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Risk factors and prediction of acute kidney injury after liver transplantation:Logistic regression and artificial neural network approaches

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World Journal of Hepatology 2022年第3期14卷 570-582页

作者： luis cesar bredt luis Alberto Batista Peres Michel Risso Leandro Cavalcanti de Albuquerque Leite Barros Department of Surgical Oncology and Hepatobilary Surgery UnioesteCascavel 85819-110ParanáBrazil Department of Nephrology UnioesteCascavel 85819-110ParanáBrazil Department of Internal Medicine Assis Gurgacz UniversityCascavel 85000ParanáBrazil Department of Hepatobiliary Surgery UnioesteCascavel 85819-110ParanáBrazil

BACKGROUND Acute kidney injury(AKI)has serious consequences on the prognosis of patients undergoing liver ***,artificial neural network(ANN)was reported to have better predictive ability than the classical logistic regression(LR)for this postoperative *** To identify the risk factors of AKI after deceased-donor liver transplantation(DDLT)and compare the prediction performance of ANN with that of LR for this *** Adult patients with no evidence of end-stage kidney dysfunction(KD)who underwent the first DDLT according to model for end-stage liver disease(MELD)score allocation system was *** was defined according to the International Club of Ascites criteria,and potential predictors of postoperative AKI were identified by *** prediction performance of both ANN and LR was *** The incidence of AKI was 60.6%(n=88/145)and the following predictors were identified by LR:MELD score>25(odds ratio[OR]=1.999),preoperative kidney dysfunction(OR=1.279),extended criteria donors(OR=1.191),intraoperative arterial hypotension(OR=1.935),intraoperative massive blood transfusion(MBT)(OR=1.830),and postoperative serum lactate(SL)(OR=2.001).The area under the receiver-operating characteristic curve was best for ANN(0.81,95%confidence interval[CI]:0.75-0.83)than for LR(0.71,95%CI:0.67-0.76).The root-mean-square error and mean absolute error in the ANN model were 0.47 and 0.38,*** The severity of liver disease,pre-existing kidney dysfunction,marginal grafts,hemodynamic instability,MBT,and SL are predictors of postoperative AKI,and ANN has better prediction performance than LR in this scenario.

关键词： Logistic regression Liver transplantation Acute kidney injury Machine learning Artificial neural network

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Risk factors for acute kidney injury after partial hepatectomy

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World Journal of Hepatology 2017年第18期9卷 815-822页

作者： luis cesar bredt luis Alberto Batista Peres Department of Surgical Oncology and Hepa- tobiliary Surgery University Hospital of Western Paraná State University of Western Paraná Department of Nephrology University Hospital of Western Paraná State University of Western Paraná

AIM To identify risk factors for the occurrence of acute kidney injury(AKI) in the postoperative period of partial hepatectomies. METHODS Retrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified. RESULTS Of the total 446 partial liver resections, postoperative AKI occurred in 80 cases(17.9%). Identified predictors of AKI were: Non-dialytic chronic kidney injury(CKI), biliary obstruction, the Model for End-Stage Liver Disease(MELD) score, the extent of hepatic resection, the occurrence of intraoperative hemodynamic instability, post-hepatectomy haemorrhage, and postoperative sepsis. CONCLUSION The MELD score, the presence of non-dialytic CKIand biliary obstruction in the preoperative period, and perioperative hemodynamics instability, bleeding, and sepsis are risk factors for the occurrence of AKI in patients that underwent partial hepatectomy.

关键词：肾损害 Hepatectomy 手术后肝切除术

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Is there a role for liver transplantation in the treatment of hepatocellular carcinoma in non-cirrhotic liver?

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World Journal of Meta-Analysis 2022年第2期10卷 46-51页

作者： luis cesar bredt Ingryd Betina Garcia Felisberto Doroty Eva Garcia Felisberto Surgical Oncology and Hepatobiliary Surgery Unioeste UniversityCascavel 85819-110ParanáBrazil Internal Medicine Univates UniversityLajeado 95914-014Rio Grande do SulBrazil Department of Surgery Nossa Senhora das Graças HospitalCuritiba 80810-040ParanáBrazil

Whether liver transplantation(LT)plays a role in the treatment of patients with hepatocellular carcinoma(HCC)in non-cirrhotic liver(NCL)is a matter of *** recommendations for LT in this setting are extremely fragile and less welldefined than for cirrhosis-associated *** reports of LT for NCL-HCC revealed that long-term outcomes of these patients are poor,and these dismal figures are justified by the advanced tumor stage at the time of LT,suggesting the presence of systemic micrometastatic *** decision-making regarding LT for NCL-HCC is difficult,since specific selection criteria are scarce,and basically the potential candidates are those with unresectable only-liver tumor at admission,or unresectable intrahepatic recurrence *** the surgical aspects regarding the tumor resectability,other phenotypic and genetic characteristics of the tumor should be considered for the indication of LT in this *** present minireview aims to discuss and analyze the last series of LT for NCL-HCC,in order to help clinicians in the decision-making process regarding the role of LT in NCL-HCC treatment.

