Background High Mobility Group Box-1 (HMGB-1) is implicated in the pathogenesis of thrombosis and cancer. In the present study, we aimed to evaluate its potential role as a diagnostic biomarker of portal vein thrombosis (PVT) among patients with hepatocellular carcinoma (HCC). Methods The study population included N=100 prospectively recruited patients with a novel diagnosis of HCC. We compared circulating HMGB-1 levels between 34 healthy controls, HCC patients with PVT (N=22), and HCC patients without PVT (N=78). Results HCC patients without PVT showed significantly higher median HMGB-1 serum levels (8.2 [5.5-13.1] ng/ml) than those observed in the case of HCC with PVT (5.5 [4.4-8.5] ng/ml; p=0.012) and in healthy controls (4.1 [3.1-8.2] ng/ml; p<0.001). Among HCC patients, at univariate analysis, the presence of PVT was associated with higher median age (p=0.036), larger major cancer node diameter (p<0.001), and lower HMGB-1 serum level (p=0.012). At multivariate analysis, the presence of PVT maintained a positive association with major node diameter p=0.001) and an inverse association with serum HMGB-1 levels (p=0.003). Conclusions These findings indicate that serum HMGB-1 bears an inverse association with PVT complicating HCC at the time of diagnosis and suggest that serum HMGB-1 depletion may mark PVT development in cirrhotic patients with HCC.

This article offers an overview of congenital and acquired vascular anomalies involving the portal venous system in dogs and cats, as determined by multidetector-row computed tomography angiography. Congenital absence of the portal vein, portal vein hypoplasia, portal vein thrombosis and portal collaterals are described. Portal collaterals are further discussed as high- and low-flow connections, and categorized in hepatic arterioportal malformation, arteriovenous fistula, end-to-side and side-to-side congenital portosystemic shunts, acquired portosystemic shunts, cavoportal and porto-portal collaterals. Knowledge of different portal system anomalies helps understand the underlying physiopathological mechanism and is essential for surgical and interventional approaches.

Introduction. “Vein definition” for locally advanced pancreatic ductal adenocarcinoma (LA PDAC) assumes portal-to-superior mesenteric vein (PV/SMV) unreconstructability due to tumor involvement or occlusion. Radical pancreatectomies with SMV resection without PV/SMV reconstruction are scarcely discussed in the literature. Retrospective analysis of 19 radical pancreatectomies for “low” LA PDAC with SMV and all its tributaries resection without PV/SMV reconstruction has shown zero mortality, overall morbidity – 56%, Dindo-Clavien – 3-10,5%, R0- rate – 82%, mean operative procedure time – 355±154 min, mean blood loss – 330±170 ml, delayed gastric emptying– 25%, clinically relevant postoperative pancreatic fistula – 8%. In three cases surgery was associated with superior mesenteric (n2) and common hepatic artery (n1) resection. Surgery was completed without vein reconstruction (n13) and with inferior mesenteric-to-splenic anastomosis (n6). There were no cases of liver, gastric, or intestinal ischemia. A specific complication of the SMV resection without reconstruction was 2-3 days-long intestinal edema (48%). Median overall survival – 25 months, median progression-free survival – 18 months. All the relapses, except two, were distant. The possibility of successful SMV resection without PV/SMV reconstruction can be predicted before surgery by CT-based reconstructions. The mandatory anatomical conditions for the procedure were: 1) preserved SMV-SV confluence; 2) occluded SMV for any reason (tumor or thrombus); 3) well-developed inferior mesenteric vein collaterals with dilated intestinal veins; 4) no right-sided vein collaterals, and 5) no varices in the upper abdomen. Conclusion: “Low” LA PDACs involving SMV with all its tributaries can be radically and safely resected in highly and specifically selected cases without PV/SMV reconstruction with an acceptable survival rate.

