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Refractory hepatic encephalopathy in a patient with hypothyroidism: Another element in ammonia metabolism

World Journal of Gastroenterology 2017年第28期23卷 5246-5252页

作者： Fernando Díaz-Fontenla marta Castillo-Pradillo Arantxa Díaz-Gómez Luis Ibanez-Samaniego Pilar Gancedo Juan Adan Guzmán-de-Villoria Pilar Fernández-garcía Rafael Banares-Canizares rita garcía-martínez Unidad de Hepatología Servicio de Aparato DigestivoHospital General Universitario Gregorio Maranón Instituto de Investigación Sanitaria Hospital Gregorio Maranón Servicio de Aparato Digestivo Hospital Santa Bárbara Servicio de Radiodiagnóstico Hospital General Universitario Gregorio Maranón Centro de Investigación Biomédica en Red de Salud Mental Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas Facultad de Medicina Universidad San Pablo CEU

Hepatic encephalopathy(HE) remains a diagnosis of exclusion due to the lack of specific signs and symptoms. Refractory HE is an uncommon but serious condition that requires the search of hidden precipitating events(i.e.,portosystemic shunt) and alternative diagnosis. Hypothyroidism shares clinical manifestations with HE and is usually considered within the differential diagnosis of HE. Here,we describe a patient with refractory HE who presented a large portosystemic shunt and post-ablative hypothyroidism. Her cognitive impairment,hyperammonaemia,electroencephalograph alterations,impaired neuropsychological performance,and magnetic resonance imaging and spectroscopy disturbances were highly suggestive of HE,paralleled the course of hypothyroidism and normalized after thyroid hormone replacement. There was no need for intervention over the portosystemic shunt. The case findings support that hypothyroidism may precipitate HE in cirrhotic patients by inducing hyperammonaemia and/or enhancing ammonia brain toxicity. This case led us to consider hypothyroidism not only in the differential diagnosis but also as a precipitating factor of HE.

关键词： Hepatic encephalopathy Hypothyroidism Cognitive impairment Cirrhosis Portosystemic shunt Magnetic resonance spectroscopy

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Autoantibodies against beta cells to predict early insulin requirements in pediatric patients with clinically diagnosed type 2 diabetes

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World Journal of Diabetes 2024年第8期15卷 1717-1725页

作者： Jorge M Molina Patricia G Medina rita A Gomez Julia R Herrera Nancy L martínez Brenda Hernández Yesenia garcía Department of Endocrinology Children’s Hospital Federico GomezMexico 06720Mexico National Medical Center"Siglo XXI" UMAE Hosp EspecialidadesUnidad Invest Med Epidemiol ClinMexican Social Security InstituteMexico 06720Mexico Research Division UMAE Hospital de EspecialidadesCentro Médico Nacional Siglo XXIMexican Institute of Social SecurityMexico 06720Mexico Epidemiology Research Unit in Endocrinology and Nutrition Federico Gómez Children’s HospitalMexico 06720Mexico Department of Endocrinology Comprehensive Health Unit for Trans PersonsMexico 11340Mexico

BACKGROUND Autoimmunity has emerged as a probable disease modifier in patients with clinically diagnosed type 2 diabetes mellitus(T2DM),that is,patients who have insulin resistance,obesity,and other cardiovascular risk factors,suggesting that the presence of glutamic acid decarboxylase(anti-GAD65),islet antigen 2(anti-IA2),and zinc transporter 8(anti-Zn8T)antibodies could have deleterious effects on beta cell function,causing failure and earlier requirement for insulin *** To evaluate anti-GAD65,anti-IA2 and anti-Zn8T as predictors of early insulin requirement in adolescents with a clinical diagnosis of *** This was a case–control study in patients with clinically diagnosed with T2DM(68 cases and 64 controls with and without early insulin dependence respectively),male and female,aged 12–18 ***,blood pressure,glucose,insulin,C-peptide,glycated hemoglobin A1c,and lipid profiles were *** was used to measure anti-GAD65,anti-IA2,and anti-Zn8T *** statistics,Pearson'sχ2 test,Student's t test,and logistic regression was performed.P<0.05 was considered statistically *** There were 132 patients(53.8%female),with a mean age was 15.9±1.3 years,and there was a disease evolution time of 4.49±0.88 *** presence of anti-GAD65,anti-IA2,and anti-Zn8T positivity was found in 29.5%,18.2%,and 15.9%,*** the groups by early or no insulin dependence showed that the group with insulin had a higher frequency of antibody positivity:anti-GAD65 odds ratio(OR):2.42(1.112–5.303,P=0.026);anti-IA2:OR:1.55(0.859–2.818,P=0.105);and anti-Zn8T:OR:7.32(2.039–26.279,P=0.002).CONCLUSION Anti-GAD65 positivity was high in our ***-GAD65 and anti-Zn8T positivity showed a significantly depleted beta cell reserve phenotype,leading to an increased risk of early insulin dependence.

