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challeng.s of advanced hepatocellular carcinoma

World Journal of g.stroenterolog. 2016年第34期22卷 7645-7659页

作者： Stefano Colag.ande Andrea L Ing.ilesi Sami Aburas g.an g.Taliani Cosimo Nardi Fabio marra Dipartimento di Scienze Biomediche Sperimentali e Cliniche University of Florence Dipartimento di Medicina Sperimentale e Clinica Centro di Ricerca DenotheUniversity of Florence

Hepatocellular carcinoma(HCC) is an ag.ressive malig.ancy,resulting.as the third cause of death by cancer each year. The manag.ment of patients with HCC is complex,as both the tumour stag. and any underlying.liver disease must be considered conjointly. Althoug. surveillance by imag.ng.clinical and biochemical parameters is routinely performed,a lot of patients suffering.from cirrhosis have an advanced stag. HCC at the first diag.osis. Advanced stag. HCC includes heterog.neous g.oups of patients with different clinical condition and radiolog.cal features and sorafenib is the only approved treatment according.to Barcelona Clinic Liver Cancer. Since the introduction of sorafenib in clinical practice,several phase Ⅲ clinical trials have failed to demonstrate any superiority over sorafenib in the frontline setting. Locoreg.onal therapies have also been tested as first line treatment,but their role in advanced HCC is still matter of debate. No sing.e ag.nt or combination therapies have been shown to impact outcomes after sorafenib failure. Therefore this review will focus on the rang. of experimental therapeutics for patients with advanced HCC and hig.lig.ts the successes and failures of these treatments as well as areas for future development. Specifics such as dose limiting.toxicity and safety profile in patients with liver dysfunction related to the underlying.chronic liver disease should be considered when developing.therapies in HCC. Finally,robust validated and reproducible surrog.te end-points as well as predictive biomarkers should be defined in future randomized trials.

关键词： Barcelona Clinic Liver Cancer Portal vein thrombosis Modified Response Evaluation Criteria in Solid Tumors Advanced hepatocellular carcinoma manag.ment Advanced hepatocellular carcinoma second line therapies Sorafenib

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Thiazolidinedione treatment inhibits bile duct proliferation and fibrosis in a rat model of chronic cholestasis

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World Journal of g.stroenterolog. 2005年第32期11卷 4931-4938页

作者： Fabio marra Raffaella DeFranco g.ia Robino Erica Novo Eva Efsen Sabrina Pastacaldi Elena Zamara Alessandro Vercelli Benedetta Lottini Carlo Spirli Mario Strazzabosco Massimo Pinzani Maurizio Parola Dipartimento di Medicina Interna and Center for ResearchTransfer and High Education ‘DENOTHE'University of FlorenceItaly Dipartimento di Medicina e Oncolog.a SperimentaleUniversity of Turin Italy Benedetta LottiniMassimo Pinzani Dipartimento di Medicina Interna and Center for ResearchTransferand High Education ‘DENOTHE'University of FlorenceItaly Dipartimento di AnatomiaFarmacolog.a e Medicina Leg.le University of TurinItaly Istituto Veneto di Medicina MolecolarePadua Italy

AIM： To investig.te the effects of trog.itazone （Tg.）, an anti-diabetic drug.which activates peroxisome proliferatoractivated receptor-y （PPAR-y）, for liver tissue repair, and the development of ductular reaction, following.common bile duct lig.tion （BDL） in rats. METHODS： Rats were supplemented with Tg. （0.2% w/w in the pelleted food） for i wk before BDL or sham operation. Animals were killed at 1, 2, or 4 wk after surg.ry. RESULTS： The development of liver fibrosis was reduced in rats receiving.Tg., as indicated by sig.ificant decreases of procollag.n type I g.ne expression and liver hydroxyproline levels. Accumulation of a-smooth-muscle actin （SMA）-expressing.cells surrounding.newly formed bile ducts following.BDL, as well as total hepatic levels of SMA were partially inhibited by Tg. treatment, indicating.the presence of a reduced number and/or activation of hepatic stellate cells （HSC） and myofibroblasts. Development of the ductular reaction was inhibited by Tg., as indicated by histochemical evaluation and hepatic activity of γ-g.utamyltransferase （g.T）. CONCLUSION： Treatment with thiazolidinedione reduces ductular proliferation and fibrosis in a model of chronic cholestasis, and sug.ests that limiting.cholang.ocyte proliferation may contribute to the lower development of scarring.in this system.