Ascites is a term that describes a pathological accumulation of fluid in a peritoneal cavity. It is generally a rare occurrence in a pediatric population and is most commonly associated with liver failure and cirrhosis. In that case, a diuretic treatment is usually implemented to relieve the ascites as it forms in the mechanism of water retention and water leakage from the portal venous system due to portal hypertension. It is important to note however that many other issues may cause ascites in children. Those require a catered approach suited to the pathomechanism of ascites formation in those underlying conditions. That is why a complex diagnostic process ought to be run in pediatric patients with ascites to correctly identify a condition causing it and provide the patient with adequate and thorough care.

This short paper raises and answers a question related to orthographic lexicography in general and its reference to efforts in making contemporary dictionary portals. As orthographic dictionaries have not yet been researched as a specialized lexicographic variety, part of their metalexicographic description in those European languages that have online normative orthographic dictionaries is presented. Metalexicographic elements that are analyzed were chosen from the perspective of casual and professional users and online dictionary visitors. Regardless of the fact that this is a specific kind of dictionary, as well as of the fact that European orthographic tradition and practice is quite heterogeneous, the belief that the European Dictionary Portal should also include available online orthographic dictionaries is defended. An argument in favor of this could contribute to an awareness of the importance of orthography for online dictionary users, even in those languages whose written form greatly corresponds to the spoken form.

The portal website of a university or a college usually represents the cultural characteristics and teaching advantages and plays a vital role in higher education, showing the style of the university or college to society and improving the admission rate. Mississippi State (MS) is bounded by the Mississippi River in the west and the Gulf of Mexico in the south, with a population of 3.1 million. It has a rich cultural heritage, and many universities, especially historically black colleges and universities (HBCUS), have strong scientific research strength in agriculture, medicine, petrochemicals and papermaking. Therefore, this article will analyze the design of the portal websites of four HBCUs in Mississippi from two aspects: user experience (UE) and functional architecture (FA), determine their advantages, disadvantages, similarities and differences, and propose some optimization suggestions.

Background: In the landscape of thoracic surgery, innovation continually drives progress, offering novel approaches to address complex pathologies while prioritizing patient well-being. Dual-portal robotic-assisted thoracic surgery DRATS represents the next frontier in this evolution. In this report we describe our experience with the DRATS approach for segmentectomy with the indocyanine green intersegmental plane identification. Methods: We presented the case of a patient who underwent a DRATS lingulectomy and lymphadenectomy stations 5, 6, 7, and 10 using the daVinci Surgical System. Results: The patient's postoperative course was uneventful with chest tube was removed in second post operative day. The final pathological analysis confirmed a low-grade malignant potential adenocarcinoma, with main diameter of 1.1 cm, at 3 cm from lung margins. 12 nodes were removed, from station 5,6,7,10,11, all of the free of metastases. Conclusions: Our initial observations suggest that Dual-Portal Robotic-Assisted Tho-racic Surgery (DRATS) demonstrates notable feasibility.

Type II grass carp reovirus (GCRV-II) with high pathogenicity and infectivity causes severe hemorrhagic disease, which leads to extensive death in the grass carp and black carp aquaculture. However, the early invasion portal remains unclear. In this study, we explored the invasion portal, time, and pathway of GCRV-II by immersion infection in grass carp. Through the detection of the infected grass carp external body surface tissues, most of them could be detectable to carry GCRV-II within 45 minutes except for the skin covered by scales. Further shortening the duration of infection, we proved that GCRV-II rapidly invades through the nostril (especially), gill, and skin on head at only 5 min post immersion, rather than merely adhesion. Subsequently, visual localization investigations of GCRV-II were conducted on the nostril, olfactory system (olfactory bulb and olfactory tract), and brain by immunofluorescence microscopy and transmission electron microscopy. We found that few viruses were located in the nostril at 5 min post immersion infection, while significantly increased viruses were distributed in all these tissues at 45 min. Furthermore, semi-qRT-PCR and western blotting results of different infection time confirmed that GCRV-II invades grass carp via nostril-olfactory system-brain axis and then unfolds viral replication. These results revealed the infection mechanism of GCRV-II on the invasion portal, time, and pathway in grass carp. This study aims to understand the invasion mode of GCRV-II in grass carp, which provides theoretical support for the prevention and control strategies of hemorrhagic disease.

