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Anna Sessa,1– 3 Sébastien Mulé,2– 4 Raffaele Brustia,2,3,5 Hélène Regnault,1,3 Athena Galletto Pregliasco,4 Rami Rhaiem,6,7 Vincent Leroy,1– 3 Daniele Sommacale,2,3,5 Alain Luciani,2– 4 Julien Calderaro,2,3,8 Giuliana Amaddeo1– 3 1Hepatology Department, APHP, Henri Mondor University Hospital, Créteil, France; 2Université Paris-Est Créteil, Faculté de Médecine, Créteil, France; 3Inserm, U955, Team 18, Créteil, France; 4Medical Imaging Department, AP-HP, Henri Mondor University Hospital, Créteil, France; 5Department of Digestive and Hepato-Pancreato-Biliary Surgery, AP-HP, Henri Mondor University Hospital, Créteil, France; 6Department of Hepato-Biliary Pancreatic and Digestive Oncological Surgery, Robert Debré University Hospital, Reims, France; 7Reims Champagne-Ardenne University, Reims, France; 8Department of Pathology, APHP, Henri Mondor University Hospital, Créteil, FranceCorrespondence: Giuliana Amaddeo; Anna Sessa, Hepatology Department, APHP, Henri Mondor University Hospital, 1 rue Gustave Eiffel, Créteil, 94000, France, Tel +33 149812353, Email giuliana.amaddeo@aphp.fr; asessa1990@gmail.comAbstract: The subject of this narrative review is macrotrabecular-massive hepatocellular carcinoma (MTM‐HCC). Despite their rarity, these tumours are of general interest because of their epidemiological and clinical features and for representing a distinct model of the interaction between the angiogenetic system and neoplastic cells. The MTM‐HCC subtype is associated with various adverse biological and pathological parameters (the Alfa-foetoprotein (AFP) serum level, tumour size, vascular invasion, and satellite nodules) and is a key determinant of patient prognosis, with a strong and independent predictive value for early and overall tumour recurrence. Gene expression profiling has demonstrated that angiogenesis activation is a hallmark feature of MTM-HCC, with overexpression of both angiopoietin 2 (ANGPT2) and vascular endothelial growth factor A (VEGFA).Keywords: hepatocellular carcinoma, macrotrabecular, angiopoietin 2 inhibitors, TP53, immunotherapy

Maria Chiara Parati,1 Rebecca Pedersini,2 Gianluca Perego,3 Roberto Reduzzi,4 Tommaso Savio,4 Mary Cabiddu,1 Karen Borgonovo,1 Mara Ghilardi,1 Andrea Luciani,1 Fausto Petrelli1 1Oncology Unit, Medical Science Department, ASST Bergamo Ovest, Treviglio, BG, Italy; 2Breast Unit-Medical Oncology, ASST Spedali Civili, Brescia, Italy; 3Pharmacy Unit, IRCCS San Raffaele Hospital, Milan, Italy; 4Breast Unit, ASST Bergamo Ovest, Treviglio, BG, ItalyCorrespondence: Fausto Petrelli, Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Piazzale Ospedale 1, Treviglio, 24047, BG, Italy, Tel +390363424420, Fax +390363424380, Email faupe@libero.itAbstract: Among pre- and postmenopausal women with hormone receptor-positive (HR+) breast cancer (BC), combinations of an aromatase inhibitor (AI) or fulvestrant with a CDK 4/6 inhibitor (palbociclib, ribociclib, or abemaciclib) have demonstrated improved progression-free survival (PFS) and overall survival (OS) compared to standard single-agent hormone therapy alone as first-line therapy for de novo metastatic disease or relapse during or after adjuvant therapy and no previous therapies in an advanced setting. We here reviewed clinical data about ribociclib in advanced and early BC. Also, we shed light on patient selection and special settings in which medical oncologists urgently await an advance in treatment. Ribociclib was FDA-approved in combination with letrozole based on a Phase III study in which 668 postmenopausal women with HR+, HER2-negative recurrent or metastatic BC were treated with first-line letrozole with or without ribociclib. For patients with metastatic disease at presentation or after a course of AIs, the results of the MONALEESA-3 trial suggest ribociclib’s efficacy in combination with fulvestrant, and this combination is FDA-approved for initial- and subsequent-line endocrine therapy for postmenopausal women with metastatic hormone receptor-positive, HER2-negative BC. In adjuvant and neoadjuvant settings, the use of CDK 4/6 inhibitors may be useful to boost outcomes in high-risk patients with HR+ BC, but data contrast with those of a phase III study, which produced positive results. New combinations are being explored in upfront disease (neoadjuvant) or in association with other targeted agents in metastatic disease. Compared to other CDK 4/6 available, ribociclib has a higher incidence of liver function test abnormalities than the other agents and can cause QTc prolongation, and therefore may be prudently avoided in patients with cardiac morbidities or other risk factors for QTc prolongation (drugs, interactions). In these cases, different agents (palbociclib or abemaciclib) may be used. In conclusion, ribociclib with letrozole or with fulvestrant is effective for the entire spectrum of patients with HR+ BC in the advanced setting. Ribociclib has all the characteristics of an innovative drug able to change the clinical practice and most BC patients’ prognoses.Keywords: breast cancer, ribociclib, CDK 4/6 inhibitors, review