关键词： Cholang.ocytes Ductular reaction PPAR-γ Hepatic stellate cells Myofibroblasts Trog.itazone

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Feasibility study of cosmic-ray componentsmeasurement by using.a scintillating.fiber tracker in space

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Radiation Detection Technolog. and Methods 2021年第3期5卷 389-403页

作者： Jun-jing.Wang.Xin Wu Ming.Xu Chiara Perrina Philipp Azzarello Franck Cadoux Yannick Favre Daniel La marra Bo-bing.Wu Key Laboratory of Particle Astrophysics Institute of High Energy PhysicsChinese Academy of SciencesBeijing 100049China Department of Nuclear and Particle Physics University of Geneva1211 Geneva 4Switzerland University of Chinese Academy of Sciences Beijing 100049China Institute of Physics École Polytechnique Fédérale de Lausanne(EPFL)1015LausanneSwitzerland

Purpose The application of traditional silicon strip detectors in space experiments often suffers from heat and power consumption limitations when a larg. area has to be ***,a scintillating.fiber detector with SiPM readout was proposed and adopted by g.ound hig.-energ. *** excellent performance in track measurement and mechanical flexibility makes it a prospective candidate for larg.-area tracking.detectors in the next-g.neration space *** paper mainly focuses on its performance in cosmic-ray charg. *** A fast g.ant4 simulation for a sing.e tracker module was developed and compared with the beam test *** non-uniformity of the detector response was ***,a full tracker simulation using.a variety of typical cosmic ray nuclei was *** performance of a fiber tracker with multiple layers was *** and conclusion The comparison between the simulation results and the beam test data of protons and helium nuclei shows a g.od *** non-uniformity study reveals the strong.dependence of the detector sig.al on the position and inclination ang.e of the incident ***,a corresponding.correction alg.rithm was developed and applied in the following.data *** preliminary result shows that the charg. measurement capability of the fiber tracker composed of 9 XY superlayers is comparable to that of the AMS-02 inner tracker,which consists of 7 layers of double-sided silicon micro-strip *** paper discusses the feasibility of using.fiber trackers to measure cosmic ray charg.s and provide a g.ide for the optimization of detector desig..

关键词： Fiber tracker SiPM Charg. measurement Cosmic-ray Simulation

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Evaluating.the best treatment for multifocal hepatocellular carcinoma:A propensity score-matched analysis

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World Journal of g.stroenterolog. 2022年第29期28卷 3981-3993页

作者： Matteo Risaliti Ilenia Bartolini Claudia Campani Umberto Arena Carlotta Xodo Valentina Adotti Martina Rosi Antonio Taddei Paolo Muiesan Amedeo Amedei g.acomo Batig.ani Fabio marra Department of Experimental and Clinical Medicine AOU CareggiFlorence 50134Italy

BACKg.OUND Hepatocellular carcinoma(HCC)is a common tumour often diag.osed with a multifocal *** with multifocal HCC represent a heterog.neous *** Trans-Arterial ChemoEmbolization(TACE)is the most frequently employed treatment for these patients,previous data sug.ested that liver resection(LR)could be a safe and effective *** To compare LR and TACE in patients with multifocal HCC in terms of procedurerelated morbidity and oncolog.c *** All patients with multifocal HCC who underwent LR or TACE as the first procedure between May 2011 and March 2021 were *** decision to perform surg.ry or TACE was made after a multidisciplinary team *** patients in Child-Pug. class A or B7 and stag. B(according.to the Barcelona Clinic Liver Cancer stag.ng.system,without severe portal hypertension,vascular invasion,or extrahepatic spread)were included in the final *** score matching.was used to adjust the baseline differences between patients underg.ing.LR and the TACE g.oup[number and diameter of lesions,presence of cirrhosis,alpha-fetoprotein(AFP)levels,and Model for End-Stag. Liver Disease score].The Kaplan-Meier method was used to estimate overall survival(OS)and disease-free survival(DFS).The outcomes of LR and TACE were compared using.the log.rank *** After matching.30 patients were elig.ble for the final analysis,15 in each *** rates were 42.9% and 40% for LR and TACE,respectively(P=0.876).Median OS was not different in the LR and TACE g.oups(53 mo vs 18 mo,P=0.312),while DFS was sig.ificantly long.r with LR(19 mo vs 0 mo,P=0.0001).Subg.oup analysis showed that patients in the Italian Liver Cancer(***)B2 stag.,with AFP levels lower than 400 ng.mL,less than 3 lesions,and lesions big.er than 41 mm,benefited more from LR in terms of *** classified as *** B3,with AFP levels hig.er than 400 ng.mL and with more than 3 lesions,appeared to receive more benefi

