Usefulness of bioelectrical impedance analysis for monitoring patients with refractory ascites

Background: bioelectrical impedance analysis is a technique for the determination of the hydropic component. The hydropic component, determined by blood volume, could be a reflection of the hemodynamic situation. This study aimed to evaluate the usefulness of peripheral bioelectrical impedance analysis (BIA) for the prediction of hemodynamic changes in large-volume paracentesis and prognosis. Methods: this was a proof-of-concept prospective study of 14 patients with liver cirrhosis and refractory ascites. Peripheral bioimpedance was measured three times using a portable device, IVOL®, before and after large-volume paracentesis, at different frequencies (5, 10, 20, 50, 100 and 200 kHz). Consequently, resistance, reactance and phase angle were obtained, both pre- and post-paracentesis (the difference between them was defined as Δ). Results: the mean age of patients was 62.2 ± 9.6 years, the Child-Pugh was 8.4 ± 1.3 and the MELD score was 15.2 ± 3.9. A direct correlation between the extraction of ascitic fluid and Δresistance (10 kHz [r = 0.722; n = 12; p = 0.008], 20 kHz [r = 0.658; n = 12; p = 0.020] and 50 kHz [r = 0.519; n = 14; p = 0.057]) was observed. The presence of edema was related to lower values of both pre-paracentesis resistance (10 Hz [23.9 ± 8 vs 32.2 ± 4; p = 0.043]) and phase angle (5 kHz [-1.9 ± 2.8 vs 5.9 ± 7.3; p = 0.032]). Pre-paracentesis phase angle was directly correlated with the decline in blood pressure after paracentesis at lower frequencies (5 kHz [r = 0.694; n = 13; p = 0.008] and 10 kHz [r = 0.661; n = 13; p = 0.014]). Lower frequencies of Δphase-angle impacted on patient prognosis (5 kHz [-8.6 ± 5 vs -2.5 ± 2.7; p = 0.021]), patients with Δphase-angle 5 kHz > -4 had a higher rate of mortality (83.3% [5/6] vs 0% [0/6]; logRank 7.306, p = 0.007). Δresistance values were associated with overt HE at six months (10 kHz [4.9 ± 2.5 vs -0.4 ± 4.7; p = 0.046]). Conclusions: in conclusion, a significant correlation between peripheral impedance and hemodynamic changes was found. Impedance was also significantly related to prognosis and overt hepatic encephalopathy

Exploitation of Liquefied Natural Gas Cold Energy in Floating Storage Regasification Units

[Abstract] This paper aims to review regasification technology installed in Floating Storage Regasification Units (FSRUs) and the potential offered by the exploitation of cold energy from liquefied natural gas (LNG) in these vessels. The assessment describes the main characteristics of regasification systems along with their respective advantages and limitations. Regasification systems in direct exchange (seawater and steam) and systems with intermediate fluids that use propane or water-glycol in the heat transfer process are studied. In recent years, water-glycol systems have cornered the market. The mixture, besides reducing the risk of freezing, is non-flammable, economical and highly available. Thermodynamic analysis of the regasification process shows that LNG cold energy is the main source of residual energy in these vessels; the specific energy and exergy content is more than double that of engine exhaust gases. Exploitation of this cold energy in power cycles could significantly reduce FSRUs harmful emissions and electrical energy could even be exported to shore. The organic Rankine cycle technology is the most well-known and widely studied, although scientific literature is scarce and there is a need to propose new regasification systems with cold energy exploitation that can be adopted on these vessels

Analysis and Simulation of the Leg of an Hexapod Robot for Remote Exploration

The locomotion system is determined by the terrain conditions. The aim of this paper is to introduce the characteristics and simulation of a hexapod legged robot that can be easily used for exploration of abrupt and harsh terrains, Jike the Rio Tinto environment. A walking robot seems like the best option for this kind of terrain. Some of the advantages are that they do not need continuous terrain, they have less problems with sliding and they also have greater capacity to overcome obstacles as they produce Jess harm to the environment that the scientist wants to explore on the contrary when faced with mechanical design they present a design challenge, also in the static and dynamic analysis problem of a legged robot, there is a high complexity that has to be taken into account. This paper shows how to easily cope with the analysis of hexapod robot movement based on a design developed by the Center of Astrobiology INTA-CSIC for operation in RioTinto (Huelva - Spain)

COVID-19 and the liver: the chicken or the egg dilema

After the publication of our meta-analysis, in which we demonstrated that aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin were related to a poor prognosis in patients suffering COVID-19, some authors raised the question about whether these findings are directly linked, or they are epiphenomena

Looking for a new name for non-alcoholic fatty liver disease in Spanish: esteatosis hepatica metabolica (EHmet)

