Prognostic values of serum lactate-to-bicarbonate ratio and lactate for predicting 28-day in-hospital mortality in children with dengue shock syndrome.

This study aimed to assess the clinical utility of blood lactate-to-bicarbonate (L/B) ratio, as a prognostic factor for 28-day in-hospital mortality in children with dengue shock syndrome (DSS), admitted to the pediatric intensive care unit (PICU). This single-center retrospective study was conducted at a tertiary children hospital in southern Vietnam from 2013 to mid-2022. Prognostic models for DSS mortality were developed, using a predefined set of covariates in the first 24 hours of PICU admission. Area under the curves (AUCs), multivariable logistic and Least Absolute Shrinkage and Selection Operator (LASSO) regressions, bootstrapping and calibration slope were performed. A total of 492 children with DSS and complete clinical and biomarker data were included in the analysis, and 26 (5.3%) patients died. The predictive values for DSS mortality, regarding lactate showing AUC 0.876 (95% CI, 0.807-0.944), and that of L/B ratio 0.867 (95% CI, 0.80-0.934) (P values of both biomarkers < .001). The optimal cutoff point of the L/B ratio was 0.25, while that of lactate was 4.2 mmol/L. The multivariable model showed significant clinical predictors of DSS fatality including severe bleeding, cumulative amount of fluid infused and vasoactive-inotropic score (>30) in the first 24 hours of PICU admission. Combined with the identified clinical predictors, the L/B ratio yielded higher prognostic values (odds ratio [OR] = 8.66, 95% confidence interval [CI], 1.96-38.3; P < .01) than the lactate-based model (OR = 1.35, 95% CI, 1.15-1.58; P < .001). Both the L/B and lactate models showed similarly good performances. Considering that the L/B ratio has a better prognostic value than the lactate model, it may be considered a potential prognostic biomarker in clinical use for predicting 28-day mortality in PICU-admitted children with DSS.

Morphological Characteristics of the Vietnamese Adult Human Acetabulum Using Multiplanar Reconstruction Computed Tomography in Total Hip Replacement Surgery.

Background: The anatomical parameters of the acetabulum vary among races and geographical regions. Multislice Computed Tomography (CT) has proven to be a practical approach to assess morphological parameters of the acetabulum. The purpose of this study was to explore morphological characteristics of the acetabulum measured by CT scans in Vietnamese adults. Methods: Thirty-five consecutive patients aged 18 years and older received indications and eligibility for total hip replacement surgery. Sixty-three acetabulum were examined with multislice computed tomographic system (CT) with multiplanar reconstruction (MPR). Measured morphometric parameters of acetabulum included acetabular inclination angle (AIA), acetabular anteversion angle (AAA), acetabular angle of sharp (AAS), sagittal acetabular angle (SAA), acetabular horizontal offset (AHO), transverse acetabular ligament anteversion (TALA), transverse acetabular ligament inclination (TALI), acetabular depth (ADe), acetabular depth ratio (ADr) and acetabular diameter (ADi). Results: The mean values of acetabular diameter, femoral head diameter, AIA, AAA, AAS, SAA, TALA, TALI, AHO, ADe, ADr were 50.22±3.56 mm, 43.54±3.68 mm, 40.27±5.09 mm, 13.30±5.54 mm, 39.46±5.41 mm, 26.38±9.01 mm, 9.49±3.92 mm, 47.70±6.73 mm, 3.06±0.37 mm, 18.62±2.95 mm and 309.60±41.87 mm. Conclusion: Our initial data has showed morphological characteristics of the acetabulum in Vietnamese adults, different from the populations from other parts of world. Also, significant correlation between the orientation of the acetabulum and the transverse acetabular ligament was documented.

Extracorporeal life support and continuous renal replacement therapy in a patient with Enterovirus A71 associated cardiopulmonary failure: A case report.

