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Hematological abnormalities in liver cirrhosis

World Journal of Hepatology 2024年第9期16卷 1229-1244页

作者： Oscar Manuel Fierro-Angulo joséalberto gonzález-regueiro Ariana Pereira-García Astrid Ruiz-Margáin Fernando Solis-Huerta Ricardo Ulises Macías-Rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico 14080Mexico Department of Hematology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico 14080Mexico

Hematological abnormalities are common in cirrhosis and are associated with various pathophysiological *** have documented a prevalence of thrombocytopenia,leukopenia,and anemia in patients with compensated cirrhosis of 77.9%,23.5%,and 21.1%,*** abnormalities carry significant clinical implications,including considerations for invasive procedures,infection risk,bleeding risk,and ***,cirrhosis was believed to predispose patients to bleeding due to alterations observed in classical coagula-tion tests such as prothrombin time,partial thromboplastin time,international normalized ratio,and ***,this understanding has evol-ved,and cirrhosis patients are now also acknowledged as being at a high risk for thrombotic *** in cirrhosis patients presents a complex pheno-type,with procoagulant and anticoagulant abnormalities offsetting each *** multifactorial phenomenon is inadequately reflected by routine laboratory *** complications are more prevalent in decompensated cirrhosis and may correlate with disease *** is primarily associated with portal hypertension,endothelial dysfunction,mechanical vessel injury,dissem-inated intravascular coagulation,endotoxemia,and renal *** review comprehensively outlines hematologic index abnormalities,mechanisms of hemostasis,coagulation,and fibrinolysis abnormalities,limitations of laboratory testing,and clinical manifestations of bleeding and thrombosis in patients with liver cirrhosis.

关键词： Cirrhosis Anemia Leukopenia Thrombocytopenia Coagulopathy Bleeding Thrombosis

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Clinical assessment and management of liver fibrosis in nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2020年第39期26卷 5919-5943页

作者： Alejandro Campos-Murguía Astrid Ruiz-Margáin joséA gonzález-regueiro Ricardo U Macías-Rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico

Non-alcoholic fatty liver disease(NAFLD)is among the most frequent etiologies of cirrhosis worldwide,and it is associated with features of metabolic syndrome;the key factor influencing its prognosis is the progression of liver *** review aimed to propose a practical and stepwise approach to the evaluation and management of liver fibrosis in patients with NAFLD,analyzing the currently available *** the assessment of NAFLD patients,it is important to identify clinical,genetic,and environmental determinants of fibrosis development and its *** properly detect fibrosis,it is important to take into account the available methods and their supporting scientific evidence to guide the approach and the sequential selection of the best available biochemical scores,followed by a complementary imaging study(transient elastography,magnetic resonance elastography or acoustic radiation force impulse)and finally a liver biopsy,when *** help with the selection of the most appropriate method a Fagan′s nomogram analysis is provided in this review,describing the diagnostic yield of each method and their post-test probability of detecting liver ***,treatment should always include diet and exercise,as well as controlling the components of the metabolic syndrome,+/-vitamin E,considering the presence of sleep apnea,and when available,allocate those patients with advanced fibrosis or high risk of progression into clinical *** final end of this approach should be to establish an opportune diagnosis and treatment of liver fibrosis in patients with NAFLD,aiming to decrease/stop its progression and improve their prognosis.

关键词： Non-alcoholic fatty liver disease Liver fibrosis Clinical assessment Diagnosis Treatment Test accuracy

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Nutritional therapy for hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2021年第10期13卷 1440-1452页

作者： Astrid Ruiz-Margáin Berenice M Román-Calleja Paulina Moreno-Guillén joséA gonzález-regueiro DeyaniraKúsulas-Delint Alejandro Campos-Murguía Nayelli C Flores-García Ricardo Ulises Macías-Rodríguez Liver Nutrition Clinic Department of GastroenterologyInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Liver Fibrosis and Nutrition Lab MICTLÁN-Network(Mechanisms of Liver InjuryCell Death and Translational Nutrition in Liver Diseases-Research Network)Mexico City 14080Mexico Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico

Hepatocellular carcinoma(HCC)is the most frequent primary liver cancer and presents together with cirrhosis in most *** addition to commonly recognized risk factors for HCC development,such as hepatitis B virus/hepatitis C virus infection,age and alcohol/tobacco consumption,there are nutritional risk factors also related to HCC development including high intake of saturated fats derived from red meat,type of cooking(generation of heterocyclic amines)and contamination of foods with *** the contrary,protective nutritional factors include diets rich in fiber,fruits and vegetables,n-3 polyunsaturated fatty acids and *** the patient is being evaluated for staging and treatment of HCC,special attention should be paid to nutritional support,including proper nutritional assessment and therapy by a multidisciplinary *** must be considered that these patients usually develop HCC on top of long-lasting cirrhosis,and therefore they could present with severe *** complications should be properly addressed and considered for nutritional *** addition to traditional methods,functional testing,phase angle and computed tomography scan derived skeletal muscle index-L3 are among the most useful tools for nutritional *** therapy should be centered on providing enough energy and protein to manage the increased requirements of both cirrhosis and *** with branched-chain amino acids is also recommended as it improves response to treatment,nutritional status and survival,and finally physical exercise must be encouraged and adapted to individual needs.

