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1.
Ther Clin Risk Manag ; 20: 577-595, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39253031

RESUMO

This article reviews the mechanisms and prevention strategies associated with vitamin D and sarcopenia in older adults. As a geriatric syndrome, sarcopenia is defined by a notable decline in skeletal muscle mass and strength, which increases the risk of adverse health outcomes such as falls and fractures. Vitamin D, an essential fat-soluble vitamin, is pivotal in skeletal muscle health. It affects muscle function through various mechanisms, including regulating calcium and phosphorus metabolism, promoting muscle protein synthesis, and modulation of muscle cell proliferation and differentiation. A deficiency in vitamin D has been identified as a significant risk factor for the development of sarcopenia in older adults. Many studies have demonstrated that low serum vitamin D levels are significantly associated with an increased risk of sarcopenia. While there is inconsistency in the findings, most studies support the importance of vitamin D in maintaining skeletal muscle health. Vitamin D influences the onset and progression of sarcopenia through various pathways, including the promotion of muscle protein synthesis, the regulation of mitochondrial function, and the modulation of immune and inflammatory responses. Regarding the prevention and treatment of sarcopenia, a combination of nutritional, exercise, and pharmacological interventions is recommended. Further research should be conducted to elucidate the molecular mechanism of vitamin D in sarcopenia, to study genes related to sarcopenia, to perform large-scale clinical trials, to investigate special populations, and to examine the combined application of vitamin D with other nutrients or drugs. A comprehensive investigation of the interconnection between vitamin D and sarcopenia will furnish a novel scientific foundation and productive strategies for preventing and treating sarcopenia. This, in turn, will enhance the senior people's quality of life and health.

2.
Ann Med ; 56(1): 2409342, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39348274

RESUMO

OBJECTIVE: The objective of this study was to thoroughly investigate the clinical value of triglyceride glucose-body mass index (TyG-BMI) in patients diagnosed with non-alcoholic fatty liver disease (NAFLD). Specifically, we aimed to determine its association with non-alcoholic steatohepatitis (NASH) and the progression of liver fibrosis. METHODS: The study included 393 patients diagnosed with NAFLD after liver biopsy. The patients were divided into two distinct cohorts: a training cohort (N = 320) and a validation cohort (N = 73). The training cohort was further divided into four groups based on TyG-BMI quartiles. The clinical characteristics of the patients in each group were compared in detail, and the association between TyG-BMI and NASH, NAFLD Activity Score (NAS) ≥ 4, at-risk NASH, significant fibrosis, advanced fibrosis, and cirrhosis was analyzed using multiple models. Additionally, we generated receiver operating characteristic (ROC) curves to evaluate the predictive ability of TyG-BMI for NASH and fibrosis staging in patients with NAFLD. RESULTS: Patients with higher TyG-BMI values had a significantly higher prevalence of NASH, NAS ≥ 4, at-risk NASH, significant fibrosis, advanced fibrosis, and cirrhosis (all p < .05). TyG-BMI was an independent predictor of these diseases in both unadjusted and adjusted models (all p < .05). ROC curve analysis further revealed the excellent performance of TyG-BMI in predicting NASH, NAS ≥ 4, at-risk NASH, significant fibrosis, advanced fibrosis, and cirrhosis. The validation cohort yielded analogous results. Furthermore, we constructed three multivariate models of TyG-BMI in conjunction with elastography metrics, which demonstrated elevated diagnostic AUC values of 0.782, 0.792, 0.794, 0.785, 0.834, and 0.845, respectively. CONCLUSION: This study confirms a significant association between insulin resistance and NAFLD, including at-risk NASH and fibrosis staging, as assessed using the TyG-BMI index. TyG-BMI and its associated multivariate models can be valuable noninvasive indicators for NAFLD diagnosis, risk stratification, and disease course monitoring.


