In this study,a phosphate-based conversion coating(PCC)was applied as a precursor before forming silicate-fluoride(SiF)and silicate-phosphate-fluoride(SiPF)based flash-plasma electrolytic oxidation(Flash-PEO)coatings ...In this study,a phosphate-based conversion coating(PCC)was applied as a precursor before forming silicate-fluoride(SiF)and silicate-phosphate-fluoride(SiPF)based flash-plasma electrolytic oxidation(Flash-PEO)coatings on AZ31B magnesium alloy.The main novelty is the successful incorporation of calcium,zinc,manganese and phosphate species into the Flash-PEO coatings via a precursor layer rather than using the electrolyte.The precursor also led to longer lasting and more intense discharges during the PEO process,resulting in increased pore size.Corrosion studies revealed similar short-term performance for all coatings,with impedance modulus at low frequencies above 10^(7)Ωcm^(2),and slightly better performance for the SiPF-based coating.Nonetheless,the enlarged pores in the PEO coatings functionalized with the PCC precursor compromised the effectiveness of self-healing mechanisms by creating diffusion pathways for corrosive species,leading to earlier failure.These phenomena were effectively monitored by recording the open circuit potential during immersion in 0.5 wt.%NaCl solution.In summary,this study demonstrates that conversion coatings are a viable option for the functionalization of PEO coatings on magnesium alloys,as they allow for the incorporation of cationic and other species.However,it is crucial to maintain a small pore size to facilitate effective blockage through self-healing mechanisms.展开更多
Autophagy is a cellular degradation and recycling system,indispensable for cellular and organ development,homeostasis,and function.This cellular process is evolutionarily highly conserved to quality control of many pr...Autophagy is a cellular degradation and recycling system,indispensable for cellular and organ development,homeostasis,and function.This cellular process is evolutionarily highly conserved to quality control of many proteins and dysfunctional organelles,which finally recycle components as amino acids.This process is effective during normal physiology as part of anabolism and plays an additional important role during starvation(Dikic and Elazar,2018).Different types of autophagy have been chara cterized based on their dynamic,mechanism of action,target substrates,and protein markers.Some of them are macroautophagy(hereafter called"autophagy"),microa utophagy,and chape rone-media ted autophagy(Fleming et al.,2022).展开更多
Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of t...Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of treatment, the success rate in left-sided IE is often limited,as nearly half of all patients eventually require surgical intervention for definitive management.^([2]) Heart failure is the main indication for surgery, but access to surgery is frequently restricted by several factors, particularly in patients with advanced age, often driven by the presence of comorbidities or hemodynamic instability.^([3,4])展开更多
We extend a well-known mass-gap equation for pure gluodynamics in global colour models(formulated in equal-time quantization in Coulomb gauge)to one in which gluons are split into two sets,each exhibiting different ma...We extend a well-known mass-gap equation for pure gluodynamics in global colour models(formulated in equal-time quantization in Coulomb gauge)to one in which gluons are split into two sets,each exhibiting different masses.If the theory is SU(N)×SU(M)with gluons in both groups having identical couplings(as suggested by Grand Unification arguments at large scales)it is immediate to see that different masses are generated for each subgroup.This global symmetry is not broken,but the split masses erase accidental symmetries that might be present due to the two couplings being the same at a large scale,such as SU(N×M)or similar.We also numerically explore a couple of low-dimensional examples of simple Lie groups,but in spite of the system of equations having a form that would seem to allow spontaneous symmetry breaking,it is not triggered for these groups whose algebra has no ideal,and the dispersion relations for the various gluons converge to the same form.展开更多
Gastrointestinal malignancies,particularly pancreatobiliary and gastroesophageal cancers,are associated with poor prognosis due to their frequent late-stage diagnosis.Many of these tumors contribute to anorexia-cachex...Gastrointestinal malignancies,particularly pancreatobiliary and gastroesophageal cancers,are associated with poor prognosis due to their frequent late-stage diagnosis.Many of these tumors contribute to anorexia-cachexia syndrome and malnutrition,further exacerbating disease progression.Inflammation plays a crucial role in tumor proliferation,and growing evidence suggests that gut microbiome significantly influence inflammatory responses and clinical outcomes in these patients.Additionally,the gut microbiome contributes to carcinogenesis through multiple mechanisms,including DNA damage,activation of oncogenic pathways,and modulation of immune responses.The emerging field of nutritional interventions highlight the microbiome’s impact on anticancer drug responses,affecting both chemotherapy and molecular-targeted treatments.Given its pivotal role,microbiome modulation through probiotics,fecal microbiome transplantation,and antibiotics represents a promising approach for cancer pre-vention and treatment.In this review,we explore the intricate interplay between gut microbiome,inflammation,and nutritional status in gastrointestinal cancers,emphasizing potential therapeutic strategies to improve patient outcomes.展开更多