关键词： Sarcopenia Liver Cancer Diet Branched-chain amino acids Nutrition

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Clinical perspectives,assessment,and mechanisms of metabolicassociated fatty liver disease in patients with COVID-19

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World Journal of Gastroenterology 2021年第33期27卷 5502-5519页

作者： Alejandro Campos-Murguía Berenice M Román-Calleja joséA gonzález-regueiro Ivonne Hurtado-Díaz-de-León alberto Adrián Solís-Ortega Nayelli C Flores-García Ignacio García-Juárez Astrid Ruiz-Margáin Ricardo Ulises Macías-Rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Liver Fibrosis and Nutrition Lab(LFNLab) MICTLÁN-Network(Mechanisms of Liver InjuryCell Death and Translational Nutrition in Liver Diseases-Research Network)Mexico City 14080Mexico

Metabolic diseases are highly prevalent worldwide and have been associated with adverse clinical outcomes,including mortality,in patients developing coronavirus disease(COVID-19).Because of the close relationship between metabolic diseases such as type 2 diabetes mellitus and obesity and the presence of metabolicassociated fatty liver disease(MAFLD),a high number of cases of patients affected by both MAFLD and COVID-19 would be expected,especially in highrisk *** studies have shown an increased risk of adverse clinical outcomes,viral shedding,and deep vein thrombosis,especially in patients with MAFLD-related liver *** predisposition to poor outcomes and severe acute respiratory syndrome coronavirus 2 infection in patients with MAFLD could be secondary to mechanisms common to both,including preexisting systemic chronic inflammation,endothelial dysfunction,and involvement of the renin-angiotensin *** of the increased risk of adverse outcomes,MAFLD should be screened in all patients admitted for *** computed tomography scans could be of help,assessment of liver fibrosis is also recommended,favoring noninvasive methods to limit the exposure of healthcare *** involvement in this population ranges from abnormalities in liver chemistry to hepatic steatosis in postmortem ***,preventive measures should be strongly advocated in patients already known to have MAFLD,including the use of telemedicine and vaccination in addition to general measures.

关键词： Metabolic-associated fatty liver disease COVID-19 Mortality Fibrosis Histology Epidemiology

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Clinical characteristics and treatment outcomes in patients with liver cirrhosis and lymphoma

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World Journal of Hepatology 2020年第2期12卷 34-45页

作者： joséA gonzález-regueiro Astrid Ruiz-Margáin Mariana Cruz-Contreras Ana M Montaña-Duclaud Andrea Cavazos-Gómez Roberta Demichelis-Gómez Ricardo U Macías-Rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición SalvadorGastroenterologyInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránVasco de Quiroga 15Belisario Domínguez Sección XVITlalpanMexico City 14080Mexico Department of Hematology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránVasco de Quiroga 15Belisario Domínguez Sección XVITlalpanMexico City 14080Mexico

BACKGROUND A significant number of patients with liver cirrhosis concomitantly develop some type of solid or hematological cancer,including *** of patients with lymphoma and cirrhosis is challenging for physicians due to the clinical characteristics related to cirrhosis,including biochemical and functional abnormalities,as well as portal hypertension and lack of scientific evidence,limiting the use of ***,experts recommend only offering oncological treatment to patients with compensated *** To evaluate the clinical characteristics and treatment outcomes in patients with cirrhosis and lymphoma treated with *** This was a case-control study conducted at a tertiary care center in *** was recorded from medical files and from 8658 possible candidates with cirrhosis and/or lymphoma(2000 to 2018).Only 23 cases had both diseases concomitantly;10 patients with cirrhosis and lymphoma(cases)met the selection criteria and were included,and 20 patients with lymphoma(controls)were included and matched according to age,sex,and date of diagnosis,type and clinical stage of *** patients received treatment with *** statistical analysis,descriptive statistics,Shapiro-Wilk test,Mann-Whitney U test,chisquare test and Fisher's exact test were *** was evaluated using Kaplan-Meier curves and Log-rank *** There were differences in biochemical variables inherent to liver disease and portal hypertension in patients with *** most frequent etiology of cirrhosis was hepatitis C virus(50%);80%were decompensated,the median Child-Turcotte-Pugh score was 7.5(6.75-9.25),and mean Model for End-stage Liver Disease was 11.5±*** lymphomas,non-Hodgkin's were the most common(90%),and diffuse large B cell subtype was the most frequent,with a higher International Prognostic Index in the cases(3 vs 2,P=0.049).The chemotherapy regimens had to be adjusted more frequently in the case