关键词： Diabetes Obesity Adolescents Autoimmunity Beta cell Insulin requirements

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A review on the scale-up of high-shear wet granulation processes and the impact of process parameters

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Particuology 2024年第9期92卷 180-195页

作者： Ana rita Alves marta Filipe Simões Sérgio Simões João Gomes University of Coimbra CERESDepartment of Chemical EngineeringFaculty of Sciences and TechnologyRua Sílvio Lima3030-790CoimbraPortugal Bluepharma-Indústria Farmacêutica São Martinho do BispoCoimbra3045-016Portugal Faculty of Pharmacy University of CoimbraAzinhaga de Santa Comba3000-548CoimbraPortugal

Wet granulation is one of the most important agglomeration processes,and high-shear granulation(HSG)one of the most employed technologies in the pharmaceutical *** most critical process parameters of HSG are discussed in this *** main concern in scaling up the wet granulation process is the differences between scales,which prevent the particles from having the same experience across all *** scale-up of wet granulation processes is commonly divided into two categories:engineering and attribute-based *** engineering-based scale-up approach is a strategy based on dimensional analysis and an attribute-based supported on the principles of“equifinality”,where process variables are adjusted to obtain equivalent granule *** work presents the effect of different HSG process parameters on the scale-up,as well as the use of process analytical tools(PAT)and modelling *** aim is to review applied scale-up approaches in HSG and discuss benefits and *** is proven why the scale-up for oral solid pharmaceutical products is still considered a hot topic and a very challenging task for development and engineering teams.

关键词： High-shear wetgranulation Parametric-based Attribute-based Physics-based modelling Impeller design Scale-up

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Artificial intelligence in detection of small bowel lesions and their bleeding risk:A new step forward

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World Journal of Gastroenterology 2024年第18期30卷 2482-2484页

作者： Silvia Cocca Giuseppina Pontillo Giuseppe Grande rita Conigliaro Gastroenterology and Endoscopy Unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy Gastroenterology and Endoscopy Unit Presidio Ospedaliero San Giuseppe Moscati(AversaCE)-ASL CasertaCaserta 81100Italy Department of Gastroenterology and Digestive Endoscopy Azienda Ospedaliero Universitaria di ModenaModena 41121Italy

The present letter to the editor is related to the study with the title“Automatic detection of small bowel(SB)lesions with different bleeding risk based on deep learning models”.Capsule endoscopy(CE)is the main tool to assess SB diseases but it is a time-consuming procedure with a significant error *** development of artificial intelligence(AI)in CE could simplify physicians’*** novel deep learning model by Zhang et al seems to be able to identify various SB lesions and their bleeding risk,and it could pave the way to next perspective studies to better enhance the diagnostic support of AI in the detection of different types of SB lesions in clinical practice.

