Institute of Chartered Accountants of Nigeria

About: Institute of Chartered Accountants of Nigeria is a based out in . It is known for research contribution in the topics: Population & Adipose tissue. The organization has 528 authors who have published 579 publications receiving 18688 citations.

Personalized medicine for ARDS: the 2035 research agenda

Abstract: In the last 20 years, survival among patients with acute respiratory distress syndrome (ARDS) has increased substantially with advances in lung-protective ventilation and resuscitation. Building on this success, personalizing mechanical ventilation to patient-specific physiology for enhanced lung protection will be a top research priority for the years ahead. However, the ARDS research agenda must be broader in scope. Further understanding of the heterogeneous biology, from molecular to mechanical, underlying early ARDS pathogenesis is essential to inform therapeutic discovery and tailor treatment and prevention strategies to the individual patient. The ARDSne(x)t research agenda for the next 20 years calls for bringing personalized medicine to ARDS, asking simultaneously both whether a treatment affords clinically meaningful benefit and for whom. This expanded scope necessitates standard acquisition of highly granular biological, physiological, and clinical data across studies to identify biologically distinct subgroups that may respond differently to a given intervention. Clinical trials will need to consider enrichment strategies and incorporate long-term functional outcomes. Tremendous investment in research infrastructure and global collaboration will be vital to fulfilling this agenda.

Systematic review of bariatric surgery liver biopsies clarifies the natural history of liver disease in patients with severe obesity

Abstract: Objective Non-alcoholic fatty liver disease (NAFLD) is a frequent complication of morbid obesity, but its severity varies greatly and thus there is a strong need to better define its natural history in these patients. Design Liver biopsies were systematically performed in 798 consecutive patients with severe obesity undergoing bariatric surgery. Histology was compared with clinical, biological, anthropometrical and body composition characteristics. Results Patients with presumably normal liver (n=179, 22%) were significantly younger at bariatric surgery than patients with NAFLD (37.0 vs 44.4 years, p Conclusions These results suggest that young adults are more prone to store fat in subcutaneous tissue and reach the threshold of bariatric surgery indication before their liver is damaged. A shift of fat storage from subcutaneous to visceral adipose tissue compartment is associated with liver damages. Liver might also be targeted by subcutaneous hypertrophic adipocytes in females since hypertrophic adipocytes are more exposed to lipolysis and to the production of inflammatory mediators.

Nonalcoholic fatty liver disease in chronic obstructive pulmonary disease.

Abstract: Nonalcoholic fatty liver disease (NAFLD) is independently linked to cardiometabolic morbidity and mortality. Low-grade inflammation, oxidative stress and ectopic fat, common features of chronic obstructive pulmonary disease (COPD), might contribute to the development of NAFLD. We aimed to investigate the prevalence of NAFLD and to evaluate the relationship between various types of liver damage and COPD severity, comorbidities and circulating inflammatory cytokines. Validated noninvasive tests (FibroMax: SteatoTest, NashTest and FibroTest) were used to assess steatosis, nonalcoholic steatohepatitis (NASH) and liver fibrosis. Patients underwent an objective assessment of COPD comorbidities, including sleep studies. Biological parameters included a complete lipid profile and inflammatory markers. In COPD patients the prevalence of steatosis, NASH and fibrosis were 41.4%, 36.9% and 61.3%, respectively. In multivariate analysis, SteatoTest and FibroTest were significantly associated with sex, body mass index (BMI), untreated sleep apnoea and insulin resistance, and, in addition, COPD Global Initiative for Chronic Obstructive Lung Disease stage for SteatoTest. Patients with steatosis had higher tumour necrosis factor-α levels and those with NASH or a combination of liver damage types had raised leptin levels after adjustment for age, sex and BMI. We concluded that NAFLD is highly prevalent in COPD and might contribute to cardiometabolic comorbidities.

SmartSettle Described with the Montreal Taxonomy

Abstract: This paper uses the Montreal Taxonomy endogenous classification criteria as a basis with which to describe the SmartSettle negotiation support system (Strobel and Weinhardt 2002). SmartSettle is an implementation of the US ICANS neutral site patent 5,495,412 and it is based on research at Cornell University (Thiessen 1993; Thiessen and Loucks 1992, 1998). The description in this paper is extended beyond the Montreal Taxonomy where the existing granularity is not fine enough or further clarity seems warranted. The SmartSettle negotiation system puts any number of decision makers with conflicting objectives in control of a process that produces better agreements (measured in terms of efficiency and fairness) in a shorter time than non-electronic negotiation processes. SmartSettle’s current advanced mode is practical for the most complex business negotiations. The configuration is customizable by the user by means of parameter settings. A simple mode soon to be released will also be applicable to even the simplest cases such as single-issue auctions and insurance claims. If the reader is not already familiar with the SmartSettle system, s/he may benefit from a review of examples posted on the SmartSettle website (www.smartsettle.com) before reading this paper.