This article aims to analyze the repercussions of food trade between China and various regions of the world to understand the dynamics of food flows and offer a novel perspective on the contemporary globalization proc...This article aims to analyze the repercussions of food trade between China and various regions of the world to understand the dynamics of food flows and offer a novel perspective on the contemporary globalization process.Understanding these flows involves analyzing the global production and commercialization of food and the effects of these movements on exporting and importing countries in economic terms and food security.The concept of unequal caloric exchange is applied to the case of China,which allows for an understanding of how its economic growth and participation in international trade have transformed its global and internal commercial dynamics by establishing links with self-sufficiency and the composition of its population’s diet.The results show that China is increasingly dependent on international markets for its food supply.From 1961 to 2021,food consumption in China has tripled in calories and experienced qualitative changes,with a reduction in high-quality carbohydrates and vegetable proteins and an increase in cereals,vegetable oils,alcohol,and vegetables.This dietary transformation is related to economic growth and greater dependence on international trade.From 1987 to 2022,China has shown a growing deficit in the food trade balance,with imports exceeding exports in volume,value,and calories,although it maintains favorable terms of trade.Food self-sufficiency has decreased from 95%in 1961 to 76%in 2022,and the diet has diversified,replacing traditional foods with products demanded in international trade.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
To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases ri...To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade.展开更多
Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin.Compared with individuals without diabetes,patients with type 2 diabetes mellitus have a considera...Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin.Compared with individuals without diabetes,patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality,and are disproportionately affected by cardiovascular disease.Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension,dyslipidaemia and obesity in these patients.However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors.Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus.Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events.Many of these risk factors could be common history for both di-abetes mellitus and cardiovascular disease,reinforcing the postulate that both disorders come independently from"common soil".The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.展开更多
Stable carbon isotope geochemistry provides important information for the recognition of funda- mental isotope exchange processes related to the movement of carbon in the lithosphere and permits the elab- oration of m...Stable carbon isotope geochemistry provides important information for the recognition of funda- mental isotope exchange processes related to the movement of carbon in the lithosphere and permits the elab- oration of models for the global carbon cycle. Carbon isotope ratios in fluid-deposited graphite are powerful tools for unravelling the ultimate origin of carbon （organic matter, mantle, or carbonates） and help to constrain the fluid history and the mechanisms involved in graphite deposition. Graphite precipitation in fluid-deposited occurrences results from C02- and/or CH4-bearing aqueous fluids. Fluid flow can be considered as both a closed （without replenishment of the fluid） or an open system （with renewal of the fluid by successive fluid batches）. In closed systems, carbon isotope systematics in graphite is mainly governed by Rayleigh precipi- tation and/or by changes in temperature affecting the fractionation factor between fluid and graphite. Such processes result in zoned graphite crystals or in successive graphite generations showing, in both cases, isotopic variation towards progressive 13C or 12C enrichment （depending upon the dominant carbon phase in the fluid, C02 or CH4, respectively）. In open systems, in which carbon is episodically introduced along the fracture systems, the carbon systematics is more complex and individual graphite crystals may display oscillatory zoning because of Rayleigh precipitation or heterogeneous variations of 613C values when mixing of fluids or changes in the composition of the fluids are the mechanisms responsible for graphite precipitation.展开更多
