12 research outputs found
Advanced Logistics for people and goods mobility: mathematical models and trials related to new protocols for mail delivery (LAMRECOR project)
No full textLAMRECOR project, funded by MiUR with Poste Italiane as prime
contractor, aims at demonstrating an innovative integrated system for advanced
logistics targeted at minimizing the environmental impact of the fleet of vehicles,
optimizing the productive processes, improving the safety of the postal workers, and
developing new logistics procedures for mail delivery. For enhancing the safety of
the workers, an integrated sensors system has been designed. The system includes an
on-board unit to control the appropriate use of personal protective equipment,
improving protection of the postmen also through the activation of an emergency
call in case of accident, and to monitor functional performances of the vehicles. A
prototype of the sensors system has been developed confirming the design results.
Some mathematical models for studying the driving behaviour have been also
analysed. A Decision Support System for the management of the logistics
infrastructure has been developed and tested and data mining algorithms have been
studie
Minimally Invasive Versus Open Liver Resections for Hepatocellular Carcinoma in Patients With Metabolic Syndrome
No full textObjective: To compare minimally invasive (MILR) and open liver resections (OLRs) for hepatocellular carcinoma (HCC) in patients with metabolic syndrome (MS). Background: Liver resections for HCC on MS are associated with high perioperative morbidity and mortality. No data on the minimally invasive approach in this setting exist. Material and Methods: A multicenter study involving 24 institutions was conducted. Propensity scores were calculated, and inverse probability weighting was used to weight comparisons. Short-term and long-term outcomes were investigated. Results: A total of 996 patients were included: 580 in OLR and 416 in MILR. After weighing, groups were well matched. Blood loss was similar between groups (OLR 275.9±3.1 vs MILR 226±4.0, P=0.146). There were no significant differences in 90-day morbidity (38.9% vs 31.9% OLRs and MILRs, P=0.08) and mortality (2.4% vs 2.2% OLRs and MILRs, P=0.84). MILRs were associated with lower rates of major complications (9.3% vs 15.3%, P=0.015), posthepatectomy liver failure (0.6% vs 4.3%, P=0.008), and bile leaks (2.2% vs 6.4%, P=0.003); ascites was significantly lower at postoperative day 1 (2.7% vs 8.1%, P=0.002) and day 3 (3.1% vs 11.4%, P<0.001); hospital stay was significantly shorter (5.8±1.9 vs 7.5±1.7, P<0.001). There was no significant difference in overall survival and disease-free survival. Conclusions: MILR for HCC on MS is associated with equivalent perioperative and oncological outcomes to OLRs. Fewer major complications, posthepatectomy liver failures, ascites, and bile leaks can be obtained, with a shorter hospital stay. The combination of lower short-term severe morbidity and equivalent oncologic outcomes favor MILR for MS when feasible
Model to predict major complications following liver resection for HCC in patients with metabolic syndrome
No full textBackground: Metabolic syndrome (MS) is rapidly growing as risk factor for HCC. Liver resection for HCC in patients with MS is associated with increased postoperative risks. There are no data on factors associated with postoperative complications. Aims: The aim was to identify risk factors and develop and validate a model for postoperative major morbidity after liver resection for HCC in patients with MS, using a large multicentric Western cohort. Materials and Methods: The univariable logistic regression analysis was applied to select predictive factors for 90 days major morbidity. The model was built on the multivariable regression and presented as a nomogram. Performance was evaluated by internal validation through the bootstrap method. The predictive discrimination was assessed through the concordance index. Results: A total of 1087 patients were gathered from 24 centers between 2001 and 2021. Four hundred and eighty-four patients (45.2%) were obese. Most liver resections were performed using an open approach (59.1%), and 743 (68.3%) underwent minor hepatectomies. Three hundred and seventy-six patients (34.6%) developed postoperative complications, with 13.8% major morbidity and 2.9% mortality rates. Seven hundred and thirteen patients had complete data and were included in the prediction model. The model identified obesity, diabetes, ischemic heart disease, portal hypertension, open approach, major hepatectomy, and changes in the nontumoral parenchyma as risk factors for major morbidity. The model demonstrated an AUC of 72.8% (95% CI: 67.2%-78.2%) (https://childb.shinyapps.io/NomogramMajorMorbidity90days/). Conclusions: Patients undergoing liver resection for HCC and MS are at high risk of postoperative major complications and death. Careful patient selection, considering baseline characteristics, liver function, and type of surgery, is key to achieving optimal outcomes
Recurrence and tumor-related death after resection of hepatocellular carcinoma in patients with metabolic syndrome
No full textBackground & Aims: Metabolic syndrome (MS) is a growing epidemic and a risk factor for the development of hepatocellular carcinoma (HCC). This study investigated the long-term outcomes of liver resection (LR) for HCC in patients with MS. Rates, timing, patterns, and treatment of recurrences were investigated, and cancer-specific survivals were assessed. Methods: Between 2001 and 2021, data from 24 clinical centers were collected. Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival were analyzed as well as recurrence patterns and treatment. The analysis was conducted using a competing-risk framework. The trajectory of the risk of recurrence over time was applied to a competing risk analysis. For post-recurrence survival, death resulting from tumor progression was the primary endpoint, whereas deaths with recurrence relating to other causes were considered as competing events. Results: In total, 813 patients were included in the study. Median OS was 81.4 months (range 28.1–157.0 months), and recurrence occurred in 48.3% of patients, with a median RFS of 39.8 months (range 15.7–174.7 months). Cause-specific hazard of recurrence showed a first peak 6 months (0.027), and a second peak 24 months (0.021) after surgery. The later the recurrence, the higher the chance of receiving curative intent approaches (p = 0.001). Size >5 cm, multiple tumors, microvascular invasion, and cirrhosis were independent predictors of recurrence showing a cause-specific hazard over time. RFS was associated with death for recurrence (hazard ratio: 0.985, 95% CI: 0.977–0.995; p = 0.002). Conclusions: Patients with MS undergoing LR for HCC have good long-term survival. Recurrence occurs in 48% of patients with a double-peak incidence and time-specific hazards depending on tumor-related factors and underlying disease. The timing of recurrence significantly impacts survival. Surveillance after resection should be adjusted over time depending on risk factors. Impact and implications: Metabolic syndrome (MS) is a growing epidemic and a significant risk factor for the development of hepatocellular carcinoma (HCC). The present study demonstrated that patients who undergo surgical resection for HCC on MS have a good long-term survival and that recurrence occurs in almost half of the cases with a double peak incidence and time-specific hazards depending on tumor-related factors and underlying liver disease. Also, the timing of recurrence significantly impacts survival. Clinicians should therefore adjust follow-up after surgery accordingly, considering timing of recurrence and specific risk factors. Also, the results of the present study might help design future trials on the use of adjuvant therapy following resection
Physics of high-energy heavy-ion collisions
No full textThis a review of the present status of heavy-ion collisions at intermediate energies. The main goal of heavy-ion physics in this energy regime is to shed some light on the nuclear equation of state (EOS), hence we present the basic concept of the EOS in nuclear matter as well as of nuclear shock waves which provide the key mechanism for the compression of nuclear matter. The main part of this article is devoted to the models currently used for describing heavy-ion reactions theoretically and to the observables useful for extracting information about the EOS from experiments. A detailed discussion of the flow effects with a broad comparison with the avaible data is presented. The many-body aspects of such reactions are investigated via the multifragmentation break up of excited nuclear systems and a comparison of model calculations with the most recent multifragmentation experiments is presented