Assuntos
Índice de Massa Corporal , Cirrose Hepática , Hepatopatia Gordurosa não Alcoólica , Triglicerídeos , Humanos , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Feminino , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico , Cirrose Hepática/patologia , Adulto , Glicemia/metabolismo , Glicemia/análise , Curva ROC , Índice de Gravidade de Doença , Fígado/patologia , Progressão da Doença , Biópsia , Estudos Retrospectivos
3.
Front Nutr ; 11: 1435403, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39346653

RESUMO

The association between vitamin D and kidney stones is characterized by a remarkable multi-dimensional complexity involving numerous physiological and metabolic pathways. Vitamin D is pivotal in maintaining calcium-phosphorus metabolic homeostasis and bone health. However, fluctuations in its intake, whether excessive or insufficient, May potentially increase the risk of kidney stones. Vitamin D exerts its influence on kidney stone formation indirectly by increasing the efficiency of intestinal calcium absorption and regulating renal calcium excretion. Moreover, there is a robust correlation between various states of vitamin D, particularly its active form, 1,25-dihydroxyvitamin D, and the development of numerous kidney stones. This finding underscores the necessity of individualized medical treatment in vitamin D supplementation and kidney stone prevention. When developing treatment strategies, it is essential to consider the patient's genetic background, lifestyle, environmental factors, and overall health. To prevent the formation of kidney stones, it is recommended that patients adopt a comprehensive approach, which May include measures such as moderate sun exposure, dietary modification, moderate exercise, and weight management. These preventive measures are designed to maintain healthy calcium and phosphorus metabolism and reduce kidney stone formation risk. Future studies should aim to elucidate the detailed mechanisms of vitamin D metabolism, individual differences, and the role of genes in this process. Furthermore, the role of lifestyle interventions in preventing kidney stones requires greater attention. Moreover, the implementation of large-scale, long-term prospective studies and randomized controlled trials will facilitate the assessment of the actual effects of diverse vitamin D supplementation strategies, thereby providing a robust scientific foundation for advancing more precise prevention strategies and clinical guidelines.

4.
PLoS One ; 19(8): e0305876, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39172957

RESUMO

Online travel agency (OTA) platforms frequently engage in unfair behaviors that infringe on the legitimate rights and interests of consumers and airlines in the ticket sale market. Effective governance of the OTA platforms' misconduct has become an urgent topic. In order to address the governance dilemma of OTA platforms' misconduct, a tripartite evolutionary game model considering the collaborative supervision between airlines and consumers is constructed. This study analyzes the evolutionary path and stable strategy of the three participants, airlines, platforms and consumers by numerical simulation. The results show that some actions, such as airlines' strict control of ticket sales resources and high fines on the platform, reducing the cost of customers' rights protection, and effectively guiding online public opinion, can benefit airlines and consumers and enhance their willingness to cooperate in supervision. Legitimate consumer rights protection not only brings negative public opinion and image loss to airlines, but also to platforms, which can force airlines to impose stricter constraints on platforms and force platforms to strengthen self-restraint. Therefore, a market mechanism instead of government regulatory that can effectively suppress platforms misconduct should be established to promote platforms self-regulation through a collaborative effort between airlines and consumers. Some special measures that guide the interests of three participators are also provided.


Assuntos
Teoria dos Jogos , Humanos , Comportamento Cooperativo , Comportamento do Consumidor , Viagem , Internet , Opinião Pública
6.
J Colloid Interface Sci ; 674: 959-971, 2024 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-38959741

RESUMO

Despite the bright fortune of lithium-sulfur (Li-S) batteries as one of the next-generation energy storage systems owing to the ultrahigh theoretical energy density and earth-abundance of sulfur, crucial challenges including polysulfide shuttling and low sulfur content of sulfur cathodes need to be overcome before the commercial survival of sulfur cathodes. Herein, cobalt/carbon spheres embedded CNTs (Co-C-CNTs) are rationally designed as multifunctional hosts to synergistically address the drawbacks of sulfur cathodes. The host is synthesized by a facile pyrolysis using Co(OH)2 template and followed with the controllable etching process. The hierarchical porous structure owning high pore volume and surface area can buffer the volume change, physically confine polysulfides, and provide conductive networks. Besides, partially remained metallic cobalt nanoparticles are favorable for chemical adsorption and conversion of polysulfides, as validated by density functional theory simulations. With the combination of above merits, the S@Co-C-CNTs cathodes with a high sulfur content of 80 wt% present a superior initial capacity (1568 mAh g-1 at 0.1C) with ultrahigh 93.6% active material utilization, and excellent rate performance (649 mAh g-1 at 2C), providing feasible strategies for the optimization of cathodes in metal-sulfur batteries.

