 8 patients were considered as subclinical HPS. Dyspnoea was more often present in patients with clinically significant HPS (100%) compared with subclinical HPS (25%), and patients without HPS (9%). HPS correlated significantly with severity of liver disease according to the Child-Pugh score.Conclusion: hepatopulmonary syndrome is not uncommon , the prevalence of clinically significant hepatopulmonary syndrome (in this study) was 10% of patients with chronic liver disease and it correlated with disease severity according to the Child-Pugh score
Aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a potent ligand for AhR and a known carcinogen. While AhR activation by TCDD leads to significant immunosuppression, how this translates into carcinogenic signal is unclear. Recently, we demonstrated that activation of AhR by TCDD in naïve C57BL6 mice leads to massive induction of myeloid derived-suppressor cells (MDSCs). In the current study, we investigated the role of the gut microbiota in TCDD-mediated MDSC induction. TCDD caused significant alterations in the gut microbiome, such as increases in Prevotella and Lactobacillus, while decreasing Sutterella and Bacteroides. Fecal transplants from TCDD-treated
... Show MoreThe international reporting auditor witness rapidly developed over the past years, where profession began give attention to the development of auditor reporting and improve its informational report through the issuance and amendment of some relevant international auditing standards. The reality of the situation refers to the failure to inform the auditor in Iraq in many areas, including: Clearly defined management responsibility for the preparation of financial and auditor's responsibility to express an opinion on these statements and Amendment of opinion when the financial statements as a whole is free from material misstatement based on the evidence is sufficient and appropriate audit, or not to build the auditor's ability to obt
... Show MoreThe current research studies the digital techniques in order to identify the treatments with graphic techniques for the theatrical scene, which includes a number of programs and treatment tools with digital technique to identify the visual and aesthetic dimensions and outputs achieved in the design of the theatrical scene in addition to the options, that they provide in the design of a system of hypotheses for the theatrical world, In order to be an experimental mediator in achieving the creative hypothesis, which limited the research with a pivotal objective which is: identifying the digital techniques employed in the graphic digital design for the scene in the theatrical show. The research lies in its objective limits stated in the met
... Show MoreThis paper presents a cognition path planning with control algorithm design for a nonholonomic wheeled mobile robot based on Particle Swarm Optimization (PSO) algorithm. The aim of this work is to propose the circular roadmap (CRM) method to plan and generate optimal path with free navigation as well as to propose a nonlinear MIMO-PID-MENN controller in order to track the wheeled mobile robot on the reference path. The PSO is used to find an online tune the control parameters of the proposed controller to get the best torques actions for the wheeled mobile robot. The numerical simulation results based on the Matlab package show that the proposed structure has a precise and highly accurate distance of the generated refere
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In this work, a novel technique to obtain an accurate solutions to nonlinear form by multi-step combination with Laplace-variational approach (MSLVIM) is introduced. Compared with the traditional approach for variational it overcome all difficulties and enable to provide us more an accurate solutions with extended of the convergence region as well as covering to larger intervals which providing us a continuous representation of approximate analytic solution and it give more better information of the solution over the whole time interval. This technique is more easier for obtaining the general Lagrange multiplier with reduces the time and calculations. It converges rapidly to exact formula with simply computable terms wit
... Show MoreThis research dealt with the subject of auditing bank credit risks in accordance with international auditing standards and aims to develop procedures and design a credit risk audit program in accordance with international auditing standards and demonstrate their impact on the truth, truthfulness and fairness of financial statements and on their overall performance and continuity in the banking sector Its importance lies in relying on international auditing standards to assess and measure bank credit risk and its impact on the financial situation as well as the ability to predict financial failure. A set of conclusions have been reached, the most important of which is that the bank faces difficulties in measuring credit risk in accordance
... Show MoreA three-stage learning algorithm for deep multilayer perceptron (DMLP) with effective weight initialisation based on sparse auto-encoder is proposed in this paper, which aims to overcome difficulties in training deep neural networks with limited training data in high-dimensional feature space. At the first stage, unsupervised learning is adopted using sparse auto-encoder to obtain the initial weights of the feature extraction layers of the DMLP. At the second stage, error back-propagation is used to train the DMLP by fixing the weights obtained at the first stage for its feature extraction layers. At the third stage, all the weights of the DMLP obtained at the second stage are refined by error back-propagation. Network structures an
... Show MoreOnline service is used to be as Pay-Per-Use in Cloud computing. Service user need not be in a long time contract with cloud service providers. Service level agreements (SLAs) are understandings marked between a cloud service providers and others, for example, a service user, intermediary operator, or observing operators. Since cloud computing is an ongoing technology giving numerous services to basic business applications and adaptable systems to manage online agreements are significant. SLA maintains the quality-of-service to the cloud user. If service provider fails to maintain the required service SLA is considered to be SLA violated. The main aim is to minimize the SLA violations for maintain the QoS of their cloud users. In this res
... Show MoreThe reaction of 2-amino-benzothiazole with bis [O,O-2,3,O,O – 5,6 – (chloro(carboxylic) methiylidene) ] – L – ascorbic acid (L-AsCl2) gave new product 3-(Benzo[d]Thaizole-2-Yl) – 9-Oxo-6,7,7a,9-Tertrahydro-2H-2,10:4,7-Diepoxyfuro [3,2-f][1,5,3] Dioxazonine – 2,4 (3H) – Dicarboxylic Acid, Hydro-chloride (L-as-am)), which has been insulated and identified by (C, H, N) elemental microanalysis (Ft-IR),(U.v–vis), mass spectroscopy and H-NMR techniques. The (L-as am) ligand complexes were obtained by the reaction of (L-as-am) with [M(II) = Co,Ni,Cu, and Zn] metal ions. The synthesized complexes are characterized by Uv–Visible (Ft –IR), mass spectroscopy molar ratio, molar conductivity, and Magnetic susceptibility techniques. (
... Show MoreThe research included five sections containing the first section on the introduction of the research and its importance and was addressed to the importance of the game of gymnastic and skilled parallel effectiveness and the importance of learning, but the problem of research that there is a difference in learning this skill and difficulty in learning may be one of the most important reasons are fear and fear of falling and injury, And a lack of sense of the movement of the movement is one of the obstacles in the completion of the skill and the goal of research to design a device that helps in learning the skill of descending Almtor facing with half a cycle according to the typical locomotor track on the parallel device of the technical men'
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