In this work, the use of sepiolite for the removal of carbon dioxide from a carbon dioxide/methane mixture by a pressure swing adsorption （PSA） process has been researched. Adsorption equilibrium and kinetics have b...In this work, the use of sepiolite for the removal of carbon dioxide from a carbon dioxide/methane mixture by a pressure swing adsorption （PSA） process has been researched. Adsorption equilibrium and kinetics have been measured in a fixed-bed, and the adsorption equilibrium parameters of carbon dioxide and methane on sepiolite have been obtained. A model based on the LDF approximation has been employed to simulate the fixed-bed kinetics, using the Langmuir equation to describe the adsorption equilibrium isotherm. The functioning of a PSA cycle for separating carbon dioxide/methane mixtures using sepiolite as adsorbent has also been studied. The experimental results were compared with the ones predicted by the model adapted to a PSA system. Methane with purity higher than 97% can be obtained from feeds containing carbon dioxide with concentrations ranging from 34% to 56% with the proposed PSA cycle. These results suggest that sepiolite is an adsorbent with good properties for its employment in a PSA cycle for carbon dioxide removal from landfill gases.展开更多
Plasma electrolytic oxidation(PEO)coatings developed under voltage-controlled mode on various commercial wrought,gravity cast and rheocast aluminium alloys were discussed with respect to enhancement of their tribologi...Plasma electrolytic oxidation(PEO)coatings developed under voltage-controlled mode on various commercial wrought,gravity cast and rheocast aluminium alloys were discussed with respect to enhancement of their tribological and corrosionperformance and minimization of the PEO energy consumption.It is demonstrated that use of conventional porous anodic filmprecursors reduces the PEO energy consumption by up to50%.The wear of6082alloy with PEO coatings with addedα-Al2O3particles is two times lower compared with electrolytic hard chrome.The long-term corrosion resistance of the PEO-coatedA356rheocast alloy is enhanced via use of a precursor and hydrophobic post-treatment.展开更多
Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in...Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in approximately 40% of people with type 1 diabetesmellitus(T1DM) and with less frequency in T2 DM.Though the aetiology of HU is multifactorial,possible mechanisms include chronic exposure to low blood glucose,antecedent hypoglycaemia,recurrent severe hypoglycaemia and the failure of counter-regulatory hormones.Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms,but the mechanisms and mediators remain largely unknown.Prevention and management of HU is complex,and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team.Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes.Several medications are thought to worsen or promote HU,whereas others may have an attenuating effect on the problem.This article reviews recent advances in how the brain senses and responds to hypoglycaemia,novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses.The consequences that HU has on the person with diabetes and their family are also described.Finally,it examines the evidence for prevention and treatment of HU,and summarizes the effects of medications that may influence it.展开更多
Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particular...Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particularly due to the reactivation of latent infections due to opportunistic agents such as Mycobacterium tuberculosis.Active tuberculosis(TB)after SOT is a significant cause of morbidity and mortality.Most cases of posttransplant TB are secondary to reactivation of latent tuberculosis infection(LTBI)due to the effects of long-term immunosuppressive therapy.Risk minimization strategies have been developed to diagnose LTBI and initiate treatment prior to transplantation.Isoniazid with vitamin B6 supplementation is the treatment of choice.However,liver transplantation(LT)candidates and recipients have an increased risk of isoniazid-induced liver toxicity,leading to lower treatment completion rates than in other SOT populations.Fluoroquinolones(FQs)exhibit good in vitro antimycobacterial activity and a lower risk of drug-induced liver injury than isoniazid.In the present review,we highlight the disease burden posed by posttransplant TB and summarize the emerging clinical evidence supporting the use of FQs for the treatment of LTBI in LT recipients and candidates.展开更多