Glucosamine Treatment-mediated O-GlcNAc Modification of Paxillin Depends on Adhesion State of Rat Insulinoma INS-1 Cells
No full textProtein-protein interactions and/or signaling activities at focal adhesions, where integrin-mediated adhesion to extracellular matrix occurs, are critical for the regulation of adhesion-dependent cellular functions. Although the phosphorylation and activities of focal adhesion molecules have been intensively studied, the effects of the O-GlcNAc modification of their Ser/Thr residues on cellular functions have been largely unexplored. We investigated the effects of O-GlcNAc modification on actin reorganization and morphology of rat insulinoma INS-1 cells after glucosamine (GlcN) treatment. We found that paxillin, a key adaptor molecule in focal adhesions, could be modified by O-GlcNAc in INS-1 cells treated with GlcN and in pancreatic islets from mice treated with streptozotocin. Ser-84/85 in human paxillin appeared to be modified by O-GlcNAc, which was inversely correlated to Ser-85 phosphorylation (Ser-83 in rat paxillin). Integrin-mediated adhesion signaling inhibited the GlcN treatment-enhanced O-GlcNAc modification of paxillin. Adherent INS-1 cells treated with GlcN showed restricted protrusions, whereas untreated cells showed active protrusions for multiple-elongated morphologies. Upon GlcN treatment, expression of a triple mutation (S83A/S84A/S85A) resulted in no further restriction of protrusions. Together these observations suggest that murine pancreatic beta cells may have restricted actin organization upon GlcN treatment by virtue of the O-GlcNAc modification of paxillin, which can be antagonized by a persistent cell adhesion process.Harburger DS, 2009, J CELL SCI, V122, P159, DOI 10.1242/jcs.018093Vicente-Manzanares M, 2009, J CELL SCI, V122, P199, DOI 10.1242/jcs.018564Kang ES, 2008, EXP CELL RES, V314, P2238, DOI 10.1016/j.yexcr.2008.04.014Dehennaut V, 2008, BIOCHEM BIOPH RES CO, V369, P539, DOI 10.1016/j.bbrc.2008.02.063Lee SA, 2008, J CLIN INVEST, V118, P1354, DOI 10.1172/JCI33768Lock JG, 2008, SEMIN CANCER BIOL, V18, P65, DOI 10.1016/j.semcancer.2007.10.001Zaidel-Bar R, 2007, J CELL SCI, V120, P137, DOI 10.1242/jcs.03314Yang WH, 2006, NAT CELL BIOL, V8, P1074, DOI 10.1038/ncb1470Zachara NE, 2006, BBA-MOL CELL BIOL L, V1761, P599, DOI 10.1016/j.bbalip.2006.04.007Werstruck GH, 2006, DIABETES, V55, P93, DOI 10.2337/diabetes.55.01.06.db05-0633Schroeder MJ, 2005, J PROTEOME RES, V4, P1832, DOI 10.1021/pr0502020Lin Y, 2005, J BIOL CHEM, V280, P4617, DOI 10.1074/jbc.M411863200Love D. C., 2005, SCI STKE, pre13, DOI DOI 10.1126/STKE.3122005RE13Ishibe S, 2004, MOL CELL, V16, P257, DOI 10.1016/j.molcel.2004.10.006Brown MC, 2004, PHYSIOL REV, V84, P1315, DOI 10.1152/physrev.00002.2004Zachara NE, 2004, BBA-GEN SUBJECTS, V1673, P13, DOI 10.1016/j.bbagen.2004.03.016Lee JW, 2004, MOL CELLS, V17, P188D`Alessandris C, 2004, FASEB J, V18, P959, DOI 10.1096/fj.03-0725fjeHuang C, 2004, J CELL BIOL, V164, P593, DOI 10.1083/jcb.200307081Webb DJ, 2004, NAT CELL BIOL, V6, P154, DOI 10.1038/ncb1094Thiery JP, 2003, CURR OPIN CELL BIOL, V15, P740, DOI 10.1016/j.ceb.2003.10.006Huang C, 2003, NATURE, V424, P219, DOI 10.1038/nature01745Vosseller K, 2002, CURR OPIN CHEM BIOL, V6, P851, DOI 10.1016/S1367-5931(02)00384-8Cooksey RC, 2002, ANN NY ACAD SCI, V967, P102Sesti G, 2002, ANN MED, V34, P444, DOI 10.1080/078538902321012397Du XL, 2001, J CLIN INVEST, V108, P1341, DOI 10.1172/JCI11235Schaller MD, 2001, ONCOGENE, V20, P6459, DOI 10.1038/sj.onc.1204786Wells L, 2001, SCIENCE, V291, P2376, DOI 10.1126/science.1058714Turner CE, 2000, NAT CELL BIOL, V2, pE231, DOI 10.1038/35046659Cheng XG, 2000, BIOCHEMISTRY-US, V39, P11609, DOI 10.1021/bi000755iLiu K, 2000, P NATL ACAD SCI USA, V97, P2820, DOI 10.1073/pnas.97.6.2820Hanover JA, 1999, ARCH BIOCHEM BIOPHYS, V362, P38, DOI 10.1006/abbi.1998.1016CHOU TY, 1995, J BIOL CHEM, V270, P18961KELLY WG, 1993, J BIOL CHEM, V268, P10416BURRIDGE K, 1992, J CELL BIOL, V119, P893, DOI 10.1083/jcb.119.4.893HYNES RO, 1992, CELL, V69, P11, DOI 10.1016/0092-8674(92)90115-STURNER CE, 1990, J CELL BIOL, V111, P1059, DOI 10.1083/jcb.111.3.1059MCEVOY RC, 1984, J CLIN INVEST, V74, P715, DOI 10.1172/JCI111487GEIGER B, 1980, P NATL ACAD SCI-BIOL, V77, P4127, DOI 10.1073/pnas.77.7.4127KORNFELD R, 1967, J BIOL CHEM, V242, P3135