关键词： Liver transplantation Non-cirrhotic liver Liver Cancer Hepatocellular carcinoma Treatment

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Acute renal injury after partial hepatectomy

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World Journal of Hepatology 2016年第21期8卷 891-901页

作者： luis Alberto Batista Peres luis cesar bredt Raphael Flavio Fachini Cipriani Department of Nephrology University Hospital of Western ParanáState University of Western Paraná Department of Surgical Oncology and Hepatobiliary Surgery University Hospital of Western ParanáState University of Western Paraná Department of General Surgery University Hospital of Western ParanáState University of Western Paraná

Currently, partial hepatectomy is the treatment of choice for a wide variety of liver and biliary conditions. Among the possible complications of partial hepatectomy, acute kidney injury(AKI) should be considered as an important cause of increased morbidity and postoperative mortality. Difficulties in the data analysis related to postoperative AKI after liver resections are mainly due to the multiplicity of factors to be considered in the surgical patients, moreover, there is no consensus of the exact definition of AKI after liver resection in the literature, which hampers comparison and analysis of the scarce data published on the subject. Despite this multiplicity of risk factors for postoperative AKI after partial hepatectomy, there are main factors that clearly contribute to its occurrence. First factor relates to large blood losses with renal hypoperfusion during the operation, second factor relates to the occurrence of post-hepatectomy liver failure with consequent distributive circulatory changes and hepatorenal syndrome. Eventually, patients can have more than one factor contributing to post-operative AKI, and frequently these combinations of acute insults can be aggravated by sepsis or exposure to nephrotoxic drugs.

关键词： Hepatectomy Liver resection Acute renal injury Hepatorenal syndrome Kidney

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Artificial neural network for prediction of acute kidney injury after liver transplantation for cirrhosis and hepatocellular carcinoma

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Artificial Intelligence in Cancer 2021年第5期2卷 51-59页

作者： luis cesar bredt luis Alberto Batista Peres Department of Surgical Oncology and General Surgery University Hospital of Western ParanáState University of Western ParanáCascavel 85819-110ParanáBrazil Department of Nephrology University Hospital of Western ParanáState University of Western ParanáCascavel 85819-110ParanáBrazil

Acute kidney injury(AKI)has serious consequences on the prognosis of patients undergoing liver transplantation(LT)for liver cancer and *** neural network(ANN)has recently been proposed as a useful tool in many fields in the setting of solid organ transplantation and surgical oncology,where patient prognosis depends on a multidimensional and nonlinear relationship between variables pertaining to the surgical procedure,the donor(graft characteristics),and the recipient *** the specific case of LT,ANN models have been developed mainly to predict survival in patients with cirrhosis,to assess the best donor-to-recipient match during allocation processes,and to foresee postoperative complications and *** is a specific opinion review on the role of ANN in the prediction of AKI after LT for liver cancer and cirrhosis,highlighting potential strengths of the method to forecast this serious postoperative complication.

关键词： Liver transplantation Acute kidney injury Artificial neural network Prediction Hepatocellular carcinoma Postoperative

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Multitemporal landslide inventory analysis of an intertropical mountain in west-central Mexico——Basis for hazard management

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Journal of Mountain Science 2022年第6期19卷 1650-1669页

作者： Alejandro cesar VALDES CARRERA Manuel E.MENDOZA Teodoro CARLÓN ALLENDE Jose luis MACIAS Centro de Investigaciones en Geografia Ambiental Universidad Nacional Autonoma de MexicoMorelia 58190Mexico Consejo Nacional de Ciencia y Tecnologia-Instituto de Geofisica-Unidad Michoacan Universidad Nacional Autonoma de MexicoMorelia 58190Mexico Instituto de Geofisica-Unidad Michoacan Universidad Nacional Autonoma de MexicoMorelia 58190Mexico

