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Simple Summary: This review paper deals with incidentally found focal liver lesions (IFLLs) in otherwise healthy subjects, which is a frequent occurrence in daily practice. The clinical presentation and the imaging aspects play an important role in deciding whether and what further evaluation is required. In low-risk patients (i.e., those without a history of malignant or chronic liver disease or related symptoms, younger than 40 years old), more than 95% of IFLLs are benign. Shear Wave liver Elastography of the surrounding liver parenchyma should be considered to exclude liver cirrhosis and for further risk stratification. If an IFLL in a low-risk patient has a typical appearance on a B-mode ultrasound of a benign lesion, no further imaging is needed. Contrast-Enhanced Ultrasound (CEUS) should be considered as the first-line contrast imaging modality to differentiate benign from malignant IFLLs. In high-risk patients (i.e., with chronic liver disease or an oncological history), each IFLL should initially be considered as potentially malignant, and every effort should be made to confirm or exclude malignancy. An incidental focal liver lesion (IFLL) is defined as a hepatic lesion identified in a patient imaged for an unrelated reason. They are frequently encountered in daily practice, sometimes leading to unnecessary, invasive and potentially harmful follow-up investigations. The clinical presentation and the imaging aspects play an important role in deciding if, and what further evaluation, is needed. In low-risk patients (i.e., without a history of malignant or chronic liver disease or related symptoms), especially in those younger than 40 years old, more than 95% of IFLLs are likely benign. Shear Wave liver Elastography (SWE) of the surrounding liver parenchyma should be considered to exclude liver cirrhosis and for further risk stratification. If an IFLL in a low-risk patient has a typical appearance on B-mode ultrasound of a benign lesion (e.g., simple cyst, calcification, focal fatty change, typical hemangioma), no further imaging is needed. Contrast-Enhanced Ultrasound (CEUS) should be considered as the first-line contrast imaging modality to differentiate benign from malignant IFLLs, since it has a similar accuracy to contrast-enhanced (CE)-MRI. On CEUS, hypoenhancement of a lesion in the late vascular phase is characteristic for malignancy. CE-CT should be avoided for characterizing probable benign FLL and reserved for staging once a lesion is proven malignant. In high-risk patients (i.e., with chronic liver disease or an oncological history), each IFLL should initially be considered as potentially malignant, and every effort should be made to confirm or exclude malignancy. US-guided biopsy should be considered in those with unresectable malignant lesions, particularly if the diagnosis remains unclear, or when a specific tissue diagnosis is needed. [ABSTRACT FROM AUTHOR]

Fontan-type surgery is the final step in the sequential palliative surgical treatment of infants born with a univentricular heart. The resulting long-term haemodynamic changes promote liver damage, leading to Fontan-associated liver disease (FALD), in virtually all patients with Fontan circulation. Owing to the lack of a uniform definition of FALD and the competitive risk of other complications developed by Fontan patients, the impact of FALD on the prognosis of these patients is currently debatable. However, based on the increasing number of adult Fontan patients and recent research interest, the European Association for The Study of the Liver and the European Reference Network on Rare Liver Diseases thought a position paper timely. The aims of the current paper are: (1) to provide a clear definition and description of FALD, including clinical, analytical, radiological, haemodynamic, and histological features; (2) to facilitate guidance for staging the liver disease; and (3) to provide evidence- and experience-based recommendations for the management of different clinical scenarios. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought into prominence several emergent medical and surgical entities, but, also, it served as trigger and contributor for numerous apparently unrelated ailments such as arterial and venous thromboembolic complications. Additional risk factors for these thrombotic traits may be concurrent (known or unknown) malignancies, including at hepatic level. Among these, cholangiocarcinoma (CCA), a rare cancer of intra- and extra-hepatic biliary ducts, represents a very aggressive condition that typically associates local and distant advanced stages on first presentation requiring a prompt diagnosis and a stratified management. This neoplasia has been reported to present a large spectrum of paraneoplastic syndromes in terms of dermatologic, renal, systemic, neurologic, endocrine, and cardiovascular settings, that, overall, are exceptional in their epidemiologic impact when compared to other cancers. Our aim was to introduce a most unusual case of CCA-associated distant thrombosis in a male adult who initially was considered to experience COVID-19-related thrombotic features while having a history of obesity and bariatric surgery. This is a hybrid type of paper: this clinical vignette is accompanied by two distinct sample-focused analyses as a basis for discussion; they each had different methods depending on their current level of statistical evidence. We only included English-published articles in PubMed, as follows: Firstly, we conducted a search of reports similar to the present case, regarding distant vein thrombosis in CCA, from inception until the present time. We performed a literature search using the keywords "cholangiocarcinoma", "thrombosis", and "Trousseau's syndrome" and identified 20 cases across 19 original papers; hence, the current level of evidence remains very low Secondly, we searched for the highest level of statistical evidence concerning the diagnosis of venous thrombosis/thromboembolism in patients who underwent COVID-19 infection (key search terms were "COVID-19", alternatively, "coronavirus", and "SARS-CoV-2", and "thrombosis", alternatively, "thromboembolism") and included the most recent systematic reviews and meta-analyses that were published in 2024 (from 1 January 2024 until 8 July 2024). After excluding data on vaccination against coronavirus or long COVID-19 syndrome, we identified six such articles. To conclude, we presented a probably unique case of malignancy with an initial manifestation consisting of recurrent superficial vein thrombosis under anticoagulation therapy, with no gastrointestinal manifestations, in a patient with a notable history for multiple episodes of SARS-CoV-2 infection and a prior endocrine (gastric) surgery. To our knowledge, this is the first identification of a CCA under these specific circumstances. [ABSTRACT FROM AUTHOR]

The prevalence of nonalcoholic fatty liver disease (NAFLD) is likely to be approaching 38% of the world's population. It is predicted to become worse and is the main cause of morbidity and mortality due to hepatic pathologies. It is particularly worrying that NAFLD is increasingly diagnosed in children and is closely related, among other conditions, to insulin resistance and metabolic syndrome. Against this background is the concern that the awareness of patients with NAFLD is low; in one study, almost 96% of adult patients with NAFLD in the USA were not aware of their disease. Thus, studies on the therapeutic tools used to treat NAFLD are extremely important. One promising treatment is a well-formulated ketogenic diet (KD). The aim of this paper is to present a review of the available publications and the current state of knowledge of the effect of the KD on NAFLD. This paper includes characteristics of the key factors (from the point of view of NAFLD regression), on which ketogenic diet exerts its effects, i.e., reduction in insulin resistance and body weight, elimination of fructose and monosaccharides, limitation of the total carbohydrate intake, anti-inflammatory ketosis state, or modulation of gut microbiome and metabolome. In the context of the evidence for the effectiveness of the KD in the regression of NAFLD, this paper also suggests the important role of taking responsibility for one's own health through increasing self-monitoring and self-education. [ABSTRACT FROM AUTHOR]

