The Role of Substrate on Thermal Evolution of Ag/TiO2 Nanogranular Thin Films

In multicomponent thin films, properties and functionalities related to post-deposition annealing treatments, such as thermal stability, optical absorption and surface morphology are typically ra-tionalized, neglecting the role of the substrate. Here, we show the role of the substrate in deter-mining the temperature dependent behaviour of a paradigmatic two-component nanogranular thin film (Ag/TiO2) deposited by gas phase supersonic cluster beam deposition (SCBD) on silica and sapphire. Up to 600 °C, no TiO2 grain growth nor crystallization is observed, likely inhibited by the Zener pinning pressure exerted by the Ag nanoparticles on the TiO2 grain boundaries. Above 600 °C, grain coalescence, formation of anatase and rutile phases and drastic modification of the optical absorption are observed. However, the two substrates steer the evolution of the film morphology and optical properties in two different directions. On silica, Ag is still present as NPs distributed into the TiO2 matrix, while on sapphire, hundreds of nm wide Ag aggregates appear on the film surface. Moreover, the silica-deposited film shows a broad absorption band in the visi-ble range while the sapphire-deposited film becomes almost transparent for wavelengths above 380 nm. We discuss this result in terms of substrate differences in thermal conductivity, thermal expansion coefficient and Ag diffusivity. The study of the substrate role during annealing is possi-ble since SCBD allows the synthesis of the same film independently of the substrate, and suggests new perspectives on the thermodynamics and physical exchanges between thin films and their substrates during heat treatments

Implementing a robotic liver resection program does not always require prior laparoscopic experience

Background: Preliminary experience in laparoscopic liver surgery is usually suggested prior to implementation of a robotic liver resection program. Methods: This was a retrospective cohort analysis of patients undergoing robotic (RLR) versus laparoscopic liver resection (LLR) for hepatocellular carcinoma at a center with concomitant initiation of robotic and laparoscopic programs RESULTS: A total of 92 consecutive patients operated on between May 2014 and February 2019 were included: 40 RLR versus 52 LLR. Median age (69 vs. 67; p = 0.74), male sex (62.5% vs. 59.6%; p = 0.96), incidence of chronic liver disease (97.5% vs.98.1%; p = 0.85), median model for end-stage liver disease (MELD) score (8 vs. 9; p = 0.92), and median largest nodule size (22 vs. 24 mm) were similar between RLR and LLR. In the LLR group, there was a numerically higher incidence of nodules located in segment 4 (20.0% vs. 16.6%; p = 0.79); a numerically higher use of Pringle's maneuver (32.7% vs. 20%; p = 0.23), and a shorter duration of surgery (median of 165.5 vs. 217.5 min; p = 0.04). Incidence of complications (25% vs.32.7%; p = 0.49), blood transfusions (2.5% vs.9.6%; p = 0.21), and median length of stay (6 vs. 5; p = 0.54) were similar between RLR and LLR. The overall (OS) and recurrence-free (RFS) survival rates at 1 and 5 years were 100 and 79 and 95 and 26% for RLR versus 96.2 and 76.9 and 84.6 and 26.9% for LLR (log-rank p = 0.65 for OS and 0.72 for RFS). Conclusions: Based on our results, concurrent implementation of a robotic and laparoscopic liver resection program appears feasible and safe, and is associated with similar oncologic long-term outcomes

The perioperative period of liver transplantation from unconventional extended criteria donors: data from two high-volume centres