关键词： Capsule endoscopy Small bowel Artificial intelligence Bleeding risk Vascular lesions

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Ammonia and greenhouse gas distribution in a dairy barn during warm periods

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Frontiers of Agricultural Science and Engineering 2024年第3期11卷 428-441页

作者： Provvidenza rita D’URSO Claudia ARCIDIACONO Giovanni CASCONE Department of Agriculture Food and EnvironmentUniversity of CataniaVia S.Sofia n.100Catania 95123Italy

This research aimed to quantify concentrations of ammonia(NH3),carbon dioxide(CO_(2))and methane(CH_(4)),estimate emissions,and analyze the factors influencing them during warm periods in an open dairy barn equipped with two cooling systems in a Mediterranean climate *** distribution within the barn was observed to vary both vertically and horizontally,with the highest gas concentrations observed in the central area of the ***_(3),CH_(4)and CO_(2)ranged in 1.7–7.4,7–18,560–724μg·g^(–1),*** ventilation through openings and the operation of cooling systems induced changes in indoor microclimate conditions,influencing cow behavior and,consequently,gas *** concentrations were the highest at air velocities below 0.5 m·s^(–1).The highest concentration of NH_(3)was observed when the temperature-humidity index(THI)was>72 and≤78;and CO_(2)and CH_(4)concentrations were the highest with THI≥72 and decreased with THI≤***_(3)concentrations when barn management included three daily milkings were higher than those measured when barn management was based on two daily milkings,and lower for CH_(4)and CO_(2).NH_(3)and CH_(4)emissions were the highest during barn cleaning,while the lowest NH_(3)emissions occurred during activity of the cows(i.e.,feeding,walking).

关键词： Ammonia greenhouse gas environmental monitoring cows’behavior barn management housing system climatic parameters

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Portal Venous Thrombosis and Splenic Hemangioma, Secondary to Acute Pancreatitis: Case Report

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Open Journal of Gastroenterology 2024年第1期14卷 11-17页

作者： Gustavo Adolfo Hernández Valdez Harvey Yair Zamora Veliz Estefany Gilberty Mendoza Verdin Quitzia Mayanim Rentería Fonseca Itzel Velázquez Viniegra Janette Alejandra Gamiño Gutierrez Diana rita Velázquez Jimenez Florencio Favian Andrade Luis Fernando Baez Bustos Jorge Morales Rojas María Jacqueline martínez Tejeda Graciela Gaddy Robles martínez Juan Antonio Contreras Escamilla Departamento de Medicina Interna ISSSTE Tepic General Hospital APP Tepic Nayarit México General Surgery Department ISSSTE Tepic General Hospital APP Tepic Nayarit México Hospital Civil Fray Antonio Alcalde Guadalajara Jalisco México

We present an unusual case of portal vein thrombosis with a splanchnic hemangioma secondary to acute biliary pancreatitis. We report a 45-year-old patient, who has systemic arterial hypertension in treatment, was admitted for abdominal pain in the epigastrium, with irradiation to the right hypochondrium, accompanied by nausea and vomiting of 10 occasions of bile content, physical examination with pain in the right hypochondrium, Murphy positive. We have laboratory studies with a lipase of 788, so a diagnosis of pancreatitis is made with an etiology to be determined. The laboratories suggestive of acute biliary pancreatitis (lipase 788.71);an imaging study was subsequently performed (ultrasonography) with the result of stone in the common bile duct. A laparoscopy was performed with relative improvement, so he was discharged and returned 20 days after surgery due to abdominal pain of the same intensity in the left hypochondrium. Ending his hospitalization with a splenectomy for splenic hemangioma with portal vein thrombosis.

关键词： Pancreatitis Esplenic Hemangioma Esplenectomy Portal Vein Thrombosis Surgery

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Syndecans in Alzheimer's disease:pathogenetic mechanisms and potential therapeutic targets

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Neural Regeneration Research 2025年第9期20卷 2594-2595页

作者： Carmela rita Balistreri Roberto Monastero Cellular Molecular and Clinical Pathological LaboratoryDepartment of BiomedicineNeuroscience and Advanced Diagnostics(Bi.N.D.)University of PalermoPalermoItaly Memory and Parkinson’s disease Center Policlinico“Paolo Giaccone”PalermoDepartment of BiomedicineNeuroscience and Advanced Diagnostics(Bi.N.D.)University of PalermoVia La Loggia 1PalermoItaly

With increasing age,humans become more susceptible to the onset of neurodegenerative diseases(NDs),and among these,Alzheimer's disease(AD)is the most frequent(Nicoletti et al.,2023).NDs are primarily characterized by neuronal loss and atrophy,but also by lesions involving the cerebral and/or cardiovascular system(Balistreri,2021).Lesions such as macroinfa rcts,microinfarcts,hemorrhages,white matter lesions,atherosclerosis,and arteriolosclerosis have also been significantly described in the preclinical stages of cognitive impairment characterizing NDs(Mariani et al.,2007).