Simple Summary: Radiation therapy is becoming increasingly important in the treatment of liver and pancreatic tumors, particularly in situations where high doses of radiation can be delivered safely. However, there are several challenges to treating tumors in the abdomen, including poor visibility of the tumor and movements due to breathing and digestion. The typical imaging available at the time of treatment makes it difficult to see both the tumor and nearby portions of the digestive tract, which is particularly sensitive to radiation damage. This paper describes the workflow involved when using high-quality computed tomography imaging at the time of treatment, to ensure that the tumor is accurately targeted and normal tissues are avoided. This study shows that by using these images and the planned dose distribution, the dose to normal structures can be maintained below specified targets. With this technology and workflow, more patients can benefit from high-dose radiation treatment to the liver and pancreas. Background/Objectives: Stereotactic body radiation therapy (SBRT) for abdominal targets faces a variety of challenges, including motion caused by the respiration and digestion and a relatively poor level of contrast between the tumor and the surrounding tissues. Breath-hold treatments with computed tomography-on-rails (CTOR) image guidance is one way of addressing these challenges, allowing for both the tumor and normal tissues to be well-visualized. Using isodose lines (IDLs) from CT simulations as a guide, the anatomical information can be used to shift the alignment or trigger a replan, such that normal tissues receive acceptable doses of radiation. Methods: This study aims to describe the workflow involved when using CTOR for pancreas and liver SBRT and demonstrates its effectiveness through several case studies. Results: In these case studies, using the anatomical information gained through diagnostic-quality CT guidance to make slight adjustments to the alignment, resulted in reductions in the maximum dose to the stomach. Conclusions: High-quality imaging, such as CTOR, and the use of IDLs to estimate the doses to OARs, enable the safe delivery of SBRT, without the added complexity and resource commitment required by daily online adaptive planning. [ABSTRACT FROM AUTHOR]

Rhubarb, the Rhei radix et rhizoma (Da huang) is a member of the Polygonaceae family, included in the 2020 edition of the Chinese Pharmacopoeia, and is mainly distributed in Gansu, Sichuan, Qinghai, northwestern Yunnan, and eastern Tibet. Rhei radix et rhizoma is one of the most commonly used traditional Chinese medicines, processed into drinkable tablets in different concoctions for clinical use. Phytochemical studies showed that more than 170 compounds were isolated and identified from Rhei radix et rhizoma, including anthraquinones/anthrones (major constituents), stilbenes, chromones, flavonoids, tannins, and other compounds, etc. Rhei radix et rhizoma is an herb with a long history of traditional use and many potential therapeutic benefits. It can play the role of diarrhea, clearing heat in response to different combinations and concoctions. It is mainly used for the treatment of constipation, gastrointestinal function impairment, and other diseases. In addition, Rhei radix et rhizoma has significant antitumor, anti-inflammatory, antibacterial, hepato-renal protective, neuroprotective, hypolipidemic, and immunomodulatory activities. Its active constituents have anti-tumor, anti-inflammatory, anti-inflammatory and hepato-kidney protective properties. Although it is primarily used for gastrointestinal disorders, it may also have wider applications in various inflammatory and liver disorders. Therefore, further studies are needed to explore its full potential and mechanism of action. This paper reviews the research progress of Rhei radix et rhizoma in terms of botany, traditional use, chemistry, pharmacology, and clinical studies. It aims to provide a scientific basis for in-depth research and development of Rhei radix et rhizome resources. [ABSTRACT FROM AUTHOR]

Simple Summary: In liver surgery, the complex and individualized nature of liver vascular anatomy makes planning and execution challenging. Traditional 2D intraoperative ultrasonography (IOUS) often suffers from interpretability issues due to noise and artifacts. This paper introduces an AI-based model, the "2D-weighted U-Net model," designed to enhance real-time IOUS navigation by accurately segmenting key blood vessels, including the inferior vena cava, hepatic veins, portal vein, and its major branches. Our deep learning model demonstrated high performance, with Dice scores ranging from 0.84 to 0.96 across different vessels. This advancement promises improved precision in liver resection procedures and sets the stage for future development of real-time multi-label segmentation for broader liver vasculature. Background/Objectives: In the field of surgical medicine, the planning and execution of liver resection procedures present formidable challenges, primarily attributable to the intricate and highly individualized nature of liver vascular anatomy. In the current surgical milieu, intraoperative ultrasonography (IOUS) has become indispensable; however, traditional 2D ultrasound imaging's interpretability is hindered by noise and speckle artifacts. Accurate identification of critical structures for preservation during hepatectomy requires advanced surgical skills. Methods: An AI-based model that can help detect and recognize vessels including the inferior vena cava (IVC); the right (RHV), middle (MHV), and left (LVH) hepatic veins; the portal vein (PV) and its major first and second order branches the left portal vein (LPV), right portal vein (RPV), and right anterior (RAPV) and posterior (RPPV) portal veins, for real-time IOUS navigation can be of immense value in liver surgery. This research aims to advance the capabilities of IOUS-guided interventions by applying an innovative AI-based approach named the "2D-weigthed U-Net model" for the segmentation of multiple blood vessels in real-time IOUS video frames. Results: Our proposed deep learning (DL) model achieved a mean Dice score of 0.92 for IVC, 0.90 for RHV, 0.89 for MHV, 0.86 for LHV, 0.95 for PV, 0.93 for LPV, 0.84 for RPV, 0.85 for RAPV, and 0.96 for RPPV. Conclusion: In the future, this research will be extended for real-time multi-label segmentation of extended vasculature in the liver, followed by the translation of our model into the surgical suite. [ABSTRACT FROM AUTHOR]

Cell junctions, including anchoring, occluding and communicating junctions, play an indispensable role in the structural and functional organization of multicellular tissues, including in liver. Specifically, hepatic cell junctions mediate intercellular adhesion and communication between liver cells. The establishment of the hepatic cell junction network is a prerequisite for normal liver functioning. Hepatic cell junctions indeed support liver‐specific features and control essential aspects of the hepatic life cycle. This review paper summarizes the role of cell junctions and their components in relation to liver physiology, thereby also discussing their involvement in hepatic dysfunctionality, including liver disease and toxicity. [ABSTRACT FROM AUTHOR]

Background: Reference intervals, which define an interval in which a specific proportion of measurements from a healthy population are expected to fall, are commonly used in medical practice. Synthesizing information from multiple studies through meta-analysis can provide a more precise and representative reference interval than one derived from a single study. However, the current approaches for estimating the reference interval from a meta-analysis mainly rely on aggregate data and require parametric distributional assumptions that cannot always be checked. Methods: With the availability of individual participant data (IPD), non-parametric methods can be used to estimate reference intervals without any distributional assumptions. Furthermore, patient-level covariates can be introduced to estimate personalized reference intervals that may be more applicable to specific patients. This paper introduces quantile regression as a method to estimate the reference interval from an IPD meta-analysis under the fixed effects model. Results: We compared several non-parametric bootstrap methods through simulation studies to account for within-study correlation. Under fixed effects model, we recommend keeping the studies fixed and only randomly sampling subjects with replacement within each study. Conclusion: We proposed to use the quantile regression in the IPD meta-analysis to estimate the reference interval. Based on the simulation results, we identify an optimal bootstrap strategy for estimating the uncertainty of the estimated reference interval. An example of liver stiffness measurements, a clinically important diagnostic test without explicitly established reference range in children, is provided to demonstrate the use of quantile regression in estimating both overall and subject-specific reference intervals. [ABSTRACT FROM AUTHOR]

Liver ultrasound is widely used in clinical practice due to its advantages of non-invasiveness, non-radiation, and real-time imaging. Accurate segmentation of the liver region in ultrasound images is essential for accelerating the auxiliary diagnosis of liver-related diseases. This paper proposes BACANet, a deep learning algorithm designed for real-time liver ultrasound segmentation. Our approach utilizes a lightweight network backbone for liver feature extraction and incorporates a convolutional attention mechanism to enhance the network's ability to capture global contextual information. To improve early localization of liver boundaries, we developed a selective large kernel convolution module for boundary feature extraction and introduced explicit liver boundary supervision. Additionally, we designed an enhanced attention gate to efficiently convey liver body and boundary features to the decoder to enhance the feature representation capability. Experimental results across multiple datasets demonstrate that BACANet effectively completes the task of liver ultrasound segmentation, achieving a balance between inference speed and segmentation accuracy. On a public dataset, BACANet achieved a DSC of 0.921 and an IOU of 0.854. On a private test dataset, BACANet achieved a DSC of 0.950 and an IOU of 0.907, with an inference time of approximately 0.32 s per image on a CPU processor. [ABSTRACT FROM AUTHOR]