7.
Adv Sci (Weinh) ; 11(33): e2309170, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38952062

RESUMO

The long-term durability of triboelectric nanogenerators (TENGs) remains a main challenge for practical applications because of inevitable material abrasion and wear, especially for sliding TENGs. Herein, an inorganic triboelectric pair composed of diamond-like carbon (DLC) and glass with excellent durability and triboelectric output for sliding-mode TENGs is proposed. This triboelectric pair possesses a low coefficient of friction and little abrasion and accordingly excellent durability (>500 000 cycles). Moreover, compared with the traditional copper-polytetrafluoroethylene (Cu-PTFE) TENG with maximum transferred charges of 50 nC, those of the DLC-glass TENG reaches 141 nC. Due to the low-friction and high hardness of the triboelectric pair, the output quickly recovers after simply cleaning wear debris. The DLC-glass TENG demonstrates an output power density of 530 mW m-2 and a fourfold faster capacitor charging speed than the Cu-PTFE TENG. Compared to the reported durable TENGs via structure optimization and interface lubrication, the DLC-glass TENG shows higher outputs and simpler structure. This DLC-glass pair structure is also introduced into a spherical TENG for blue energy harvesting with excellent durability. The inorganic triboelectric pair with excellent mechanical durability and electrical performance proposed in this work shows huge prospects for practical applications of TENGs.

9.
Mater Today Bio ; 26: 101112, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38873104

RESUMO

Multifunctional wound dressings, enriched with biologically active agents for preventing or treating infections and promoting wound healing, along with cell delivery capability, are highly needed. To address this issue, composite scaffolds with potential in wound dressing applications were fabricated in this study. The poly-lactic acid/nanodiamonds (PLA/ND) scaffolds were first printed using melt electrowriting (MEW) and then coated with quaternized ß-chitin (QßC). The NDs were well-dispersed in the printed filaments and worked as fillers and bioactive additions to PLA material. Additionally, they improved coating effectiveness due to the interaction between their negative charges (from NDs) and positive charges (from QßC). NDs not only increased the thermal stability of PLA but also benefitted cellular behavior and inhibited the growth of bacteria. Scaffolds coated with QßC increased the effect of bacteria growth inhibition and facilitated the proliferation of human dermal fibroblasts. Additionally, we have observed rapid extracellular matrix (ECM) remodeling on QßC-coated PLA/NDs scaffolds. The scaffolds provided support for cell adhesion and could serve as a valuable tool for delivering cells to chronic wound sites. The proposed PLA/ND scaffold coated with QßC holds great potential for achieving fast healing in various types of wounds.