The rapid development of technology has led to the implementation of data-driven systems whose performance heavily relies on the amount and type of the data itself. In the latest decades, in the fields of bioengineering data management, among others, eye-tracking data has become one of the most interesting and essential components for many medical, psychological, and engineering research applications. However, despite the large usage of eye-tracking data in many studies and applications, a strong gap is still present in the literature regarding real-time data collection and management, which led to strong constraints for the reliability and accuracy of on-time results. To address this gap, this study aims to introduce a system that enables the collection, processing, real-time streaming, and storage of eye-tracking data. The system is developed by using Java programming language, WebSocket protocol, and Representational State Transfer (REST), improving the efficiency in transferring and managing eye-tracking data. Results were computed in two test conditions, i.e., local and online scenarios, within a time window of 100 seconds. The experiments conducted for this study were carried out by comparing the time delay between two different scenarios. Even if preliminary, results showed a significantly improved performance of data management systems in managing real-time data transfer. Overall, this system can significantly benefit the research community by providing real-time data transfer and storing the data, enabling more extensive studies using eye-tracking data.

Cirrhosis is a critical global health issue, responsible for 2.4% of deaths worldwide in 2019. The Global Burden of Disease Study reported a near doubling of decompensated cirrhosis cases from 1990 to 2017. In the U.S., cirrhosis is the 12th leading cause of death and often requires hospitali-zation and procedural interventions for severe complications such as hepatocellular carcinoma, ascites, hepatic encephalopathy, and variceal bleeding. This study aims to identify racial, ethnic, and socioeconomic disparities in receiving critical interventions among U.S. patients with de-compensated cirrhosis during 2020-2021. We conducted a retrospective cross-sectional analysis using 2020-2021 National Inpatient Sample data of adult patients (≥18 years) with cirrhosis-related and cirrhosis complication-related ICD-10 codes and who underwent procedures for cirrhosis-related indications such as esophagogastroduodenoscopy (EGD) for variceal hemor-rhage, transjugular intrahepatic portosystemic shunt (TIPS) for variceal hemorrhage or refractory ascites, hemodialysis for acute kidney failure or hepatorenal syndrome, and liver transplantation We collected data on patient baseline clinicodemographic and procedural outcomes. Statistical analyses included multivariable logistic regression to assess for associations with outcomes. There were significant disparities in procedure utilization: White and Hispanic patients more likely than Black patients to receive EGD and TIPS, while Black and Hispanic patients had higher odds of receiving hemodialysis. Insurance type also influenced access, with Private/HMO insurance holders having higher odds of undergoing procedures. These findings underscore the need for targeted interventions to address healthcare inequities.

With more and more transportation tunnels have been and will be constructed in loess areas in Northwest China with high earthquake potential, the overall stability of portal section under earthquakes actions and the related aseismic countermeasures attracted the attentions from both the scholars and engineers, especially the tunnels in the upper slope connecting the high bridges crossing rivers or valleys. In order to study the dynamic response characteristics and damage evolution of steep loess slope with a tunnel under the earthquake actions, a large-scale shaking table tests were performed on steep loess slope with a tunnel. Wenchuan-tangyu (WT) wave and El Centro (El) wave records were applied on the model to investigate the displacement response and acceleration response of loess slope with a tunnel under the horizontal (X) and the combined action of horizontal and vertical (X-Z) seismic loads, respectively. In particular, three-dimensional non-contact optical measurement techniques were used to obtain the slope surface displacements. The results showed that the main deformation pattern of the slope was horizontal movement and settlement when the seismic wave input was in the X and X-Z directions, respectively. However, the X direction seismic wave had a greater impact on the deformation of the slope, and the tunnel portal slope was destroyed under the action of a large horizontal seismic acceleration finally. Slope failure ahead of a tunnel could be divided into four stages, i.e. elastic deformation stage, plastic deformation accumulation stage, local failure stage, and overall failure stage. The peak ground displacement of X direction (PGDX) and peak ground displacement of Z direction (PGDZ) of the slope surface increased with the increasing of the input peak ground acceleration (PGA) when the input wave was same waveform and same direction. The existence of the tunnel had a great influence on the PGA and the PGA amplification factor (PGAAF) of the soil mass surrounding it. This was because the seismic waves encounter a tunnel surface with clear differences in the physical properties of the medium during their propagation in the slope, thereby forming a strong reflection and refraction effect, and the amplitude changed significantly. Numerical simulation results were basically consistent with the experimental results.