RATIONALE: Hand-foot-mouth disease (HFMD) caused by Enterovirus A71, complicated by cardiopulmonary failure, is associated with a high mortality rate despite intensive treatment. To date, there is a paucity of clinical management data, regarding the use of extracorporeal life support (VA-ECMO) for Enterovirus-A71 associated cardiopulmonary failure reported. PATIENT CONCERNS: The patient in this study presented with severe HFMD complicated by cardiopulmonary failure, polymorphic ventricular tachycardia, and cardiac arrest. DIAGNOSES: Clinical presentations, laboratory data, and polymerase chain reaction (PCR) results from rectal swabs were used to confirm the diagnosis of severe HFMD caused by Enterovirus A71. INTERVENTIONS: The patient was managed with chest compression and an automatic external defibrillator, mechanical ventilation, intravenous immunoglobulin (IVIG), continuous renal replacement therapy (CRRT) and inotrope (milrinone). The patient did not respond to these interventions and subsequently required further management with VA-ECMO. OUTCOMES: The patient achieved a favorable outcomes. LESSONS: Our study highlights that extracorporeal membrane oxygenation and CRRT can enhance the survival outcomes of patients with severe HFMD with cardiopulmonary failure complications. Furthermore, we propose specific indications for the initiation of VA-ECMO.

Stem cell therapies for periodontal tissue regeneration: A meta-analysis of clinical trials.

Objective: Stem cell therapy in periodontal tissue regeneration has reported optimistic regenerative results; evidence supporting its superiority over conventional methods is still ambiguous. Therefore, this meta-analysis aims to evaluate the therapeutic effects of stem cells in human periodontal regeneration. Design: A literature search was conducted to retrieve relevant articles on periodontal regeneration in stem cell therapy. A meta-analysis of the studies was conducted using the Stata software. Results: Fifteen studies that examined the effect of stem cell therapies on periodontal tissue regeneration in 369 patients were selected from databases. Regardless of the various types of cells, both odontogenic (periodontal ligament, dental pulp, gingiva stem cell) and non-odontogenic (bone marrow, periosteum-derived, and umbilical cord stem cells), the cell therapies witnessed significant improvements in terms of clinical attachment level (SMD, -0.67; 95CI, -0.90 to -0.43), probing depth (SMD, -0.76; 95% CI, -1.21 to - 0.31), radiographic intrabony defect depth (SMD, -0.87; 95% CI, -1.52 to -0.23), and histomorphometric analysis of mineralized bone (SMD, 0.80; 95% CI, 0.42 to 1.19) when compared to traditional without-cell treatment in patients. However, evidence on gingival recession, alveolar thickness gain, bone mineral density of bone core, and bone volume fraction of bone core outcomes did not reach statistical significance. Conclusions: Evidence suggests that the implementation of stem cell therapies in reconstructing compromised gingiva and alveolar bone tissue produces positive outcomes compared with conventional approaches. However, further well-designed investigations are needed to comprehensively identify the most effective source of cells and biomaterials for each case.

Atomistic Study of the Bandgap Engineering of Two-Dimensional Silicon Carbide by Hydrogenation.

This work studied hydrogen adsorption by a two-dimensional silicon carbide using a combined molecular dynamics and density functional theory approach. The geometrical properties of partially and fully hydrogenated structures were investigated, considering the effect of zero-point energy. The preferred hydrogen atom location is on top of silicon atoms. The hydrogen interaction energies were obtained for the first time as the attractive force. For fully hydrogenated 2D SiC, the chair-like conformer is the most stable configuration, and the next is the boat-like conformer, while the table-like structure is not stable. The coverage and arrangement of the adsorbed hydrogen atoms significantly influence the values of the direct/indirect bandgaps of the considered systems, increasing the bandgap to 4.07, 3.64, and 4.41 eV for chair-like, table-like, and boat-like, respectively. Their dynamical stability was investigated by phonon dispersion calculations. The obtained results can serve as a guide for the application of hydrogenated two-dimensional silicon carbide in optoelectronic applications in manufacturing innovation.

Zidovudine-ß-Lactam Pronucleoside Strategy for Selective Delivery into Gram-Negative Bacteria Triggered by ß-Lactamases.

Addressing antibacterial resistance is a major concern of the modern world. The development of new approaches to meet this deadly threat is a critical priority. In this article, we investigate a new approach to negate bacterial resistance: exploit the ß-lactam bond cleavage by ß-lactamases to selectively trigger antibacterial prodrugs into the bacterial periplasm. Indeed, multidrug-resistant Gram-negative pathogens commonly produce several ß-lactamases that are able to inactivate ß-lactam antibiotics, our most reliable and widely used therapeutic option. The chemical structure of these prodrugs is based on a monobactam promoiety, covalently attached to the active antibacterial substance, zidovudine (AZT). We describe the synthesis of 10 prodrug analogues (5a-h) in four to nine steps and their biological activity. Selective enzymatic activation by a panel of ß-lactamases is demonstrated, and subsequent structure-activity relationships are discussed. The best compounds are further evaluated for their activity on both laboratory strains and clinical isolates, preliminary stability, and toxicity.