Landslides in intertropical mountainous areas of Mexico are a natural hazard that could potentially generate a disaster. Despite this, many areas lack landslide inventories, making it difficult to monitor and efficiently manage the associated risks for local populations. For this reason, the aim of this research was to undertake a multitemporal landslide inventory and analyze its conditioning factors in the Pico de Tancítaro stratovolcano, which, in recent decades, has presented several high-risk geomorphological events with disastrous consequences for nearby localities. The spatial distribution of landslides and its conditioning factors were mapped at a 1:50,000 scale for the 1995-2020 period, through visual interpretation of orthophotos and satellite images(Landsat, SPOT, and SENTINEL). The conditioning factors that link the most to landslides were Quaternary andesite and basaltic andesite rocks;volcanic cones, mountain river valleys, and very steep to steep slopes(30° to >45°), oriented to the South, North, and East;Andosols and Leptosols;and the oyamel fir and mixed forests. 505 landslide events classified into slides and flows that occurred in 1995, 2004, 2010, and 2015 were identified. New scars generated by the reactivation of landslide processes were also observed. The landslides in the study area were triggered by torrential rains caused by hurricanes and tropical storms;such as hurricanes Alex and Patricia. The inventory and analysis of conditioning factors highlighted the distribution and dynamics of slides and flows in the study area. In addition, the most important factors for studies of landslide susceptibility, hazards, and risks in the Pico de Tancítaro stratovolcano were identified, contributing to the management of geomorphological risks in intertropical mountain areas.

关键词： Geomorphology Mass wasting Natural hazards Pico de Tancítaro stratovolcano Risk management

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Abiotic stress on seed germination and plant growth of Zeyheria tuberculosa

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林业研究:英文版 2023年第5期34卷 1511-1522页

作者： Robson luis Silva de Medeiros Rinaldo cesar de Paula Joao Vitor Oliveira de Souza Joao Pedro Peixoto Fernandes Department of Agricultural Sciences School of Agricultural and Veterinarian SciencesSao Paulo State University(Unesp)14884-900JaboticabalSao PauloBrazil

Zeyheria tuberculosa(Vell.)Bureau ex *** among the Brazilian flora threatened with *** has high-quality wood and can be used to recover herbicidecontaminated ***,abiotic stresses can harm seed germination and seedling development under adverse conditions and need to be understood to improve autochthonous or indigenous biodiversity conservation and strengthen reforestation *** study evaluated the effects of temperature,water and saline stress on *** seed germination and water stress on seedling *** laboratory experiments evaluated germination under:(1)different temperatures(20,25,30,35 and 40℃);(2)different water potentials simulated with polyethylene glycol(PEG6000)at 25 and 30℃;and,(3)different osmotic potentials simulated with NaCl at 25 and 30℃.In addition,a greenhouse experiment subjected seedlings to five water regimes(20%,35%,50%,65%and 80%of maximum substrate water holding capacity).In the laboratory,seedling biometry and germination were evaluated,while physiological and morphological parameters were assessed in the *** potential of seeds increased at 25 and 30℃.Germination and vigor decreased as water and saline stresses *** tolerance thresholds for water and salt stresses were-0.6 and-0.4 MPa,*** the greenhouse,the most restrictive water regimes reduced seedling physiological and morphological *** development was compromised at moisture levels below50%field capacity.

关键词： Bignoniaceae Climate change Ipê-felpudo Ipê-preto Water stress

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3D-bioprinted cholangiocarcinoma-on-a-chip model for evaluating drug responses

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Bio-Design and Manufacturing 2023年第4期6卷 373-389页

作者： Qiong Liu luis SMille cesar Villalobos Ingrid Anaya Matthias Vostatek Sili Yi Wanlu Li Junlong Liao Huanghui Wu Yongteng Song Lize Xiong Yu Shrike Zhang Division of Engineering in Medicine Department of MedicineBrigham and Women’s HospitalHarvard Medical SchoolCambridgeMA 02139USA Translational Research Institute of Brain and Brain-Like Intelligence Shanghai Fourth People’s HospitalSchool of MedicineTongji UniversityShanghai 200434China Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai 200434China Department of Bioengineering Stanford UniversityPalo AltoCA 94305USA Biotechnological Engineering Program Monterrey Institute of Technology and Higher Education64849 MonterreyNuevo LeónMexico Molecular Biotechnology University of Applied Sciences Campus Vienna1100 ViennaAustria Rapid Manufacturing Engineering Center School of Mechatronical Engineering and AutomationShanghai UniversityShanghai 200444China

Cholangiocarcinoma(CCA)is characterized by heterogeneous mutations and a refractory ***,the development of a model for effective drug screening is urgently *** the established therapeutic testing models for CCA are often ineffective,we fabricated an enabling three-dimensional(3D)-bioprinted CCA-on-a-chip model that to a good extent resembled the multicellular microenvironment and the anatomical microstructure of the hepato-vascular-biliary system to perform high-content antitumor drug ***,cholangiocytes,hepatocytes,and vascular endotheliocytes were employed for 3D bioprinting of the models,allowing for a high degree of spatial and tube-like microstructural ***,it was possible to observe CCA cells attached to the surfaces of the gelatin methacryloyl(GelMA)hydrogelembedded microchannels and overgrown in a thickening manner,generating bile duct stenosis,which was expected to be analogous to the in vivo *** 4000 differentially expressed genes were detected in the CCA cells in our 3D coculture model compared to the traditional two-dimensional(2D)*** screening revealed that the CCA cells grown in the 3D traditional model were more sensitive to the antitumoral prodrug than those in the 2D monoculture due to drug biotransformation by the neighboring functional *** study provides proof-of-concept validation of our bioprinted CCA-on-a-chip as a promising drug screening model for CCA treatment and paves the way for potential personalized medicine strategies for CCA patients in the future.

