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Purpose: The Barcelona Clinic Liver Cancer (BCLC) staging schema is widely used for hepatocellular carcinoma (HCC) treatment. In the updated recommendations, HCC BCLC stage B can become candidates for transplantation. In contrast, hepatectomy is currently not recommended. Methods: This systematic review includes a multi-institutional meta-analysis of patient-level data. Survival, postoperative mortality, morbidity and patient selection criteria for liver resection and transplantation in BCLC stage B are explored. All clinical studies reporting HCC patients with BCLC stage B undergoing liver resection or transplantation were included. Results: A total of 31 studies with 3163 patients were included. Patient level data was available for 580 patients from 9 studies (423 after resection and 157 after transplantation). The overall survival following resection was 50 months and recurrence-free survival was 15 months. Overall survival after transplantation was not reached and recurrence-free survival was 45 months. The major complication rate after resection was 0.11 (95%-CI, 0.0-0.17) with the 90-day mortality rate of 0.03 (95%-CI, 0.03-0.08). Child-Pugh A (93%), minor resection (60%), alpha protein level less than 400 (64%) were common in resected patients. Resected patients were mostly outside the Milan criteria (99%) with mean tumour number of 2.9. Studies reporting liver transplantation in BCLC stage B were scarce. Conclusion: Liver resection can be performed safely in selected patients with HCC BCLC stage B, particularly if patients present with preserved liver function. No conclusion can done on liver transplantation due to scarcity of reported studies.
(2024) López-López, Victor; Sánchez Velázquez, Patricia, 1985-; Dalmau, Mar; Eshmuminov, DilmurodjonBlood biomarkers have emerged as accessible, cost-effective, and highly promising tools for advancing the diagnostics of Alzheimer's disease. However, transitioning from cerebrospinal fluid biomarkers to blood biomarkers-eg, to verify amyloid ß pathology-requires careful consideration. This Series paper highlights the main challenges in the implementation of blood biomarkers for Alzheimer's disease in different possible contexts of use. Despite the robustness of measuring blood biomarker concentrations, the widespread adoption of blood biomarkers requires rigorous standardisation efforts to address inherent challenges in diverse contexts of use. The challenges include understanding the effect of pre-analytical and analytical conditions, potential confounding factors, and comorbidities that could influence outcomes of blood biomarkers and their use in diverse populations. Additionally, distinct scenarios present their own specific challenges. In memory clinics, the successful integration of blood biomarkers in diagnostic tests will require well-established diagnostic accuracy and comprehensive assessments of the effect of blood biomarkers on the diagnostic confidence and patient management of clinicians. In primary care settings, and even more when implemented in population-based screening programmes for which no experience with any biomarkers for Alzheimer's disease currently exists, the implementation of blood biomarkers will be challenged by the need for education of primary care clinical staff and clear guidelines. However, despite the challenges, blood biomarkers hold great promise for substantially enhancing the diagnostic accuracy and effectively streamlining referral processes, leading to earlier diagnosis and access to treatments. The ongoing efforts that are shaping the integration of blood biomarkers across diverse clinical settings pave the way towards precision medicine in Alzheimer's disease.
(2024) Schöll, Michael; Verberk, Inge M. W.; Campo, Marta del; Delaby, Constance; Therriault, Joseph; Chong, Joyce R.; Palmqvist, Sebastian; Alcolea, DanielObjective: Life expectancy and obesity prevalence are increasing worldwide, leading to an increase in the prevalence of cardiovascular disease. High-density lipoprotein (HDL) functionality and immunosenescence play key roles in cardiovascular disease, longevity, and quality of aging. Both molecular hallmarks of aging are impacted by obesity and metabolic syndrome and can be modulated by lifestyle. We aimed to evaluate the effect of a lifestyle intervention focused on an energy-reduced Mediterranean diet (erMedDiet), physical activity (PA), and behavioral support on HDL cholesterol efflux capacity (CEC) and immunosenescence. Method: CEC and immunosenescent T cells were determined in 60 participants from the control group (CG) and 56 from the intervention group (IG) of the PREDIMED-Plus trial at baseline and after 1 and 3 years of follow-up. PREDIMED-Plus is a randomized, controlled, parallel-group trial with an IG of erMedDiet, PA promotion, and behavioral support for weight loss and a CG of usual primary care advice. The sample included 116 volunteers from the PREDIMED-Plus-IMDEA subsample of the PREDIMED-Plus trial. Men aged 55 to 75 years and women aged 60 to 75 years with a body mass index between 27 and 40 kg/m2 and metabolic syndrome were included. Results: Participants within the IG had significantly improved CEC (2.42% and 10.69% after 1 and 3 years of follow-up) and a decreased in senescent T cell profile (-3.32% ± 12.54% and -6.74% ± 11.2%, p < 0.001, after 1 and 3 years of follow-up). Baseline obesity status impacted the response to the intervention. Conclusions: A weight loss intervention program with erMedDiet and PA ameliorated senescence markers.
(2025) Díez-Ricote, Laura; Cuadrado-Soto, Esther; Pastor-Fernández, Andrés; Peña, Gema de la; Martinez-Botas, Javier; Castañer, Olga; Martínez-González, Miguel Ángel, 1957-; Salas Salvadó, Jordi; Fernandez-Marcos, Pablo J.; Gómez-Coronado, Diego; Ordovás, José M.; Daimiel, LidiaThis essay focuses on the Catalan translation of a selection of James Joyce's letters, Cartes antologia. The essay discusses the main translation problems the translator encountered and the strategies and methods deployed to solve them. The difficulties analyzed center around the translation of 1) quotations from Joyce's own works, including those of works in the pre-publication stages of writing; 2) literary allusions to Homer's Odyssey and Joyce's Ulysses; 3) the combination of high and low registers; 4) wordplay; 5) idioms; and 6) metaphorical language. Natural, idiomatic language was required when translating idioms and metaphorical language. A sense of rhythm and poeticality was indispensable when translating the coalescence of high and low registers. Being able to create alliterations and near-homophones was of vital importance to convey wordplay. Familiarity with Joyce's works, especially Ulysses and its Catalan translation, was essential to translate urtexts. And, finally, a sound knowledge of the Catalan literary tradition, especially regarding the translations of the Odyssey, proved useful when translating literary allusions. In all, translating Joyce's letters is regarded as an act of literary translation, a creative process that demanded the ability to fashion a fresh, vibrant new text that had to live up to the original.
(2024) Pujol, Dídac
The aim of the present study is to disentangle the role of syntactic and pragmatic factors on pronominal subject anaphora resolution in a null subject language, Catalan. Through the manipulation of information structure, we assess how and to what extent the syntactic function (subject vs.object), the information status (focus vs.topic), and the sequential or hierarchic position of the antecedents (first vs.second position) in the main clause guide the interpretation of ambiguous null and overt subject pronouns in the subordinate clause. The results of a two-alternative forced-choice task reveal a different sensitivity of null and overt pronouns to syntactic and pragmatic cues, in line with multifactorial and form-specific approaches, and no overriding factor is identified. Null pronouns appear highly sensitive to both the syntactic function and the information status of their antecedent, preferring both subjects and topics and not showing a specialization when these syntactic and pragmatic features are misaligned. The interpretation of overt pronouns, on the other hand, is mainly guided by the syntactic function and hierarchical position of the antecedent, preferring coreference with objects and second-mentioned, hierarchically lower positions. Different from null pronouns, overt pronouns appear less sensitive to the information status of their antecedent-showing that they can be interpreted as pragmatically 'inert'.
(2025) Rocafiguera Montanyà, Núria de
; Bel, Aurora