Biophysical models can predict the behavior of cell cultures including 3D cell aggregates (3DCAs), thereby reducing the need for costly and time-consuming experiments. Specifically, mass transfer models enable studying the transport of nutrients, oxygen, signaling molecules, and drugs in 3DCA. These models require the defining of boundary conditions (BC) between the 3DCA and surrounding medium. However, accurately modeling the BC that relates the inner and outer boundary concentrations at the border between the 3DCA and the medium remains a challenge that this paper addresses using both theoretical and experimental methods. The provided biophysical analysis indicates that the concentration of molecules inside boundary is higher than that at the outer boundary, revealing an amplification factor that is confirmed by a particle-based simulator (PBS). Due to the amplification factor, the PBS confirms that when a 3DCA with a low concentration of target molecules is introduced to a culture medium with a higher concentration, the molecule concentration in the medium rapidly decreases. The theoretical model and PBS simulations were used to design a pilot experiment with liver spheroids as the 3DCA and glucose as the target molecule. Experimental results agree with the proposed theory and derived properties. [ABSTRACT FROM AUTHOR]

Background: A few months after the COVID-19 pandemic onset, knowledge of SARS-CoV-2 infection and outcomes and treatments blew up. This paper aimed to evaluate the features of a Tuscany COVID-19 hospitalized cohort and to identify risk factors for COVID-19 severity. Methods: This retrospective observational COVID-19 cohort study (1 March 2020–1 March 2021) was conducted on patients ≥ 18 years old, admitted to Tuscany Hospital, and subjected to follow-up within 12 months after discharge. Patients were enrolled at Pisana, Senese and Careggi University Hospitals, and South East, North West, and Center Local Hospitals. Results: 2888 patients (M = 58.5%, mean age = 66.2 years) were enrolled, of whom 14.3% (N = 413) were admitted to an intensive care unit. Smokers were 25%, and overweight and obese 65%. The most used drugs were corticosteroids, antacids, antibiotics, and antithrombotics, all antiviral drugs, with slight differences between 2020 and 2021. A strong association was found between outcomes of evolution towards critical COVID-19 (non-invasive mechanical ventilation (NIV) and/or admission to intensive care) and smoking (RR = 4.91), ex-smoking (RR = 3.48), overweight (RR = 1.30), obese subjects (RR = 1.62), comorbidities (aRR = 1.38). The alteration of liver enzymes (aspartate aminotransferase, alanine aminotransferase, or gamma-glutamyl transpeptidase) was associated with NIV (aOR = 2.28). Conclusions: Our cohort, characterized by patients with a mean age of 66.2 years, showed 65% of patients were overweight and obese. Smoking/ex-smoking, overweight/obesity, and other comorbidities were associated with COVID-19 adverse outcomes. The findings also demonstrated that alterations in liver enzymes were associated with worse outcomes. [ABSTRACT FROM AUTHOR]

Salvianolic acid B (SalB), among the most abundant bioactive polyphenolic compounds found in Salvia miltiorrhiza Bge., exerts therapeutic and protective effects against various diseases. Although some summaries of the activities of SalB exist, there is lack of a scientometric and in-depth review regarding disease therapy. In this review, scientometrics was employed to analyze the number of articles, publication trends, countries, institutions, keywords, and highly cited papers pertaining to SalB research. The scientometric findings showed that SalB exerts excellent protective effects on the heart, lungs, liver, bones, and brain, along with significant therapeutic effects against atherosclerosis (AS), Alzheimer's disease (AD), liver fibrosis, diabetes, heart/brain ischemia, and osteoporosis, by regulating signaling pathways and acting on specific molecular targets. Moreover, this review delves into in-depth insights and perspectives, such as the utilization of SalB in combination with other drugs, the validation of molecular mechanisms and targets, and the research and development of novel drug carriers and dosage forms. In conclusion, this review aimed to offer a comprehensive scientometric analysis and in-depth appraisal of SalB research, encompassing both present achievements and future prospects, thereby providing a valuable resource for the clinical application and therapeutic exploitation of SalB. [ABSTRACT FROM AUTHOR]

Liver, an important regulator of metabolic homeostasis, is critical for healthy brain function. In particular, age‐related neurodegenerative diseases seriously reduce the quality of life for the elderly. As population aging progresses rapidly, unraveling the mechanisms that effectively delay aging has become critical. Appropriate exercise is reported to improve aging‐related cognitive impairment. Whereas current studies focused on exploring the effect of exercise on the aging brain itself, ignoring the persistent effects of peripheral organs on the brain through the blood circulation. The aim of this paper is to summarize the communication and aging processes of the liver and brain and to emphasize the metabolic mechanisms of the liver–brain axis about exercise ameliorating aging‐related neurodegenerative diseases. A comprehensive understanding of the potential mechanisms about exercise ameliorating aging is critical for improving adaptation to age‐related brain changes and formulating effective interventions against age‐related cognitive decline. [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years, the development of liver organoids has made it a hot spot in the field of international liver disease research, but there is still no article on the bibliometric analysis of liver organoids. OBJECTIVE: To explore the hot trends in liver organoids in the last 20 years based on bibliometrics and visualization analysis. METHODS: We searched the articles about liver organoids in the Web of Science Core Collection from January 1, 2002 to November 12, 2022. Origin, Office, and CiteSpace software were used for bibliometrics and visualization analysis. We statistically analyzed the number of annually published articles, countries, institutions, authors, journals, and keywords of the articles by generating charts. RESULTS AND CONCLUSION: The number of articles, citation frequency, institutions and personnel involved in the research about liver organoids showed an overall upward trend in the last 20 years, indicating that the field was growing rapidly and attention was increasing. The USA had published the most papers and had the strongest influence in this field. Although it had invested a lot of time and energy, the number of papers published by a single research institution in the USA was not the highest among many research institutions. China was second only to the USA in the number of publications, with the Chinese Academy of Sciences and Fudan University leading the list. Utrecht University in the Netherlands was the institution with the most publications. Clevers H was the author with the highest number of articles. The article with the highest co-citation frequency was “Long-term culture of genome-stable bipotent stem cells from adult human liver”. The main fields of study for liver organoids were Molecular Science, Biology, and Immunology. The most frequently occurring keywords were stem cell, in vitro, and culture. The research hotspots in the liver organoids field were mainly focused on in vitro stem cell three-dimensional culture, differentiation and gene expression. [ABSTRACT FROM AUTHOR]

• This is the third of four papers updating standards for the care of pwCF. • Monitoring and treating lung infection is important in all people with CF. • People with more advanced CF disease need holistic individualised care. • This should balance quality of life, treatment burden and clinical outcomes. • The CF team delivers lifelong care through advanced disease and end of life. This is the third in a series of four papers updating the European Cystic Fibrosis Society (ECFS) standards for the care of people with CF. This paper focuses on recognising and addressing CF health issues. The guidance was produced with wide stakeholder engagement, including people from the CF community, using an evidence-based framework. Authors contributed sections, and summary statements which were reviewed by a Delphi consultation. Monitoring and treating airway infection, inflammation and pulmonary exacerbations remains important, despite the widespread availability of CFTR modulators and their accompanying health improvements. Extrapulmonary CF-specific health issues persist, such as diabetes, liver disease, bone disease, stones and other renal issues, and intestinal obstruction. These health issues require multidisciplinary care with input from the relevant specialists. Cancer is more common in people with CF compared to the general population, and requires regular screening. The CF life journey requires mental and emotional adaptation to psychosocial and physical challenges, with support from the CF team and the CF psychologist. This is particularly important when life gets challenging, with disease progression requiring increased treatments, breathing support and potentially transplantation. Planning for end of life remains a necessary aspect of care and should be discussed openly, honestly, with sensitivity and compassion for the person with CF and their family. CF teams should proactively recognise and address CF-specific health issues, and support mental and emotional wellbeing while accompanying people with CF and their families on their life journey. [ABSTRACT FROM AUTHOR]

