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Alpha-Fetoprotein Level >1000 ng/mL as an Exclusion Criterion for Liver Transplantation in Patients With Hepatocellular Carcinoma Meeting the Milan Criteria

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LIVER TRANSPLANTATION 2014年第8期20卷 945-951页

作者： Hameed, Bilal Mehta, Neil Sapisochin, Gonzalo Roberts, John P. Yao, Francis Y. Univ Calif San Francisco Dept Med Div Gastroenterol San Francisco CA 94143 USA Univ Calif San Francisco Dept Surg Div Transplant Surg San Francisco CA 94143 USA Vall dHebron Univ Hosp Dept Hepatobiliopancreat Surg & Transplantat Barcelona Spain

Serum alpha-fetoprotein (AFP) has been increasingly recognized as a marker for a poor prognosis after liver transplantation (LT) for hepatocellular carcinoma (HCC). Many published reports, however, have included a large proportion of patients with HCC beyond the Milan criteria, and the effects of incorporating AFP as an exclusion criterion for LT remain unclear. We studied 211 consecutive patients undergoing LT for HCC within the Milan criteria according to imaging under the Model for End-Stage Liver Disease organ allocation system between June 2002 and January 2009. The majority (93.4%) had locoregional therapy before LT. The median follow-up was 4.5 years (minimum = 2 years). The Kaplan-Meier 1- and 5-year patient survival rates were 94.3% and 83.4%, respectively. In a univariate analysis, significant predictors of HCC recurrence included vascular invasion [hazard ratio (HR) = 10, 95% confidence interval (CI) = 3.9-26, P < 0.001], a pathological tumor stage beyond the University of California San Francisco criteria (HR = 4.1, 95% CI = 1.36-12.6, P = 0.01), an AFP level > 1000 ng/mL (HR = 4.5, 95% CI = 1.3-15.3, P = 0.02), and an AFP level > 500 ng/mL (HR = 3.1, 95% CI = 1.04-9.4, P = 0.04). In a multivariate analysis, vascular invasion was the only significant predictor of tumor recurrence (HR = 5.6, 95% CI = 1.9-19, P = 0.02). An AFP level > 1000 ng/mL was the strongest pretransplant variable predicting vascular invasion (odds ratio = 6.8, 95% CI = 1.6-19.1, P = 0.006). The 1- and 5-year rates of survival without recurrence were 90% and 52.7%, respectively, for patients with an AFP level > 1000 ng/mL and 95% and 80.3%, respectively, for patients with an AFP level <= 1000 ng/mL (P = 0.026). Applying an AFP level > 1000 ng/mL as a cutoff would have resulted in the exclusion of 4.7% of the patients from LT and a 20% reduction in HCC recurrence. In conclusion, an AFP level > 1000 ng/mL may be a surrogate for vascular invasion and may be used to predict posttransplant

关键词： AFP alpha-fetoprotein CI confidence interval HCC hepatocellular carcinoma HR hazard ratio LRT locoregional therapy LT liver transplantation MELD Model for End-Stage Liver Disease mRECIST modified Response Evaluation Criteria in Solid Tumors PEI percutaneous ethanol injection RFA radiofrequency ablation TACE transarterial chemoembolization UCSF University of California San Francisco. Level Trigger End Stage Liver Disease hazard ratio Response Evaluation Criteria in Solid Tumors AFP Liver Transplantation alpha-Fetoproteins Hepatocellular Cancer radiofrequency ablation RCRA FACILITY ASSESSMENT Light rail transit human-centered computing exclusion

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Liver nodule occurrence in chronic liver disease: HCC unique option?