关键词： Cirrhosis Cancer Lymphoma Chemotherapy Treatment Survival Toxicity Adverse events

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Prognostic performance of an index based on lactic dehydrogenase and transaminases for patients with liver steatosis and COVID-19

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World Journal of Gastroenterology 2022年第37期28卷 5444-5456页

作者： Ricardo Ulises Macías-Rodríguez alberto Adrián Solís-Ortega Victoria J Ornelas-Arroyo Astrid Ruiz-Margáin Maria Sarai gonzález-Huezo Nestor A Urdiales-Morán Berenice M Román-Calleja Juan M Mayorquín-Aguilar joséA gonzález-regueiro Alejandro Campos-Murguía Israel Vicente Toledo-Coronado Mónica Chapa-Ibargüengoitia Bernardo Valencia-Peña Carlos Fernando Martínez-Cabrera Nayelli C Flores-García Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Department of Gastroenterology Centro Médico ISSEMYMToluca 52140Mexico Department of Radiology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico

BACKGROUND Metabolic associated fatty liver disease(MAFLD)is associated with complications and mortality in patients with coronavirus disease 2019(COVID-19).However,there are no prognostic scores aimed to evaluate the risk of severe disease specifically in patients with MAFLD,despite its high *** dehydrogenase,aspartate aminotransferase and alanine aminotransferase have been used as markers of liver ***,we propose an index based on lactate dehydrogenase,aspartate aminotransferase and alanine aminotransferase for the prediction of complications and mortality in patients with MAFLD and *** To evaluate the prognostic performance of an index based on lactate dehydrogenase and transaminases(aspartate aminotransferase/alanine aminotransferase)in patients with COVID-19 and MAFLD[liver fibrosis and nutrition(LNF)-COVID-19 index].METHODS In this retrospective cohort study,two cohorts from two different tertiary centers were *** first was the derivation cohort to obtain the score cutoffs,and the second was the validation *** included hospitalized patients with severe COVID-19 and *** steatosis was evaluated by computed tomography *** under the receiver operating characteristic(ROC)curve analysis and survival analysis were *** In the derivation cohort,44.6%had MAFLD;ROC curve analysis yielded a LFN-COVID-19 index>1.67 as the best cutoff,with a sensitivity of 78%,specificity of 63%,negative predictive value of 91%and an area under the ROC curve of *** the multivariate analysis,the LFN-COVID-19 index>1.67 was independently associated with the development of acute kidney injury(odds ratio:1.8,95%confidence interval:1.3-2.5,P<0.001),orotracheal intubation(odds ratio:1.9,95%confidence interval:1.4-2.4,P<0.001),and death(odds ratio:2.86,95%confidence interval:1.6-4.5,P<0.001)in both *** LFN-COVID-19 index has a good performance to predict prognosis in patients with MAFLD and COVID-19,which

关键词： COVID-19 Metabolic associated fatty liver disease Lactate dehydrogenase Transaminases Prognosis Nonalcoholic fatty liver disease

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Matrix-Free Higher-Order Finite Element Method for Parallel Simulation of Compressible and Nearly-Incompressible Linear Dedicated to Professor Karl Stark Pister for his 95th birthday Elasticity on Unstructured Meshes

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Computer Modeling in Engineering & Sciences 2021年第12期129卷 1283-1303页

作者： Arash Mehraban Henry Tufo Stein Sture Richard regueiro Department of Computer Science University of Colorado BoulderBoulderCOUSA Department of Civil Environmentaland Architectural EngineeringUniversity of Colorado BoulderBoulderCOUSA

Higher-order displacement-based finite element methods are useful for simulating bending problems and potentially addressing mesh-locking associated with nearly-incompressible elasticity,yet are computationally *** address the computational expense,the paper presents a matrix-free,displacement-based,higher-order,hexahedral finite element implementation of compressible and nearly-compressible(ν→0.5)linear isotropic elasticity at small strain with p-multigrid *** cost,solve time,and scalability of the implementation with respect to strain energy error are investigated for polynomial order p=1,2,3,4 for compressible elasticity,and p=2,3,4 for nearly-incompressible elasticity,on different number of CPU cores for a tube bending *** the context of this matrix-free implementation,higher-order polynomials(p=3,4)generally are faster in achieving better accuracy in the solution than lower-order polynomials(p=1,2).However,for a beam bending simulation with stress concentration(singularity),it is demonstrated that higher-order finite elements do not improve the spatial order of convergence,even though accuracy is improved.