Discovering NDM-1 inhibitors using molecular substructure embeddings representations.

NDM-1 (New-Delhi-Metallo-ß-lactamase-1) is an enzyme developed by bacteria that is implicated in bacteria resistance to almost all known antibiotics. In this study, we deliver a new, curated NDM-1 bioactivities database, along with a set of unifying rules for managing different activity properties and inconsistencies. We define the activity classification problem in terms of Multiple Instance Learning, employing embeddings corresponding to molecular substructures and present an ensemble ranking and classification framework, relaying on a k-fold Cross Validation method employing a per fold hyper-parameter optimization procedure, showing promising generalization ability. The MIL paradigm displayed an improvement up to 45.7 %, in terms of Balanced Accuracy, in comparison to the classical Machine Learning paradigm. Moreover, we investigate different compact molecular representations, based on atomic or bi-atomic substructures. Finally, we scanned the Drugbank for strongly active compounds and we present the top-15 ranked compounds.

Socio-economic or environmental benefits from pondscapes? Deriving stakeholder preferences using analytic hierarchy process and compositional data analysis.

Ponds occupy a large share of standing water worldwide and play an important role in providing various ecosystem services. There are concerted efforts of the European Union either to create new ponds, or to restore and preserve existing ponds as nature-based solutions to provide benefits to ecosystem and human well-being. As part of the EU PONDERFUL project, selected pondscapes (i.e. landscapes of ponds) in eight different countries - hereafter "demo-sites", are studied to comprehensively understand their characteristics and their efficiency to provide ecosystem services. In addition, the needs and knowledge of stakeholders who own, work, research, or benefit from the pondscapes are also important, because of their capabilities to create, manage and develop the pondscapes. Therefore, we established connection with stakeholders to study their preferences and visions on the pondscapes. Using the analytic hierarchy process, this study shows that in general stakeholders in the European and Turkish demo-sites prefer environmental benefits to economic benefits, while stakeholders in the Uruguayan demo-sites rank the economic benefits higher. More specifically, in the European and Turkish demo-sites, the biodiversity benefits, i.e. life-cycle maintenance, habitat and gene pool protection, receive the highest ranking among all groups. On the other hand, stakeholders at the Uruguayan demo-sites rank provisioning benefits as the most important, because many ponds in Uruguayan demo-sites are being used for agricultural purposes. Understanding those preferences helps policy makers to address the needs of stakeholders more correctly, when considering any action or policy for the pondscapes.

Multi-Camera-Based Sorting System for Surface Defects of Apples.

In this paper, we addressed the challenges in sorting high-yield apple cultivars that traditionally relied on manual labor or system-based defect detection. Existing single-camera methods failed to uniformly capture the entire surface of apples, potentially leading to misclassification due to defects in unscanned areas. Various methods were proposed where apples were rotated using rollers on a conveyor. However, since the rotation was highly random, it was difficult to scan the apples uniformly for accurate classification. To overcome these limitations, we proposed a multi-camera-based apple sorting system with a rotation mechanism that ensured uniform and accurate surface imaging. The proposed system applied a rotation mechanism to individual apples while simultaneously utilizing three cameras to capture the entire surface of the apples. This method offered the advantage of quickly and uniformly acquiring the entire surface compared to single-camera and random rotation conveyor setups. The images captured by the system were analyzed using a CNN classifier deployed on embedded hardware. To maintain excellent CNN classifier performance while reducing its size and inference time, we employed knowledge distillation techniques. The CNN classifier demonstrated an inference speed of 0.069 s and an accuracy of 93.83% based on 300 apple samples. The integrated system, which included the proposed rotation mechanism and multi-camera setup, took a total of 2.84 s to sort one apple. Our proposed system provided an efficient and precise solution for detecting defects on the entire surface of apples, improving the sorting process with high reliability.

Role of Shear Flow on Structure Development during Post-Processing Annealing for Poly(lactic acid).