10.
Eur Heart J Digit Health ; 5(3): 219-228, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38774374

RESUMO

Aims: Permanent pacemaker implantation and left bundle branch block are common complications after transcatheter aortic valve replacement (TAVR) and are associated with impaired prognosis. This study aimed to develop an artificial intelligence (AI) model for predicting conduction disturbances after TAVR using pre-procedural 12-lead electrocardiogram (ECG) images. Methods and results: We collected pre-procedural 12-lead ECGs of patients who underwent TAVR at West China Hospital between March 2016 and March 2022. A hold-out testing set comprising 20% of the sample was randomly selected. We developed an AI model using a convolutional neural network, trained it using five-fold cross-validation and tested it on the hold-out testing cohort. We also developed and validated an enhanced model that included additional clinical features. After applying exclusion criteria, we included 1354 ECGs of 718 patients in the study. The AI model predicted conduction disturbances in the hold-out testing cohort with an area under the curve (AUC) of 0.764, accuracy of 0.743, F1 score of 0.752, sensitivity of 0.876, and specificity of 0.624, based solely on pre-procedural ECG images. The performance was better than the Emory score (AUC = 0.704), as well as the logistic (AUC = 0.574) and XGBoost (AUC = 0.520) models built with previously identified high-risk ECG patterns. After adding clinical features, there was an increase in the overall performance with an AUC of 0.779, accuracy of 0.774, F1 score of 0.776, sensitivity of 0.794, and specificity of 0.752. Conclusion: Artificial intelligence-enhanced ECGs may offer better predictive value than traditionally defined high-risk ECG patterns.

15.
Inflammation ; 47(4): 1328-1343, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38630167

RESUMO

Innate immune response is the first line of defense for the host against virus invasion. One important response is the synthesis and secretion of type I interferon (IFN-I) in the virus-infected host cells. Here, we found that respiratory syncytial virus (RSV) infection induced high expression of TRIM25, which belongs to the tripartite motif-containing (TRIM) family of proteins. TRIM25 bound and activated retinoic acid-inducible gene I (RIG-I) by K63-linked ubiquitination. Accordingly, RIG-I mediated the production of IFN-I mainly through the nuclear factor kappa-B (NF-κB) pathway in respiratory epithelial cells. Interestingly, IFN-I, in turn, promoted a high expression of TRIM38 which downregulated the expression of IFN-I by reducing the protein level of RIG-I by K48-linked ubiquitination. More importantly, the binding site of TRIM25 to RIG-I was found in the narrow 25th-43rd amino acid (aa) region of RIG-I N-terminus. In contrast, the binding sites of TRIM38 to RIG-I were found in a much wider amino acid region, which included the binding site of TRIM25 on RIG-I. As a result, TRIM38 inhibits the production of IFN-I by competing with TRIM25 for RIG-I binding. Thus, TRIM38 negatively regulates RIG-I activation to, in turn, downregulate IFN-I expression, thus interfering with host immune response. A negative feedback loop effectively "puts the brakes" on the reaction once host immune response is overactivated and homeostasis is unbalanced. We also discovered that TRIM25 bound RIG-I by a new K63-linked ubiquitination located at K-45 of the first caspase recruitment domain (CARD). Collectively, these results confirm an antagonism between TRIM38 and TRIM25 in regulating IFN-I production by affecting RIG-I activity following RNA virus infection.


Assuntos
Proteína DEAD-box 58 , Regulação para Baixo , Interferon Tipo I , Receptores Imunológicos , Fatores de Transcrição , Proteínas com Motivo Tripartido , Ubiquitina-Proteína Ligases , Ubiquitinação , Proteínas com Motivo Tripartido/metabolismo , Proteína DEAD-box 58/metabolismo , Humanos , Ubiquitina-Proteína Ligases/metabolismo , Interferon Tipo I/metabolismo , Interferon Tipo I/biossíntese , Fatores de Transcrição/metabolismo , Receptores Imunológicos/metabolismo , Infecções por Vírus Respiratório Sincicial/imunologia , Infecções por Vírus Respiratório Sincicial/metabolismo , Infecções por Vírus Respiratório Sincicial/virologia , Ligação Proteica , Células A549 , Vírus Sinciciais Respiratórios/imunologia
16.
Ann Med ; 56(1): 2337739, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38574396

