Hepatic encephalopathy get a liver transplant, the risk of death is less than 30% over the subsequent five years. The condition has been described since at least 1860. The mildest form of hepatic encephalopathy is difficult to detect clinically, but may be demonstrated on neuropsychological testing. It is experienced as forgetfulness, mild confusion, and irritability. The first stage of hepatic encephalopathy is characterised by an inverted sleep-wake pattern (sleeping by day, being awake at night). The second stage is marked by lethargy and personality changes. The third stage is marked by worsened confusion. The fourth stage is marked by a progression to
Proper adjective adjectives. In general, an adjective is capitalized if its meaning is "pertaining to "X"", where "X" is some specific person, place, language, or organized group. Most capitalized adjectives are derived from proper nouns; for example, the proper adjective "American" is derived from the proper noun "America". Sometimes, an adjective is capitalized because it designates an ethnic group with a shared culture, heritage, or ancestry. This usage asserts the existence of a unified group with common goals. For example, in Canadian government documents, "Native" and "Aboriginal" are capitalized. An adjective can lose its capitalization when it takes on new meanings, such