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CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY 2014年第1期38卷 3-4页

作者： Sandri, Giovanni Battista Levi Carboni, Fabio Covello, Renato Valle, Mario Garofalo, Alfredo Regina Elena Inst Canc Res Dept Digest Surg I-00144 Rome Italy Regina Elena Inst Canc Res Dept Pathol I-00144 Rome Italy

True gastric hepatoid adenocarcinoma (HAC) has been reported less than 1% of gastric carcinomas [1]. High level of a-fetoprotein is a typical feature and first clinical manifestation is often liver metastasis [2,3]. At imaging studies, HAC shows morphologic similarity to hepatocellullar carcinoma and in patients with chronic liver disease, a correct diagnosis may be a challenge. We present the case of a 64-year-old-man with HCV chronic liver disease presenting at follow-up visit with serum level of AFP higher than 50.00f>and ultrasound showing a 3.5 cm nodule at liver segment II. Computed tomography confirmed HCC suspect. Orthotopic liver transplantation option was considered. During esophagogastroduodenoscopy a large mass in the gastric antrum was observed and biopsy showed adenocarcinoma. Considering the good condition of hepatic function a D2 subtotal gastrectomy was performed together with wedge resection of hepatic nodule. Microscopic examination revealed a hepatoid adenocarcinoma of stomach and the liver nodule was classified as metastatis. Histology showed large polygonal cells with abundant eosinophilic cytoplasm, central nuclei and exhibit trabecular disposition (Fig. 1).

关键词： subtotal gastrectomy Biopsy Carcinoma liver segments Metastatic Malignant Neoplasm to the Liver Serum levels chronic liver disease wedge resection Pyloric Antrum Adenocarcinoma Hepatoid Adenocarcinoma Adenoma Nodule of liver human-centered computing Cerebellar Nuclei

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Liver graft allocation for hepatocellular carcinoma patients: Is a forced ablate-and-wait protocol nationally applicable?

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LIVER TRANSPLANTATION 2014年第5期20卷 629-630页

作者： Bazerbachi, Fateh Aby, Elizabeth Lake, John Univ Minnesota Dept Med Minneapolis MN 55455 USA

In the original article, Mehta et al.~2 identified a specific cohort of hepatocellular carcinoma (HCC) patients with T2 tumors whose risk of wait-list dropout was very low, and they suggested that such patients should not receive the same allocation advantage as higher risk groups (ie, those not meeting their criteria). In our editorial, we raised the issue of whether using such data to inform a new allocation algorithm might lead to worsening outcomes through the selection of recipients with a higher risk of tumor recurrence for liver transplantation (LT). The authors have now provided outcome data to supplement their study and compared the identified outcomes of transplantation for their low-risk subgroup with those for the remaining HCC patients. Although the recurrence rates did not appear different, the non–low-risk recipients had worse 5-year patient survival, with HCC recurrence representing the most common cause of death. We disagree with their conclusion that “excluding patients with a very low risk of wait-list dropout from LT does not mean that we would instead perform transplantation for patients with a high risk of posttransplant HCC recurrence and poor survival,” and here we will focus on 2 primary issues.

关键词： Hepatocellular Forced Protocol Nationally Level Trigger Transplantation High risk tumor Cause of Death Liver Transplantation Population at Risk Forced Allocation Algorithm Relapse Hepatocellular Cancer Recipients human-centered computing Recurrent Neoplasm Patients

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Reply to the Letter to the Editor: Orthopaedic Education in the United Kingdom

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CLINICAL ORTHOPAEDICS AND RELATED RESEARCH 2014年第10期472卷 3237-3238页

作者： McAlinden, M. Gavan Dougherty, Paul J. Ulster Hosp Dept Trauma & Orthopaed Surg Belfast Antrim North Ireland Detroit Med Ctr Dept Orthopaed Surg Detroit MI 48201 USA

To the editor,

关键词： systemic therapy United Kingdom Survival human-centered computing Peritoneum letter Orthopedics

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Virtual shopping agents Persona effects for older users

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JOURNAL OF RESEARCH IN INTERACTIVE MARKETING 2014年第2期8卷 144-162页