Orthotopic liver transplantation(OLT) is an established life-saving procedure for alcoholic cirrhotic(AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in c...Orthotopic liver transplantation(OLT) is an established life-saving procedure for alcoholic cirrhotic(AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in comparison with patients who undergo OLT for other etiologies. Tobacco, a known carcinogen, has been reported to be between 52% and 83.3% in AC patients before OLT. Other risk factors that contribute to the development of malignancies are dose-dependent immunosuppression, advanced age, viral infections, sun exposure, and premalignant lesions(inflammatory bowel disease, Barrett's esophagus). A significantly more frequent incidence of upper aerodigestive(UAD) tract, lung, skin, and kidney-bladder tumors has been found in OLT recipients for AC in comparison with other etiologies. Liver transplant recipients who develop de novo non-skin tumors have a decreased long-term survival rate compared with controls. This significantly lower survival rate is more evident in AC recipients who develop UAD tract or lung tumors after OLT mainly because the diagnosis is usually performed at an advanced stage. All transplant candidates, especially AC patients, should be encouraged to cease smoking and alcohol consumption in the pre- and postOLT periods, use skin protection, avoid sun exposure and over-immunosuppression, and have a yearly otopharyngolaryngeal exploration and chest computed tomography scan in order to prevent or reduce the incidence of de novo malignancies. Although still under investigation, substitution of calcineurin inhibitors for sirolimus or everolimus may reduce the incidence of de novo tumors after OLT.展开更多
The treatment of metastatic colorectal cancer(mCRC)has evolved considerably in the last decade,currently allowing most mCRC patients to live more than two years.Monoclonal antibodies targeting the epidermal growth fac...The treatment of metastatic colorectal cancer(mCRC)has evolved considerably in the last decade,currently allowing most mCRC patients to live more than two years.Monoclonal antibodies targeting the epidermal growth factor receptor(EGFR)and vascular endothelial growth factor play an important role in the current treatment of these patients.However,only antibodies directed against EGFR have a predictive marker of response,which is the mutation status of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog(KRAS).Cetuximab has been shown to be effective in patients with KRAS wild-type mCRC.The CRYSTAL study showed that adding cetuximab to FOLFIRI(regimen of irinotecan,infusional fluorouracil and leucovorin)significantly improved results in the first-line treatment of KRAS wildtype mCRC.However,results that evaluate the efficacy of cetuximab in combination with oxaliplatin-based chemotherapy in this setting are contradictory.On the other hand,recent advances in the management of colorectal liver metastases have improved survival in these patients.Adding cetuximab to standard chemotherapy increases the response rate in patients with wild-type KRAS and can thus increase the resectability rate of liver metastases in this group of patients.In this paper we review the different studies assessing the efficacy of cetuximab in the first-line treatment of mCRC.展开更多
Alcoholic liver disease(ALD) is a major cause of acute and chronic liver injury. Extensive evidence has been accumulated on the pathological process of ALD during the past decades. However, effective treatment options...Alcoholic liver disease(ALD) is a major cause of acute and chronic liver injury. Extensive evidence has been accumulated on the pathological process of ALD during the past decades. However, effective treatment options for ALD are very limited due to the lack of suitable in vivo models that recapitulate the full spectrum of ALD. Experimental animal models of ALD, particularly rodents, have been used extensively to mimic human ALD. An ideal animal model should recapitulate all aspects of the ALD process, including significant steatosis, hepatic neutrophil infiltration, and liver injury. A better strategy against ALD depends on clear diagnostic biomarkers, accurate predictor(s) of its progression and new therapeutic approaches to modulate stop or even reverse the disease. Numerous models employing rodent animals have been established in the last decades to investigate the effects of acute and chronic alcohol exposure on the initiation and progression of ALD. Although significant progress has been made in gaining better knowledge on the mechanisms and pathology of ALD, many features of ALD are unknown, and require further investigation, ideally with improved animal models that more effectively mimic human ALD. Although differences in the degree and stages of alcoholic liver injury inevitably exist between animal models and human ALD, the acquisition and translational relevance will be greatly enhanced with the development of new and improved animal models of ALD.展开更多
基金support of the PID2021-124341OB-C22/AEI/10.13039/501100011033/FEDER,UE(MICIU)J.M.Vega also acknowledges the Grant RYC2021-034384-I funded by MICIU/AEI/10.13039/501100011033 and by“European Union Next Generation EU/PRTR”.