关键词： Tumor-on-a-chip Biliary tumor 3D bioprinting Tumor microenvironment Drug screening

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Dermatoscopy in the Diagnosis of Vulvar Basal Cell Carcinoma:A Case Report

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International Journal of Dermatology and Venereology 2022年第2期5卷 107-109页

作者： Diego Adolfo de los Cobos Davaios Rodrigo Cepeda-Valdes luis Fernando Favela-Fernandez Claudia Villarreal-Carrillo Julio cesar Salas-Alanis Debra Mexico GuadalupeNuevo León 67150Mexico Julio Salas Dermatology GuadalupeNuevo León 67150Mexico Facultad de Medicina Universidad Autónoma de Nuevo LeónMonterreyNuevo León 67150México.

Introduction: Basal cell carcinoma (BCC) is the most common human malignancy commonly in white people, but in less than 1% of cases it may appear on unexposed areas, like the perineal and anal regions. Vulvar BCC is often diagnosed late because it grows slowly and tends to be asymptomatic, with no specific physical findings. Here, we present a rare Latin patient with a 10-year history of vulvar BCC with dermatoscopic and histopathologic *** report: A 65-year-old Latin woman presented with a nodule on her left labium majus, which she first noted 10 years ago, and that had grown slowly but constantly. She also reported a 20-year history of pruritus and occasional pain. Physical examination showed a 3.5 cm × 3.0 cm erythematous lesion with a central rough without inguinal lymphadenopathy. Contact dermatoscopy (Dermalite DL3 Gen.) showed one blurred cluster of arborising vessels in a pinkish background with white homogeneous areas and lines radial converging. An incisional biopsy was realized, and histopathology diagnosed ***: Vulvar BCC is a rare malignancy that affects mainly Caucasian women over 70 years of age. The most common etiology for BCC is ultraviolet radiation, but as the vulva is unexposed its cause is unclear. Mutations in tumor suppressor and regulatory genes such as p53 are present in 50% of cases. Gorlin syndrome, chronic radiation, chronic arsenic exposure, xeroderma pigmentosum, and immunosuppression have been considered as risk ***: Vulvar BCC characteristics are the same as other cutaneous forms, featuring blue ovoid nests and arborizing telangiectasia, confused with inflammatory diseases, such as eczema, psoriasis, and chronic infection (especially if it is accompanied by pruritus), this makes diagnosis complex, with a delay of 5 to 6 years on average, with an average size of 2.1 cm. Diagnosis is enhanced with dermatoscopy, as the preferred treatment for most BCC cases is wide surgical excision.

关键词： basal cell carcinoma cancer case report latino tumors woman

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Experience with the surgical treatment of hepatic hydatidosis: Case series with follow-up

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World Journal of Gastroenterology 2010年第26期16卷 3305-3309页

作者： Hector Losada Morales luis Burgos San Juan Jorge Silva Abarca cesar Muoz Castro Department of Surgery Universidad de La Frontera Hepato Pancreatic and Biliary Surgery Hospital Hernán Henríquez Aravena Department of Surgery Clínica Alemana de Temuco

AIM: To describe patient characteristics and the results of surgical treatment for hepatic hydatidosis (HH) in the Hospital Hernán Henríquez Aravena from December 2001 to March 2005. METHODS: Subjects older than 16 years with suspected HH were included based on the clinical picture and radiological studies. Variables examined included clinical and laboratory aspects, outcome, features of the parasite and surgical aspects. Descriptive statistics were used, calculating central tendency, dispersion and extreme tendency. RESULTS: The series was comprised of 122 patients, with an average age of 44 ± 16.9 years. The most frequently used surgical technique was subtotal cys-tectomy in 90% of the patients, followed by hepatic resection (hepatectomy, segmentectomy and subsegmentectomy) in 5%. In 2%, a combination of subtotal cystectomy and segmentectomy was performed. In addition, 28% of the series presented complications in the postoperative period and mortality was 2%. CONCLUSION: The most frequently used surgical technique for HH was subtotal cystectomy and the morbidity and mortality rates in this Chilean series are comparable to other national and international series.

关键词： Echinococcosis of liver Surgery Cases series Mortality Morbidity

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