The document is a correction notice for an article titled "Near-infrared molecular sensor for visualizing and tracking ONOO- during the process of anti-tuberculosis drug-induced liver damage" published in Analytical & Bioanalytical Chemistry. The correction addresses an error in Fig. 3A due to personal negligence, providing a new corrected version of the figure. The authors assure that this correction does not affect the discussion and conclusions of the original paper, and apologize for any inconvenience caused. The correction was reported by multiple authors. [Extracted from the article]

Acute-on-chronic liver failure (ACLF) is a group of clinical syndromes related to severe acute liver function damage and multiple organ failure caused by various acute inducing factors on the basis of chronic liver disease. Due to its serious condition, rapid progression and high mortality, it has attracted more and more attention. Recent studies have shown that the pathogenesis of ACLF mainly includes direct injury and immune injury. As the main immune cells in the liver, the immunoregulatory role of liver macrophages in ACLF has been increasingly recognized. Liver macrophages have excellent phenotype conversion function and plasticity characteristics under the influence of epigenetic reprogramming or local microenvironment. This adaptive expression ability can use key mediators to promote the early conversion of anti-inflammatory phenotype to alleviate liver injury. A large number of studies have shown that liver macrophages have a certain potential in reversing the process of ACLF. Therefore, from the perspective of the plasticity characteristics of liver macrophages, this paper expounds the role of liver macrophages in ACLF and the research on the intervention of ACLF disease process, and summarizes its potential significance in the treatment of ACLF. [ABSTRACT FROM AUTHOR]

The liver is a major metabolic organ of the human body and has a high incidence of diseases. In recent years, the annual incidence of liver disease has increased, seriously endangering human life and health. The study of the occurrence and development mechanism of liver diseases, discovery of new therapeutic targets, and establishment of new methods of medical treatment are major issues related to the national economy and people's livelihood. The development of stable and effective research models is expected to provide new insights into the pathogenesis of liver diseases and the search for more effective treatment options. Organoid technology is a new in vitro culture system, and organoids constructed by human cells can simulate the morphological structure, gene expression, and glucose and lipid metabolism of organs in vivo, providing a new model for related research on liver diseases. This paper reviews the latest research progress on liver organoids from the establishment of cell sources and application of liver organoids and discusses their application potential in the field of liver disease research. [ABSTRACT FROM AUTHOR]

Simple Summary: This manuscript systematically reviewed the literature on the use of vascular shunts during advanced pancreatic surgery, analyzing intraoperative and postoperative outcomes, and enlightening excellent long-term patency, negligible additional operative time, and acceptable postoperative morbidity. The importance of the study was to underline feasibility of this technical artifice, which may help expert surgeons to achieve clear margins in borderline or locally advanced PDAC. Background: The rising diffusion of vascular resections during complex pancreatectomy for malignancy, for both oncological and technical matters, brought with it the use of vascular shunts, either temporary or definitive, to prevent bowel congestion and liver ischemia. This study aimed to systematically review the literature on the technical feasibility of vascular shunts during advanced pancreatic surgery, analyzing intraoperative and postoperative outcomes. Methods: A systematic literature search was performed on PubMed, Scopus, Web of Science, and the Cochrane Library Central, according to PRISMA guidelines. Studies published before 2006 were excluded, considering the lack of a standardized definition of locally advanced pancreatic cancer. The main outcomes evaluated were the overall complication rate and shunt patency. Results: Among 789 papers retrieved from the database search, only five fulfilled the inclusion criteria and were included in the review, amounting to a total of 145 patients undergoing a shunt creation at the time of pancreatectomy. Pancreatic adenocarcinoma (PDAC) was found to be the most common diagnosis and pancreaticoduodenectomy was the main surgical procedure, accounting for 88% and 83% of the overall cohort, respectively. The distal splenorenal shunt was the most performed. Overall, 44 out of 145 patients (30%) experienced postoperative complications; the long-term patency of definitive shunts was 83% (110 out of 120 patients). Conclusions: An increasing number of patients with borderline resectable or locally advanced PDAC are becoming amenable to resection and shunt creation may facilitate vascular resection with clear margins, becoming a valid tool of modern pancreatic surgery. [ABSTRACT FROM AUTHOR]

Drug-induced liver injury (DILI) is a common clinical pharmacogenic disease. In the United States and Europe, DILI is the most common cause of acute liver failure. Drugs can cause hepatic damage either directly through inherent hepatotoxic properties or indirectly by inducing oxidative stress, immune responses, and inflammatory processes. These pathways can culminate in hepatocyte necrosis. The role of the gut microecology in human health and diseases is well recognized. Recent studies have revealed that the imbalance in the gut microecology is closely related to the occurrence and development of DILI. The gut microecology plays an important role in liver injury caused by different drugs. Recent research has revealed significant changes in the composition, relative abundance, and distribution of gut microbiota in both patients and animal models with DILI. Imbalance in the gut microecology causes intestinal barrier destruction and microorganism translocation; the alteration in microbial metabolites may initiate or aggravate DILI, and regulation and control of intestinal microbiota can effectively mitigate drug-induced liver injury. In this paper, we provide an overview on the present knowledge of the mechanisms by which DILI occurs, the common drugs that cause DILI, the gut microbiota and gut barrier composition, and the effects of the gut microbiota and gut barrier on DILI, emphasizing the contribution of the gut microecology to DILI. [ABSTRACT FROM AUTHOR]

Hepatic ischemia/reperfusion injury (IRI) remains a severe threat during liver surgery and transplantation, accounting for unfavorable clinical outcomes. Modafinil (MOD), a wakefulness‐inducing compound, is increasingly disclosed to protect against IRI. However, the specific literatures covering the association between MOD and hepatic IRI are few. Here, this paper is committed to unraveling the role and response mechanism of MOD in hepatic IRI. After the establishment of hepatic IRI mice model and cell model, relevant assay kits measured the concentrations of biochemical indicators of hepatotoxicity and hematoxylin and eosin staining estimated liver morphology. Enzyme‐linked immunosorbent assay, reverse‐transcription quantitative polymerase chain reaction, and western blot evaluated inflammatory levels. Terminal‐deoxynucleoitidyl transferase‐mediated nick end labeling assay and western blot appraised apoptosis. Western blot also analyzed the expression of Toll‐like receptor 9 (TLR9)/myeloid differentiation primary response gene 88 (MyD88)/p38 signaling‐associated proteins. Cell counting kit‐8 method judged cell viability. MOD was discovered to mitigate liver dysfunction and morphological damage, inflammatory response, apoptosis in vivo and improve cell viability, suppress inflammatory response and apoptosis in vitro. In addition, MOD inactivated TLR9/Myd88/p38 signaling both in vitro and in vivo. Further, TLR9 elevation reversed the inhibitory role of MOD in inflammatory response and cell apoptosis in vitro. Anyway, MOD blocked TLR9/Myd88/p38 signaling to exhibit anti‐inflammatory and anti‐apoptotic properties in hepatic IRI. [ABSTRACT FROM AUTHOR]