文摘In this study,a phosphate-based conversion coating(PCC)was applied as a precursor before forming silicate-fluoride(SiF)and silicate-phosphate-fluoride(SiPF)based flash-plasma electrolytic oxidation(Flash-PEO)coatings on AZ31B magnesium alloy.The main novelty is the successful incorporation of calcium,zinc,manganese and phosphate species into the Flash-PEO coatings via a precursor layer rather than using the electrolyte.The precursor also led to longer lasting and more intense discharges during the PEO process,resulting in increased pore size.Corrosion studies revealed similar short-term performance for all coatings,with impedance modulus at low frequencies above 10^(7)Ωcm^(2),and slightly better performance for the SiPF-based coating.Nonetheless,the enlarged pores in the PEO coatings functionalized with the PCC precursor compromised the effectiveness of self-healing mechanisms by creating diffusion pathways for corrosive species,leading to earlier failure.These phenomena were effectively monitored by recording the open circuit potential during immersion in 0.5 wt.%NaCl solution.In summary,this study demonstrates that conversion coatings are a viable option for the functionalization of PEO coatings on magnesium alloys,as they allow for the incorporation of cationic and other species.However,it is crucial to maintain a small pore size to facilitate effective blockage through self-healing mechanisms.
基金supported by Grants from Spanish FEDER/Science and Innovation Ministry I+D+i-RETOS-PID2021-124801NB-100Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas(CIBERN ED+1 种基金an initiative of the ISCIII)[PI2016/01]the Fundocion Ramon Areces and Banco Santander to the CBMSO(to FW)。
文摘Autophagy is a cellular degradation and recycling system,indispensable for cellular and organ development,homeostasis,and function.This cellular process is evolutionarily highly conserved to quality control of many proteins and dysfunctional organelles,which finally recycle components as amino acids.This process is effective during normal physiology as part of anabolism and plays an additional important role during starvation(Dikic and Elazar,2018).Different types of autophagy have been chara cterized based on their dynamic,mechanism of action,target substrates,and protein markers.Some of them are macroautophagy(hereafter called"autophagy"),microa utophagy,and chape rone-media ted autophagy(Fleming et al.,2022).
文摘Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of treatment, the success rate in left-sided IE is often limited,as nearly half of all patients eventually require surgical intervention for definitive management.^([2]) Heart failure is the main indication for surgery, but access to surgery is frequently restricted by several factors, particularly in patients with advanced age, often driven by the presence of comorbidities or hemodynamic instability.^([3,4])
基金supported by the EU under grant 824093(STRONG2020)spanish MICINN under PID2019-108655GBI00/AEI/10.13039/501100011033,PID2019-106080GB-C21 and PRX23/00225(estancias en el extranjero)Univ.Complutense de Madrid under research group 910309 and the IPARCOS institute。
文摘We extend a well-known mass-gap equation for pure gluodynamics in global colour models(formulated in equal-time quantization in Coulomb gauge)to one in which gluons are split into two sets,each exhibiting different masses.If the theory is SU(N)×SU(M)with gluons in both groups having identical couplings(as suggested by Grand Unification arguments at large scales)it is immediate to see that different masses are generated for each subgroup.This global symmetry is not broken,but the split masses erase accidental symmetries that might be present due to the two couplings being the same at a large scale,such as SU(N×M)or similar.We also numerically explore a couple of low-dimensional examples of simple Lie groups,but in spite of the system of equations having a form that would seem to allow spontaneous symmetry breaking,it is not triggered for these groups whose algebra has no ideal,and the dispersion relations for the various gluons converge to the same form.
文摘Gastrointestinal malignancies,particularly pancreatobiliary and gastroesophageal cancers,are associated with poor prognosis due to their frequent late-stage diagnosis.Many of these tumors contribute to anorexia-cachexia syndrome and malnutrition,further exacerbating disease progression.Inflammation plays a crucial role in tumor proliferation,and growing evidence suggests that gut microbiome significantly influence inflammatory responses and clinical outcomes in these patients.Additionally,the gut microbiome contributes to carcinogenesis through multiple mechanisms,including DNA damage,activation of oncogenic pathways,and modulation of immune responses.The emerging field of nutritional interventions highlight the microbiome’s impact on anticancer drug responses,affecting both chemotherapy and molecular-targeted treatments.Given its pivotal role,microbiome modulation through probiotics,fecal microbiome transplantation,and antibiotics represents a promising approach for cancer pre-vention and treatment.In this review,we explore the intricate interplay between gut microbiome,inflammation,and nutritional status in gastrointestinal cancers,emphasizing potential therapeutic strategies to improve patient outcomes.
