Integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme: A recent initiative in India

Non-alcoholic fatty liver disease (NAFLD) is an emerging public health problem globally. NAFLD is one of the most common liver diseases worldwide and is the most common cause of abnormal liver enzymes in many developed countries. NAFLD is estimated to afflict approximately 1 billion individuals worldwide. An estimated 20-30 % of general population is afflicted from it globally. In India NAFLD could be a silent epidemic with its prevalence ranging from 9-32%. Studies have shown, strong association of NAFLD with major Non Communicable diseases (NCD) like Diabetes, Obesity, CVD, Chronic Kidney diseases, Cancers, etc. Perceiving the threat of NAFLD and the central role of hepatic accumulation of fat in the pathogenesis of other NCD, the Government of India (GoI) has taken steps to include NAFLD in the public health agenda. It has included it in the national NCD programme, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2021. India has become the first country in the world to start a national programme for preventive efforts for NAFLD. The present review describes public health relevance of NAFLD and the process of integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme in India.

Destrezas académicas y velocidad de procesamiento. Modelos predictivos del rendimiento escolar en básica primaria / Academic skills and processing speed. Predictive models of school achievement in primary school

Resumen El modelo de inteligencia de Cattell-Horn-Carroll (CHC) propone que los procesos cognitivos que componen la inteligencia pueden conceptualizarse como habilidades específicas, implicadas en tareas particulares, y habilidades generales, relacionadas con una amplia cantidad de contextos. Entre las habilidades más estudiadas bajo este modelo se encuentra la velocidad de procesamiento, identificada como uno de los mejores predictores del rendimiento académico y de la capacidad cognitiva general. En este artículo se presentan los resultados del análisis de la relación entre la velocidad de procesamiento y rendimiento académico general. Se evaluó una muestra de 223 estudiantes (53% mujeres) de Preescolar y básica primaria. Los resultados muestran una diferencia en la capacidad predictiva del componente perceptual (β =.76, p < .001) y conceptual (β =.09; p = .121) de la velocidad de procesamiento en procesos académicos básicos de lectura y matemática, así como ajustes similares en modelos de regresión a partir de su conceptualización como habilidad general (R2 = .68) o específica (R2 = .69). El análisis de la relación grado a grado mostró cambios en la capacidad predictiva de la velocidad de procesamiento sobre las habilidades académicas conforme avanza el proceso educativo, apoyando modelos previamente establecidos en el área (Cai, Li & Deng, 2013; Demetriou, Spanodius & Shayer, 2014). Finalmente, es generó un modelo de ecuaciones estructurales (X 2=1.431; p=.232; CFI=1.000; TLI=.999; NFI=.999; RFI=.996; RMSEA=.044) que permitió probar el ajuste de los modelos propuestos a los datos.

Abstract The Cattell-Horn-Carroll (CHC) intelligence model proposes that the cognitive processes that make up intelligence can be conceptualized as specific skills, involved in particular tasks, and general skills, related to a wide variety of contexts. Among the most studied skills under this model is the speed of processing, identified as one of the best predictors of academic performance and general cognitive ability. This article presents the results of the analysis of the relationship between processing speed and general academic performance. A sample of 223 students (53% women) of preschool and primary school was evaluated. The results show a difference in the predictive capacity of the perceptual component (β = .76, p < .001) and conceptual (β = .09; p = .121) of the processing speed in basic academic processes of reading and mathematics, as well as similar adjustments in regression models from their conceptualization as general (R 2 = .68) or specific (R 2 = .69) ability. The analysis of the grade-to-grade relationship showed changes in the predictive capacity of processing speed over academic skills as the educational process progresses, supporting previously established models in the area (Cai, Li & Deng, 2013; Demetriou, Spanodius & Shayer, 2014). Finally, a model of structural equations (X 2 = 1.431, p = .232, CFI = 1.000, TLI = .999, NFI = .999, RFI = .996, RMSEA = .044) was used to prove the adjustment of the proposed models to data.

Direct-acting antivirals response in hepatocellular carcinoma: Does the presence of hepatocellular carcinoma matter?