The effect of shear history on structure development during post-processing annealing was studied using poly(lactic acid) PLA. Since PLA shows a low crystallization rate, quenched films had no crystallinity. Moreover, molecular orientation was not detected in the films. During the annealing procedure beyond its glass transition temperature, however, molecular orientation to the flow direction occurred with the crystallization growth in the films having an appropriate shear history. This peculiar crystal growth during the annealing was most probably attributed to the crystallization from extended chain crystals generated during the applied shear history, although the amount of extended chain crystals was low. The results obtained in this study should be noted because the molecular orientation proceeded due to the annealing history applied. Furthermore, this phenomenon will be used to suppress dimensional change and increase product rigidity.

Effect of different co-foaming agents on PFAS removal from the environment by foam fractionation.

Per- and poly-fluoroalkyl substances (PFAS) are recalcitrant, synthetic chemicals that are ubiquitous in the environment because of their widespread use in a variety of consumer and industrial products. PFAS contamination has become an increasing issue in recent years, which needs to be urgently addressed. Foam fractionation is emerging as a potential remediation option that removes PFAS by adsorption to the surface of rising air bubbles which are removed from the system as a foam. PFAS concentrations in the environment are often not sufficient to allow for formation of a foam by itself and often a co-foaming agent is required to be added to enhance the foamability of the solution. In this study, the effect of different classes of co-foaming agents, anionic, non-ionic, zwitterionic and cationic surfactants on the removal of PFAS with varying fluorocarbon chain length from 3 to 8 in a foam fractionation process have been investigated. Evaluation of the air-water interface partitioning coefficient (k') in addition with surface tension and PFAS removal results support the contention that using a co-foaming agent with the opposite charge to the PFAS in question significantly facilitates the adsorption of PFAS to the air-water interface, enhancing the efficiency of the process. Using the non-ionic surfactant (no headgroup electrostatic interaction with PFAS), as a reference, it was observed, in terms of PFAS separation and rate of PFAS removal, that anionic co-surfactant performed worst, zwitterionic was better, and cationic co-surfactant performed best. All of the PFAS species were able to be removed below the limit of detection (0.05 µg/L) after 45 minutes of foaming time with the cationic surfactant.

Screening Wetland and Forage Plants for Phytoremediation of Salt-Affected Soils in the Vietnamese Mekong Delta.

This study evaluated the salt tolerance and sodium (Na) bioaccumulation of Typha orientalis, Lepironia articulata, Eleocharis dulcis, Scirpus littoralis, Brachiaria mutica, Paspalum atratum and Setaria sphacelata at five salinity levels of 0, 5, 10, 15 and 20‰ (corresponding to 0, 2.4, 6.9, 12.6 and 18 g NaCl L-1). S. littoralis showed zero-reduction in total dry biomass and was classified as a salt tolerant plant based on the membership function value. The highest Na+ accumulation was observed in S. sphacelata (307.9 mg plant-1) in spite of its salt sensitivity, followed by S. littoralis and T. orientalis at concentration of 155 mg plant-1. Consequently, the Na+ phytoextraction potential of these species can be estimated as 46.2, 23.3 and 23.3 kg ha-1 over 49 days, respectively. Taken together, they show high potential as Na+ hyperaccumulators, and can be selected in the national reclamation program for salt-affected soils in the context adaptation to climate change.

Optimization of 1,2,4-Triazole-3-thiones toward Broad-Spectrum Metallo-ß-lactamase Inhibitors Showing Potent Synergistic Activity on VIM- and NDM-1-Producing Clinical Isolates.

Metallo-ß-lactamases (MBLs) contribute to the resistance of Gram-negative bacteria to carbapenems, last-resort antibiotics at hospital, and MBL inhibitors are urgently needed to preserve these important antibacterial drugs. Here, we describe a series of 1,2,4-triazole-3-thione-based inhibitors displaying an α-amino acid substituent, which amine was mono- or disubstituted by (hetero)aryl groups. Compounds disubstituted by certain nitrogen-containing heterocycles showed submicromolar activities against VIM-type enzymes and strong NDM-1 inhibition (Ki = 10-30 nM). Equilibrium dialysis, native mass spectrometry, isothermal calorimetry (ITC), and X-ray crystallography showed that the compounds inhibited both VIM-2 and NDM-1 at least partially by stripping the catalytic zinc ions. These inhibitors also displayed a very potent synergistic activity with meropenem (16- to 1000-fold minimum inhibitory concentration (MIC) reduction) against VIM-type- and NDM-1-producing ultraresistant clinical isolates, including Enterobacterales and Pseudomonas aeruginosa. Furthermore, selected compounds exhibited no or moderate toxicity toward HeLa cells, favorable absorption, distribution, metabolism, excretion (ADME) properties, and no or modest inhibition of several mammalian metalloenzymes.