Summary: The SIMulation supported LIVer Assessment for donor organs (SimLivA) project aims to develop a mathematical model to accurately simulate the influence of mechanical alterations in marginal liver grafts (specifically steatotic ones) and cold ischemia on early ischemia‐reperfusion injury (IRI) during liver transplantation. Our project tackles significant research challenges, including the co‐development of computational methodologies, experimental studies, clinical processes, and technical workflows. We aim to refine a continuum‐biomechanical model for enhanced IRI prediction, collect pivotal experimental and clinical data, and assess the clinical applicability of our model. Our efforts involve augmenting and tailoring a coupled continuum‐biomechanical, multiphase, and multi‐scale partial differential equation‐ordinary differential equation (PDE‐ODE) model of the liver lobule, allowing us to numerically simulate IRI depending on the degree of steatosis and the duration of ischemia. The envisaged model will intertwine the structure, perfusion, and function of the liver, serving as a crucial aid in clinical decision‐making processes. We view this as the initial step towards an in‐silico clinical decision support tool aimed at enhancing the outcomes of liver transplantation. In this paper, we provide an overview of the SimLivA project and our preliminary findings, which include: a cellular model that delineates critical processes in the context of IRI during transplantation; and the integration of this model into a multi‐scale PDE‐ODE model using a homogenized, multi‐scale, multi‐component approach within the Theory of Porous Media (TPM) framework. The model has successfully simulated the interconnected relationship between structure, perfusion, and function—all of which are integral to IRI. Initial results show simulations at the cellular scale that describe critical processes related to IRI during transplantation. After integrating this model into a multiscale PDE‐ODE model, first simulations were performed on the spatial distribution of key functions during warm and cold ischaemia. In addition, we were able to study the effect of tissue perfusion and temperature, two critical parameters in the context of liver transplantation and IRI. [ABSTRACT FROM AUTHOR]

Currently, staging the degree of liver fibrosis predominantly relies on liver biopsy, a method fraught with potential risks, such as bleeding and infection. With the rapid development of medical imaging devices, quantification of liver fibrosis through image processing technology has become feasible. Stacking technology is one of the effective ensemble techniques for potential usage, but precise tuning to find the optimal configuration manually is challenging. Therefore, this paper proposes a novel EVO-MS model—a multiple stacking ensemble learning model optimized by the energy valley optimization (EVO) algorithm to select most informatic features for fibrosis quantification. Liver contours are profiled from 415 biopsied proven CT cases, from which 10 shape features are calculated and inputted into a Support Vector Machine (SVM) classifier to generate the accurate predictions, then the EVO algorithm is applied to find the optimal parameter combination to fuse six base models: K-Nearest Neighbors (KNNs), Decision Tree (DT), Naive Bayes (NB), Extreme Gradient Boosting (XGB), Gradient Boosting Decision Tree (GBDT), and Random Forest (RF), to create a well-performing ensemble model. Experimental results indicate that selecting 3–5 feature parameters yields satisfactory results in classification, with features such as the contour roundness non-uniformity (Rmax), maximum peak height of contour (Rp), and maximum valley depth of contour (Rm) significantly influencing classification accuracy. The improved EVO algorithm, combined with a multiple stacking model, achieves an accuracy of 0.864, a precision of 0.813, a sensitivity of 0.912, a specificity of 0.824, and an F1-score of 0.860, which demonstrates the effectiveness of our EVO-MS model in staging the degree of liver fibrosis. [ABSTRACT FROM AUTHOR]

We perform an analytical study on the propagation properties of Laguerre higher-order cosh-Gaussian beam (LhchGB) passing through liver tissue, utilizing the power spectrum refractive index and the extended Huygens-Fresnel integral. Our investigation includes numerical simulations based on the derived formula, illustrating how varying beam parameter configurations within liver tissue impact the properties of the beam. Additionally, we thoroughly discuss the influence of both optical parameters and biological tissue characteristics on the received intensity. Our observations indicate that the LhchGB undergoes changes in its shape as it traverses a considerable distance through this medium. The results presented in this paper hold significant importance for their potential applications in determining the deterioration or disruption of biological tissue, as well as in the fields of medical imaging and medical diagnosis. [ABSTRACT FROM AUTHOR]

Through their personal experience of having intrahepatic cholestasis of pregnancy (ICP), this paper covers the development of current understanding of ICP. It summarises how research and clinical practice was developed through clinicians and followed by the inception of an ICP research group in the 1990s. This group's work has led to a better understanding of the mechanisms behind ICP, the risk threshold for stillbirth, and a genomic understanding of the condition. It focuses on how collaborative work between the author and researchers led to the formation of a charity for ICP. Despite this, some obstetric healthcare professionals continue to provide misinformation about ICP to women and birthing people. Furthermore, the views of those affected by ICP, together with the research they present to clinicians, are being ignored. It highlights a need for those managing ICP to listen to their patients and to pay closer attention to the research being published. [ABSTRACT FROM AUTHOR]

The Deadly Liver Mob (DLM) is a peer-delivered incentivised health promotion program by and for Aboriginal and Torres Strait Islander Australians, and was introduced in response to the disproportionate number of Aboriginal and Torres Strait Islander Australians who are impacted by blood borne viruses (BBVs) and sexually transmitted infections (STIs). The goal of the program is to increase access to BBV and STI education, screening, treatment, and vaccination in recognition and response to the systemic barriers that Aboriginal and Torres Strait Islander peoples face in accessing health care. This commentary introduces a series of papers that report on various aspects of the evaluation of the Deadly Liver Mob (DLM) program. In this paper, we explain what DLM is and how we constructed an evaluation framework for this complex health promotion intervention. [ABSTRACT FROM AUTHOR]

Automatic segmentation of the liver in abdominal CT images is critical for guiding liver cancer biopsies and treatment planning. Yet, automatic segmentation of CT liver images remains challenging due to the poor contrast between the liver and surrounding organs in abdominal CT images. In this paper, we propose a novel network for liver segmentation, and the network is essentially a U-shaped network with an encoder–decoder structure. Firstly, the complementary feature enhancement unit is designed in the network to mitigate the semantic gap between encoder and decoder. The complementary feature enhancement unit is based on subtraction, which enhances the complementary features between encoder and decoder. Secondly, this paper proposes a new cross attention model that no longer generates value by convolution, which reduces redundant information and enhances the contextual information of single sparse attention by encoding contextual information by 3 × 3 convolution. The dice score, accuracy, and precision of our network on the LiTS dataset were 95.85 % , 97.19 % , and 97.11 % , and the dice score, accuracy, and precision on the dataset consisted of 3Dircadb and CHAOS were 93.65 % , 94.38 % , and 97.53 % . [ABSTRACT FROM AUTHOR]

This technical paper introduces a novel organ preservation system based on isochoric (constant volume) supercooling. The system is designed to enhance the stability of the metastable supercooling state, offering potential long-term preservation of large biological organs at subfreezing temperatures without the need for cryoprotectant additives. Detailed technical designs and usage protocols are provided for researchers interested in exploring this field. The paper also presents a control system based on the thermodynamics of isochoric freezing, utilizing pressure monitoring for process control. Sham experiments were performed using whole pig liver sourced from a local food supplier to evaluate the system's ability to sustain supercooling without ice nucleation for extended periods. The results demonstrated sustained supercooling without ice nucleation in pig liver tissue for 24 and 48 h. These findings suggest the potential of this technology for large-volume, cryoprotectant-free organ preservation with real-time control over the preservation process. The simplicity of the isochoric supercooling device and the design details provided in the paper are expected to serve as encouragement for other researchers in the field to pursue further research on isochoric supercooling. However, final evidence that these preserved organs can be successfully transplanted is still lacking. [ABSTRACT FROM AUTHOR]