基金supported by the Government of Catalonia,and the ETOS project(TED2021-132032A-I00)supported by the Spanish Ministry of Science and Innovation.
文摘This article aims to analyze the repercussions of food trade between China and various regions of the world to understand the dynamics of food flows and offer a novel perspective on the contemporary globalization process.Understanding these flows involves analyzing the global production and commercialization of food and the effects of these movements on exporting and importing countries in economic terms and food security.The concept of unequal caloric exchange is applied to the case of China,which allows for an understanding of how its economic growth and participation in international trade have transformed its global and internal commercial dynamics by establishing links with self-sufficiency and the composition of its population’s diet.The results show that China is increasingly dependent on international markets for its food supply.From 1961 to 2021,food consumption in China has tripled in calories and experienced qualitative changes,with a reduction in high-quality carbohydrates and vegetable proteins and an increase in cereals,vegetable oils,alcohol,and vegetables.This dietary transformation is related to economic growth and greater dependence on international trade.From 1987 to 2022,China has shown a growing deficit in the food trade balance,with imports exceeding exports in volume,value,and calories,although it maintains favorable terms of trade.Food self-sufficiency has decreased from 95%in 1961 to 76%in 2022,and the diet has diversified,replacing traditional foods with products demanded in international trade.
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.
基金open project(No.47549P0)of the State Key Laboratory of Scientific and Engineering Computing,Chinese Academy of SciencesNational Natural Science Foundation of China(Grant No.10872037)+2 种基金Natural Science Research Project of Henan Province(Grant No.2009A110017)Ministerio de Educación y Ciencia(Spain)(grant MTM2005-05573)Sabbatical Program(SAB2006-0070)of the Spanish Ministry of Education and Science
文摘To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade.
文摘Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin.Compared with individuals without diabetes,patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality,and are disproportionately affected by cardiovascular disease.Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension,dyslipidaemia and obesity in these patients.However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors.Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus.Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events.Many of these risk factors could be common history for both di-abetes mellitus and cardiovascular disease,reinforcing the postulate that both disorders come independently from"common soil".The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.
基金contribution from project CGL2010-16008 (Spanish Ministry for Science and Innovation)
文摘Stable carbon isotope geochemistry provides important information for the recognition of funda- mental isotope exchange processes related to the movement of carbon in the lithosphere and permits the elab- oration of models for the global carbon cycle. Carbon isotope ratios in fluid-deposited graphite are powerful tools for unravelling the ultimate origin of carbon （organic matter, mantle, or carbonates） and help to constrain the fluid history and the mechanisms involved in graphite deposition. Graphite precipitation in fluid-deposited occurrences results from C02- and/or CH4-bearing aqueous fluids. Fluid flow can be considered as both a closed （without replenishment of the fluid） or an open system （with renewal of the fluid by successive fluid batches）. In closed systems, carbon isotope systematics in graphite is mainly governed by Rayleigh precipi- tation and/or by changes in temperature affecting the fractionation factor between fluid and graphite. Such processes result in zoned graphite crystals or in successive graphite generations showing, in both cases, isotopic variation towards progressive 13C or 12C enrichment （depending upon the dominant carbon phase in the fluid, C02 or CH4, respectively）. In open systems, in which carbon is episodically introduced along the fracture systems, the carbon systematics is more complex and individual graphite crystals may display oscillatory zoning because of Rayleigh precipitation or heterogeneous variations of 613C values when mixing of fluids or changes in the composition of the fluids are the mechanisms responsible for graphite precipitation.