Efficient 3D Spatial Queries for Complex Objects.

3D spatial data has been generated at an extreme scale from many emerging applications, such as high definition maps for autonomous driving and 3D Human BioMolecular Atlas. In particular, 3D digital pathology provides a revolutionary approach to map human tissues in 3D, which is highly promising for advancing computer-aided diagnosis and understanding diseases through spatial queries and analysis. However, the exponential increase of data at 3D leads to significant I/O, communication, and computational challenges for 3D spatial queries. The complex structures of 3D objects such as bifurcated vessels make it difficult to effectively support 3D spatial queries with traditional methods. In this article, we present our work on building an efficient and scalable spatial query system, iSPEED, for large-scale 3D data with complex structures. iSPEED adopts effective progressive compression for each 3D object with successive levels of detail. Further, iSPEED exploits structural indexing for complex structured objects in distance-based queries. By querying with data represented in successive levels of details and structural indexes, iSPEED provides an option for users to balance between query efficiency and query accuracy. iSPEED builds in-memory indexes and decompresses data on-demand, which has a minimal memory footprint. iSPEED provides a 3D spatial query engine that can be invoked on-demand to run many instances in parallel implemented with, but not limited to, MapReduce. We evaluate iSPEED with three representative queries: 3D spatial joins, 3D nearest neighbor query, and 3D spatial proximity estimation. The extensive experiments demonstrate that iSPEED significantly improves the performance of existing spatial query systems.

12-OAHSA is a component of olive oil and mitigates obesity-induced inflammation.

Fatty acid esters of hydroxyl fatty acids (FAHFAs) are a new family of endogenous lipids that exert anti-inflammatory action. Among the various FAHFA isomers, the dietary source of oleic acid-hydroxy stearic acid (OAHSA) and its anti-inflammatory functions are poorly understood. This study investigated the composition of OAHSA isomers in dietary oils and the impact of 12-OAHSA on obesity-induced inflammation. Liquid chromatography with tandem mass spectrometry analysis revealed that various dietary oils, including fish oil, corn oil, palm oil, soybean oil, and olive oil, present a wide variation in OAHSA profiles and amounts. The highest amounts of total OAHSAs are present in olive oil including 12-OAHSA. Compared to vehicle-treated obese mice, administration of 12-OAHSA significantly improved glucose homeostasis, independent of body weight. 12-OAHSA-treated mice displayed significantly reduced accumulation of CD11c+ adipose tissue macrophages, and CD4+/CD8+ adipose tissue T lymphocytes. Concomitantly, the expression of pro-inflammatory cytokine genes and the nuclear factor kappa-light-chain-enhancer of activated B cells signaling pathway were significantly decreased in the 12-OAHSA-treated adipose tissue, while the expression of the anti-inflammatory gene Il10 was markedly increased. Moreover, in vitro cell culture experiments showed that 12-OAHSA significantly inhibited the lipopolysaccharides-induced inflammatory response in macrophages by suppressing the nuclear factor kappa-light-chain-enhancer of activated B cells signaling pathway. Collectively, these results indicated that 12-OAHSA, as a component of olive oil, mitigates obesity-induced insulin resistance by regulating AT inflammation. Therefore, 12-OAHSA could be used as a novel nutritional intervention against obesity-associated metabolic dysregulation.

1,2,4-Triazole-3-thione analogues with an arylakyl group at position 4 as metallo-ß-lactamase inhibitors.

