AST/ALT ratio is the most important independent predictor of servere hepatic fibrosis in hispanic and caucasian patients with monalcoholic stesishepstitis

Abstract Fibrosis results from a disordered wound healing response within the liver with activated hepatic stellate cells laying down dense, collagen-rich extracellular matrix that eventually restricts liver hepatic synthetic function and causes increased sinusoidal resistance. The end result of progressive fibrosis, cirrhosis, is associated with significant morbidity and mortality as well as tremendous economic burden. Fibrosis can be conceptualized as an aberrant wound healing response analogous to a chronic ankle sprain that is driven by chronic liver injury commonly over decades. Two unique aspects of hepatic fibrosis – the chronic nature of insult required and the liver’s unique ability to regenerate – give an opportunity for pharmacologic intervention to stop or slow the pace of fibrosis in patients early in the course of their liver disease. Two potential biologic mechanisms link together hemostasis and fibrosis: focal parenchymal extinction and direct stellate cell activation by thrombin and Factor Xa. Available translational research further supports the role of thrombosis in fibrosis. In this review, we will summarize what is known about the convergence of hemostatic changes and hepatic fibrosis in chronic liver disease and present current preclinical and clinical data exploring the relationship between the two. We will also present clinical trial data that underscores the potential use of anticoagulant therapy as an antifibrotic factor in liver disease.

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Exploring the Potential Impact of Sentence-Level Comprehension and Sentence-Level Fluency on Deaf Students' Passage Comprehension

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00205 ◽

2020 ◽

Vol 63 (7) ◽

pp. 2281-2292

Author(s):

Ying Zhao ◽

Xinchun Wu ◽

Hongjun Chen ◽

Peng Sun ◽

Ruibo Xie ◽

...

Keyword(s):

Independent Predictor ◽

Vocabulary Knowledge ◽

Group Differences ◽

Regression Analyses ◽

Deaf Students ◽

Mediating Role ◽

Sentence Level ◽

Mediating Mechanisms ◽

Potential Impact ◽

The Relationship

Purpose This exploratory study aimed to investigate the potential impact of sentence-level comprehension and sentence-level fluency on passage comprehension of deaf students in elementary school. Method A total of 159 deaf students, 65 students ( M age = 13.46 years) in Grades 3 and 4 and 94 students ( M age = 14.95 years) in Grades 5 and 6, were assessed for nonverbal intelligence, vocabulary knowledge, sentence-level comprehension, sentence-level fluency, and passage comprehension. Group differences were examined using t tests, whereas the predictive and mediating mechanisms were examined using regression modeling. Results The regression analyses showed that the effect of sentence-level comprehension on passage comprehension was not significant, whereas sentence-level fluency was an independent predictor in Grades 3–4. Sentence-level comprehension and fluency contributed significant variance to passage comprehension in Grades 5–6. Sentence-level fluency fully mediated the influence of sentence-level comprehension on passage comprehension in Grades 3–4, playing a partial mediating role in Grades 5–6. Conclusions The relative contributions of sentence-level comprehension and fluency to deaf students' passage comprehension varied, and sentence-level fluency mediated the relationship between sentence-level comprehension and passage comprehension.

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