The Go-BACK catheter is a novel device designed to be used for both intraluminal crossing or re-entry, into a vessel lumen from the subintimal space during subintimal angioplasty.It is reserved for cases where reentry has not been possible using conventional wire and catheter techniques. We report our experience in recanalization of the chronic total occlusions of the common iliac artery (CIA) using the Go-BACK catheter, in cases where other techniques were unsuccessful.

OBJECTIVES: Our aim was to describe the epidemiology and outcomes of multisystem inflammatory syndrome in children (MIS-C) in Latin America. METHODS: We conducted an observational, retrospective, and prospective multicenter study that gathered information from 84 participating centers across 16 Latin American countries between August 1, 2020 and June 30, 2022. RESULTS: Of the 1239 reported children with MIS-C, 84.18% were previously healthy. The most frequent clinical manifestation in our studied population was abdominal pain (N = 804, 64.9%), followed by conjunctival injection (N = 784, 63.3%). The median duration of fever at the time of hospital admission was 5 days and a significant number of subjects required admission to an intensive care unit (N = 589, 47.5%). Most of the subjects (N = 1096, 88.7%) were treated with intravenous immunoglobulin, whereas 76.7% (N = 947) were treated with steroids, of whom 10.6% (N = 100) did not receive intravenous immunoglobulin. The death rate attributed to MIS-C was 4.88%, with a rate of 3.39% for those initially diagnosed with MIS-C and 8.85% for those whose admission diagnosis was not MIS-C (P

Waterproofing systems of tunnels is of crucial importance for the long-term effectiveness of the underground works and for the possible impact on the surrounding environment. In conventional tunnelling, polymeric geomembranes are nowadays used with fluid barrier function, while nonwoven geotextiles and geonets are commonly employed with mechanical protection and drainage functions. After some descriptions of the main requirements of the geosynthetics used in tunnels and underground structures, the durability aspects of the materials forming the waterproofing systems are briefly outlined.

The steel pipe umbrella is a widely used technology when tunnelling in weak soils in order to create pre-support ahead of the tunnel face. The design of steel pipes is frequently done through simplified analytical approaches which are easy to apply but require proper assessment of the loads acting on the pipe. To provide information on this key design aspect, the results of the comparison between a three-dimensional numerical model developed with the code FLAC 3D and an analytical model based on the approach of a beam on yielding supports is presented and discussed. The comparison refers to a shallow tunnel with an overburden of three times its diameter for two different types of weak rock masses. The obtained results provide suggestions about the load that has to be applied in the analytical model for the design phase.

This work presents contributions on the application of pedagogy of projects in initial traning of teachers the use of Learning Investigation method, wich has as its technical support the working in projects that is improved by experiences in classroom, inthis case, focused on initial trainig of teachers. For such a proposl, we performed a brief chronological review on the working by projects since its firt using trials, as well as its various denominations over the time. We brought the relations between working by projects and interdisciplinary, once it rises in a natural manner guven the investigative characteristics, from the type og methodology, also presenting examples of trainig of teachers whom fomented by pedagogy of projects, abd last, we conclude demonstraing how The Learnig Investigating may be used as a form of application of pedagogy of projects on formation of initial teachers.

