University of Verona
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Minimally invasive hepatectomy vs. thermoablation for single small (≤3 cm) hepatocellular carcinoma: A weighted real-life national comparison
No full textBackground & Aims: For patients with single small (<-3 cm) hepatocellular carcinoma ablation is the first-line treatment, although a high rate of recurrence has been reported. The aim was to compare videolaparoscopic liver resection (laparoscopic resection group) vs. percutaneous thermoablation (ablation group) in terms of overall survival, recurrence-free survival and early recurrence in a real-life national scenario.Methods: The study is a retrospective collection with subsequent survival analysis. Data were collected from two Italian HCC registries, ITA.LI.CA and HE.RC.O.LE.S. An inverse probability of treatment weighting analysis was performed to balance baseline differences between groups. The Kaplan-Meier method and double-robust Cox multivariable regression were run to estimate the survival and the risk of mortality and recurrence.Results: Between 2008 and 2022, 1,465 patients were enrolled. The laparoscopic resection group and ablation group consisted of 496 and 969 patients, respectively. At baseline, the ablation group had more advanced liver disease, with higher rates of cirrhosis (90.7% vs. 77.3%, p <0.001) and Child-Pugh B status (18.4% vs. 8.8%, p <0.001). After a median follow-up of 59 months and after weighting median overall survival was 60 months (95% CI 52-66) for the ablation group and 93 months (95% CI 75-110) for the laparoscopic resection group (hazard ratio [HR] 0.607, 95% CI 0.533-0.691, p <0.001). Median recurrence-free survival was 26 months (95% CI 23-29) for the ablation group and 39 months (95% CI 30-55) for the laparoscopic resection group (HR 0.736, 95% CI 0.659-0.822, p = 0.0013). Laparoscopy was associated with a reduced risk of early recurrence (HR 0.747, 95% CI 0.655-0.853, p = 0.011).Conclusions: This study provides real-world evidence that for patients with single <= 3 cm HCC, videolaparoscopic liver resection offers superior long-term oncological outcomes compared with thermoablation. These findings support the preference for surgical treatment in this patient population.(c) 2025 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
From north to south: exploring Italian sun-exposure habits through the “Save your skin” campaign
Get PDFsun-exposure habits, skin protection, public health
awareness, skin cancer preventio
Metabolic Dysfunction-Associated Steatotic Liver Disease
No full textThis review discusses the global clinical burden and consequences of MASLD as a multisystem disease, briefly describing the natural history, pathophysiology, risk stratification and case finding of the disease, and focuses on the new and promising metabolism-based pharmacotherapies targeting the liver and cardiovascular-kidney-metabolic comorbidities of MASLD. Current areas of uncertainty where further research is needed are also discussed
I patti parasociali: questioni attuali e problemi irrisolti
No full textIl contributo si occupa della materia dei patti parasociali, partendo dalla loro introduzione nel Testo Unico della Finanza, passando per la disciplina del codice civile per giungere alla disamina di alcune fattispecie particolari (non oggetto di specifica disciplina ma molto usate nella prassi societaria ed indagate dalla giurisprudenza) tra le quali i cd sindacati di amministrazione e i patti utilizzati per realizzare il controllo analogo congiunto nelle società in-house
Critical Response to the Comments on the Critical Issue of Infant and Child Mortality in Afghanistan
No full textThis paper critically examines a set of arguments challenging a study on infant and child mortality in Afghanistan, highlighting several inaccuracies and oversights. It defends the use of secondary data as a practical necessity in conflict-affected and resource-limited settings where primary data collection is often impossible. The paper clarifies that, as a scoping review, the study’s purpose was to map existing evidence rather than perform advanced statistical analysis. It also explains the difficulty of obtaining comparative or counterfactual data in unstable regions with limited infrastructure. Concerns about political bias are deemed speculative and unsupported by evidence, while suggestions such as expanding rural healthcare facilities are criticized as unrealistic given Afghanistan’s economic challenges. The paper concludes that the study offers meaningful insights into the country’s complex child mortality crisis despite these unfounded criticisms
Microbiological and Clinical Evaluation of the Efficacy of a Chemical Desiccant Agent in Non-Surgical Periodontal Treatment: A Randomized Controlled Clinical Trial