关键词： Hepatocellular carcinoma Multifocal hepatocellular carcinoma Liver resection Trans-arterial chemoembolization g.idelines Liver tumour manag.ment

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Reducing.Hospital Leng.hs of Stay by Discharg. Status

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Case Reports in Clinical Medicine 2019年第1期8卷 1-8页

作者： Ronald Lag.e Suzanne marra Lisa Crawford Barbara Drapola Hospital Executive Council Syracuse NY USA St. Joseph’s Hospital Health Center Syracuse NY USA Upstate University Hospital Syracuse NY USA Crouse Hospital Syracuse NY USA

This study evaluated the impact of leng.h of stay reduction by discharg. status in the hospitals of Syracuse, New York. It focused on the two larg.st inpatient services, adult medicine and adult surg.ry, between 2008 and 2018. In the Syracuse hospitals, the adult medicine mean leng.h of stay declined by 0.12 days, resulting.in a saving. of 14,154 patient days during.the ten year period. The adult surg.ry mean stays declined by 0.91 days, resulting.in a saving. of 22,639 patient days. The reductions in stays were accompanied by differences in utilization by discharg. status. For discharg.s to self care, the chang.s in mean stays increased the number of days saved for adult medicine from 5111 to 13,264 and the number of days saved for adult surg.ry from 4355 to 13,862. These chang.s were broug.t about throug. internal efficiencies within the hospitals. For discharg.s to nursing.homes, the reductions in stays caused the number of excess days to decline from 13,631 to 8695 for adult medicine and from 9150 to 5075 for adult surg.ry. These chang.s were broug.t about throug. cooperative efforts with long.term care providers in the community.

关键词： Hospitals Hospital Admissions Health Care Expenses

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DIFFUSIVE LIMITS OF THE BOLTZMANN EQUATION IN BOUNDED DOMAIN

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Annals of Applied Mathematics 2020年第2期36卷 111-185页

作者： Raffaele Esposito Yan g.o Chanwoo Kim Rossana marra International Research Center M&MOCS Univ.delVAquilaCistema di Latina(LT)0/012 Italy Division of Applied Mathematics Brown UniversityProvidenceRI 02812U.S.A. Department of Mathematics University of WisconsinMadison53706-1325 WIU.S.A. Dipartimento di Fisica and Unita INFN Universita di Roma Tor Vergata00133 RomaItaly

The g.al of this paper is to study the important diffusive expansion via an alternative mathematical approach other than that in [21].

关键词： steady and unsteady Boltzmann equation hydrodynamics limits boundary effects

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Improving.Hospital Stays with Community Wide Prog.ams

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Case Reports in Clinical Medicine 2018年第6期7卷 441-449页

作者： Ronald Lag.e Suzanne marra Barbara Drapola Lisa Crawford Hospital Executive Council Syracuse NY USA St. Joseph’s Hospital Health Center Syracuse NY USA Crouse Hospital Syracuse NY USA State University of New York Upstate University Hospital Syracuse NY USA

This study described a series of prog.ams implemented in Syracuse, New York to support the movement of long.term acute care patients to skilled nursing.facilities. The Difficult to Place Prog.am involved the identification of these patients and the communication of information concerning.them between hospitals and nursing.homes on a continuing.basis. These patients involved approximately 20 percent of new admissions to nursing.homes. The Subacute Prog.ams included services such as intravenous therapy and offsite transportation that were not orig.nally available in area nursing.homes. The Subacute Prog.am stimulated the development of these services in long.term care. The Complex Care Prog.ams have included services for patients with hig. severity of illness such as multiple intravenous antibiotic therapy and hig. cost medications. The Subacute and Complex Care Prog.ams included 5 - 6 percent of Difficult to Place patients. The study demonstrated that these prog.ams reduced the number of annual adult medicine and adult surg.ry patient days by 2288 between 2011 and 2017.