Plectranthus scutellarioides (L.) R. Br. is part of the Lamiaceae family and is commonly known as coleus, due to the genus denomination in the past. This ornamental plant species has been gaining importance in the floristic industry due to the great number of exotic cultivars available in the market. Coleus commercial exploitation by seeds is held up by genetic instability, which makes it usually being propagated through semi-hardwood stem cuttings and leaves have great importance in stem cuttings adventitious rooting. The objective of this study was to evaluate the presence or absence of apical leaves and the use of indolebutyric acid (IBA) in coleus stem cuttings rooting. Semi-hardwood coleus stem cuttings with 6 cm long were prepared with or without apical leaves, and then treated with hydroalcoholic solutions (50% v v-1) of 0, 1000 and 2,000 mg L-1 IBA. The propagules were planted in tubes containing vermiculite and kept for 30 days in a greenhouse under intermittent misting (24 ± 2 °C, Relative Humidity 90%) until final evaluation. The experiment was conducted in a completely randomized design, in a 3x2 factorial scheme (3 IBA concentrations x presence and absence of apical leaves). The rooting was evaluated after 30 days. Stem cuttings with and without apical leaves has 100 and 57% rooting, respectively. Stem cuttings rooting did not vary according to IBA concentrations. Roots length and number were higher in stem cuttings with apical leaves in comparison to leafless ones, regardless IBA concentrations. On average, 97.7% sprouting was observed in cuttings with apical leaves, significantly higher rates when compared to the average of 2.2% on leafless cuttings. The presence of apical leaves is fundamental for coleus stem cuttings rooting and the use of IBA is not required for this species propagation.

El pseudotumor inflamatorio del hígado es una rara entidad benigna. Se presenta como una masa hepática generalmen - te voluminosa que puede comprimir o infiltrar estructuras vasculares o las vías biliares. Clínicamente se presenta como un cuadro agudo de dolor abdominal y un síndrome infla - matorio. Analizaremos el caso de una mujer de 39 años que presenta un cuadro de dolor abdominal, ictericia y fiebre. Se realizan estudios por imágenes y se diagnostica una masa he - pática de 15 cm en el lóbulo izquierdo por la que la paciente es tratada con una hepatectomía izquierda. El estudio his - tológico informa un pseudotumor inflamatorio. La paciente recurre al año de la cirugía con un cuadro clínico similar al anterior y una nueva imagen de 10 cm en el segmento I. Ante la recurrencia, se decide un tratamiento conservador. La masa disminuye de tamaño en un 50% en el primer mes y desaparece definitivamente en los controles posteriores. Dos años más tarde la paciente es admitida nuevamente con un cuadro clínico compatible con los dos precedentes y una nue - va lesión de 8 cm en el segmento VII. Es tratada nuevamente con anti-inflamatorios y control, evolucionando favorable - mente. El pseudotumor inflamatorio del hígado es una enti - dad que, si bien es benigna, puede tener un comportamiento recidivante. Su forma de presentación clínica y su apariencia en los estudios por imágenes hacen que muchas veces sea im - posible de distinguir de un tumor maligno. Debe siempre ser tenido en cuenta en el manejo de las masas ocupantes del hígado.

The mosquito-borne alphavirus o’nyong-nyong virus (ONNV) has proven its potential to cause major human outbreaks. On the African continent, ONNV causes unspecific febrile illness and co-circulates with the close relative chikungunya virus (CHIKV). The true scale of ONNV burden is poorly understood in Africa, because of the scarce availability of molecular in-house and commercial assays, strong cross-reactivity between ONNV and CHIKV in serological assays and a lack of surveillance. We designed a new RT-qPCR assay targeting the E1 gene for the detection of ONNV that can be used in monoplex or in duplex format, combined with a previously published CHIKV monoplex assay targeting the nsp1. The lower limit of detection with 95% positivity rate was determined to be

The article focuses on challenges and disruption in the higher education sector in Italy due to COVID-19 pandemic. The study explores the experience of the Single-Cycle Master's Degree in Law of the University of Genoa, especially taking into account students' perspective.