Metallo-ß-lactamases (MBLs) represent an increasingly serious threat to public health because of their increased prevalence worldwide in relevant opportunistic Gram-negative pathogens. MBLs efficiently inactivate widely used and most valuable ß-lactam antibiotics, such as oxyiminocephalosporins (ceftriaxone, ceftazidime) and the last-resort carbapenems. To date, no MBL inhibitor has been approved for therapeutic applications. We are developing inhibitors characterized by a 1,2,4-triazole-3-thione scaffold as an original zinc ligand and few promising series were already reported. Here, we present the synthesis and evaluation of a new series of compounds characterized by the presence of an arylalkyl substituent at position 4 of the triazole ring. The alkyl link was mainly an ethylene, but a few compounds without alkyl or with an alkyl group of various lengths up to a butyl chain were also synthesized. Some compounds in both sub-series were micromolar to submicromolar inhibitors of tested VIM-type MBLs. A few of them were broad-spectrum inhibitors, as they showed significant inhibitory activity on NDM-1 and, to a lesser extent, IMP-1. Among these, several inhibitors were able to significantly reduce the meropenem MIC on VIM-1- and VIM-4- producing clinical isolates by up to 16-fold. In addition, ACE inhibition was absent or moderate and one promising compound did not show toxicity toward HeLa cells at concentrations up to 250 µM. This series represents a promising basis for further exploration. Finally, molecular modelling of representative compounds in complex with VIM-2 was performed to study their binding mode.

Assessment of Mobilization Potential of Per- and Polyfluoroalkyl Substances for Soil Remediation.

This study investigated the mobilization of a wide range of per- and polyfluoroalkyl substances (PFASs) present in aqueous film-forming foams (AFFFs) in water-saturated soils through one-dimensional (1-D) column experiments with a view to assessing the feasibility of their remediation by soil desorption and washing. Results indicated that sorption/desorption of most of the shorter-carbon-chain PFASs (C ≤ 6) in soil reached greater than 99% rapidly─after approximately two pore volumes (PVs) and were well predicted by an equilibrium transport model, indicating that they will be readily removed by soil washing technologies. In contrast, the equilibrium model failed to predict the mobilization of longer-chain PFASs (C ≥ 7), indicating the presence of nonequilibrium sorption/desorption (confirmed by a flow interruption experiment). The actual time taken to attain 99% sorption/desorption was up to 5 times longer than predicted by the equilibrium model (e.g., ∼62 PVs versus ∼12 PVs predicted for perfluorooctane sulfonate (PFOS) in loamy sand). The increasing contribution of hydrophobic interactions over the electrostatic interactions is suggested as the main driving factor of the nonequilibrium processes. The inverse linear relationship (R2 = 0.6, p < 0.0001) between the nonequilibrium mass transfer rate coefficient and the Freundlich sorption coefficient could potentially be a useful means for preliminary evaluation of potential nonequilibrium sorption/desorption of PFASs in soils.

Volatile fatty acids production from waste streams by anaerobic digestion: A critical review of the roles and application of enzymes.

Volatile fatty acids (VFAs) produced from organic-rich wastewater by anaerobic digestion attract attention due to the increasing volatile fatty acids market, sustainability and environmentally friendly characteristics. This review aims to give an overview of the roles and applications of enzymes, a biocatalyst which plays a significant role in anaerobic digestion, to enhance volatile fatty acids production. This paper systematically overviewed: (i) the enzymatic pathways of VFAs formation, competition, and consumption; (ii) the applications of enzymes in VFAs production; and (iii) feasible measures to boost the enzymatic processes. Furthermore, this review presents a critical evaluation on the major obstacles and feasible future research directions for the better applications of enzymatic processes to promote VFAs production from wastewater.

Identification of potential microRNA groups for the diagnosis of hepatocellular carcinoma (HCC) using microarray datasets and bioinformatics tools.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and the third cause of cancer-related death worldwide. Potential microRNAs have been reported as biomarkers for early detection of HCC as well as novel molecular targets for HCC treatment. Various tissue expression profiles of miRNAs using three microarray datasets from groups in Asia (2), Europe, America (GSE147892, GSE21362, GSE74618, GSE40744) and multiple bioinformatics tools were integrated to determine the most significant miRNA groups to assist in the diagnosis of HCC. Statistical analyses identified at least 30 miRNAs with 17 up-regulated and 13 down-regulated in HCC-related tumor tissues. All the miRNAs also showed relevance to the hallmarks of cancer such as cell proliferation, invasion, metastasis, angiogenesis, metabolism, epithelial-mesenchymal transition and apoptosis. Expression levels of miRNAs observed in the European group showed up-regulation at 5-37% compared to both Asian and American groups. Interestingly, four miRNAs divided into two groups as miR-182-5p/miR-1269a and miR-199a/miR-422a were the most promising for diagnosis of HCC patients from healthy controls, with AUC values of 0.902 and 0.892, respectively. Results provided evidence of the correlation between potential miRNAs and HCC that could be useful for disease diagnosis based on in-depth analyses of large case numbers and cohort studies.