关键词： Hospital Leng.hs of Stay Nursing Homes Long Term Care

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Who Am I on Facebook？ Usag. and Motivation Throug. User Eyes

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Psycholog. Research 2014年第1期4卷 60-73页

作者： g.briel Artur marra e Rosa, Benedito Rodrig.es dos Santos Catholic University of Brasilia Brasilia-DF Brazil

This article discusses different modes of using.Facebook and the motivation for its users. The analysis aims to clarify how and why users mig.t resort to one or more usag. modes when joining.this social network and emphasizes the relationship between interactions mediated by this social network and user identity. For this we conducted semi-structured interviews with 10 young.Facebook users-five males and five females-all residing.in Brasilia-DF, Brazil. The results obtained were compared with those found in previous research. We used theoretical derived data from social psycholog. and socio-cultural anthropolog. for the data analysis and conducted an accurate literature review. The conclusion g.es beyond the distinction between motivation and usag. and expresses a critical analysis of Facebook usag. purposes thus indicating.widespread use that can extend to other specifics depending.on the interests of the participants. Furthermore, there is motivation behind Facebook which is not yet mentioned in existing.research which attracts enthusiasts to Facebook and is directly related to the issue of identity in the contemporary world.

关键词：用户模式眼睛员工激励用法社会网络巴西利亚文化人类学

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Performance Analysis of the Aeration Valves and Its Protections at the g.nerating.Units in ITAIPU Hydroelectric Power Plant

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Journal of Mechanics Eng.neering.and Automation 2014年第7期4卷 601-609页

作者： Joao Maria marra Lucas Rafael Hara Motta Liliana Madalena g.amani Department of Maintenance Eng.neering Itaipu Binacional Foz do lguaqu 85856-970 Brazil Department of Mechanical Eng.neering Western Parana State University Foz do Igua~u 85857-900 Brazil Department of Mathematics Federal University of Parana Curitiba 80210-170 Brazil

With the g.owing.energ.tic need present in the world, it is increasing.y necessary for the researches and facilities to seek a better use of renewable natural resources. This paper is applied in the study of the performance of the aeration system of the Francis turbines present in Itaipu Hydroelectric Power Plant. When a Francis turbine operates off its optimal conditions, a vortex is formed inside the draft tube that, besides produces cavitation and pressure fluctuations, can pulse at frequencies with risk of resonance with hydraulic system, producing.efforts and vibrations that may cause structural failures in the turbines, g.nerators and civil parts of the power house. These damag.ng.effects can be reduced using.atmospheric aeration of the turbines. Because of this, the availability and effectively of the aeration system is fundamental to smooth the behavior of the turbines, helping.preserve the health of the power plant. An analysis of the performance of the aeration system will be done using.maintenance records and disturbances analysis reports （RAP）, allowing.verification of the operating.conditions of the turbine and fatality of water inlet in air pipes. Throug. the improvements detected, it is possible to reduce machine stoppag.s by tripping. thus increasing.the availability of the turbines.

关键词： turbine aeration performance.

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Stemness features in liver cancer

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Hepatoma Research 2018年第11期4卷 1-15页

作者： Marg.erita Correnti Richell Booijink g.ovanni Di Maira Chiara Rag.i Fabio marra Center for Autoimmune Liver Diseases Humanitas Clinical and Research CenterRozzano20089Italy Department of Biomaterial Science and Technolog. University of TwenteEnschede7500AEThe Netherlands Department of Clinical and Experimental Medicine University of FlorenceFlorence50141Italy

Heterog.neity is a cardinal hallmark of cancer, including.primary liver cancer (PLC), and occurs at different layers including.putative cell-of-orig.n. Current evidence sug.ests that within cellular subpopulations in PLC there are stem-like cells, the cancer stem cells (CSCs). The CSC concept has been recently proposed as an explanation of such intra-tumor heterog.neity. According.to this model, CSCs are responsible for tumor initiation, recurrence, metastasis as well as drug.resistance. However, althoug. the CSC hypothesis is intrig.ing.and supported by a larg. number of experimental studies, there are still open questions reg.rding.the orig.n of putative CSCs. Since chemo-resistance and recurrence represent major issues in PLC treatment, the development of new therapeutic strateg.es is needed, for which a g.od understanding.of tumor behavior and in particular of CSCs biolog. is an imperative prerequisite. In this review we summarize the reg.latory pathways that support CSC features in PLC. Moreover, we hig.lig.t the key features of hepatic CSC, in terms of enhanced drug.resistance, increased metastatic potential and metabolic rearrang.ment. Knowledg. of the molecular mechanisms underlying.CSC biolog. may provide novel options for PLC combination therapies.

关键词： Hepatocellular carcinoma cholang.ocarcinoma cancer stem cells tumor heterog.neity drug.resistance

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