Hepatocellular carcinoma(HCC)is the most common type of primary liver cancer,the sixth most common cancer worldwide,and the third leading cause of cancer-related death.Cirrhosis is the predominant risk factor for HCC,...Hepatocellular carcinoma(HCC)is the most common type of primary liver cancer,the sixth most common cancer worldwide,and the third leading cause of cancer-related death.Cirrhosis is the predominant risk factor for HCC,driven by major etiologies including hepatitis B and C,excessive alcohol consumption,and metabolic dysfunction-associated steatotic liver disease(MASLD).While approximately 80%of HCC cases occur in patients with cirrhosis,its incidence among individuals without cirrhosis has significantly increased,particularly in developed countries,driven by the rising prevalence of MASLD.The prevalence of patients with non-cirrhotic HCC varies geographically,yet data on this subgroup remain limited.Consequently,screening and clinical management guidelines for patients with non-cirrhotic HCC are underdeveloped.Current surveillance is typically not recommended for non-cirrhotic populations,except for individuals with hepatitis B,and diagnostic criteria like Liver Imaging Reporting and Data System are designed explicitly for cirrhotic or hepatitis B-associated HCC.Furthermore,treatment strategies for non-cirrhotic HCC are often extrapolated from studies focused on patients with cirrhosis,leading to gaps in knowledge regarding treatment efficacy,survival outcomes,and etiological variability in noncirrhotic cohorts.Thus,emerging evidence must be reviewed to guide the development of enhanced diagnostic and therapeutic strategies for patients with non-cirrhotic HCC.To address these gaps,we comprehensively reviewed the epidemiology,clinical and genetic characteristics,diagnostic modalities,and therapeutic approaches for patients with non-cirrhotic HCC.展开更多
This article presents the optical evaluation of the vibrational behavior of a steel bar,by a non-conventional optoacoustic procedure,the LPD(laser photo deflection)method.On this occasion the bar is located horizontal...This article presents the optical evaluation of the vibrational behavior of a steel bar,by a non-conventional optoacoustic procedure,the LPD(laser photo deflection)method.On this occasion the bar is located horizontal and fixed at both ends.Through our procedure we experimentally find the first 9 Eigen frequencies(21 Hz,60 Hz,116 Hz...)and correlate them using the cantilever theory.展开更多
BACKGROUND The location of gastric neoplasms can influence the level of technical difficulty and performance of endoscopic submucosal dissection(ESD).There are few studies that analyze the influence of tumor location ...BACKGROUND The location of gastric neoplasms can influence the level of technical difficulty and performance of endoscopic submucosal dissection(ESD).There are few studies that analyze the influence of tumor location in the stomach on ESD outcomes.AIM To compare the clinical efficacy and safety of ESD in the proximal vs distal stomach.METHODS A retrospective analysis was conducted on patients admitted in chronological order who received gastric ESD between 2009 and 2024.Patients were stratified into two groups based on tumor location:Group 1 included patients with tumors in the lower third of the stomach,while Group 2 included those with tumors in the middle or upper third.The following parameters were evaluated for each group:procedure duration,curative resection rate,en bloc resection rate,complete resection rate,incidence of complications,and depth of neoplastic invasion.RESULTS The mean procedure time was 97.07 minutes for lesions located in the distal stomach and 129.08 minutes for those in the proximal stomach(P=0.0011).En bloc resection rates for ESD in the distal and proximal stomach were 97.9%and 85.7%,respectively(P=0.0016),while complete resection rates were 93.9%and 73.4%,respectively(P=0.0002).Curative resection was achieved in 90.9%of distal lesions compared to 65.3%of proximal lesions(P=0.0001).Submucosal invasion was identified in 4.0%of distal lesions and 14.2%of proximal lesions(P=0.013).CONCLUSION ESD performed in the proximal stomach requires a longer procedural time compared to ESD in the distal stomach,independent of lesion size and histopathological characteristics.Additionally,proximal gastric ESD is associated with reduced clinical efficacy and increased incidence of submucosal invasion.展开更多
The bowel preparation is a crucial step to achieve an optimal quality in colonoscopy.The major clinical impact of an adequate colonic cleansing is to allow a more detailed and thorough inspection reducing the rates of...The bowel preparation is a crucial step to achieve an optimal quality in colonoscopy.The major clinical impact of an adequate colonic cleansing is to allow a more detailed and thorough inspection reducing the rates of missing lesions during the procedure and consequently reducing the incidence of interval colorectal carcinomas.Currently there are different colonoscopic preparation schemes,being the polyethylene glycol(PEG)based regimen one of the most used and recommended by the main international clinical guidelines.Nevertheless,PEG preparation requires the ingestion of considerably large volumes to achieve an optimal colonic cleansing,leading to poor tolerability in may patients,particularly in an elderly population.Other aspects that make accessibility to most colonoscopy preparation regimens difficult is their high cost and low availability.New options of colonoscopic preparation schemes based on oral lactulose are emerging with promising results,showing excellent efficacy-safety profiles and high tolerability indexes.Lactulose regimens present other benefits such as low cost and wide availability.The aim of this review is to analyze the scientific evidence to date and the current status of colonoscopy bowel preparation utilizing lactulose-based regimens,in order to consolidate this agent as a feasible“new player”in the field of colonoscopic preparation.展开更多
Type 2 diabetes mellitus(T2DM)is a metabolic disorder marked by chronic hyperglycemia and low-grade inflammation,contributing to various complications.Natural agents with immunomodulatory and antioxidant properties ha...Type 2 diabetes mellitus(T2DM)is a metabolic disorder marked by chronic hyperglycemia and low-grade inflammation,contributing to various complications.Natural agents with immunomodulatory and antioxidant properties have gained attention as adjunct therapies.To review the effects of Allium sativum on inflammatory pathways and metabolic alterations associated with T2DM.A narrative review was performed using PubMed/MEDLINE,EMBASE,and Scielo databases.The search included terms such as“allium sativum”,“inflammation",“oxidative stress”,and“diabetes mellitus”.Studies in English and Spanish-ranging from clinical trials to meta-analyses-were selected based on relevance.Bioactive compounds such as allicin,S-allyl cysteine,and diallyl disulfide exhibit anti-inflammatory,antioxidant,hypoglycemic,and lipid-lowering actions.Preclinical studies show improved glucose metabolism,insulin sensitivity,and organ function.Moreover,clinical evidence supports reductions in fasting glucose,hemoglobin A1c,blood pressure,and oxidative stress,with good safety profiles.Allium sativum appears to be a promising adjuvant in T2DM management,offering metabolic and anti-inflammatory benefits.Nonetheless,further high-quality clinical trials are needed to confirm its long-term efficacy and standardize its therapeutic use.展开更多