No full textThis randomized clinical trial compared the effects of topical irrigation with a desiccant agent (HybenX Oral Tissue Decontaminant, HBX) combined with full- mouth ultrasonic debridement as well as scaling and root planing (FMUD-SRP) versus conventional non-surgical periodontal therapy (US-SRP). Methods: Three quadrants per patient with probing pocket depth (PPD) ≥ 5 mm were randomly assigned to (i) the control group (US-SRP only), (ii) test group 1 (HBX + US-SRP at baseline, HBX 1T (one time)), or (ii) test group 2 (HBX + US-SRP across three sessions, HBX 3T (three times)). Clinical parameters included probing pocket depth (PPD), bleeding on probing (BOP), plaque index (PI), gingival recession (REC), and Clinical Attachment Level (CAL), recorded at baseline (Tbase), 45 days (T45d), and 90 days (T90d). Microbiological sampling was conducted for all sites at Tbase, T45d, and T90d to assess periodontal pathogens. HBX-treated sites received gel application for 60 s, followed by a saline rinse and US-SRP. Results: Significant differences were found between groups in PPD (p = 0.04) and CAL (p = 0.02) at T45d versus Tbase, while BOP, PI, and REC showed no significant inter-group differences at T45d. The HBX 3T group demonstrated greater pathogen reduction compared to the control and HBX 1T groups, except for one bacterial species. Conclusions: All treatments improved clinical and microbiological parameters. Even if single and triple applications of HBX showed similar clinical results, the repeated application achieved greater bacterial reduction
Running session-conditioned human serum lowers prostate cancer cell spheroid formation
Get PDFPurpose: Physical activity is associated with a lower mortality and recurrence risk in cancer, yet the underlying mechanisms remain unclear. This study aimed to evaluate the effects of running sessions on the tumorigenic potential of prostate cancer cells using a 3D in vitro model. Methods: Fifteen healthy males completed two outdoor running sessions (5 km and 10 km), interspersed by 1 month of wash-out time. Blood samples were collected before (PRE), immediately after (POST), and 3 h after (POST-3 h) sessions. Human serum (HS) samples were used to stimulate LNCaP and PC3 cell lines in 3D in vitro culture technique. The spheroid formation ability was quantified after 21 days of incubation, using GelCount. Results: In both prostate cancer cell lines, a reduction in spheroid number was shown, by both running sessions and in all timepoints considered (LNCaP cells: 5 km: - 23.8%; 10 km: - 5.6% POST HS; 5 km: - 37.8%; 10 km: - 34.8% POST-3 h HS; PC3 cells: 5 km: - 14%; 10 km: - 15.9% POST HS; 5 km: - 14.2%; 10 km: - 13% POST-3 h HS). The spheroid volume was reduced by 42.6% (5 km) and 51.1% (10 km) with POST-3 h HS, in LNCaP cells; no significant reduction was observed in PC3 cells. No differences were found between the running sessions, while higher muscle mass, cardiorespiratory fitness and age were associated with greater reductions in spheroid number and volume, especially in LNCaP cells. Conclusion: Running sessions reduce prostate cancer cell spheroid formation, especially in participants with higher physical fitness. Shorter running distances showed comparable effects to longer ones, highlighting practical implications for real-world exercise prescriptions in oncology
Central Dysmyelination in SSADH-Deficient Humans and Mice
Get PDFObjectives: Succinic semialdehyde dehydrogenase deficiency (SSADHD) is an inherited metabolic disorder characterized by an accumulation of γ-aminobutyric (GABA). In addition to its synaptic role as an inhibitory neurotransmitter, GABA also plays an important role in myelination. We aimed to investigate the relationship between GABA and myelination abnormalities in SSADHD patients and the mouse model. Methods: Brain MRIs performed on 44 individuals (23 with SSADHD and 21 healthy controls) were independently reviewed by two neuroradiologists and scored using a disease-specific myelination scoring system. Inter-rater reliability (IRR) was assessed by the intraclass correlation coefficient. Myelination scores of SSADHD individuals were correlated with clinical, biochemical, magnetic resonance spectroscopy, and genetic data. Additionally, we investigated the expression of myelin-related genes in a mouse SSADHD model. Results: Dysmyelination in SSADHD patients was overall mild, but significantly greater than in healthy controls (p < 0.001). In SSADHD patients, lower myelination scores were significantly correlated with younger age (R = 0.775, p < 0.001) and higher plasma GABA (R = -0.722, p < 0.001) and γ-hydroxybutyric acid (GHB) (R = -0.683, p = 0.001). In SSADH-deficient mice, there was reduced expression of genes encoding myelin basic protein (p = 0.001), myelin-associated oligodendrocyte basic protein (p = 0.001), and mitochondrial aspartate transporter (p = 0.025). Interpretation: Excessive GABA and GHB, which characterize SSADHD and are further pronounced in younger SSADHD individuals, may account for delayed oligodendrocyte maturation and altered myelination dynamics in this disorder. Studying the properties of dysmyelination in this unique disorder enhances our understanding of GABA's mediating role on myelination and may contribute to monitoring disease progression and managing other white-matter neurological disorders. Trial registration: NCT03758521
Leveraging cross-border e-commerce platforms for export strategies: a model for exporters in B2B markets
No full textPurpose
Exporters are increasingly using business-to-business (B2B) cross-border e-commerce (CBEC) through third-party platforms as a foreign market entry mode. B2B CBEC platforms resemble online trade shows and aim to facilitate the establishment of relationships between sellers and foreign buyers (e.g. distributors, importers and original equipment manufacturers) to promote repeated exchanges. However, how international buyer−seller relationships are established through such platforms remains unclear. This study aims to draw on the new open resource, linkage and integration (OLI) advantages theory to develop a model for exporters to successfully use CBEC platforms.