关键词： Matrix-free higher-order finite element parallel linear elasticity multigrid solvers unstructured meshes

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Gastrointestinal and hepatic manifestations of COVID-19:A comprehensive review

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World Journal of Gastroenterology 2020年第19期26卷 2323-2332页

作者： Ming Han Cha Miguel regueiro Dalbir S Sandhu Department of Internal Medicine Cleveland ClinicAkron GeneralAkronOH 44307United States Department of Gastroenterology Hepatology and NutritionDigestive Disease and Surgery InstituteCleveland ClinicClevelandOH 44307United States

The severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)that causes coronavirus disease-2019(COVID-19)is a global pandemic,manifested by an infectious *** patients primarily present with fever,cough and dyspnea,some patients also develop gastrointestinal(GI)and hepatic *** most common GI symptoms reported are diarrhea,nausea,vomiting,and abdominal *** chemistry abnormalities are common and include elevation of aspartate transferase,alanine transferase,and total *** have shown that SARS-CoV-2 infects the GI tract via its viral receptor angiotensin converting enzyme Ⅱ,which is expressed on enterocytes of the ileum and *** RNA has also been isolated from stool specimens of COVID-19 patients,which raised the concern for fecal-oral transmission in addition to droplet *** indirect evidence has suggested possible fecal-oral transmission of SARS-CoV-2,more effort is needed to establish the role of the fecal-oral transmission *** research will help elucidate the association between patients with underlying GI diseases,such as chronic liver disease and inflammatory bowel disease,and severity of *** this review,we summarize the data on GI involvement to date,as well as the impact of COVID-19 on underlying GI diseases.

关键词： COVID-19 SARS-CoV-2 Gastrointestinal Liver Diarrhea Inflammatory bowel disease

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Point Charge between Two Grounded and Conducting Planes Forming a 60°Angle and for Yukawa’s Potential and Coulomb’s Potential

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Journal of Electromagnetic Analysis and Applications 2021年第4期13卷 57-66页

作者： Miguel Angel López-Mariño Omar Olmos López josé Manuel Pardo regueiro Tecnologico de Monterrey Escuela de Ingeniería y Ciencias Chihuahua México Tecnologico de Monterrey Escuela de Ingeniería y Ciencias Monterrey México Tecnologico de Monterrey Escuela de Ingeniería y Ciencias Torreón México

For a point charge between two grounded conductor planes forming a 60° angle, the potential and electric field generated by point charge for Yukawa’s potential (e-μr/r) and Coulomb’s potential (1/r) are modeled and simulated. The expression for the potential that generalizes the cases discussed in López-Mariño, M. and Trujillo Caballero, J. (2017) Point Charges and Conducting Planes for Yukawa’s Potential and Coulomb’s Potential. Journal of Electromagnetic Analysis and Applications, 9, 135-146. https://***/10.4236/jemaa.2017.910012 is presented. Graphs for the potential and electric field for both cases are showed using Maple, that of Coulomb and that of Yukawa for different values of μ . The purpose of this work is to offer students a practical guide for problem analysis of electrostatics using Maple’s capabilities as a computational tool.

关键词： Yukawa’s Potential Coulomb’s Potential Method of Images

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Blockchain-based refurbishment certification system for enhancing the circular economy

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Blockchain(Research and Applications) 2024年第1期5卷 85-96页

作者： Cristina regueiro Aitor Gómez-Goiri Nuno Pedrosa Christos Semertzidis Eider Iturbe Jason Mansell TECNALIA Research&Innovation Basque Research and Technology Alliance(BRTA)Parque Científico y Tecnológico de Bizkaia48160Derio BizkaiaSpain Projecto Desenvolvimento Manutenção Formação e Consultadoria Rua Fradesso da Silveira n.41B1300-609LisbonPortugal

As the global population continues to grow,the enormous stress on our environment and resources is becoming impossible to ignore.A focus on producing and consuming as cheaply as possible has created an economy in which objects are briefly used and then discarded as waste,featuring a linear lifecycle that creates an enormous amount of *** alternative to the linear economy“take-make-waste”is called the“circular economy”.Under this paradigm,materials are recycled to build new products or components that are designed and built to promote their reuse and *** assures the continuous(re-)exploitation of existing resources,reducing the extraction of new raw ***,customers often reject these reused or refurbished products under the suspicion that they do not meet the same usability,safety,or performance levels of new *** this sense,trustworthy records of historical details of refurbished products could increase consumers’confidence in products and components of the“circular economy”,prioritizing trustworthiness,reliability,and *** work presents a new certification tool based on blockchain technology to guarantee trusted,accurate,transparent,and traceable lifecycle information of products and their components and to generate trustworthy certificates to probe refurbished product historical *** tool aims to enhance refurbished product visibility by creating the basis for making the circular economy a reality in any domain.

关键词： Blockchain Traceability Lifecycle Product lifecycle management(PLM) Refurbishment Certification Circular economy

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