Histologically cirrhosis is characterised by vascularised fibrosis septa that link portal tract with each other and with central veins leading to hepatocyte islands that are surrounded by fibrotic septa which are devoid of a central vein. The major clinical manifestations of cirrhosis are impaired hepatocyte function and increased intrahepatic resistance and development of portal hypertension and hepatocellular carcinoma. Liver has multiple functions including key role in metabolism, control of infection, elimination of toxins and byproducts of metabolism. This was a prospective study from 1st January 2023-31st December 2023 with a total of 100 deaths with presence of cirrhosis of liver detected during autopsy conducted in mortuary, Department of FMT, PMCH was analysed. Complete demographic, clinical details were obtained from accompanying relatives of the diseased, information sourced from police IO, inquest paper and medical records of the treatment furnished at the time of autopsy. Higher incidence of liver cirrhosis was found in age group 31-50 years, 74 percent of them were males, 30 percent were diabetic, alcohol was the etiological factor in 65 percent cases, NASH was etiological factor in 19%, hepatitis B and C was etiological factor in 12 % of the cases. [ABSTRACT FROM AUTHOR]

The liver is the second most common solid organ injured in blunt and penetrating abdominal trauma. Non-operative management (NOM) has become the standard of care for liver injuries in stable patients, where transarterial embolization (TAE) represents the main treatment, increasing success rates and avoiding invasive surgical procedures. In hemodynamically (HD) unstable patients, operative management (OM) is the standard of care. To date, there are no consensus guidelines about the endovascular treatment of patients with HD instability or in ones that responded to initial infusion therapy. A review of the literature was performed for published papers addressing the outcome of using TAE as the primary treatment for HD unstable/transient responder trauma liver patients with hemorrhagic vascular lesions, both as a single treatment and in combination with surgical treatment, focusing additionally on the different definitions used in the literature of unstable and transient responder patients. Our review demonstrated a good outcome in HD unstable/transient responder liver trauma patients treated with TAE but there still remains much debate about the definition of unstable and transient responder patients. [ABSTRACT FROM AUTHOR]

MR is a powerful diagnostic tool in the diagnosis and management of most hepatic and pancreatic diseases. Thanks to its multiple sequences, the use of dedicated contrast media and special techniques, it allows a multiparametric approach able to provide both morphological and functional information for many pathological conditions. The knowledge of correct technique is fundamental in order to obtain a correct diagnosis. In this paper, different MR sequences will be illustrated in the evaluation of liver and pancreatic diseases, especially those sequences which provide information not otherwise obtainable with other imaging techniques. Practical MR protocols with the most common indications of MR in the study of the liver and pancreas are provided. [ABSTRACT FROM AUTHOR]

Using liver phantoms for mimicking human tissue in clinical training, disease diagnosis, and treatment planning is a common practice. The fabrication material of the liver phantom should exhibit mechanical properties similar to those of the real liver organ in the human body. This tissue-equivalent material is essential for qualitative and quantitative investigation of the liver mechanisms in producing nutrients, excretion of waste metabolites, and tissue deformity at mechanical stimulus. This paper reviews the mechanical properties of human hepatic tissues to develop liver-mimicking phantoms. These properties include viscosity, elasticity, acoustic impedance, sound speed, and attenuation. The advantages and disadvantages of the most common fabrication materials for developing liver tissue-mimicking phantoms are also highlighted. Such phantoms will give a better insight into the real tissue damage during the disease progression and preservation for transplantation. The liver tissue-mimicking phantom will raise the quality assurance of patient diagnostic and treatment precision and offer a definitive clinical trial data collection. [ABSTRACT FROM AUTHOR]

Liver diseases of various etiologies are becoming increasingly common in the pediatric population. So far, the gold diagnostic standard in these disorders is liver biopsy. This procedure is invasive, painful and requires general anesthesia in this group of patients. Due to the continuous development of new research techniques, such as liver elastography, it is necessary to evaluate them in the context of their diagnostic usefulness. Ultrasound elastography, as a quick and effective method, is being used more and more often in the assessment and monitoring of liver dysfunction in both adults and children. There are several techniques of liver elastography, such as transient elastography, shear wave elastography consisting of various subtypes such as two-dimensional shear wave elastography, acoustic radiation force impulse and point shear wave elastography, which differ in terms of the measurement technique and the achieved results. The purpose of our review was to determine whether techniques of liver elastography could replace liver biopsy. Although now, based on the analyzed papers, elastography cannot replace liver biopsy, in our opinion, the role of this tool in monitoring pediatric patients with liver diseases will grow in the coming years. [ABSTRACT FROM AUTHOR]

Schisandra chinensis (S. chinensis) has a long history as a traditional Chinese medicine that is astringent, beneficial to vital energy, tonifies the kidney, tranquilizes the heart, etc. Significantly, Schisandrol A (SA) is extracted from S. chinensis and shows surprising and satisfactory biological activity, including anti-inflammatory, hepatoprotective, cardiovascular protection, and antitumor properties, among others. SA has a more pronounced protective effect on central damaged nerves among its numerous pharmacological effects, improving neurodegenerative diseases such as Alzheimer's and Parkinson's through the protection of damaged nerve cells and the enhancement of anti-oxidant capacity. Pharmacokinetic studies have shown that SA has a pharmacokinetic profile with a rapid absorption, wide distribution, maximal concentration in the liver, and primarily renal excretion. However, hepatic and intestinal first-pass metabolism can affect SA's bioavailability. In addition, the content of SA, as an index component of S. chinensis Pharmacopoeia, should not be less than 0.40%, and the content of SA in S. chinensis compound formula was determined with the help of high-performance liquid chromatography (HPLC), which is a stable and reliable method, and it can lay a foundation for the subsequent quality control. Therefore, this paper systematically reviews the preparation, pharmacological effects, pharmacokinetic properties, and content determination of SA with the goal of updating and deepening the understanding of SA, as well as providing a theoretical basis for the study of SA at a later stage. [ABSTRACT FROM AUTHOR]

Simple Summary: Yaks are a major economic source for people in the Tibetan Plateau region. Yaks are rich in nutrients, but their low fat content is not conducive to the large-scale promotion of yak meat, so the study of the mechanism of yak lipid deposition is beneficial to the marketing of yak meat. In this paper, the results of transcriptome sequencing analysis of yak liver showed that it could be determined that the expression levels of genes associated with partial lipid deposition were significantly up-regulated during yak fattening. In addition, this study found that the tenderness of yak meat improved during this process. Fattening significantly affects fat deposition in yaks, which may be realized through its effects on lipid metabolic pathways. Therefore, studying the mechanism of lipid deposition in yaks and fattening yaks will improve the quality of yak meat. Yak meat is nutritionally superior to beef cattle but has a low fat content and is slow-growing. The liver plays a crucial role in lipid metabolism, and in order to determine whether different feeding modes affect lipid metabolism in yaks and how it is regulated, we employed RNA sequencing (RNA-seq) technology to analyze the genome-wide differential gene expression in the liver of yaks maintained under different raising systems. A total of 1663 differentially expressed genes (DEGs) were identified (|log2FC| ≥ 0 and p-value ≤ 0.05), including 698 down-regulated and 965 up-regulated genes. According to gene ontology (GO) and KEGG enrichment analyses, these DEGs were significantly enriched in 13 GO terms and 26 pathways (p < 0.05). Some DEGs were enriched in fatty acid degradation, PPAR, PI3K-Akt, and ECM receptor pathways, which are associated with lipid metabolism. A total of 16 genes are well known to be related to lipid metabolism (e.g., APOA1, FABP1, EHHADH, FADS2, SLC27A5, ACADM, CPT1B, ACOX2, HMGCS2, PLIN5, ACAA1, IGF1, FGFR4, ALDH9A1, ECHS1, LAMA2). A total of 11 of the above genes were significantly enriched in the PPAR signaling pathway. The reliability of the transcriptomic data was verified using qRT-PCR. Our findings provide new insights into the mechanisms regulating yak meat quality. It shows that fattening improves the expression of genes that regulate lipid deposition in yaks and enhances meat quality. This finding will contribute to a better understanding of the various factors that determine yak meat quality and help develop strategies to improve yield and quality. [ABSTRACT FROM AUTHOR]