Angiosperms experienced one of the most remarkable radiations of land plants and are now the dominant autotrophs in terrestrial ecosystems.Recent phylogenomic studies based on large-scale data from plastid,mitochondri...Angiosperms experienced one of the most remarkable radiations of land plants and are now the dominant autotrophs in terrestrial ecosystems.Recent phylogenomic studies based on large-scale data from plastid,mitochondrial,or nuclear transcriptomes/genomes and increased taxon sampling have provided unprecedent resolution into the phylogeny of flowering plants.However,owing to ancient rapid radiations,the interrelationships among the five lineages of Mesangiospermae,the vast majority of angiosperms,remain contentious.Here we show that,although plastid and mitochondrial genomes lack sufficient phylogenetic signal for resolving deeper phylogeny,the relationships among five mesangiosperm lineages can be confidently resolved under better-fitting models using genome-scale data.According to our Bayesian cross-validation and model test in a maximum likelihood framework,siteheterogeneous models(e.g.,CAT-GTR+G4,LG+C20+F+G)outperform site-homogeneous or partition models often used in previous studies.Under site-heterogeneous models,the approximately unbiased test favored our preferred tree recovered from various datasets:Ceratophyllales(coontails)are robustly recovered as sister to monocots,and they together are sister to the clade comprising magnoliids,Chloranthales,and eudicots.Our phylogenomic analyses resolve the last enigma of the deeper phylogeny of angiosperms and emphasize the efficacy of modeling compositional heterogeneity in resolving rapid radiations of plants.展开更多
Different habitat types exert particular challenges to ecological performance,ultimately having a strong influence on the evolution of morphology.Although it is well known that external morphology can evolve under the...Different habitat types exert particular challenges to ecological performance,ultimately having a strong influence on the evolution of morphology.Although it is well known that external morphology can evolve under the selective pressure of habitat structure,the evolutionary response of internal morphological traits remains vastly unexplored.Here,we test for morphological divergence between arenicolous and nonarenicolous species in a clade of tropidurid lizards,considering external morphological proportions and limb muscle dimensions.We found that arenicolous species seem to have evolved internal and external morphological adaptations that separate them from other habitat specialists.Moreover,comparative analyses suggested that the traits that differed the most between arenicolous and nonarenicolous lizards might have evolved divergently towards different optima.Additionally,the axis of higher morphological divergence between arenicolous and nonarenicolous species represented an important proportion of the morphological diversity within our sample,indicating that the hypothetical adaptive divergence of internal and external traits has contributed significantly to phenotypic diversity.Our results show that evolutionary associations between morphology and habitat use can be detected on both external body proportions and muscle morphology.Moreover,they highlight the emergent importance of internal anatomical traits in ecomorphological studies,especially when such traits are directly involved in determining functional performance.展开更多
Self-Explaining Autonomous Systems(SEAS)have emerged as a strategic frontier within Artificial Intelligence(AI),responding to growing demands for transparency and interpretability in autonomous decisionmaking.This stu...Self-Explaining Autonomous Systems(SEAS)have emerged as a strategic frontier within Artificial Intelligence(AI),responding to growing demands for transparency and interpretability in autonomous decisionmaking.This study presents a comprehensive bibliometric analysis of SEAS research published between 2020 and February 2025,drawing upon 1380 documents indexed in Scopus.The analysis applies co-citation mapping,keyword co-occurrence,and author collaboration networks using VOSviewer,MASHA,and Python to examine scientific production,intellectual structure,and global collaboration patterns.The results indicate a sustained annual growth rate of 41.38%,with an h-index of 57 and an average of 21.97 citations per document.A normalized citation rate was computed to address temporal bias,enabling balanced evaluation across publication cohorts.Thematic analysis reveals four consolidated research fronts:interpretability in machine learning,explainability in deep neural networks,transparency in generative models,and optimization strategies in autonomous control.Author co-citation analysis identifies four distinct research communities,and keyword evolution shows growing interdisciplinary links with medicine,cybersecurity,and industrial automation.The United States leads in scientific output and citation impact at the geographical level,while countries like India and China show high productivity with varied influence.However,international collaboration remains limited at 7.39%,reflecting a fragmented research landscape.As discussed in this study,SEAS research is expanding rapidly yet remains epistemologically dispersed,with uneven integration of ethical and human-centered perspectives.This work offers a structured and data-driven perspective on SEAS development,highlights key contributors and thematic trends,and outlines critical directions for advancing responsible and transparent autonomous systems.展开更多
This study investigates the design and implementation of Flying Ad Hoc Networks(FANETs),a network architec-ture inspired by the Mobile Ad Hoc Network(MANET)model,specifically tailored to support unmanned aerial vehicl...This study investigates the design and implementation of Flying Ad Hoc Networks(FANETs),a network architec-ture inspired by the Mobile Ad Hoc Network(MANET)model,specifically tailored to support unmanned aerial vehicles(UAVs).As UAVs increasingly contribute to diverse fields,from surveillance to delivery,FANETs have emerged as essential in ensuring stable,dynamic communication channels among drones in flight.This research adopts a dual approach,combining rigorous theoretical analysis with detailed practical simulations to assess the performance,adaptability,and efficiency of FANETs in varying conditions.The findings emphasize the ability of FANETs to manage network congestion effectively in densely populated areas,a critical feature for maintaining reliable communications in complex scenarios.Moreover,FANETs demonstrate high potential to support critical applications,such as emergency response,disaster management,and public safety operations,where quick and coordinated action is paramount.The study also underscores the importance of establishing a hierarchical structure among nodes within the network,which allows for more efficient data exchange and helps optimize the overall network performance.Through this work,significant insights are offered into the design principles that can enhance UAV communication networks,providing a foundation for the development of more resilient,scalable,and efficient technological solutions.These advancements could accelerate the deployment of UAVs across a variety of sectors,including logistics,agriculture,environmental monitoring,and more.As such,this study not only contributes to the field of ad hoc networking but also holds potential for transformative impacts across industries where UAVs play an increasingly central role,promoting greater integration and operational success.展开更多