Background: As literature largely focuses on long-term outcomes, this study aimed at elucidating the perioperative outcomes of liver transplant patients receiving a graft from two groups of unconventional expanded criteria donors: brain dead aged > 80 years and cardiac dead.Methods: Data of 247 cirrhotic patients transplanted at two high volume liver transplant centers were analysed. Confounders were balanced using a stabilized inverse probability therapy weighting and a propensity score for each patient on the original population was generated. The score was created using a multivariate logistic regression model considering a Comprehensive Complication Index & GE; 42 (no versus yes) as the dependent variable and 11 possible clinically relevant confounders as covariate.Results: Forty-four patients received the graft from a cardiac-dead donor and 203 from a brain-dead donor aged > 80 years. Intraoperatively, cardiac-dead donors liver transplant cases required more fresh frozen plasma units (P < 0.0001) with similar reduced need of fibrinogen to old brain-dead donors cases. The incidence of reperfusion syndrome was similar (P = 0.80). In the Intensive Care Unit, both the groups presented a comparable low need for blood transfusions, renal replacement therapy and inotropes. Cardiac-dead donors liver transplantations required more time to tracheal extubation (P < 0.0001) and scored higher Comprehensive Complication Index (P < 0.0001) however the incidence of a severe complication status (Comprehensive Complication Index & GE; 42) was similar (P = 0.52). ICU stay (P = 0.97), total hospital stay (P = 0.57), in hospital (P = 1.00) and 6 months (P = 1.00) death were similar.Conclusion: Selected octogenarian and cardiac-dead donors can be used safely for liver transplantation

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Caratterizzazione della frazione lipidica dei prodotti ittici nell’ambito del progetto Last Minute Fish

La caratterizzazione della frazione lipidica di prodotti ittici ed un progetto a rilevante impatto sociale, il Last Minute Fish (LMF), rappresentano il quadro di riferimento di una attività di ricerca promossa dal gruppo di Scienze e Tecnologie Alimentari della Facoltà di Agraria dell’Università Politecnica delle Marche. Il LMF si inserisce nel quadro del più ampio Last Minute Market avviato dall’Università di Bologna con l’obiettivo di ridurre gli sprechi alimentari utilizzando per scopi benefici le eccedenze, altrimenti destinate alla distruzione. Le eccedenze nel nostro caso hanno riguardato il mercato ittico all’ingrosso locale. E’ stato così possibile, in meno di due anni di attività, evitare la distruzione e destinare a mense di associazioni no-profit più di una tonnellata di prodotti ittici freschi. Parallelamente è stata effettuata la caratterizzazione chimica della frazione lipidica di campioni di diverse specie di pesce marino, d’acqua dolce e di crostacei, prelevati direttamente presso i destinatari no-profit del progetto e presso i rivenditori all’ingrosso locali. A questo scopo, dopo l’estrazione del grasso e la successiva transmetilazione basicocatalizzata si è proceduto ad una analisi qualitativa e quantitativa degli acidi grassi rispettivamente mediante gascromatografia accoppiata a spettrometria di massa e gascromatografia con rilevatore a ionizzazione di fiamma. I profili lipidici delle specie marine, di acqua dolce e dei crostacei hanno mostrato somiglianze notevoli per quel che concerne gli acidi grassi ω 3, mentre sono in corso di esame le individuazioni delle molecole lipidiche caratterizzanti, in particolare degli acidi grassi furanici

Early switching to intramuscular anti-HBs Immunoglobulins (Igantibe™) after liver transplantation: feasibility, efficacy, and safety

We present the results of a single-center trial on early switching from i.v to i.m.anti HBs immunoglobulins (HBG) after liver transplantation

Locoregional Treatments for Bridging and Downstaging HCC to Liver Transplantation

Liver transplantation (LT) is the first-line treatment for patients diagnosed with unresectable early-stage hepatocellular carcinoma (HCC) in the setting of cirrhosis. It is well known that HCC patients within the Milan criteria (solitary tumour ≤ 5 cm or ≤3 tumours, each <3 cm) could undergo LT with excellent results. However, there is a growing tendency to enlarge inclusion criteria since the Milan criteria are nowadays considered too restrictive and may exclude patients who would benefit from LT. On the other hand, there is a persistent shortage of donor organs. In this scenario, there is consensus about the role of loco-regional therapy (LRT) during the waiting list to select patients who would benefit more from LT, reducing the risk of drop off from the waiting list as well as decreasing tumour dimension to meet acceptable criteria for LT. In this review, current evidence on the safety, efficacy and utility of LRTs as neoadjuvant therapies before LT are summarized