Minimally Invasive Versus Open Liver Resections for Hepatocellular Carcinoma in Patients With Metabolic Syndrome
No full textObjective: To compare minimally invasive (MILR) and open liver resections (OLR) for hepatocellular carcinoma (HCC) in patients with metabolic syndrome (MS). Summary background data: Liver resections for HCC on MS are associated with high perioperative morbidity and mortality. No data on the minimally invasive approach in this setting exist. Methods: A multicenter study involving 24 institutions was conducted. Propensity scores were calculated, and inverse probability weighting was used to weight comparisons. Short- and long-term outcomes were investigated. Results: 996 patients were included, 580 in OLR and 416 in MILR. After weighting, groups were well matched. Blood loss was similar between groups (OLR 275.9±3.1 vs. MILR 226±4.0, P=0.146). There were no significant differences in 90-day morbidity (38.9% vs. 31.9% OLRs and MILRs, P=0.08) and mortality (2.4% vs. 2.2% OLRs and MILRs, P=0.84). MILRs were associated with lower rates of major complications (9.3% vs. 15.3%, P=0.015), post hepatectomy liver failure (0.6% vs. 4.3%, P=0.008) and bile leaks (2.2% vs. 6.4%, P=0.003); ascites was significantly lower at postoperative day 1 (2.7% vs. 8.1%, P=0.002) and day 3 (3.1% vs. 11.4%, P<0.001); hospital stay was significantly shorter (5.8±1.9 vs. 7.5±1.7, P<0.001). There was no significant difference in overall survival and disease-free survival. Conclusions: MILR for HCC on MS is associated with equivalent perioperative and oncological outcomes to OLRs. Fewer major complications, post hepatectomy liver failures, ascites and bile leaks can be obtained, with shorter hospital stay. The combination of lower short-term severe morbidity and equivalent oncologic outcomes favor MILR for MS when feasible
Model to predict major complications following liver resection for HCC in patients with metabolic syndrome
No full textBackground: Metabolic syndrome (MS) is rapidly growing as risk factor for HCC. Liver resection for HCC in patients with MS is associated with increased postoperative risks. There are no data on factors associated with postoperative complications. Aims: The aim was to identify risk factors and develop and validate a model for postoperative major morbidity after liver resection for HCC in patients with MS, using a large multicentric Western cohort. Materials and methods: The univariable logistic regression analysis was applied to select predictive factors for 90 days major morbidity. The model was built on the multivariable regression and presented as a nomogram. Performance was evaluated by internal validation through the bootstrap method. The predictive discrimination was assessed through the concordance index. Results: A total of 1087 patients were gathered from 24 centers between 2001 and 2021. Four hundred and eighty-four patients (45.2%) were obese. Most liver resections were performed using an open approach (59.1%), and 743 (68.3%) underwent minor hepatectomies. Three hundred and seventy-six patients (34.6%) developed postoperative complications, with 13.8% major morbidity and 2.9% mortality rates. Seven hundred and thirteen patients had complete data and were included in the prediction model. The model identified obesity, diabetes, ischemic heart disease, portal hypertension, open approach, major hepatectomy, and changes in the nontumoral parenchyma as risk factors for major morbidity. The model demonstrated an AUC of 72.8% (95% CI: 67.2%-78.2%) (https://childb.shinyapps.io/NomogramMajorMorbidity90days/). Conclusions: Patients undergoing liver resection for HCC and MS are at high risk of postoperative major complications and death. Careful patient selection, considering baseline characteristics, liver function, and type of surgery, is key to achieving optimal outcomes
Recurrence and tumor-related death after resection of hepatocellular carcinoma in patients with metabolic syndrome.