This study highlights the regulatory potential antibacterial and antiradical of Origanum elongatum essential oil(EO),an endemic medicinal plant of Morocco used for its various properties.The chemical composition of th...This study highlights the regulatory potential antibacterial and antiradical of Origanum elongatum essential oil(EO),an endemic medicinal plant of Morocco used for its various properties.The chemical composition of the EO was characterized using gas chromatography-mass spectrometry(GC-MS).The antibacterial activity against different agricultural phytopathogens was determined by disc diffusion and microatmosphere methods,as well as by the determination of minimum inhibitory concentrations(MIC)and minimum bactericidal concentration(MBC),while the antioxidant activity was evaluated by DPPH and FRAP assays.To complement the experimental analyses,a molecular docking approach was used to predict and elucidate the mechanisms of action of the identified bioactive com-pounds,both for their antioxidant and antibacterial properties.The GC-MS analysis revealed a chemical composition dominated by the major compounds:p-cymene-2-ol(25.31%),thymol(23.88%),andγ-terpinene(19.26%).Furthermore,antibacterial analyses performed using different methodological approaches(disc diffusion,microatmosphere,MIC,and MBC)showed significant inhibitory activity against all phytopathogens tested.Moreover,O.elongatum EO exhibited interesting antioxidant ability with an IC_(50) value of 168.251.14μg/mL for DPPH assay and EC_(50) value±of 164.221.04μg/mL for FRAP assay.Furthermore,in silico molecular docking demonstrated further insights into±the interactions between the oil’s active components and bacterial targets,supporting its mode of action.This in-depth characterization highlights the potential of O.elongatum EO as a natural alternative for the biocontrol of plant pathogens.It opens new perspectives for developing natural solutions to protect crops against plant diseases.展开更多
Juniperus oxycedrus(J.oxycedrus)is a traditional culinary spice and medicinal herb with a longstanding history of ethnopharmacological applications across diverse cultures.While prior research has explored the biologi...Juniperus oxycedrus(J.oxycedrus)is a traditional culinary spice and medicinal herb with a longstanding history of ethnopharmacological applications across diverse cultures.While prior research has explored the biological activities and phytochemical constituents of extracts derived from its leaves and seed cones,the present study systematically investigates their mineral and phenolic profiles alongside their multifunctional bioactive potential.Inductively coupled plasma-atomic emission spectroscopy(ICP-AES)analysis revealed a substantial abundance of essential macro-and microelements.Reversed-phase high-performance liquid chromatography(RP-HPLC)further identified high concentrations of phenolic acids(e.g.,p-coumaric acid)and flavonoids(e.g.,rutin and quercetin).The extracts exhibited potent radical scavenging activity against 2,2-diphenyl-1-picrylhydrazyl(DPPH),robust antioxidant capacity against hydrogen peroxide,and significant inhibition of xanthine oxidase(XO)activity.Notably,both extracts demonstrated marked antibacterial efficacy.In silico molecular docking studies suggested that the antimicrobial activity may stem from the phenolic constituents,which exhibited favorable binding affinities to the active site of bacterial target proteins.These findings underscore J.oxycedrus as a promising reservoir of bioactive natural compounds,warranting further exploration for therapeutic and nutraceutical applications.展开更多
The Kunene Complex(KC)represents a very large Mesoproterozoic igneous body,mainly composed of anorthosites and gabbroic rocks that extends from SW Angola to NW Namibia(outcropping 18,000 km^(2),NE-SW trend,and ca.350 ...The Kunene Complex(KC)represents a very large Mesoproterozoic igneous body,mainly composed of anorthosites and gabbroic rocks that extends from SW Angola to NW Namibia(outcropping 18,000 km^(2),NE-SW trend,and ca.350 km long and up to 50 km wide).Little is known about its structure at depth.Here,we use recently acquired aerogeophysical data to accurately determine its hidden extent and to unravel its morphology at depth.These data have been interpreted and modelled to investigate the unexposed KC boundaries,reconstructing the upper crustal structure(between 0 and 15 km depth)overlain by the thin sedimentary cover of the Kalahari Basin.The modelling reveals that the KC was emplaced in the upper crust and extends in depth up to ca.5 km,showing a lobular geometry and following a large NE-SW to NNE-SSW linear trend,presumably inherited from older Paleoproterozoic structures.The lateral continuation of the KC to the east(between 50 and 125 km)beneath the Kalahari Cenozoic sediments suggests an overall size three times the outcropping dimension(about 53,500 km^(2)).This affirmation clearly reinforces the economic potential of this massif,related to the prospecting of raw materials and certain types of economic mineralization(Fe-Ti oxides,metallic sulphides or platinum group minerals).Up to 11 lobes have been isolated with dimensions ranging from 135.5 to 37.3 km in length and 81.9 to 20.7 km in width according to remanent bodies revealed by TMI mapping.A total volume of 65,184 km3 was calculated only for the magnetically remanent bodies of the KC.A long-lasting complex contractional regime,where large strike-slip fault systems were involved,occurred in three kinematic pulses potentially related to a change of velocity or convergence angle acting on previous Paleoproterozoic inherited sutures.The coalescent magmatic pulses can be recognized by means of magnetic anomalies,age of the bodies as well as the lineations inferred in this work:(i)Emplacement of the eastern mafic bodies and granites in a stage of significant lateral extension in a transtensional context between 1500 Ma and 1420 Ma;(ii)Migration of the mantle derived magmas westwards with deformation in a complex contractional setting with shearing structures involving western KC bodies and basement from 1415 Ma to 1340 Ma;(iii)NNW-SSE extensional structures are relocated westwards,involving mantle magmas,negative flower structures and depression that led to the formation of late Mesoproterozoic basins from 1325 Ma to 1170 Ma.Additionally,we detect several first and second order structures to place the structuring of the KC in a craton-scale context in relation to the crustal structures detected in NW Namibia.展开更多
Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypert...Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypertension, dyslipidemia, sleep apnea, and joint pain. Traditionally, bariatric surgeries have been categorized into hypoabsorptive, restrictive, or hybrid approaches. However, these classifications inadequately reflect the complex anatomical and physiological alterations associated with modern surgical methodologies. This paper explores the evolution of metabolic surgeries, emphasizing the integration of physiological concepts into classic procedures to provide more tailored and effective treatment options for obesity and its comorbidities. Finally, the proposal for a new classification based on current metabolic concepts will facilitate communication among patients, doctors, and healthcare professionals. Additionally, it will enable a more didactic and standardized approach to data collection for conducting studies and publications.展开更多