During the clinical trial development of directly acting antivirals (DAAs), evidence regarding the treatment efficacy in chronic hepatitis C patients with hepatocellular carcinoma (HCC) was scarce because these patients have always been excluded. Apart from the clinical trials, more HCC patients are currently being treated in daily practice, given that these treatments are highly effective and involve well-tolerated regimens. Large scale, real-world studies have demonstrated potentially suboptimal antiviral treatment efficacy in HCC patients who received DAAs. It is postulated that the impairment of the bioavailability of DAAs may account for the inferior treatment response. However, the results could not be generalized across all studies. The differing results were attributed to diverse patient characteristics, suboptimal regimens or imprecise definitions of active cancer statuses at the time of treatment initiation. Additional large-scale studies that utilize the treatment of choice in clearly defined HCC patients with different disease severities are warranted to clarify the issue.

Interpretación del WISC-IV: índices alternativos para la evaluación de las habilidades cristalizadas / Interpretation of the WISC-IV: alternative indices for the evaluation of crystallized abilities

Resumen En este artículo se presentan dos índices alternativos para la evaluación e interpretación de las habilidades cristalizadas a partir del WISC-IV versión argentina: el índice conocimiento léxico (Gc-VL) y el índice información general (Gc-K0). Para ello se trabajó con una muestra de 1036 casos. El análisis factorial confirmatorio revela altos índices que validan las nuevas puntuaciones. El análisis de fiabilidad resultó satisfactorio. A su vez, los resultados revelan correlaciones entre el índice comprensión verbal (ICV) del WISC-IV y los nuevos índices alternativos. Por último, se encontraron diferencias en las puntuaciones Gc-VL y Gc-K0 y el clima educativo del hogar. Si bien el WISC-IV propone cuatro índices compuestos y una medida global de la inteligencia (ICV, IRP, IMO, IVP y CIT), siguiendo los aportes de la teoría de Cattell-Horn-Carroll (CHC), se recomienda implementar estas puntuaciones alternativas en un contexto normativo e ipsativo, que favorezcan y enriquezcan el estudio de las capacidades cristalizadas del examinado.

Abstract This article presents two alternative indices for the evaluation and interpretation of crystallized abilities derived from the WISC-IV- Argentine version, the lexical knowledge index (Gc-VL) and the general information index (Gc-K0). To this end, we worked with a sample of 1,036 cases. The confirmatory factor analysis revealed high indices that validated the new scores, and the reliability analysis was satisfactory. In turn, the results revealed correlations between the verbal comprehension index (VCI) of the WISC-IV and the new alternative indexes. Finally, differences were found in the Gc-VL and Gc-K0 scores, and the educational climate of the home. Although the WISC-IV proposes four composite indices and a global measurement of intelligence (VCI, RPI, WMI, PSI and QI), following the contributions of the Cattell-Horn-Carroll theory (CHC), it is recommended to implement these alternative scores in a normative and ipsative context that favor and enrich the study of the crystallized capacities of the examinee.

Change of serum lipid profiles during antiviral therapy in chronic hepatitis C / Монголын Анагаах Ухаан

Background @#Low triglycerides and cholesterol was associated with hepatitis C virus (HCV) infection. Chronic HCV infection is the main cause of liver injury and it may influence to serum lipid levels. We aimed to evaluate the effect of antiviral treatment on the change of lipid profiles during interferon-based anti-HCV treatment. @*Material and Methods @#Totally 863 patients who completed the interferon-based antiviral therapy in Kaohsiung Medical University Hospital were included in this present study. The lipid profile measured and assessed in the baseline of the treatment and after 6 months of completion of the treatment. @*Results @#The most of the patients (81.2%) were achieved sustained virological response (SVR) by antiviral therapy. There was no significant difference between baseline triglycerides (TG) levels in the SVR group and non SVR groups. The TG levels at 6 months after completion of the treatment was significantly elevated in SVR group (102.9±57.0 mg/dL, p=0.0001) but did not elevated in non SVR group (94.5±45.6 mg/dL, p=0.690) compared with baseline TG levels. </br> After adjusting patients by four indexes for fibrosis (FIB4) in cut-off point 3.25, serum TG levels significantly increased in low FIB4 group (103.2±57.9 mg/dL, p=0.0001) but not in high FIB4 group (98.1±49.6 mg/dL, p=0.095) after 6 months end of the treatment. Serum TG level was increased greater in patients who had low FIB4 score and patients who achieved SVR (baseline 89.1±34.8 mg/dL; 6 months after treatment 104.3±59.3 mg/dL, paired T test p=0.0001). @*Conclusion@#The eradication of HCV is the main cause of the increase of lipids after Pegylated Interferon and Ribavirin treatment. </br> However advanced fibrosis also has an effect in increase of TG after the treatment.