作者： Chattaraman, Veena Kwon, Wi-Suk Gilbert, Juan E. Li, Yishuang Auburn Univ Dept Consumer & Design Sci Auburn AL 36849 USA Clemson Univ Sch Comp Human Cent Comp Div Clemson SC USA

Purpose - The purpose of this study is to investigate whether the visual presence of a virtual agent on a retail Web site reveals positive outcomes for older users with respect to enhancing perceived interactivity, social support, trust and patronage intentions and alleviating user anxiety. Design/methodology/approach - A between-subjects laboratory experiment was conducted with 50 older users, which included an interaction experience of 30 minutes followed by a paper-based questionnaire. The visual presence of the agent was manipulated in a mock retail Web site through the presence or absence of a virtual agent image, while maintaining the same agent functionality. Findings - The contrasts of senior users' shopping experiences between two agent-mediated Web sites (with or without agent image) support the direct "persona" effects of a virtual agent's visual presence on enhancing perceived interactivity, social support, trust and patronage intentions in the retail Web site, while alleviating user anxiety. Further, anxiety alleviation is fully explained by increased perceptions of interactivity. Perceived social support fully mediates trust in the benevolence of the online retailer. Trust ability emerges as a salient factor mediating the relationship between agent persona and patronage intentions. Originality/value - This work is the first to identify the value of human visual embodiment for older users' online shopping experiences, which has implications for other low-experience/expertise users of a medium.

关键词： Online retailing Interactivity Consumer behavior Internet human-centered computing Older Internet users Virtual agents

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TouchMover 2.0-3D Touchscreen with Force Feedback and Haptic Texture

TouchMover 2.0-3D Touchscreen with Force Feedback and Haptic...

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IEEE Haptics Symposium (HAPTICS)

作者： Sinclair, Mike Pahud, Michel Benko, Hrvoje Microsoft Res Redmond WA 98052 USA

ISBN: (纸本)9781479931316

This paper presents the design and development of a novel visio-haptic device that co-locates 3D stereo visualization, direct touch, texture and touch force sensing with a robotically actuated display. Our actuated immersive 3D display, called TouchMover 2.0, is capable of providing 1D movement (up to 36cm), haptic screen force feedback (up to 230N) in a single dimension perpendicular to the screen plane, and has an additional capability to render haptic texture cues via vibrotactile actuators attached to the touchscreen. We describe the details of our design and improvements. We showcase how TouchMover 2.0 allows the user to: touch and feel the 3D contour and 2D texture of a topographic map, to interact with 3D objects by pushing them on the screen with realistic force feedback and intuitively explore and feel pseudo tissue texture within volumetric data from medical imagery (e.g., MRI brain scan).

关键词： 3D touchscreen haptics texture vibrotactile human-centered computing human computer interaction (HCI) Interaction devices Haptic devices

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C-OLiVE: Group Co-located Interaction in VEs for Contextual Learning

C-OLiVE: Group Co-located Interaction in VEs for Contextual ...

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IEEE Virtual Reality (VR) Conference

作者： Apostolellis, Panagiotis Bowman, Doug A. Virginia Tech Ctr Human Comp Interact Blacksburg VA 24061 USA

ISBN: (纸本)9781479928712

In informal learning spaces employing digital content, such as museums, visitors either do not get adequate exposure to content or get information through passive instruction offered by a museum docent to the whole group. This research aims to identify which elements of co-located group collaboration, virtual environments, and serious games can be leveraged for an enhanced learning experience. Our hypothesis is that synchronous, co-located, group collaboration will afford greater learning compared to conventional approaches. We developed C-OLiVE, an interactive virtual learning environment supporting tripartite group collaboration, which we will use as a testbed to respond to our research questions. In this paper, we discuss our proposed research, which involves exploring some benefits of the involved technologies and proposing a list of design guidelines for anyone interested to exploit them in developing virtual environments for informal learning spaces.

