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To evaluate the impact of antiplatelet therapy (APT)on the incidence of hepatocellular carcinoma (HCC) and mortality following its treatment.A systematic literature search was performed using PubMed and Cochrane Central Register of Controlled Trials Databases. Two HCC clinical settings were explored: (i) incidence, and (ii) death after any HCC treatment. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to compare the pooled data between patients who received or did not receive APT.A total of 20 studies were identified, of whom 15 focused on HCC incidence, including 2,685,009 patients, and five on post-treatment death, including 3281 patients. APT was associated with an overall reduced risk of HCC incidence (OR: 0.63; 95%CI = 0.51-0.79; p 0.001) as well as of post-treatment mortality (OR: 0.54; 95%CI = 0.35-0.83; p = 0.006).Current data suggest that APT correlated with higher HCC incidence and poor overall survival following tumour treatment.

Background: Normothermic regional perfusion (NRP) and machine perfusion (MP) are variously used in many European centers to improve the outcomes after liver transplantation from donation after circulatory death (DCD). In Italy, a combination of NRP and subsequent MP has been used since the start of the activity. While NRP is mandatory for every DCD recovery, the subsequent use of MP is left to each center. Methods: We have designed a national survey to investigate practices and policies of these techniques. The questionnaire included 46 questions and was distributed to all the 21 Italian centers using an online form between June and July 2021. Results: The overall response rate was 100%. A local NRP program for controlled Maastricht type 3 DCD was active in 11/21 (52.4%) centers. Organization and availability of personnel were perceived as the main difficulties in starting such a program. Between 2015 and 2020, 119 DCD livers were transplanted, with an overall utilization rate of 69.2%. Pump flow and gross aspect were considered the most reliable parameters in liver selection during NRP. Eight (72.7%) centers adopted subsequent hypothermic MP, 1 (9.1%) center normothermic MP, and the remaining 2 (18.2%) used both MP types. Conclusion: This first snapshot survey shows that NRP with subsequent MP is the most used protocol in Italy for DCD livers, although some heterogeneity exists in the type and purpose of MP between centers. Overall, this policy ensures a high utilization rate, considering the high risk of the DCD donor population in Italy. Graphical abstract: [Figure not available: see fulltext.]

Geographical Indications (GI) are tools used to add value, protect and recognize the differentiated quality of a product as a consequence of environmental and territorial influence. The objective of this work was to determine physicochemical, melissopalynological and sugar profiles plus chemical markers of Citrus limon monofloral honey produced in Tucumán-Argentina, to the development of the GI “Lemon blossom honey from Tucumán”. Samples harvested between August and October 2016, 2017 and 2018 were analyzed. It was established that in addition to Citrus limon, the most frequent pollen species was Salix type. This honey is very light in color (≤ 30 mm Pfund), slightly acidic (≤ 20 meq.kg-1), with moisture values from 15 to 19 g/100g, low diastatic activity (≤ 27 Gothe units), HMF (≤ 3.0 mg.kg-1) and electrical conductivity (≤ 0.32 mS.cm-1). Color inversely correlates with the amount of Citrus limon pollen. The sugar profile showed a higher fructose content than glucose, sucrose and maltose, and intermediate tendency towards crystallization. Hesperidin was easily detected and quantified in all samples. The content of methyl anthranilate was much lower than the international reference for citrus honeys and also, was not detected in some samples. Hence, should be a complementary indicator and hesperidin could be used instead as a chemical marker of genuineness. Resumen Las Indicaciones Geográficas (IG) son herramientas utilizadas para agregar valor y para proteger y reconocer la calidad diferencial de un producto como consecuencia de la influencia ambiental y territorial. El objetivo de este trabajo consistió en determinar los perfiles físicoquímicos, melisopalinológicos y de azúcares, además de marcadores químicos de mieles monoflorales de Citrus limon producidas en Tucumán-Argentina, para el desarrollo de la IG “Miel de azahar de limón de Tucumán”. Se analizaron muestras cosechadas entre agosto y octubre de 2016, 2017 y 2018. Se estableció que además de Citrus limon, la especie de polen más frecuente fue la del tipo Salix. Esta miel es de color muy claro (≤ 30 mm Pfund), ligeramente ácida (≤ 20 meq.kg-1), con valores de humedad de 15 a 19 g/100 g, baja actividad diastásica (≤ 27 unidades Gothe), HMF (≤ 3,0 mg.kg-1) y conductividad eléctrica (≤ 0,32 mS.cm-1). El color se correlaciona inversamente con la cantidad de polen de Citrus limon. El perfil de azúcares mostró mayor contenido de fructosa que glucosa, sacarosa y maltosa, y una tendencia intermedia a la cristalización. La hesperidina se detectó y cuantificó fácilmente en todas las muestras. El contenido de metil antranilato fue mucho menor que la referencia internacional para mieles de cítricos y además, no se detectó en algunas muestras. Por lo tanto, debería ser un indicador complementario y la hesperidina podría usarse en su lugar como un marcador químico de autenticidad.

Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells' extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet-tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC. Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells’ extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet–tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC.

Immunosuppression after liver transplantation (LT) is presently based on use of calcineurin inhibitors (CNI), although they are associated with an increased incidence of renal dysfunction, cardiovascular complications, and de novo and recurrent malignancies. Over the past decade, mammalian target of rapamycin inhibitors have received considerable attention as immunosuppressants because they are associated with a more favorable renal profile versus CNI, as well as antiproliferative activity in clinical studies. Comprehensive guidelines on use of everolimus (EVR) in LT are still lacking. In Italy, a project, named Everolimus: the road to long-term functioning, was initiated to collect the experience on EVR after LT with the aim of providing guidance for transplant clinicians. Herein, recommendations by this national consensus group, based on Delphi methodology, are presented. Consensus was reached on 20 of the 23 statements proposed, and their level of evidence, grade of recommendation, and percent of agreement are reported. Statements are grouped into 4 areas: (A) renal function; (B) time of EVR introduction, CNI reduction and elimination, and risk for graft rejection; (C) antiproliferative effects of EVR; and (D) management of EVR-related adverse events. The high level of consensus shows that there is good agreement on the routine use of EVR in predefined clinical scenarios, especially in light of posttransplant nephrotoxicity and other adverse events associated with long-term administration of CNIs.

Con il secondo ciclo di Tirocinio Formativo Attivo è stato attivato l’insegnamento di Laboratorio Pedagogico Didattico TIC. Nell'articolo discuteremo come è stato organizzato questo insegnamento al fine di poter affrontare problematiche legate all'uso delle tecnologie dell’informazione e della comunicazione sia nella gestione amministrativa della Scuola sia in ambito didattico. Discuteremo in particolare le varie possibilità di rinnovamento della didattica introdotte dagli strumenti di comunicazione e condivisione del web 2.0, dall'uso della lavagna interattiva multimediale, fino all'uso dei dispositivi portatili multimediali come strumenti di laboratorio. We discuss the organization of the course of Laboratorio Pedagogico Didattico TIC of the Tirocinio Formativo Attivo at the University of Palermo. The course takes into account the development of information and communication technologies both for the anagement/administration of school and their application in Mathematics and Physics education. In particular, we will discuss in detail the various possibilities of renewing the teaching given by communication and sharing tools of web 2.0, the use of the digital whiteboard, and the use of technologies in Mathematics and Physics laboratories, up to the use of multimedia mobile devices as experimental tools.

For many years now our research team has been involved in an effort (both theoretical and technological) that can be labeled as an attempt to investigate the notion of cooperation from the 'participation' or 'contribution' perspective. From our perspective, it encompasses a set of situations in which different actors identified or unidentified, ratified or not, distributed in space and time, contribute to a sometimes ill-defined collective goal, using most of the time low-overhead web-based technologies. Doing so, people participate to a collective design that aims at generating a bunch of perpetually moving collective knowledge and decisions submitted to discussion, negotiation and sometimes dismissal. To avoid the design of services as a repeated 'one-shot' process we have gradually built a transverse software infrastructure that can be used in various projects aiming to design participatory services using complex knowledge and cooperations. Thanks to this “non-disposable” infrastructure, the participatory services designed take profit from the scientific outcomes of each previous project.

Background The recurrence of hepatitis C viral infection is common after liver transplant, and achieving a sustained virological response to antiviral treatment is desirable for reducing the risk of graft loss and improving patients’ survival. Aim To investigate the long-term maintenance of sustained virological response in liver transplant recipients with hepatitis C recurrence. Methods 436 Liver transplant recipients (74.1% genotype 1) who underwent combined antiviral therapy for hepatitis C recurrence were retrospectively evaluated. Results The overall sustained virological response rate was 40% (173/436 patients), and the mean follow-up after liver transplantation was 11 ± 3.5 years (range, 5–24). Patients with a sustained virological response demonstrated a 5-year survival rate of 97% and a 10-year survival rate of 93%; all but 6 (3%) patients remained hepatitis C virus RNA-negative during follow-up. Genotype non-1 (p = 0.007), treatment duration >80% of the scheduled period (p = 0.027), and early virological response (p = 0.002), were associated with the maintenance of sustained virological response as indicated by univariate analysis. Early virological response was the only independent predictor of sustained virological response maintenance (p = 0.008). Conclusions Sustained virological response achieved after combined antiviral treatment is maintained in liver transplant patients with recurrent hepatitis C and is associated with an excellent 5-year survival.

Sarà descritta l'organizzazione del primo ciclo del Corso di Tirocinio Formativo Attivo, Classe A049 - Matematica e Fisica, nell'Ateneo di Palermo, sia per quanto riguarda le attività psico-pedagogiche, sia per le attività disciplinari. In particolare, sarà descritta l'organizzazione del tirocinio svolto a scuola sotto la guida dei tutor accoglienti e sotto la guida del tutor coordinatore. Saranno evidenziati punti di forza, punti di debolezza e aspetti di criticità delle varie attività svolte e verranno proposti miglioramenti per i cicli successivi.