Hepatocrinology explores the intricate relationship between liver function and the endocrine system.Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein sy...Hepatocrinology explores the intricate relationship between liver function and the endocrine system.Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption.Despite its importance,assessing endocrine issues in cirrhotic patients is frequently neglected.This article provides a comprehensive review of the epidemiology,pathophysiology,diagnosis,and treatment of endocrine disturbances in liver cirrhosis.The review was conducted using the PubMed/Medline,EMBASE,and Scielo databases,encompassing 172 articles.Liver cirrhosis is associated with endocrine disturbances,including diabetes,hypoglycemia,sarcopenia,thyroid dysfunction,hypogonadotropic hypogonadism,bone disease,adrenal insufficiency,growth hormone dysfunction,and secondary hyperaldosteronism.The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system,respectively.Sarcopenia can be assessed through imaging and functional tests,while other endocrine disorders are evaluated using hormonal assays and imaging studies.Treatment options include metformin,glucagon-like peptide-1 analogs,sodium-glucose co-transporter-2 inhibitors,and insulin,which are effective and safe for diabetes control.Established standards are followed for managing hypoglycemia,and hormone replacement therapy is often necessary for other endocrine dysfunctions.Liver transplantation can address some of these problems.展开更多
This study investigates the influence of electropolymerization conditions on the deposition of polypyrrole(PPy)onto cotton-derived carbon fiber(CF)modified with reduced graphene oxide(rGO)for supercapacitors applicati...This study investigates the influence of electropolymerization conditions on the deposition of polypyrrole(PPy)onto cotton-derived carbon fiber(CF)modified with reduced graphene oxide(rGO)for supercapacitors applications using an experimental/theorical approach.The surface modification of CF by rGO and/or by PPy electrodeposited at 10,25 and 50 mV s^(-1) was thoroughly examined physicochemical and electrochemically.Composite electrodes comprising CF-rGo-PPy,synthesized via electropolymerization at 25 mV s^(-1),demonstrated a remarkable increase in capacitance,showcasing~742 F g^(-1) compared to 153 F g^(-1) for CF.SEM,N_(2)-surface area,XPS,and TD-DFT approach revealed that the higher capacitance observed in CF-rGo-PPy electrodes underscores the influence of morphology and charged nitrogen species on the electrochemical performance of these modified electrodes.Notably,this electrode material achieves a specific capacitance retention of~96%of their initial capacitance after 10000 cycles at 0.5 A g^(-1) measured in a two-electrodes cell configuration.This work also discusses the influence of the scan rate used for pyrrole electropolymerization on the pseudocapacitance contribution of PPy and its possible effect on the porosity of the material.These results highlight the importance of appropriate electropolymerization conditions that allow obtaining the synergistic effect between CF,rGO and PPy.展开更多
BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now...BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese or overweight counterpart.CONCLUSION MASLD is a complex disease comprising epigenetic,genetic,and metabolic factors in its pathogenesis.Results vary across populations,gender,and age.Limited data exists on clinical practice guidelines for lean patients.Future studies employing this new nomenclature can contribute to standardizing and generalizing results among lean patients with steatotic liver disease.展开更多
Liver transplantation(LT)for metabolic dysfunction-associated steatotic liver disease(MASLD)is increasing globally due to rising rates of obesity and metabolic syndrome,posing significant challenges.MASLD patients typ...Liver transplantation(LT)for metabolic dysfunction-associated steatotic liver disease(MASLD)is increasing globally due to rising rates of obesity and metabolic syndrome,posing significant challenges.MASLD patients typically present with advanced age,higher body mass index(BMI),and metabolic com-orbidities such as diabetes,hypertension,and dyslipidemia.Comprehensive pre-transplant evaluations are crucial for assessing surgical risks and preparing patients for transplantation.MASLD patients with higher BMI may experience longer operative times,potentially affecting intraoperative outcomes.In the months following LT,MASLD recipients face persistent challenges,including a higher incidence of metabolic syndrome and cardiovascular events compared to non-MASLD recipients.However,survival rates at 1-,3-,and 5-years post-LT do not markedly differ from other etiologies,indicating comparable surgical outcomes.Optimizing outcomes in MASLD patients undergoing LT demands a multidisciplinary approach from pre-transplant assessment to post-transplant care.Strategies must address metabolic comorbidities,manage cardiovascular health,and monitor steatosis recurrence,which can be exacerbated by obesity and diabetes.This approach aims to mitigate long-term graft complications and mortality risks,ultimately enhancing transplant success and patient well-being.Continued research is essential to refine these approaches and meet the evolving challenges posed by MASLD as a leading indication for LT worldwide.展开更多
In this work,we present the results of the optical evaluation of resonance vibrations in a conventional roof.On this occasion,we took advantage of having an ordinary booth near the laboratory,making it easier for us t...In this work,we present the results of the optical evaluation of resonance vibrations in a conventional roof.On this occasion,we took advantage of having an ordinary booth near the laboratory,making it easier for us to conduct this evaluation.The roof in question has a square geometry and is apparently made of concrete.Following our usual LPD(laser photo deflection)procedure,of exciting the vibrations of the structure through sound and detecting the response optically,we obtain by resonance the first 6 roof’s Eigen oscillations,the same ones that are identified as Modes(1,1),(1,2),(2,2),(1,3),(2,3)and(3,3).The occurrence of these modes in this work is justified in a first approximation through the classical acoustic resonator theory.展开更多
BACKGROUND Numerous studies have indicated that the temozolomide and capecitabine regimen(TEMCAP)exhibits a certain level of efficacy in treating advanced,welldifferentiated gastroenteropancreatic neuroendocrine tumor...BACKGROUND Numerous studies have indicated that the temozolomide and capecitabine regimen(TEMCAP)exhibits a certain level of efficacy in treating advanced,welldifferentiated gastroenteropancreatic neuroendocrine tumors(GEP-NET).However,published data from Peru are limited.We hypothesize that this regimen could be a viable therapeutic option for advanced GEP-NET in the Peruvian population.AIM To evaluate overall survival(OS)in patients diagnosed with advanced GEP-NET treated with TEMCAP at the Instituto Nacional de Enfermedades Neoplásicas(INEN)in Lima-Perú.METHODS A retrospective review was conducted to identify patients with GEP-NEN treated with the TEMCAP regimen between 2011 and 2021 at the INEN.A total of thirtyeight patients were included in the final analysis:Thirty-five received TEMCAP as a first-line treatment,and three as a second-line treatment.The primary objective was to evaluate OS.The efficacy and safety of TEMCAP were assessed until the occurrence of unacceptable toxicity or disease progression.Survival outcomes were estimated using the Kaplan-Meier method.RESULTS The median age of the patients was 52 years(range 24-77 years),and 53.3%were female.The most common symptoms at diagnosis were abdominal pain in 31 patients(81.6%).Primary tumors included 12 in the rectum(31.6%),11 in the pancreas(28.9%),3 in the ileum(7.9%),2 in the mesentery(5.3%),2 in the small intestine(5.3%),1 in the appendix(2.6%),1 in the stomach(2.6%)and 6 cases of liver metastasis of unknown primary(15.8%).Five were neuroendocrine tumors(NET)G1(13.2%),33 were NET G2(86.8%),five had Ki67<3%(13.2%),and 33 had Ki67 between 3%and 20%(86.8%).TEMCAP was administered to 35(92.1%)patients as first-line treatment.OS at 12,36,and 60 months was estimated in 80%,66%,and 42%,respectively,with a median OS of 49 months.CONCLUSION TEMCAP therapy is a viable first-line option regarding efficacy and tolerability in areas where standard therapy is inaccessible.展开更多