Recent advances in the anti-HCV mechanisms of interferon

Interferon (IFN) in combination with ribavirin has been the standard of care (SOC) for chronic hepatitis C for the past few decades. Although the current SOC lacks the desired efficacy, and 4 new direct-acting antiviral agents have been recently approved, interferons are still likely to remain the cornerstone of therapy for some time. Moreover, as an important cytokine system of innate immunity, host interferon signaling provides a powerful antiviral response. Nevertheless, the mechanisms by which HCV infection controls interferon production, and how interferons, in turn, trigger anti-HCV activities as well as control the outcome of HCV infection remain to be clarified. In this report, we review current progress in understanding the mechanisms of IFN against HCV, and also summarize the knowledge of induction of interferon signaling by HCV infection.

Historia natural / Natural history of HCC

No se puede hablar de una sola historia natural para el carcinoma hepatocelular (CHC), ya que se trata de una enfermedad multifactorial, con un comportamiento biológico además diferente, no solo por el comportamiento del crecimiento tumoral, sino por el tipo de expresión, dependiendo de las características del huésped. Por otro lado, los síntomas inespecíficos y la mayoría de veces ausentes no ayudan a determinar tampoco el curso de la enfermedad. Así, es necesario comentar su presentación dependiendo de los diferentes tópicos que pueden incluir en ella.

No one can speak of just one natural history for hepatocellular carcinoma (HCC). HCC is a multifactorial disease whose behavior differs from one case to the next. This is true not only for the behavior of tumor growth but also for the type of expression depending on the host’s characteristics. Furthermore, symptoms are not specific for HCC and most often are absent, so they cannot help to determine the course of the disease. Consequently, it is necessary to discuss HCC’s presentation based on different topics which may be included in it.

Tratamiento quirúrgico / Surgical treatment

El tratamiento quirúrgico ha sido tradicionalmente el primer tratamiento en mente cuando se enfrenta a un paciente con CHC; sin embargo, el advenimiento de nuevas técnicas no quirúrgicas ha replanteado su uso, y en la actualidad el éxito en el tratamiento depende básicamente de una adecuada selección del paciente para este tipo de terapia. El tratamiento quirúrgico del CHC varía cuando se trata de un tumor en un paciente con hígado cirrótico y no cirrótico, y esto debe tenerse en cuenta al momento de decidir el tipo de tratamiento.

Although surgical treatment has traditionally been the first treatment considered for patients with HCC, the advent of new non-surgical techniques has led to a rethinking of its use. Today, successful surgery basically depends on proper selection of the patient. Surgical treatment of HCC varies for tumors in patients with non-cirrhotic and cirrhotic livers which must be taken into account when deciding on the type of treatment.

O uso de medidas intelectuais na análise do monitoramento metacognitivo de crianças / The use of intellectual measures in the analysis of metacognitive monitoring of children

O monitoramento metacognitivo é uma das habilidades compreendidas pela metacognição. É avaliado utilizando-se instrumentos de autorrelato ou pela formulação de julgamentos. O objetivo do presente estudo foi investigar o monitoramento metacognitivo de crianças durante a realização de três subtestes de uma bateria de inteligência, cujo referencial é o Modelo Cattell-Horn-Carroll. Os participantes responderam aos subtestes e foram solicitados a emitir estimativas sobre seu desempenho. Os resultados indicaram que a amostra já apresentava habilidades de monitoramento cognitivo e algumas medidas de monitoramento mostraram-se significativamente melhores para o subteste Desempenho em Matemática. Os dados são relevantes para confirmar, na população nacional, as informações da literatura internacional, e também para discutir a importância do incentivo e estímulo ao treinamento das habilidades metacognitivas.

Metacognitive monitoring is one component of metacognition. It is assessed either through self-report instruments or judgments. The aim of the present study was to investigate metacognitive monitoring of children during the execution of three subtests of an intelligence battery, based on the Cattell-Horn-Carroll intelligence model. Participants answered the subtests and were asked to estimate their performance. Results indicate that participants already had metacognitive abilities in their repertoire, and some monitoring measures were significantly better for the subtest Performance on Mathematics. The data of this study are relevant in confirming information from the international literature using a Brazilian sample, and in discussing the importance of incentives for metacognitive training.