Flood events are becoming more severe, causing significant problems to human communities, including physical, psychological, and material damage. For both flood forecasting in emergency response situations and flood mapping, georeferencing and data curation are paramount in the context of prevention or preparedness. Hence, data display, data management, and articulation with numerical simulation results must occur on GIS platforms. Our research is motivated by recent advances in Web and GIS technologies, social sensing and high-performance computing, and an envisaged wider availability of remote sensing data. This paper presents and discusses an innovative Web GIS platform named "RiverCure Portal" or "RCP" for short. This platform combines observations and hydrodynamic modelling tools to support various stages of the flood risk management cycle, including operational response, emergency preparedness, and risk assessment. RCP is a multi-organisation, multi-context digital platform with flexible configuration features to define and support multiple sensor types and modelling options, satisfying the various needs of different organisations and stakeholders. In addition, this paper discusses the RiverCure Approach, which encompasses the following tasks directly supported by the RCP platform: defining the context and involved geometries, associating sensors to the context, pre-processing and generating the context mesh, defining the simulation event, running the simulation event, and analysing the results from the simulation event. Thus, the RCP streamlines and simplifies data analysis and simulation procedures to meet decision-makers' needs. The novelties discussed in this paper include the design and discussion of a Web GIS platform that allows (i) to manage flood data and results of simulations at several contextual levels by different stakeholders such as domain experts, decision-makers, researchers, or students; (ii) to process and curate sensed data obtained from physical and social sensors; and (iii) update the state and values of the parameters of simulation tools through continuous data assimilation techniques for forecasting purposes. Finally, this paper supports the explanation and discussion with a running example, "Águeda 2016 flood" event, which dataset is publicly available for further study and experimentation.

The prospective study enrolled 144 patients after surgical treatment of biliary atresia in early infancy. We analyze the immediate effectiveness of the surgery and the age-related structure of complications in the up to 16-year follow-up. The immediate 2-year survival rate after the surgery constituted 49.5%. At the time of this writing, 17 of the patients have celebrated their 10th birthdays with good quality of life and no indications for LT. The obtained results underscore the critical importance of surgical correction of BA by Kasai surgery during the first 60 days of life and subsequent dynamic follow-up of the patients for the purpose of the early detection and timely correction of possible complications.

This short note proposes a national Geographic Information System (GIS) - based health infrastructure to deal with epidemics and pandemics. Currently, there is no pan-India health infrastructure available that can compile, update, and report the spread of epidemic diseases. It not only curtails the opportunity of finding the real-time data on the spatial distribution of a disease but prevents one to inquire into the causes of the disease through epidemiological analysis. The proposed infrastructure in this study is a pan-India one and can broadly be divided into two parts, hotspot mapping and accessibility to services. In the first part, hospitals are proposed to act as nodes of data collection, sending data to a national GIS portal. This portal shall have the capabilities of plotting the data using map rendering services such as Google and Bing Maps. This way, hotspots can be visualized in no time, benefitting the government and common citizenry alike. The second part deals with the accessibility of citizenry to a wide range of services, i.e., healthcare services, grocery outlets, emergency services, baby food, and many other essential services of the day to day life. In order to implement this, we propose that the government need to enforce a mandatory submission of locational coordinates of all Goods and Services Tax (GST) enrolled service providers. Once the coordinates are submitted, the government can effectively control the opening and closing of services and inform the citizenry at the same time. The proposed infrastructure is going to help deal with the extraordinary situations during epidemic and pandemics similar to what the world is currently facing in the form of Corona Virus Disease 2019 (COVID-19). Furthermore, the infrastructure can be scaled up or down as per the spread of a disease. The health-GIS platform proposed in this concept paper, shall help India in controlling and managing the epidemic more efficiently.