文摘Hepatocellular carcinoma(HCC)is the most common type of primary liver cancer,the sixth most common cancer worldwide,and the third leading cause of cancer-related death.Cirrhosis is the predominant risk factor for HCC,driven by major etiologies including hepatitis B and C,excessive alcohol consumption,and metabolic dysfunction-associated steatotic liver disease(MASLD).While approximately 80%of HCC cases occur in patients with cirrhosis,its incidence among individuals without cirrhosis has significantly increased,particularly in developed countries,driven by the rising prevalence of MASLD.The prevalence of patients with non-cirrhotic HCC varies geographically,yet data on this subgroup remain limited.Consequently,screening and clinical management guidelines for patients with non-cirrhotic HCC are underdeveloped.Current surveillance is typically not recommended for non-cirrhotic populations,except for individuals with hepatitis B,and diagnostic criteria like Liver Imaging Reporting and Data System are designed explicitly for cirrhotic or hepatitis B-associated HCC.Furthermore,treatment strategies for non-cirrhotic HCC are often extrapolated from studies focused on patients with cirrhosis,leading to gaps in knowledge regarding treatment efficacy,survival outcomes,and etiological variability in noncirrhotic cohorts.Thus,emerging evidence must be reviewed to guide the development of enhanced diagnostic and therapeutic strategies for patients with non-cirrhotic HCC.To address these gaps,we comprehensively reviewed the epidemiology,clinical and genetic characteristics,diagnostic modalities,and therapeutic approaches for patients with non-cirrhotic HCC.
文摘This article presents the optical evaluation of the vibrational behavior of a steel bar,by a non-conventional optoacoustic procedure,the LPD(laser photo deflection)method.On this occasion the bar is located horizontal and fixed at both ends.Through our procedure we experimentally find the first 9 Eigen frequencies(21 Hz,60 Hz,116 Hz...)and correlate them using the cantilever theory.
文摘BACKGROUND The location of gastric neoplasms can influence the level of technical difficulty and performance of endoscopic submucosal dissection(ESD).There are few studies that analyze the influence of tumor location in the stomach on ESD outcomes.AIM To compare the clinical efficacy and safety of ESD in the proximal vs distal stomach.METHODS A retrospective analysis was conducted on patients admitted in chronological order who received gastric ESD between 2009 and 2024.Patients were stratified into two groups based on tumor location:Group 1 included patients with tumors in the lower third of the stomach,while Group 2 included those with tumors in the middle or upper third.The following parameters were evaluated for each group:procedure duration,curative resection rate,en bloc resection rate,complete resection rate,incidence of complications,and depth of neoplastic invasion.RESULTS The mean procedure time was 97.07 minutes for lesions located in the distal stomach and 129.08 minutes for those in the proximal stomach(P=0.0011).En bloc resection rates for ESD in the distal and proximal stomach were 97.9%and 85.7%,respectively(P=0.0016),while complete resection rates were 93.9%and 73.4%,respectively(P=0.0002).Curative resection was achieved in 90.9%of distal lesions compared to 65.3%of proximal lesions(P=0.0001).Submucosal invasion was identified in 4.0%of distal lesions and 14.2%of proximal lesions(P=0.013).CONCLUSION ESD performed in the proximal stomach requires a longer procedural time compared to ESD in the distal stomach,independent of lesion size and histopathological characteristics.Additionally,proximal gastric ESD is associated with reduced clinical efficacy and increased incidence of submucosal invasion.
文摘The bowel preparation is a crucial step to achieve an optimal quality in colonoscopy.The major clinical impact of an adequate colonic cleansing is to allow a more detailed and thorough inspection reducing the rates of missing lesions during the procedure and consequently reducing the incidence of interval colorectal carcinomas.Currently there are different colonoscopic preparation schemes,being the polyethylene glycol(PEG)based regimen one of the most used and recommended by the main international clinical guidelines.Nevertheless,PEG preparation requires the ingestion of considerably large volumes to achieve an optimal colonic cleansing,leading to poor tolerability in may patients,particularly in an elderly population.Other aspects that make accessibility to most colonoscopy preparation regimens difficult is their high cost and low availability.New options of colonoscopic preparation schemes based on oral lactulose are emerging with promising results,showing excellent efficacy-safety profiles and high tolerability indexes.Lactulose regimens present other benefits such as low cost and wide availability.The aim of this review is to analyze the scientific evidence to date and the current status of colonoscopy bowel preparation utilizing lactulose-based regimens,in order to consolidate this agent as a feasible“new player”in the field of colonoscopic preparation.
文摘Type 2 diabetes mellitus(T2DM)is a metabolic disorder marked by chronic hyperglycemia and low-grade inflammation,contributing to various complications.Natural agents with immunomodulatory and antioxidant properties have gained attention as adjunct therapies.To review the effects of Allium sativum on inflammatory pathways and metabolic alterations associated with T2DM.A narrative review was performed using PubMed/MEDLINE,EMBASE,and Scielo databases.The search included terms such as“allium sativum”,“inflammation",“oxidative stress”,and“diabetes mellitus”.Studies in English and Spanish-ranging from clinical trials to meta-analyses-were selected based on relevance.Bioactive compounds such as allicin,S-allyl cysteine,and diallyl disulfide exhibit anti-inflammatory,antioxidant,hypoglycemic,and lipid-lowering actions.Preclinical studies show improved glucose metabolism,insulin sensitivity,and organ function.Moreover,clinical evidence supports reductions in fasting glucose,hemoglobin A1c,blood pressure,and oxidative stress,with good safety profiles.Allium sativum appears to be a promising adjuvant in T2DM management,offering metabolic and anti-inflammatory benefits.Nonetheless,further high-quality clinical trials are needed to confirm its long-term efficacy and standardize its therapeutic use.