关键词： Informal learning collaborative virtual environments game-based learning Applied computing Interactive learning environments Applied computing Collaborative learning human-centered computing Empirical studies in HCI

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Publish-Subscribe Smartphone Sensing Platform for the Acute Phase of a Disaster: A Framework for Emergency Management Support

Publish-Subscribe Smartphone Sensing Platform for the Acute ...

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12th IEEE International Conference on Pervasive computing and Communication (PERCOM)

作者： Radianti, Jaziar Gonzalez, Jose J. Granmo, Ole-Christoffer Univ Agder CIEM N-4898 Grimstad Norway

ISBN: (纸本)9781479927364

The advanced sensors embedded in modern smartphones opens up for novel research opportunities, as for instance manifested in the field of mobile phone sensing. Most notable is perhaps research activities within human activity recognition and context-aware applications. Along a similar vein, the SmartRescue project targets monitoring of both hazard developments as well as tracking of people in a disaster, taking advantage of smartphone sensing, processing and communication capabilities. The goal is to help crisis managers and the public in early hazard detection, hazard prediction, and in the forming of risk minimizing evacuation plans when disaster strikes. In this paper we propose a novel smartphone based communication framework for disaster specific machine learning techniques that intelligently process sensor readings into useful information for the crisis responders. Core to the framework is a robust content-based publish-subscribe mechanism that allows flexible sharing of sensor data and computation results. The proposed communication platform has been tested at the proof of concept level, with several detailed features providing promising results. We also provide the initial results from the development of this platform and discuss how to enhance the platform to become a disaster monitoring system for practical use.

关键词： publish-subscribe emergency management mobile sensing human-centered computing decision support sensors hazard tracking human tracking pervasive computing

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Constrained Holistic Cornering Control

Constrained Holistic Cornering Control

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American Control Conference

作者： Kasinathan, Dhanaraja Khajepour, Amir Chen, Shih-Ken Litkouhi, Bakhtiar Univ Waterloo Waterloo ON N2L 3G1 Canada

ISBN: (纸本)9781479932740

The objective of the Holistic Corner Control (HCC) is to keep the vehicle on a target path by minimizing the error between the actual and target center of gravity (CC) forces and moment. A real time optimization procedure has been proposed in order to calculate the necessary tire force adjustments to minimize the error and to give the driver a normal driving feel even though the road conditions differ from what is perceived. In this paper, we extend the HCC methodology by adding constraints to the optimization problem. Some important applications are (1) differential braking on all wheels (AWD), applicable to both electrically driven wheels or conventional cars;and (2) hybrid torque vectoring on front wheels (FWD) and differential braking on the rear wheels. Performance of the constrained IICC is compared against the HCC optimization using both simulation and experimental results.

关键词： Force Optimization Tires Torque Vectors Vehicles Wheels Automotive Control applications Optimization algorithms automotive engineering Wheels Optimization algorithms Force vehicle tyres Torque human-centered computing

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NCOA5, IL-6, Type 2 Diabetes, and HCC: The Deadly Quartet

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CELL METABOLISM 2014年第1期19卷 6-7页

作者： Dhar, Debanjan Seki, Ekihiro Karin, Michael Univ Calif San Diego Sch Med Dept Pharmacol Lab Gene Regulat & Signal Transduct La Jolla CA 92093 USA Univ Calif San Diego Sch Med Dept Pathol La Jolla CA 92093 USA Univ Calif San Diego Sch Med Dept Med La Jolla CA 92093 USA Univ Calif San Diego Sch Med Moores UCSD Canc Ctr La Jolla CA 92093 USA

Although type 2 diabetes (T2D) is an established risk factor for hepatocellular carcinoma (HCC), the underlying mechanism that connects these two diseases is unknown. Gao et al. (2013) now suggest that nuclear receptor coactivator 5 (NCOA5) provides a genetic link between the two diseases through its effects on hepatic IL-6 expression.

关键词： Interleukin-6 Risk Factors human-centered computing Type 2 Diabetes Mellitus

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