No full textBACKGROUND & AIMS: Metabolic syndrome (MS) is a growing epidemic and a risk factor for the development of hepatocellular carcinoma (HCC). This study investigated the long-term outcomes of liver resection (LR) for HCC in patients with MS. Rates, timing, patterns, and treatment of recurrences were investigated, and cancer-specific survivals were assessed. METHODS: Between 2001 and 2021, data from 24 clinical centers were collected. Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival were analyzed as well as recurrence patterns and treatment. The analysis was conducted using a competing-risk framework. The trajectory of the risk of recurrence over time was applied to a competing risk analysis. For post-recurrence survival, death resulting from tumor progression was the primary endpoint, whereas deaths with recurrence relating to other causes were considered as competing events. RESULTS: In total, 813 patients were included in the study. Median OS was 81.4 months (range 28.1-157.0 months), and recurrence occurred in 48.3% of patients, with a median RFS of 39.8 months (range 15.7-174.7 months). Cause-specific hazard of recurrence showed a first peak 6 months (0.027), and a second peak 24 months (0.021) after surgery. The later the recurrence, the higher the chance of receiving curative intent approaches (p = 0.001). Size >5 cm, multiple tumors, microvascular invasion, and cirrhosis were independent predictors of recurrence showing a cause-specific hazard over time. RFS was associated with death for recurrence (hazard ratio: 0.985, 95% CI: 0.977-0.995; p = 0.002). CONCLUSIONS: Patients with MS undergoing LR for HCC have good long-term survival. Recurrence occurs in 48% of patients with a double-peak incidence and time-specific hazards depending on tumor-related factors and underlying disease. The timing of recurrence significantly impacts survival. Surveillance after resection should be adjusted over time depending on risk factors. IMPACT AND IMPLICATIONS: Metabolic syndrome (MS) is a growing epidemic and a significant risk factor for the development of hepatocellular carcinoma (HCC). The present study demonstrated that patients who undergo surgical resection for HCC on MS have a good long-term survival and that recurrence occurs in almost half of the cases with a double peak incidence and time-specific hazards depending on tumor-related factors and underlying liver disease. Also, the timing of recurrence significantly impacts survival. Clinicians should therefore adjust follow-up after surgery accordingly, considering timing of recurrence and specific risk factors. Also, the results of the present study might help design future trials on the use of adjuvant therapy following resection
Strategies adopted by undergraduate physics students when modelling solutions to hands-on tasks
No full textIncludes bibliographical references.Over the last three to four decades there has been a focus on the role of models and modelling in physics education. At the same time, there has also been a move away from the use of recipe-style tasks in physics laboratories to inquiry-based problem solving. From the ensuing research, model-based views of physics have emerged which have contributed to the fields of pedagogy as well as epistemology; the contribution depending on whether the research interest has been that of education or philosophy of science. And while there is still some consensus seeking on the nature and definitions of modelling, there has in recent years been a shift to research questions that consider how models are constructed by students when engaged in hands-on tasks. Model-based instruction courses have been researched at length, but there is a perceived gap in the research that considers the hands-on strategies that are actually employed by 1st-year university students who are in a teaching and learning environment in which the physics curriculum emphasises the modelling of real world systems. This study contributes to this research area in that it investigates the strategies students actually adopt when engaged in student-driven, hands-on laboratory tasks and interprets those strategies in terms of a particular model-based view of physics; a model-based view that posits that the processes of modelling are those of the particularisation and application of physics theory, the idealisation and approximation of real world phenomena, and the eventual realisation of a conceptual model