基金supported by the National Natural Science Foundation of China(42222201,42288201)。
文摘Angiosperms experienced one of the most remarkable radiations of land plants and are now the dominant autotrophs in terrestrial ecosystems.Recent phylogenomic studies based on large-scale data from plastid,mitochondrial,or nuclear transcriptomes/genomes and increased taxon sampling have provided unprecedent resolution into the phylogeny of flowering plants.However,owing to ancient rapid radiations,the interrelationships among the five lineages of Mesangiospermae,the vast majority of angiosperms,remain contentious.Here we show that,although plastid and mitochondrial genomes lack sufficient phylogenetic signal for resolving deeper phylogeny,the relationships among five mesangiosperm lineages can be confidently resolved under better-fitting models using genome-scale data.According to our Bayesian cross-validation and model test in a maximum likelihood framework,siteheterogeneous models(e.g.,CAT-GTR+G4,LG+C20+F+G)outperform site-homogeneous or partition models often used in previous studies.Under site-heterogeneous models,the approximately unbiased test favored our preferred tree recovered from various datasets:Ceratophyllales(coontails)are robustly recovered as sister to monocots,and they together are sister to the clade comprising magnoliids,Chloranthales,and eudicots.Our phylogenomic analyses resolve the last enigma of the deeper phylogeny of angiosperms and emphasize the efficacy of modeling compositional heterogeneity in resolving rapid radiations of plants.
文摘Different habitat types exert particular challenges to ecological performance,ultimately having a strong influence on the evolution of morphology.Although it is well known that external morphology can evolve under the selective pressure of habitat structure,the evolutionary response of internal morphological traits remains vastly unexplored.Here,we test for morphological divergence between arenicolous and nonarenicolous species in a clade of tropidurid lizards,considering external morphological proportions and limb muscle dimensions.We found that arenicolous species seem to have evolved internal and external morphological adaptations that separate them from other habitat specialists.Moreover,comparative analyses suggested that the traits that differed the most between arenicolous and nonarenicolous lizards might have evolved divergently towards different optima.Additionally,the axis of higher morphological divergence between arenicolous and nonarenicolous species represented an important proportion of the morphological diversity within our sample,indicating that the hypothetical adaptive divergence of internal and external traits has contributed significantly to phenotypic diversity.Our results show that evolutionary associations between morphology and habitat use can be detected on both external body proportions and muscle morphology.Moreover,they highlight the emergent importance of internal anatomical traits in ecomorphological studies,especially when such traits are directly involved in determining functional performance.
基金partially funded by the Programa Nacional de Becas y Crédito Educativo of Peru and the Universitat de València,Spain.
文摘Self-Explaining Autonomous Systems(SEAS)have emerged as a strategic frontier within Artificial Intelligence(AI),responding to growing demands for transparency and interpretability in autonomous decisionmaking.This study presents a comprehensive bibliometric analysis of SEAS research published between 2020 and February 2025,drawing upon 1380 documents indexed in Scopus.The analysis applies co-citation mapping,keyword co-occurrence,and author collaboration networks using VOSviewer,MASHA,and Python to examine scientific production,intellectual structure,and global collaboration patterns.The results indicate a sustained annual growth rate of 41.38%,with an h-index of 57 and an average of 21.97 citations per document.A normalized citation rate was computed to address temporal bias,enabling balanced evaluation across publication cohorts.Thematic analysis reveals four consolidated research fronts:interpretability in machine learning,explainability in deep neural networks,transparency in generative models,and optimization strategies in autonomous control.Author co-citation analysis identifies four distinct research communities,and keyword evolution shows growing interdisciplinary links with medicine,cybersecurity,and industrial automation.The United States leads in scientific output and citation impact at the geographical level,while countries like India and China show high productivity with varied influence.However,international collaboration remains limited at 7.39%,reflecting a fragmented research landscape.As discussed in this study,SEAS research is expanding rapidly yet remains epistemologically dispersed,with uneven integration of ethical and human-centered perspectives.This work offers a structured and data-driven perspective on SEAS development,highlights key contributors and thematic trends,and outlines critical directions for advancing responsible and transparent autonomous systems.
基金funded by Direccion General de Investigaciones of Universidad Santiago de Cali under call No.01-2024.
文摘This study investigates the design and implementation of Flying Ad Hoc Networks(FANETs),a network architec-ture inspired by the Mobile Ad Hoc Network(MANET)model,specifically tailored to support unmanned aerial vehicles(UAVs).As UAVs increasingly contribute to diverse fields,from surveillance to delivery,FANETs have emerged as essential in ensuring stable,dynamic communication channels among drones in flight.This research adopts a dual approach,combining rigorous theoretical analysis with detailed practical simulations to assess the performance,adaptability,and efficiency of FANETs in varying conditions.The findings emphasize the ability of FANETs to manage network congestion effectively in densely populated areas,a critical feature for maintaining reliable communications in complex scenarios.Moreover,FANETs demonstrate high potential to support critical applications,such as emergency response,disaster management,and public safety operations,where quick and coordinated action is paramount.The study also underscores the importance of establishing a hierarchical structure among nodes within the network,which allows for more efficient data exchange and helps optimize the overall network performance.Through this work,significant insights are offered into the design principles that can enhance UAV communication networks,providing a foundation for the development of more resilient,scalable,and efficient technological solutions.These advancements could accelerate the deployment of UAVs across a variety of sectors,including logistics,agriculture,environmental monitoring,and more.As such,this study not only contributes to the field of ad hoc networking but also holds potential for transformative impacts across industries where UAVs play an increasingly central role,promoting greater integration and operational success.