RESUMO

BACKGROUND AND AIM: This study aims to validate the efficacy of the conventional non-invasive score in predicting significant fibrosis in metabolic-associated fatty liver disease (MAFLD) and to develop a non-invasive prediction model for MAFLD. METHODS: This cross-sectional study was conducted among 7701 participants with MAFLD from August 2018 to December 2023. All participants were divided into a training cohort and a validation cohort. The study compared different subgroups' demographic, anthropometric, and laboratory examination indicators and conducted logistic regression analysis to assess the correlation between independent variables and liver fibrosis. Nomograms were created using the logistic regression model. The predictive values of noninvasive models and nomograms were evaluated using receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA). RESULTS: Four nomograms were developed for the quantitative analysis of significant liver fibrosis risk based on the multivariate logistic regression analysis results. The nomogram's area under ROC curves (AUC) was 0.710, 0.714, 0.748, and 0.715 in overall MAFLD, OW-MAFLD, Lean-MAFLD, and T2DM-MAFLD, respectively. The nomogram had a higher AUC in all MAFLD participants and OW-MAFLD than the other non-invasive scores. The DCA curve showed that the net benefit of each nomogram was higher than that of APRI and FIB-4. In the validation cohort, the AUCs of the nomograms were 0.722, 0.750, 0.719, and 0.705, respectively. CONCLUSION: APRI, FIB-4, and NFS performed poorly predicting significant fibrosis in patients with MAFLD. The new model demonstrated improved diagnostic accuracy and clinical applicability in identifying significant fibrosis in MAFLD.


Assuntos
Nomogramas , Hepatopatia Gordurosa não Alcoólica , Humanos , Estudos Transversais , Cirrose Hepática/diagnóstico , Antropometria , Área Sob a Curva , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico
17.
Ir J Med Sci ; 193(4): 1843-1853, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38520612

RESUMO

BACKGROUND AND AIM: Early identification of liver fibrosis is essential for the prognosis of metabolic-associated fatty liver disease (MAFLD), particularly in type 2 diabetes mellitus (T2DM) patients. Here, we explored the association of chitinase-3-like protein 1 (CHI3L1) and liver fibrosis in T2DM-MAFLD patients. METHODS: Liver fibrosis was staged in T2DM-MAFLD patients, and a liver stiffness measurement (LSM) of ≥ 8 kPa was used to differentiate between non-significant (NSLF) and significant liver fibrosis (SLF) subgroups. The two subgroups were compared for serum CHI3L1 and other parameters. Linear correlation, logistic regression, and restricted cubic spline (RCS) analyses were performed to evaluate the association between CHI3L1 and liver fibrosis. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic accuracy of CHI3L1. RESULTS: Among T2DM-MAFLD, SLF patients had higher CHI3L1 compared to NSLF patients. CHI3L1 was found to be positively correlated with LSM. Multivariate logistic regression analysis suggested that CHI3L1 may be a potential independent risk factor for SLF. Further stratified analysis indicated that the odds ratios of SLF in the high CHI3L1 group were higher than in the low CHI3L1 group in the subgroups. RCS analysis suggested an increasing trend in the incidence of significant fibrosis with the rising level of CHI3L1. The area under the ROC curve for detecting significant fibrosis was 0.749 (95% CI: 0.668-0.829). CONCLUSIONS: Serum CHI3L1 demonstrates an association with significant liver fibrosis. High serum levels of CHI3L1 may indicate the existence of significant liver fibrosis in T2DM-MAFLD patients.


Assuntos
Proteína 1 Semelhante à Quitinase-3 , Diabetes Mellitus Tipo 2 , Cirrose Hepática , Humanos , Proteína 1 Semelhante à Quitinase-3/sangue , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/sangue , Masculino , Feminino , Pessoa de Meia-Idade , Cirrose Hepática/sangue , Cirrose Hepática/complicações , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/sangue , Curva ROC , Idoso , Biomarcadores/sangue , Fatores de Risco
18.
Diabetes Metab Syndr Obes ; 17: 943-957, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38435634