An abdominal Computed Tomography (CT) scan gives more information about diseases of the liver, gallbladder, and biliary tract. In the image processing approach, liver segmentation is an essential step to be done before liver lesion detection. Liver segmentation removes the unwanted regions from the CT image and makes the task of lesion detection easier. In this paper, a novel Morph-Rec model based on morphological reconstruction operation is proposed for liver segmentation from CT images. The proposed work is focused on segmenting the liver region from the CT slices irrespective of the size and shape of the liver region. The proposed model is validated on 2650 CT slices of 120 and 20 CT scans from the LITS and 3DIRCADb datasets, respectively. The proposed Morph-Rec method is evaluated using metrics such as dice score, accuracy, F1 score, Jaccard index and Matthew's correlation coefficient. To justify the adaptability and efficiency of the proposed model, it is also validated on 50 CT slices of nine CT scans provided by a local scan centre. The proposed method has produced excellent results on all metrics and the obtained results are better than the state-of-the-art conventional methods for liver segmentation. Hence, the proposed technique is an automatic and dataset-generic model that can perform liver segmentation precisely on any CT acquisition of the liver. [ABSTRACT FROM AUTHOR]

Transplantation is currently the only effective treatment for patients with end-stage liver failure. In recent years, many advanced studies have been conducted to improve the efficiency of organ preservation techniques. Modifying the composition of the preservation fluids currently used may improve graft function and increase the likelihood of transplantation success. The modified fluid is expected to extend the period of safe liver storage in the peri-transplantation period and to increase the pool of organs for transplantation with livers from marginal donors. This paper provides a literature review of the effects of antioxidants on the efficacy of liver preservation fluids. Medline (PubMed), Scopus, and Cochrane Library databases were searched using a combination of MeSH terms: "liver preservation", "transplantation", "preservation solution", "antioxidant", "cold storage", "mechanical perfusion", "oxidative stress", "ischemia-reperfusion injury". Studies published up to December 2023 were included in the analysis, with a focus on publications from the last 30 years. A total of 45 studies met the inclusion criteria. The chemical compounds analyzed showed mostly bioprotective effects on hepatocytes, including but not limited to multifactorial antioxidant and free radical protective effects. It should be noted that most of the information cited is from reports of studies conducted in animal models, most of them in rodents. [ABSTRACT FROM AUTHOR]

Metabolic dysfunction-associated steatotic liver disease (MASLD) typically presents with hepatic fibrosis in advanced disease, resulting in increased liver stiffness. A subset of patients further develops liver cirrhosis and hepatocellular carcinoma. Cardiovascular disease is a common comorbidity in patients with MASLD and its prevalence is increasing in parallel. Recent evidence suggests that especially liver stiffness, whether or not existing against a background of MASLD, is associated with heart diseases. We conducted a narrative review on the role of liver stiffness in the prediction of highly prevalent heart diseases including heart failure, cardiac arrhythmias (in particular atrial fibrillation), coronary heart disease, and aortic valve sclerosis. Research papers were retrieved from major scientific databases (PubMed, Web of Science) until September 2023 using 'liver stiffness' and 'liver fibrosis' as keywords along with the latter cardiac conditions. Increased liver stiffness, determined by vibration-controlled transient elastography or hepatic fibrosis as predicted by biomarker panels, are associated with a variety of cardiovascular diseases, including heart failure, atrial fibrillation, and coronary heart disease. Elevated liver stiffness in patients with metabolic liver disease should lead to considerations of cardiac workup including N-terminal pro-- B-type natriuretic peptide/B-type natriuretic peptide determination, electrocardiography, and coronary computed tomography angiography. In addition, patients with MASLD would benefit from heart disease case-finding strategies in which liver stiffness measurements can play a key role. In conclusion, increased liver stiffness should be a trigger to consider a cardiac workup in metabolically compromised patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Most of the existing data on the resection of liver metastases with inferior vena cava infiltration come from case reports or small case series. This systematic review on the subject found postoperative morbidity and mortality rates and overall survival to be acceptable, offering a surgical alternative to these patients previously considered unresectable. Combined hepatic and inferior vena cava (IVC) resection is the only potentially curative treatment for patients with colorectal liver metastases (CRLM) involving the IVC. Most of the existing data come from case reports or small case series. In this paper, a systematic review based on the PICO strategy was performed in accordance with the PRISMA statement. Papers from January 1980 to December 2022 were searched in Embase, PubMed, and the Cochrane Library databases. Articles considered for inclusion had to present data on simultaneous liver and IVC resection for CRLM and report surgical and/or oncological outcomes. From a total of 1175 articles retrieved, 29, including a total of 188 patients, met the inclusion criteria. The mean age was 58.3 ± 10.8 years. The most frequent techniques used were right hepatectomy ± caudate lobe for hepatic resections (37.8%), lateral clamping (44.8%) for vascular control, and primary closure (56.8%) for IVC repair. The thirty-day mortality reached 4.6%. Tumour relapse was reported in 65.8% of the cases. The median overall survival (OS) was 34 months (with a confidence interval of 30–40 months), and the 1-year, 3-year, and 5-year OS were 71.4%, 19.8%, and 7.1%, respectively. In the absence of prospective randomized studies, which are difficult to perform, IVC resection seems to be safe and feasible. [ABSTRACT FROM AUTHOR]

In the modern healthcare system, the segmentation process is really helpful to aid in the diagnosis process. In this paper, the efficient metaheuristic approach - Modified Whale Optimization Algorithm and Minimum Cross Entropy (MWOA & MCE) based multilevel thresholding is proposed for segmentation of the computer tomography (CT) liver image. Segmentation of liver cyst image is the main objective of this paper, which will assist doctors to diagnose liver cysts. The results of segmentation of CT liver images are compared with other algorithms, Teaching-Learning-based optimization algorithm, Jaya algorithm and Genetic algorithm, to evaluate the efficiency of the MCE & MWOA approach. Different performance calculating methods like Uniformity, Structure Similarity Index (SSIM), Root Mean Square Error (RMS Error), Rand Index (RI), Execution time, Variation of Information (VoI) and Peak Signal-to-Noise Ratio (PSNR) are assessed from an original and resultant image. In comparison to other algorithms, the proposed method's findings demonstrate that the MCE & MWOA algorithm achieve accurate and efficient segmentation results. [ABSTRACT FROM AUTHOR]

A pressing health problem, both in clinical and socio-economic terms, is the increase in the number of patients with liver damage caused by viral diseases (hepatitis), cancer, toxicological damage, or metabolic disorders. Liver function assessment is a complex task, for which various existing diagnostic methods are used. Unfortunately, they all have several limitations which frequently make prompt and accurate diagnosis impossible. The high level of disability and mortality caused by liver diseases makes the development of new liver diagnostic methods very urgent. In this paper, we describe a new joint methodology for studying liver function based on optical densitometry and dynamic light scattering. This will help to diagnose and predict the dynamics of liver function during treatment with greater efficiency, due to including in consideration the individual characteristics of the cardiovascular system and tissue metabolism. In this paper, we present a laboratory model of a combined sensor for optical densitometry and dynamic light scattering. We also developed special software for controlling the sensor and processing the recorded data. Modeling experiments and physical medical studies were carried out to adjust and calibrate the sensor and software. We also assessed the sensor resolution when registering the concentration of dye in the human body and the minimum measured flow rate. [ABSTRACT FROM AUTHOR]