El nombre de una enfermedad no sigue ningún protocolo definido y es habitual la aceptación por parte de la comunidad científica de diversas variantes en función de las costumbres de cada lugar. Hay ejemplos de entidades prevalentes con curiosos procesos de denominación, como la diabetes mellitus. La primera palabra, "diabetes", proviene del griego dia (a través), be (ir) y tes (factor), mientras que la segunda palabra, "mellitus", proviene del latín melli (miel). En consecuencia, diabetes mellitus significa literalmente "el factor dulce que atraviesa...", perteneciente a una diuresis excesiva y dulce. Por lo tanto, podríamos deducir que no se requiere una definición que represente exactamente la fisiopatología de la enfermedad en particular.The name of a disease does not follow any defined protocol and the scientific community's acceptance of several variants based on the customs of every location is usual. There are examples of prevalent entities with curious naming processes, such as diabetes mellitus. The first word, "diabetes", comes from the Greek dia (through), be (to go), and tes (factor), while the second word, "mellitus", comes from Latin melli (honey). As a consequence, diabetes mellitus literally means "the sweet factor that goes through…", pertaining to an excessive and sweet diuresis. Thus, we could deduce that a definition representing exactly the pathophysiology of the particular disease is not required

Generation of H₂ on Board Lng Vessels for Consumption in the Propulsion System

[Abstract] At present, LNG vessels without reliquefaction plants consume the BOG (boil-off gas) in their engines and the excess is burned in the gas combustion unit without recovering any of its energy content. Excess BOG energy could be captured to produce H₂, a fuel with high energy density and zero emissions, through the installation of a reforming plant. Such H₂ production would, in turn, require on-board storage for its subsequent consumption in the propulsion plant when navigating in areas with stringent anti-pollution regulations, thus reducing CO₂ and SOₓ emissions. This paper presents a review of the different H₂ storage systems and the methods of burning it in propulsion engines, to demonstrate the energetic viability thereof on board LNG vessels. Following the analysis, it is identified that a pressurised and cooled H₂ storage system is the best suited to an LNG vessel due to its simplicity and the fact that it does not pose a safety hazard. There are a number of methods for consuming the H₂ generated in the DF engines that comprise the propulsión plant, but the use of a mixture of 70% CH₄-30% H₂ is the most suitable as it does not require any modifications to the injection system. Installation of an on-board reforming plant and H₂ storage system generates sufficient H₂ to allow for almost 3 days’ autonomy with a mixture of 70%CH₄-30%H₂. This reduces the engine consumption of CH₄ by 11.38%,thus demonstrating that the system is not only energy-efficient, but lends greater versatility to the vessel

Geolocalización a través de feeds RSS

Proyecto Final de Carrera basado en el análisis de noticias extraídas de flujos RSS y cuyos contenidos son examinados para identificar menciones de monumentos falleros de la ciudad de Valencia mediante técnicas de Named Entity Recognition (NER) , una subtarea enmarcada dentro del Natural Language Processing. El proyecto realiza un estudio comparativo de tres herramientas NER implementadas a partir de los servicios NLP ofrecidos por LingPipe, Stanford NLP y Apache Open NLP y, a posteriori, geolocaliza los monumentos falleros identificados en las noticias.Gómez Romero, J. (2015). Geolocalización a través de feeds RSS. http://hdl.handle.net/10251/51342.Archivo delegad

Addicions a la flora algològica del Principat de Catalunya

In a sandy-bed near Arenys de Mar (Barcelona, Spain) some algal species were collected, using scuba-diving techniques, at 25-32 m depth. Three of them were for the first time found in the catalan coast: Halymenia latifolia Crouan & Crouan, Halymenia floresia (Clemente) C. Agardh var. pinnata Codomier and Carpomitra costata (Stackhouse) Batters var. mediterranea Feldmann

Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects

Background and Aim: Histological score systems may not fully capture the essential nonalcoholic steatohepatitis (NASH) features, which is one of the leading causes of screening failure in clinical trials. We assessed the NASH distribution and its components across the fibrosis stages and their impact on the prognosis and their relationship with the concept of metabolic-associated fatty liver disease (MAFLD). Methods: Spanish multicenter study including 1893 biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients from HEPAmet registry. NASH was diagnosed by NAS score ≥4 (including steatosis, ballooning and lobular inflammation) and fibrosis by Kleiner score. The presence of MAFLD was determined. Progression to cirrhosis, first episode of decompensated cirrhosis and death were collected during the follow-up (4.7 ± 3.8 years). Results: Fibrosis was F0 34.3% (649/1893), F1 27% (511/1893), F2 16.5% (312/1893), F3 15% (284/1893) and F4 7.2% (137/1893). NASH diagnosis 51.9% (982/1893), and its individual components (severe steatosis, ballooning and lobular inflammation), increased from F0 (33.6%) to F2 (68.6%), and decreased significantly in F4 patients (51.8%) (P = .0001). M ore t han 7 0% o f n on-NASH p atients s howed s ome i nflammatory activity (ballooning or lobular inflammation), showing a similar MAFLD rate than NASH (96.2% [945/982] vs. 95.2% [535/562]) and significantly higher than nonalcoholic fatty liver (NAFL) subjects (89.1% [311/349]) (P < .0001). Progression to cirrhosis was similar between NASH (9.5% [51/539]) and indeterminate NASH (7.9% [25/316]), and higher than steatosis (5% [14/263]) (logRank 8.417; P = .015). Death and decompensated cirrhosis were similar between these. Conclusions: The prevalence of steatohepatitis decreased in advanced liver disease. However, most of these patients showed some inflammatory activity histologically and had metabolic disturbances. These findings should be considered in clinical trials whose main aim is to prevent cirrhosis progression and complications, liver transplant and death