The objectives are to: validate a panel of tissue-specific miRNAs that are differentially expressed in the plasma of patients with and without liver injuries investigate the physiological range of the circulating miRNA panel in Healthy Subjects and under stress investigate the dysregulation of circulating miRNA panel and their prognostic and predictive values in clinical outcomes in identifying patients at high risk for mortality and acute liver failure. This trial involves peripheral blood sampling from subjects at their earliest presentation and remaining stays in the hospitalization in the emergency department. The investigators will develop panels of miRNAs that are specific indicator of early onset of major organ failures,and correlate clinical outcomes with these miRNAs.