Design/methodology/approach
This study was based on a longitudinal analysis of five Italian firms from the food and beverage industry using Alibaba.com to establish relationships with foreign distributors and professional food service buyers. Grounded theory was used to analyze the data.
Findings
The analysis resulted in a model explaining how exporters engage in co-creation processes with CBEC platforms’ ecosystems to transform the generic new OLI advantages enabled by B2B CBEC platforms into firm-specific advantages that drive the establishment of relationships with international buyers.
Research limitations/implications
The cases considered in this study are linked to the food and beverage industry. The buying and selling cycles vary from industry to industry, resulting in the need for varying balances between in-platform and out-of-platform buyer interactions.
Practical implications
The model developed in this study can be readily implemented by firms using CBEC platforms. The model indicates the need to approach CBEC platform use with appropriate expectations and after assessing organizational readiness. It also emphasizes the need for exporters to adopt proactive behaviors through engagement activities, continuous learning and self-adjustment.
Originality/value
To the best of the authors’ knowledge, this study is the first to develop a comprehensive model outlining how exporters can use B2B CBEC platforms to establish stable relationships with foreign buyers
Dietary supplementation with a designer metabolic modulator improves MASLD and associated anxiety in mice
No full textBackground Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a multifaceted condition characterized by excessive liver fat accumulation associated with obesity or other risk factors. Patients with obesity-related MASLD often suffer from comorbid psychiatric conditions, including anxiety. The therapeutic approach for MASLD relies on weight management through dietary and behavioral modifications. Nutritional interventions with essential amino acids (EAAs) have emerged as safe and promising tools in treating metabolic disorders and liver diseases. This study aimed to investigate the effects of dietary supplementation with alpha 5, a designer EAA-based metabolic modulator enriched with tricarboxylic acid cycle intermediates, in a murine model of diet-induced MASLD with associated anxiety.Methods Ten-week-old male C57BL/6J mice were fed for 17 weeks either a high-fat, high-sugar diet or a standard purified diet. The alpha 5 compound (1.5 mg/g/day in drinking water) was administered to half of the mice fed each diet (n = 8/group). Mice body weight and energy intake were recorded. Liver and adipose tissue depot weights were calculated as ratios to body weight. Blood analytes were evaluated. Liver samples were analyzed for the enzymatic activity of mitochondrial chain respiratory complexes, gene expression (reverse transcription-qPCR), and histological features (hematoxylin-eosin and Masson's trichrome staining). Liver disease severity was graded using the NAFLD Activity Score. The open field behavioral test was conducted to assess anxiety.Results Mice fed the high-fat, high-sugar diet developed obesity, a MASLD phenotype, and anxiety-like behaviors. Dietary supplementation with alpha 5 ameliorated liver pathology, including reduced hepatocellular ballooning, fat lipid droplet diameter, and the expression of genes related to fibrosis, without affecting body weight. Moreover, alpha 5 supplementation significantly reduced the anxiety-like behavior observed in untreated MASLD mice.Discussion These results suggest that alpha 5 represents a novel intervention to prevent or mitigate the progression of MASLD and its associated mental health complications