Living Donor Liver Transplantation (LDLT) is a promising approach to treating end-stage liver diseases, however, some post-operatory complications such as pneumonia, bacteremia, urinary tract infections, and hepatic dysfunction have been reported. In murine models using partial hepatectomy (PHx), a model that emulates LDLT, it has been determined that the synthesis of hepatic cell proliferation factors that are associated with noradrenaline synthesis are produced in locus coeruleus (LC). In addition, studies have shown that PHx decreases GABA and 5-HT2A receptors, promotes loss of dendritic spines, and favors microgliosis in rat hippocampus. The GABA and serotonin-altered circuits suggest that catecholaminergic neurons such as dopamine and noradrenaline neurons, which are highly susceptible to cellular stress, can also be damaged. To understand post-transplant affections and to perform well-controlled studies it is necessary to know the potential causes that explain as a liver surgical procedure can produce brain damage. In this paper, we review several cellular processes that could induce gliosis in LC after rat PHx. [ABSTRACT FROM AUTHOR]

Malignant focal liver lesions (FLLs) represent various kinds of epithelial and mesenchymal tumors. In pediatric patients, the understanding of pediatric liver diseases and associated imaging manifestations is essential for making accurate diagnosis and differential diagnosis. This paper will discuss the latest knowledge of the common pediatric malignant FLLs, including undifferentiated embryonal sarcoma, rhabdomyosarcoma, epithelioid hemangioendothelioma, angiosarcoma, and malignant rhabdoid tumor. Medical imaging features are not only helpful for clinical diagnosis, but can also be useful in the evaluation and follow-up of pre- and post-treatment. The future perspectives of contrast-enhanced ultrasound (CEUS) enhancement patterns of FLLs in pediatric patients are also mentioned. [ABSTRACT FROM AUTHOR]

Malignant focal liver lesions (FLLs) are commonly reported in adults but rarely seen in the pediatric population. Due to the rarity, the understanding of these diseases is still very limited. In children, most malignant FLLs are congenital. It is very important to choose appropriate imaging examination concerning various factors. This paper will outline common pediatric malignant FLLs, including hepatoblastoma, hepatocellular carcinoma, and cholangiocarcinoma and discuss them against the background of the latest knowledge on comparable/similar tumors in adults. Medical imaging features are of vital importance for the non-invasive diagnosis and follow-up of treatment of FLLs in pediatric patients. The use of CEUS in pediatric patients for characterizing those FLLs that remain indeterminate on conventional B mode ultrasounds may be an effective option in the future and has great potential to be integrated into imaging algorithms without the risk of exposure to ionizing radiation. [ABSTRACT FROM AUTHOR]

Background: Solid Organ Transplant recipients (SOTR) appear to be at particular high risk for critical COVID-19 due to immunosuppressive drugs and comorbidities. We report the first description of clinical course and short-term outcomes of kidney and liver transplant recipients with confirmed COVID-19 in Mexico. Objective: The objective of this paper was evaluate the clinical course of transplant patients with COVID-19 infection. Methods: We retrospectively evaluated SOTR (kidney and liver) over 18 years of age with confirmed diagnosis of COVID-19 from tertiary care centers in Mexico. Results: Data from 45 kidney transplant recipients were recorded. Median (IQR) age was 43 (IQR 25-70) years. Admission to hospital was required in 37 (75.5 %) patients, of which 8 (16.3%) were hospitalized at Intensive Care Unit (ICU). Acute kidney injury (AKI) stage was documented in 33 (67%) patients. The time of hospitalization was 8 (IQR 6-12) days. Six patients died (12.2%). Additionally, data from 10 liver transplant recipients were included. During their evolution, 5 / 10 required hospital admission and there were no deaths in this group. Conclusions: Transplant recipients show a higher fatality rate and complications from SARS-CoV-2 infection; more studies are needed to identify prognostic factors and effective anti-SARS-CoV-2 therapies. [ABSTRACT FROM AUTHOR]

Wedelolide is a coumarin-like active substance extracted from Ecliptae Herba. It not only has pharmacological effects of anti-pulmo- nary fihosis, anti-arthritis, blood vessel protection and liver protection, but also effectively inhibits the poliferation of cancer cells and induces apoptosis of cancer cells, thereby delaying the further development of malignant tumors. In this paper, the pharmacological effects and mecha- nisms of wedelactone were reviewed to lay a foundation for further study and clinical application of wedelactone. [ABSTRACT FROM AUTHOR]

Hepatocellular adenomas are benign endothelial tumors of the liver, mostly associated with female individual users of estrogen-containing medications. However, the precise factors underlying the selective development of hepatic adenomas in certain females remain elusive. Additionally, the conventional profile of individuals prone to hepatic adenoma is changing. Notably, male patients exhibit a higher risk of malignant progression of hepatocellular adenomas, and there are instances where hepatic adenomas have no identifiable cause. In this paper, we theorize the role of the human gastrointestinal microbiota, specifically, of bacterial species producing β-glucuronidase enzymes, in the development of hepatic adenomas through the estrogen recycling pathway. Furthermore, we aim to address some of the existing gaps in our knowledge of pathophysiological pathways which are not yet subject to research or need to be studied further. As microbial β-glucuronidases proteins recycle estrogen and facilitate the conversion of inactive estrogen into its active form, this process results in elevated levels of unbound plasmatic estrogen, leading to extended exposure to estrogen. We suggest that an imbalance in the estrobolome could contribute to sex hormone disease evolution and, consequently, to the advancement of hepatocellular adenomas, which are estrogen related. [ABSTRACT FROM AUTHOR]

Simple Summary: Hepatoblastoma is a rare childhood liver cancer with poor outcomes for high-risk patients. Better treatments and better ways of identifying patients who respond poorly to treatment are needed. This paper uses new methods for identifying chemicals or metabolites produced in the tumour. By comparing the profiles of these metabolites in tumour tissue versus normal liver tissue taken from the same patient, we demonstrated that some metabolites differ significantly in hepatoblastoma. This correlates with gene expression data, suggesting that we identified the metabolites correctly. We also stained tumour tissues for proteins (enzymes) that regulate transport of fatty acids into the mitochondria, which are the cell's powerhouses. Taken together, our results indicate that tumour cells change the energy sources they use and rewire the cellular systems accordingly. Further work is required to verify this, but these leads could improve our understanding of the disease and lead to the development of novel therapies. Hepatoblastoma (HB) is a rare childhood tumour with an evolving molecular landscape. We present the first comprehensive metabolomic analysis using untargeted and targeted liquid chromatography coupled to high-resolution tandem mass spectrometry (LC-MS/MS) of paired tumour and non-tumour surgical samples in HB patients (n = 8 pairs). This study demonstrates that the metabolomic landscape of HB is distinct from that of non-tumour (NT) liver tissue, with 35 differentially abundant metabolites mapping onto pathways such as fatty acid transport, glycolysis, the tricarboxylic acid (TCA) cycle, branched-chain amino acid degradation and glutathione synthesis. Targeted metabolomics demonstrated reduced short-chain acylcarnitines and a relative accumulation of branched-chain amino acids. Medium- and long-chain acylcarnitines in HB were similar to those in NT. The metabolomic changes reported are consistent with previously reported transcriptomic data from tumour and non-tumour samples (49 out of 54 targets) as well as metabolomic data obtained using other techniques. Gene set enrichment analysis (GSEA) from RNAseq data (n = 32 paired HB and NT samples) demonstrated a downregulation of the carnitine metabolome and immunohistochemistry showed a reduction in CPT1a (n = 15 pairs), which transports fatty acids into the mitochondria, suggesting a lack of utilisation of long-chain fatty acids in HB. Thus, our findings suggest a reduced metabolic flux in HB which is corroborated at the gene expression and protein levels. Further work could yield novel insights and new therapeutic targets. [ABSTRACT FROM AUTHOR]