文摘In this work, the use of sepiolite for the removal of carbon dioxide from a carbon dioxide/methane mixture by a pressure swing adsorption （PSA） process has been researched. Adsorption equilibrium and kinetics have been measured in a fixed-bed, and the adsorption equilibrium parameters of carbon dioxide and methane on sepiolite have been obtained. A model based on the LDF approximation has been employed to simulate the fixed-bed kinetics, using the Langmuir equation to describe the adsorption equilibrium isotherm. The functioning of a PSA cycle for separating carbon dioxide/methane mixtures using sepiolite as adsorbent has also been studied. The experimental results were compared with the ones predicted by the model adapted to a PSA system. Methane with purity higher than 97% can be obtained from feeds containing carbon dioxide with concentrations ranging from 34% to 56% with the proposed PSA cycle. These results suggest that sepiolite is an adsorbent with good properties for its employment in a PSA cycle for carbon dioxide removal from landfill gases.
基金supported by Regional Government of Madrid and EU Structural Funds via Multimat Challenge Programme(S2013/MIT-2862-CM)Proyecto Retos Jovenes Investigadores Programme(MAT2015-73355-JIN)funded by MINECO,Spain
文摘Plasma electrolytic oxidation(PEO)coatings developed under voltage-controlled mode on various commercial wrought,gravity cast and rheocast aluminium alloys were discussed with respect to enhancement of their tribological and corrosionperformance and minimization of the PEO energy consumption.It is demonstrated that use of conventional porous anodic filmprecursors reduces the PEO energy consumption by up to50%.The wear of6082alloy with PEO coatings with addedα-Al2O3particles is two times lower compared with electrolytic hard chrome.The long-term corrosion resistance of the PEO-coatedA356rheocast alloy is enhanced via use of a precursor and hydrophobic post-treatment.
文摘Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in approximately 40% of people with type 1 diabetesmellitus(T1DM) and with less frequency in T2 DM.Though the aetiology of HU is multifactorial,possible mechanisms include chronic exposure to low blood glucose,antecedent hypoglycaemia,recurrent severe hypoglycaemia and the failure of counter-regulatory hormones.Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms,but the mechanisms and mediators remain largely unknown.Prevention and management of HU is complex,and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team.Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes.Several medications are thought to worsen or promote HU,whereas others may have an attenuating effect on the problem.This article reviews recent advances in how the brain senses and responds to hypoglycaemia,novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses.The consequences that HU has on the person with diabetes and their family are also described.Finally,it examines the evidence for prevention and treatment of HU,and summarizes the effects of medications that may influence it.
基金“Plan Nacional de I+D+I”Instituto de Salud Carlos III(Fondo de Investigaciones Sanitarias [FIS] PI14/00174)+1 种基金ubdirección General de Redes y Centros de Investigación Cooperativa,Spanish Ministry of Science,Innovation and Universities,Spanish Network for Research in Infectious Diseases(REIPI RD16/0016)cofinanced by the European Development Regional Fund(EDRF)"A way to achieve Europe"
文摘Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particularly due to the reactivation of latent infections due to opportunistic agents such as Mycobacterium tuberculosis.Active tuberculosis(TB)after SOT is a significant cause of morbidity and mortality.Most cases of posttransplant TB are secondary to reactivation of latent tuberculosis infection(LTBI)due to the effects of long-term immunosuppressive therapy.Risk minimization strategies have been developed to diagnose LTBI and initiate treatment prior to transplantation.Isoniazid with vitamin B6 supplementation is the treatment of choice.However,liver transplantation(LT)candidates and recipients have an increased risk of isoniazid-induced liver toxicity,leading to lower treatment completion rates than in other SOT populations.Fluoroquinolones(FQs)exhibit good in vitro antimycobacterial activity and a lower risk of drug-induced liver injury than isoniazid.In the present review,we highlight the disease burden posed by posttransplant TB and summarize the emerging clinical evidence supporting the use of FQs for the treatment of LTBI in LT recipients and candidates.