关键词： Alzheimer cardiovascular

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Identifying the validity domain of machine learning models in building energy systems

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Energy and AI 2024年第1期15卷 328-341页

作者： martin Rätz Patrick Henkel Phillip Stoffel rita Streblow Dirk Müller RWTH Aachen University E.ON Energy Research CenterInstitute for Energy Efficient Buildings and Indoor ClimateMathieustraβe 10Aachen52074Germany

The building sector significantly contributes to climate *** improve its carbon footprint,applications like model predictive control and predictive maintenance rely on system ***,the high modeling effort hinders practical *** learning models can significantly reduce this modeling *** ensure a machine learning model’s reliability in all operating states,it is essential to know its validity *** states outside the validity domain might lead to extrapolation,resulting in unpredictable *** paper addresses the challenge of identifying extrapolation in data-driven building energy system models and aims to raise knowledge about *** that,a novel approach is proposed that calibrates novelty detection algorithms towards the machine learning *** novelty detection algorithms are identified through a literature review and a benchmark test with 15 candidates.A subset of five algorithms is then evaluated on building energy ***,on two-dimensional data,displaying the results with a novel visualization *** on more complex multi-dimensional use *** methodology performs well,and the validity domain could be *** visualization allows for a profound analysis and an improved understanding of the fundamental effects behind a machine learning model’s validity domain and the extrapolation regimes.

关键词： Extrapolation detection Validity domain Novelty detection Machine learning Artificial neural network Data-driven model predictive control Building energy systems

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Pro-Environmental Civic Participation in the USA: The Effects of Social Media, Pro-Environmental Lifestyle and Climate Experiences

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American Journal of Climate Change 2024年第1期13卷 31-46页

作者： rita Mano Department of Human Services University of Haifa Haifa Israel

This study addresses the link between social media use and pro-environmental civic participation considering the moderating effect of social media affordances (public realm) on one hand, and lifestyle behaviors and climate change experiences (personal realm) on the other. We combine communication theory and behavioral models and using a sample of USA individuals (N = 7225) based on the American Trends Panel to predict variations in pro-environmental behavior. We show that social networks rather than information are more effective in predicting pro-environmental behavior. Moreover, a pro-environmental lifestyle as well as climate change experiences at the community level increase the likelihood for pro-environmental participation. However, affordances related to socioeconomic variations generate variations to pro-environmental civic participation. We conclude that in order to capture the depth of pro-environmental civic participation, it is necessary to theoretically and empirically bridge between private and public expressions of pro-environmental awareness.

关键词： Pro-Environmental Behavior Socio-Economic Digital Information Digital Networks Private Expressions Public Expressions Climate Changes USA

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Subplanes of PG( 2, q 3 ) and the Ruled Varieties V 2 5 of PG( 6,q )

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Open Journal of Discrete Mathematics 2024年第2期14卷 16-27页

作者： rita Vincenti Department of Mathematics and Computer Science University of Perugia Perugia Italy

In this note we study subplanes of order q of the projective plane Π=PG( 2, q 3 ) and the ruled varieties V 2 5 of Σ=PG( 6,q ) using the spatial representation of Π in Σ, by fixing a hyperplane Σ ′ with a regular spread of planes. First are shown some configurations of the affine q-subplanes. Then to prove that a variety V 2 5 of Σ represents a non-affine subplane of order q of Π, after having shown basic incidence properties of it, such a variety V 2 5 is constructed by choosing appropriately the two directrix curves in two complementary subspaces of Σ. The result can be translated into further incidence properties of the affine points of V 2 5 . Then a maximal bundle of varieties V 2 5 having in common one directrix cubic curve is constructed.

关键词： Finite Geometry Translation Planes Spreads Varieties

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