RESUMO

Purpose: This research aims to examine and scrutinize gender variations in the incidence of diabetic nephropathy (DN) and the trajectory of renal function in type 2 diabetes mellitus (T2DM) patients. Patients and Methods: We conducted a retrospective cohort study that enrolled 1549 patients diagnosed with T2DM from May 2015 to July 2023. We separately compared the clinical characteristics of male and female participants with and without DN. We utilized the Kaplan-Meier method to examine the cumulative incidence of DN among T2DM patients of varying genders. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using univariable and multivariable Cox proportional hazards regression analysis to evaluate the correlation between various factors and the risk of DN incidence. Multiple linear regression was utilized to investigate the relationship between ΔeGFR% and each factor. Logistic regression with cubic spline function and smooth curve fitting was employed to analyze the nonlinear link between ΔeGFR% and the risk of DN among participants of different genders. Results: The prevalence of DN was higher in female participants (17.31%) than in male participants (12.62%), with a significant cumulative risk ratio (1.33 [1.02-1.73], P = 0.034). Multiple linear regression analysis revealed that creatinine, female gender, blood urea nitrogen, alkaline phosphatase, and total cholesterol had a significant impact on ΔeGFR% in T2DM patients, with standardized ß coefficients of -0.325, -0.219, -0.164, -0.084, and 0.071, respectively. The restricted cubic spline analysis demonstrated a strong negative association between ΔeGFR% and the risk of developing DN (P < 0.001). Conclusion: Both male and female patients with T2DM had a higher prevalence of DN over the 5-year follow-up period. However, women had a greater risk of developing DN and a faster decline in renal function compared to men.

19.
J Colloid Interface Sci ; 665: 286-298, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38531274

RESUMO

Tailoring porous host materials, as an effective strategy for storing sulfur and restraining the shuttling of soluble polysulfides in electrolyte, is crucial in the design of high-performance lithium-sulfur (Li-S) batteries. However, for the widely studied conductive hosts such as mesoporous carbon, how the aspect ratio affects the confining ability to polysulfides, ion diffusion as well as the performances of Li-S batteries has been rarely studied. Herein, ordered mesoporous carbon (OMC) is chosen as a proof-of-concept prototype of sulfur host, and its aspect ratio is tuned from over âˆ¼ 2 down to below âˆ¼ 1.2 by using ordered mesoporous silica hard templates with variable length/width scales. The correlation between the aspect ratio of OMCs and the electrochemical performances of the corresponding sulfur-carbon cathodes are systematically studied with combined electrochemical measurements and microscopic characterizations. Moreover, the evolution of sulfur species in OMCs at different discharge states is scrutinized by small-angle X-ray scattering. This study gives insight into the aspect ratio effects of mesoporous host on battery performances of sulfur cathodes, providing guidelines for designing porous host materials for high-energy sulfur cathodes.

20.
Aquac Nutr ; 2024: 6337005, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38298207

RESUMO

The effects of plant protein sources (PPSs) on the health of the liver and intestine of the largemouth bass, Micropterus salmoides, were compared to verify the potential damaging effects of dietary fiber (DF). A diet containing 55% fish meal (FM) was used as the control. The test diets contained 25% soybean meal (SBM), rapeseed meal (RSM), cottonseed meal, or peanut meal, and the FM content was decreased to 30%. The protein and lipid contents of these five diets were balanced by casein and oil. Fish were raised for 8 weeks. The fish fed the diet containing PPS showed a trend of decreasing growth and apparent digestibility coefficients. The contents of total bile acid, lipid, and collagen in the liver were increased, and the mRNA expression levels of genes encoding inflammatory factors and enzymes involved in de novo fatty acid synthesis and bile acid synthesis were upregulated. Both the lipid and collagen contents in the liver were positively correlated with the DF content in the diet significantly. Morphology and histology showed reduced liver size, hepatic steatosis, and fibrosis in fish fed diets containing PPS. The lowest hepatosomatic index was observed in fish fed the SBM diet, and the most severe damage was observed in fish fed the RSM diet. No obvious histological abnormalities were observed in the hindgut. The bile acid profile in the liver could be used to distinguish the types of PPS very well by Fisher discriminant analysis. These results indicated that 25% of each of the four PPSs in the diet exceeded the tolerance range of largemouth bass and caused liver damage, which might be mediated by bile acid. DF in PPS might be an important agent contributing to liver damage.

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