文摘Orthotopic liver transplantation(OLT) is an established life-saving procedure for alcoholic cirrhotic(AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in comparison with patients who undergo OLT for other etiologies. Tobacco, a known carcinogen, has been reported to be between 52% and 83.3% in AC patients before OLT. Other risk factors that contribute to the development of malignancies are dose-dependent immunosuppression, advanced age, viral infections, sun exposure, and premalignant lesions(inflammatory bowel disease, Barrett's esophagus). A significantly more frequent incidence of upper aerodigestive(UAD) tract, lung, skin, and kidney-bladder tumors has been found in OLT recipients for AC in comparison with other etiologies. Liver transplant recipients who develop de novo non-skin tumors have a decreased long-term survival rate compared with controls. This significantly lower survival rate is more evident in AC recipients who develop UAD tract or lung tumors after OLT mainly because the diagnosis is usually performed at an advanced stage. All transplant candidates, especially AC patients, should be encouraged to cease smoking and alcohol consumption in the pre- and postOLT periods, use skin protection, avoid sun exposure and over-immunosuppression, and have a yearly otopharyngolaryngeal exploration and chest computed tomography scan in order to prevent or reduce the incidence of de novo malignancies. Although still under investigation, substitution of calcineurin inhibitors for sirolimus or everolimus may reduce the incidence of de novo tumors after OLT.
文摘The treatment of metastatic colorectal cancer(mCRC)has evolved considerably in the last decade,currently allowing most mCRC patients to live more than two years.Monoclonal antibodies targeting the epidermal growth factor receptor(EGFR)and vascular endothelial growth factor play an important role in the current treatment of these patients.However,only antibodies directed against EGFR have a predictive marker of response,which is the mutation status of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog(KRAS).Cetuximab has been shown to be effective in patients with KRAS wild-type mCRC.The CRYSTAL study showed that adding cetuximab to FOLFIRI(regimen of irinotecan,infusional fluorouracil and leucovorin)significantly improved results in the first-line treatment of KRAS wildtype mCRC.However,results that evaluate the efficacy of cetuximab in combination with oxaliplatin-based chemotherapy in this setting are contradictory.On the other hand,recent advances in the management of colorectal liver metastases have improved survival in these patients.Adding cetuximab to standard chemotherapy increases the response rate in patients with wild-type KRAS and can thus increase the resectability rate of liver metastases in this group of patients.In this paper we review the different studies assessing the efficacy of cetuximab in the first-line treatment of mCRC.
基金the MINECO Retos,No.SAF2016-78711 and SAF2017-87919REXOHEP-CM,No.S2017/BMD-3727+8 种基金the AMMF Cholangiocarcinoma Charity,No.2018/117the COST Action,No.CA17112Ramón y Cajal,No.RYC-2014-15242 and No.RYC-2015-17438grant of ERAB,No.EA 14/18Gilead Liver Research Scholar 2018,No.44/2018Ministerio de Sanidad,Servicios Sociales e Igualdad,No.2017I065the UCM group “Lymphocyte Immunobiology”,No.920631(imas12-associated,Ref.IBL-6)German Research Foundation(SFB/TRR57/P04 and DFG NE 2128/2-1)Interdisciplinary Center for Clinical Research from the Faculty of Medicine at RWTH Aachen University(IZKF/E8-2)
文摘Alcoholic liver disease(ALD) is a major cause of acute and chronic liver injury. Extensive evidence has been accumulated on the pathological process of ALD during the past decades. However, effective treatment options for ALD are very limited due to the lack of suitable in vivo models that recapitulate the full spectrum of ALD. Experimental animal models of ALD, particularly rodents, have been used extensively to mimic human ALD. An ideal animal model should recapitulate all aspects of the ALD process, including significant steatosis, hepatic neutrophil infiltration, and liver injury. A better strategy against ALD depends on clear diagnostic biomarkers, accurate predictor(s) of its progression and new therapeutic approaches to modulate stop or even reverse the disease. Numerous models employing rodent animals have been established in the last decades to investigate the effects of acute and chronic alcohol exposure on the initiation and progression of ALD. Although significant progress has been made in gaining better knowledge on the mechanisms and pathology of ALD, many features of ALD are unknown, and require further investigation, ideally with improved animal models that more effectively mimic human ALD. Although differences in the degree and stages of alcoholic liver injury inevitably exist between animal models and human ALD, the acquisition and translational relevance will be greatly enhanced with the development of new and improved animal models of ALD.