In the extended scalar sector of the SMASH (Standard Model - Axion - Seesaw - Higgs portal inflation) framework, we conduct a phenomenological investigation of the observable effects. In a suitable region of the SMASH scalar parameter spaces, we solve the vacuum metastability problem and discuss the one-loop correction to the triple Higgs coupling, $\lambda_{HHH}$. The $\lambda_{HHH}$ and SM Higgs quartic coupling $\lambda_H$ corrections are found to be proportional to the threshold correction. A large $\lambda_{HHH}$ correction ($\gtrsim 5 \%$) implies vacuum instability in the model and thus limits the general class of theories that use threshold correction. We performed a full two-loop renormalization group analysis of the SMASH model. The SMASH framework has also been used to estimate the evolution of lepton asymmetry in the universe.

Replacement of fee-for-service with capitation arrangements, forces physicians and institutions to minimize health care costs, while maintaining high-quality care. In this report we describe how patients, their families (and caregivers) can work with members of the medical care team to achieve these twin goals of maintaining (and perhaps improving) high-quality care and minimizing costs. We describe how increased self-management enables patients and their families/caregivers to provide electronic patient-reported outcomes (i.e., symptoms, events) (ePROs) as frequently as the patient or the medical care team consider appropriate. These capabilities also allow greater reliance on the use of mobile technologies (mHealth) to provide ongoing assessments of physiologic measurements/phenomena. Remote surveillance of these communications allows longer intervals between (fewer) visits of patients to the medical-care team when this is appropriate and earlier interventions when that is appropriate. Systems are now available that alert medical care providers to situations when interventions might be needed.

Autoimmune hepatitis (AIH) is a chronic, relapsing and remitting, immune mediated liver disease which progresses to cirrhosis if left untreated. A significant number of patients may present with acute hepatitis or acute liver failure, which are often misdiagnosed as toxic liver injury. AIH shows a preponderance for young women but may be seen in children and elderly. Diagnosis requires integration of clinical, biochemical and serologic parameters along with supportive liver histology and exclusion of other causes of liver disease. Liver biopsy is a pre-requisite for diagnosis of AIH, to assess severity and stage of disease, exclude other entities and recognize any concurrent morbidities. No single biomarker or histologic feature is pathognomonic for AIH. The diagnostic and histologic criteria have undergone several modifications since the Original Scoring system proposed by the International Autoimmune Hepatitis Group (IAIHG) in 1993. Recently, IAIHG has proposed consensus recommendations for histologic criteria, relevant for both acute and chronic AIH. This review article will describe the evolving diagnostic criteria for AIH with their limitations and utility, with an emphasis on the role of liver histology in diagnosis and management of AIH.

The paper presents the final results from the research project “Urban Abacus of Building Energy performances (Abaco Urbano Energeticodegli Edifci – AUREE)” aimed at supporting the renovation and energy efficiency enhancement of urban building heritage financed by the “Ricerca Sistema Elettrico (MISE) program”. The crux of AUREE project is a Web – GIS GeoBlog portal with customized semantic dashboards aimed at sharing information on urban built environment and promoting the participation of local stakeholders to its improvement. As the latest development of this research, a workflow integrating the AUREE portal with BIM authoring and an open source IoT platform has been implemented and applied to an experimental case study concerning a public building in Carbonia (Italy). The headquarters of the sustainable energy research center Sotacarbo was selected as case study. The presented results proved that it was possible to create an open system, which could be easily consulted by "non-expert" users as well, to make available real-time monitoring data obtained from IoT sensors measuring the energy consumption, the indoor environmental conditions and the usage profiles of public buildings. The proposed open system could also be suitable to be later used as an effective tool to support the rising “energy communities”.