文摘This study highlights the regulatory potential antibacterial and antiradical of Origanum elongatum essential oil(EO),an endemic medicinal plant of Morocco used for its various properties.The chemical composition of the EO was characterized using gas chromatography-mass spectrometry(GC-MS).The antibacterial activity against different agricultural phytopathogens was determined by disc diffusion and microatmosphere methods,as well as by the determination of minimum inhibitory concentrations(MIC)and minimum bactericidal concentration(MBC),while the antioxidant activity was evaluated by DPPH and FRAP assays.To complement the experimental analyses,a molecular docking approach was used to predict and elucidate the mechanisms of action of the identified bioactive com-pounds,both for their antioxidant and antibacterial properties.The GC-MS analysis revealed a chemical composition dominated by the major compounds:p-cymene-2-ol(25.31%),thymol(23.88%),andγ-terpinene(19.26%).Furthermore,antibacterial analyses performed using different methodological approaches(disc diffusion,microatmosphere,MIC,and MBC)showed significant inhibitory activity against all phytopathogens tested.Moreover,O.elongatum EO exhibited interesting antioxidant ability with an IC_(50) value of 168.251.14μg/mL for DPPH assay and EC_(50) value±of 164.221.04μg/mL for FRAP assay.Furthermore,in silico molecular docking demonstrated further insights into±the interactions between the oil’s active components and bacterial targets,supporting its mode of action.This in-depth characterization highlights the potential of O.elongatum EO as a natural alternative for the biocontrol of plant pathogens.It opens new perspectives for developing natural solutions to protect crops against plant diseases.
文摘Juniperus oxycedrus(J.oxycedrus)is a traditional culinary spice and medicinal herb with a longstanding history of ethnopharmacological applications across diverse cultures.While prior research has explored the biological activities and phytochemical constituents of extracts derived from its leaves and seed cones,the present study systematically investigates their mineral and phenolic profiles alongside their multifunctional bioactive potential.Inductively coupled plasma-atomic emission spectroscopy(ICP-AES)analysis revealed a substantial abundance of essential macro-and microelements.Reversed-phase high-performance liquid chromatography(RP-HPLC)further identified high concentrations of phenolic acids(e.g.,p-coumaric acid)and flavonoids(e.g.,rutin and quercetin).The extracts exhibited potent radical scavenging activity against 2,2-diphenyl-1-picrylhydrazyl(DPPH),robust antioxidant capacity against hydrogen peroxide,and significant inhibition of xanthine oxidase(XO)activity.Notably,both extracts demonstrated marked antibacterial efficacy.In silico molecular docking studies suggested that the antimicrobial activity may stem from the phenolic constituents,which exhibited favorable binding affinities to the active site of bacterial target proteins.These findings underscore J.oxycedrus as a promising reservoir of bioactive natural compounds,warranting further exploration for therapeutic and nutraceutical applications.
基金supported by the subsidiary programme“Ayudas Extraordinarias Menciones Excelencia Severo Ochoa”of the CN IGME-CSIC(project AECEX2021,grant 15903)the University of Minnesota and National Science Foundation(award NSF-EAR 2153786)+1 种基金the Portuguese Foundation for Science and Technology(FCT)support,Geosciences Center project UIDB/00073/2020(doi:10.54499/UIDB/00073/2020)University of Coimbra and and GeoBioTec project UIDB/04035/2020(doi:10.54499/UIDB/04035/2020),Nova School of Science and Technology.
文摘The Kunene Complex(KC)represents a very large Mesoproterozoic igneous body,mainly composed of anorthosites and gabbroic rocks that extends from SW Angola to NW Namibia(outcropping 18,000 km^(2),NE-SW trend,and ca.350 km long and up to 50 km wide).Little is known about its structure at depth.Here,we use recently acquired aerogeophysical data to accurately determine its hidden extent and to unravel its morphology at depth.These data have been interpreted and modelled to investigate the unexposed KC boundaries,reconstructing the upper crustal structure(between 0 and 15 km depth)overlain by the thin sedimentary cover of the Kalahari Basin.The modelling reveals that the KC was emplaced in the upper crust and extends in depth up to ca.5 km,showing a lobular geometry and following a large NE-SW to NNE-SSW linear trend,presumably inherited from older Paleoproterozoic structures.The lateral continuation of the KC to the east(between 50 and 125 km)beneath the Kalahari Cenozoic sediments suggests an overall size three times the outcropping dimension(about 53,500 km^(2)).This affirmation clearly reinforces the economic potential of this massif,related to the prospecting of raw materials and certain types of economic mineralization(Fe-Ti oxides,metallic sulphides or platinum group minerals).Up to 11 lobes have been isolated with dimensions ranging from 135.5 to 37.3 km in length and 81.9 to 20.7 km in width according to remanent bodies revealed by TMI mapping.A total volume of 65,184 km3 was calculated only for the magnetically remanent bodies of the KC.A long-lasting complex contractional regime,where large strike-slip fault systems were involved,occurred in three kinematic pulses potentially related to a change of velocity or convergence angle acting on previous Paleoproterozoic inherited sutures.The coalescent magmatic pulses can be recognized by means of magnetic anomalies,age of the bodies as well as the lineations inferred in this work:(i)Emplacement of the eastern mafic bodies and granites in a stage of significant lateral extension in a transtensional context between 1500 Ma and 1420 Ma;(ii)Migration of the mantle derived magmas westwards with deformation in a complex contractional setting with shearing structures involving western KC bodies and basement from 1415 Ma to 1340 Ma;(iii)NNW-SSE extensional structures are relocated westwards,involving mantle magmas,negative flower structures and depression that led to the formation of late Mesoproterozoic basins from 1325 Ma to 1170 Ma.Additionally,we detect several first and second order structures to place the structuring of the KC in a craton-scale context in relation to the crustal structures detected in NW Namibia.
文摘Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypertension, dyslipidemia, sleep apnea, and joint pain. Traditionally, bariatric surgeries have been categorized into hypoabsorptive, restrictive, or hybrid approaches. However, these classifications inadequately reflect the complex anatomical and physiological alterations associated with modern surgical methodologies. This paper explores the evolution of metabolic surgeries, emphasizing the integration of physiological concepts into classic procedures to provide more tailored and effective treatment options for obesity and its comorbidities. Finally, the proposal for a new classification based on current metabolic concepts will facilitate communication among patients, doctors, and healthcare professionals. Additionally, it will enable a more didactic and standardized approach to data collection for conducting studies and publications.
文摘Hepatocrinology explores the intricate relationship between liver function and the endocrine system.Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption.Despite its importance,assessing endocrine issues in cirrhotic patients is frequently neglected.This article provides a comprehensive review of the epidemiology,pathophysiology,diagnosis,and treatment of endocrine disturbances in liver cirrhosis.The review was conducted using the PubMed/Medline,EMBASE,and Scielo databases,encompassing 172 articles.Liver cirrhosis is associated with endocrine disturbances,including diabetes,hypoglycemia,sarcopenia,thyroid dysfunction,hypogonadotropic hypogonadism,bone disease,adrenal insufficiency,growth hormone dysfunction,and secondary hyperaldosteronism.The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system,respectively.Sarcopenia can be assessed through imaging and functional tests,while other endocrine disorders are evaluated using hormonal assays and imaging studies.Treatment options include metformin,glucagon-like peptide-1 analogs,sodium-glucose co-transporter-2 inhibitors,and insulin,which are effective and safe for diabetes control.Established standards are followed for managing hypoglycemia,and hormone replacement therapy is often necessary for other endocrine dysfunctions.Liver transplantation can address some of these problems.
基金CONCYTEC and PROCIENCIA agencies from Peru in the framework of the call for Basic Research Projects2019-01[contract number401-2019-FONDECYT].
文摘This study investigates the influence of electropolymerization conditions on the deposition of polypyrrole(PPy)onto cotton-derived carbon fiber(CF)modified with reduced graphene oxide(rGO)for supercapacitors applications using an experimental/theorical approach.The surface modification of CF by rGO and/or by PPy electrodeposited at 10,25 and 50 mV s^(-1) was thoroughly examined physicochemical and electrochemically.Composite electrodes comprising CF-rGo-PPy,synthesized via electropolymerization at 25 mV s^(-1),demonstrated a remarkable increase in capacitance,showcasing~742 F g^(-1) compared to 153 F g^(-1) for CF.SEM,N_(2)-surface area,XPS,and TD-DFT approach revealed that the higher capacitance observed in CF-rGo-PPy electrodes underscores the influence of morphology and charged nitrogen species on the electrochemical performance of these modified electrodes.Notably,this electrode material achieves a specific capacitance retention of~96%of their initial capacitance after 10000 cycles at 0.5 A g^(-1) measured in a two-electrodes cell configuration.This work also discusses the influence of the scan rate used for pyrrole electropolymerization on the pseudocapacitance contribution of PPy and its possible effect on the porosity of the material.These results highlight the importance of appropriate electropolymerization conditions that allow obtaining the synergistic effect between CF,rGO and PPy.
文摘BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese or overweight counterpart.CONCLUSION MASLD is a complex disease comprising epigenetic,genetic,and metabolic factors in its pathogenesis.Results vary across populations,gender,and age.Limited data exists on clinical practice guidelines for lean patients.Future studies employing this new nomenclature can contribute to standardizing and generalizing results among lean patients with steatotic liver disease.
文摘Liver transplantation(LT)for metabolic dysfunction-associated steatotic liver disease(MASLD)is increasing globally due to rising rates of obesity and metabolic syndrome,posing significant challenges.MASLD patients typically present with advanced age,higher body mass index(BMI),and metabolic com-orbidities such as diabetes,hypertension,and dyslipidemia.Comprehensive pre-transplant evaluations are crucial for assessing surgical risks and preparing patients for transplantation.MASLD patients with higher BMI may experience longer operative times,potentially affecting intraoperative outcomes.In the months following LT,MASLD recipients face persistent challenges,including a higher incidence of metabolic syndrome and cardiovascular events compared to non-MASLD recipients.However,survival rates at 1-,3-,and 5-years post-LT do not markedly differ from other etiologies,indicating comparable surgical outcomes.Optimizing outcomes in MASLD patients undergoing LT demands a multidisciplinary approach from pre-transplant assessment to post-transplant care.Strategies must address metabolic comorbidities,manage cardiovascular health,and monitor steatosis recurrence,which can be exacerbated by obesity and diabetes.This approach aims to mitigate long-term graft complications and mortality risks,ultimately enhancing transplant success and patient well-being.Continued research is essential to refine these approaches and meet the evolving challenges posed by MASLD as a leading indication for LT worldwide.
文摘In this work,we present the results of the optical evaluation of resonance vibrations in a conventional roof.On this occasion,we took advantage of having an ordinary booth near the laboratory,making it easier for us to conduct this evaluation.The roof in question has a square geometry and is apparently made of concrete.Following our usual LPD(laser photo deflection)procedure,of exciting the vibrations of the structure through sound and detecting the response optically,we obtain by resonance the first 6 roof’s Eigen oscillations,the same ones that are identified as Modes(1,1),(1,2),(2,2),(1,3),(2,3)and(3,3).The occurrence of these modes in this work is justified in a first approximation through the classical acoustic resonator theory.
文摘BACKGROUND Numerous studies have indicated that the temozolomide and capecitabine regimen(TEMCAP)exhibits a certain level of efficacy in treating advanced,welldifferentiated gastroenteropancreatic neuroendocrine tumors(GEP-NET).However,published data from Peru are limited.We hypothesize that this regimen could be a viable therapeutic option for advanced GEP-NET in the Peruvian population.AIM To evaluate overall survival(OS)in patients diagnosed with advanced GEP-NET treated with TEMCAP at the Instituto Nacional de Enfermedades Neoplásicas(INEN)in Lima-Perú.METHODS A retrospective review was conducted to identify patients with GEP-NEN treated with the TEMCAP regimen between 2011 and 2021 at the INEN.A total of thirtyeight patients were included in the final analysis:Thirty-five received TEMCAP as a first-line treatment,and three as a second-line treatment.The primary objective was to evaluate OS.The efficacy and safety of TEMCAP were assessed until the occurrence of unacceptable toxicity or disease progression.Survival outcomes were estimated using the Kaplan-Meier method.RESULTS The median age of the patients was 52 years(range 24-77 years),and 53.3%were female.The most common symptoms at diagnosis were abdominal pain in 31 patients(81.6%).Primary tumors included 12 in the rectum(31.6%),11 in the pancreas(28.9%),3 in the ileum(7.9%),2 in the mesentery(5.3%),2 in the small intestine(5.3%),1 in the appendix(2.6%),1 in the stomach(2.6%)and 6 cases of liver metastasis of unknown primary(15.8%).Five were neuroendocrine tumors(NET)G1(13.2%),33 were NET G2(86.8%),five had Ki67<3%(13.2%),and 33 had Ki67 between 3%and 20%(86.8%).TEMCAP was administered to 35(92.1%)patients as first-line treatment.OS at 12,36,and 60 months was estimated in 80%,66%,and 42%,respectively,with a median OS of 49 months.CONCLUSION TEMCAP therapy is a viable first-line option regarding efficacy and tolerability in areas where standard therapy is inaccessible.