Mortality and readmission rates for decompensated acute heart failure (AHF) is overall increasing and risk stratification might be challenging. We sought to evaluate the prognostic role of systemic venous ultraso-nography in patients hospitalized for AHF. We prospectively recruited 74 AHF patients with a NT-proBNP level above 500 pg/mL. Then, a multiorgan ultrasound assessment (lung, inferior vena cava, Doppler of hepatic, portal, intrarenal and femoral veins) were performed at admission, discharge, and follow-up (for 90 days). An intrarenal monophasic pattern (AUC 0.923, Sn 90%, Sp 81%, PPV 43%, NPV 98%), a portal pulsatility >50% (AUC 0.749, Sn 80%, Sp 69%, PPV 30%, NPV 96%) and a VExUS score of 3 (AUC 0.885, sensitivity 80%, specificity 75%, PPV 33%, NPV 96%) predicted death during hospitalization. An IVC above 2 cm (AUC 0.758, Sn 93.l% and Sp 58.3) and the presence of an intrarenal monophasic pattern (AUC 0. 834, sensitivity 0.917, specificity 67.4%) in the follow-up visit predicted AHF related readmission. Addi-tional scans during hospitalization or calculate a VExUS score probably adds unnecessary complexity to the assessment of AHF patients. In conclusion, VExUS score does not contribute to guide therapy or the predic-tion of complications, compared to the presence of an inferior vena cava greater than 2 cm, a venous mo-nophasic intrarenal pattern or a pulsatility > 50% of the portal vein in AHF patients. Early and multidisci-plinary follow-up visit remains necessary to improve prognosis of this highly prevalent disease.

COVID-19 and long COVID-19 vulnerabilities may be caused indirectly by albumin binding deficiency (ABD) which can be corrected by the correct administration of human serum albumin (HSA). The liver is the primary site of nutrient regulation and fluid volume maintenance, control of both is by changes to albumin concentration. In healthy subjects the HSA lymphatic nutrient pump (HSALNP) ensures continual pumping of nutrients from the liver are appropriately distributed to organs. Nutrients are delivered to cells according to the availability of binding to HSA. The HSALNP therefore maintains the correct nutrients and colloidal pressure balance in all tissues independently. In unhealthy tissues, following COVID-19 infection, the passage of HSA/nutrients through the interstitial spaces and lymph will be impeded. Fluid therapy into the periphery leads to dilution of essential nutrients attached to the protein-carriers such as albumin. The levels of albumin being charged by the liver with nutrients is critical in maintaining immune stability by maintaining nutrient support and colloidal pressure of cellular structures. The site of HSA binding by the liver is of great importance and direct infusion of albumin into the Hepatic Portal Vein is the most appropriate method of maintaining colloid pressure and cellular nutrient levels.

Trans-arterial radioembolization (TARE) is a form of radiation therapy performed for hepatocellular carcinoma (HCC) via selective intra-arterial injection of Yttrium-90 loaded microspheres. This was a multicenter retrospective study of consecutive patients with HCC who underwent TARE between July 2009 and May 2019. Using pre-treatment computed tomography imaging, the total cross-sectional area (cm2) of the abdominal skeletal muscle at the third lumbar vertebra was measured. The skeletal muscle index (SMI) was calculated by normalizing the muscle area to patient height. In total, 347 patients (median age, 65 years; 284 male) were included in the study. A total of 108 (31.1%) patients had portal vein tumor thrombus (PVTT) and 126 (36.3%) were classified as sarcopenic. The median overall survival (OS) was 28.1 months (95% CI, 24.8-35.7) and median progression-free survival was 8.0 months (95% CI, 6.4-9.4). Multivariate Cox regression analysis revealed that sarcopenia (hazard ratio [HR], 1.36; 95% CI, 1.00-1.85, p = 0.05), PVTT (HR, 1.82; 95% CI, 1.33-2.49, p < 0.01), alpha-fetoprotein (AFP) (≥200 ng/mL) (HR 1.41; 95% CI, 1.04-1.92, p = 0.03), and albumin-bilirubin grade (2-3) (HR 1.74; 95% CI, 1.24-2.43, p < 0.01) were independently associated with poor OS. TARE provided favorable long-term outcomes for patients with advanced HCC. Pre-treatment sarcopenia independently associated with survival, suggesting its utility as a surrogate biomarker for identifying TARE candidates.