The aim of this study was to evaluate whether hepatic resections of ovarian cancer liver metastases provide a benefit in terms of survival as part of primary, secondary, tertiary, and even quaternary cytoreductive surgery. Data of patients submitted to surgery for ovarian cancer liver metastases at Fundeni Clinical Institute between January 2002 and April 2014 were retrospectively reviewed. Liver lesions were classified according to their origin in parenchymal and peritoneal lesions. A total of 31 patients were identified: 11 of them underwent liver resection as part of primary cytoreduction, 15 at secondary cytoreduction, 3 at tertiary cytoreduction, and 2 at the time of quaternary cytoreduction. The survival of patients with primary cytoreduction including liver resection was significantly higher compared with that of patients with secondary cytoreductive surgery including liver resection (15.63 versus 6.63 months, log-rank p = 0.057, 90 % CI). The median survival of patients with hepatectomy for liver metastases from peritoneal seeding was higher than that of patients with hepatectomy for liver metastases from hematogenous origin (16.08 versus 12.66 months, log-rank p = 0.523). Hepatectomy in ovarian cancer liver metastases is a safe and effective procedure; however, a benefit in terms of survival in favor of peritoneal seeding has been systematically observed.

Blockchain is an emerging technology that has shaken the financial sector, and which is already perceived as having an impact. A blockchain is a network of many interconnected nodes, both trustworthy and malicious, which can reach a consensus and generate valid data. The resulting information is packed into a block and permanently saved on the network in a tamper-proof way. In this paper, we propose an adaptation of blockchain for securely storing data in a vehicular-based network. Our approach can work for storing data such as traffic events and user reputation. The proposed solution has two interconnected components: the Intelligent Transportation System (ITS) blockchain and the reputation system. The paper presents synthetic tests which validate the use cases of the solution: users reporting speeds and alerts behind which we see a fair reputation system penalising the (wrong/false) users.

With the rate at which smartphones are currently evolving, more and more of human life will be contained in these devices. At a time when data privacy is extremely important, it is crucial to protect one’s mobile device. In this paper, we propose a new non-intrusive gait recognition based mechanism that can enhance the security of smartphones by rapidly identifying users with a high degree of confidence and securing sensitive data in case of an attack, with a focus on a potential architecture for such an algorithm for the Android environment. The motion sensors on an Android device are used to create a statistical model of a user’s gait, which is later used for identification. Through experimental testing, we prove the capability of our proposed solution by correctly classifying individuals with an accuracy upwards of 90% when tested on data recorded during multiple activities. The experiments, conducted on a low sampling rate and at short time intervals, show the benefits of our solution and highlight the feasibility of an efficient gait recognition mechanism on modern smartphones.

Background and Objectives: Skin cancer is one of the most frequently diagnosed malignancies. The main goal of the therapeutic management is total excision with the prevention of recurrence and metastasis. The quality of life of the patients with skin cancer is affected by the morbidity risk, surgery, and cosmetic or functional aspects. The aim of this study was to evaluate the quality of life of patients with skin cancer prior to and post surgical intervention. Material and methods: We performed a prospective study on 247 patients with skin tumors. Quality of life was evaluated through an initial questionnaire that was given to all consenting patients. This was used to determine patients’ mobility, selfcare, normal activities, pain, and despair, using a five-point Likert scale. The general autoperceived health state was also recorded using a 100-point scale. The study included the responses of all patients at hospital admission, after one month of surgery, and after one year of surgery. Results: In patients with squamous cell carcinoma (SCC), the general health state indicator statistically significantly decreased one month after surgery and increased at one-year follow-up. In malignant melanoma (MM) patients, mobility, selfcare, normal activities, and discomfort presented a decrease in values one year after surgery, compared to the values registered at hospital admission. In patients with basal cell carcinoma (BCC), all indicators of quality of life presented an impaired value one year after surgery, after a decreasing trend. The general health state indicator statistically significantly increased one month after surgery and after one year. Conclusions: Surgery is one of the main steps in treating skin cancer. It has a great impact on patients’ quality of life because of pain andthe effect on mobility and normal activities. Skin cancers influence the quality of life of patients both psychologicallyand physically.

Background and Objectives: Although many of the neuroendocrine neoplasms (NEN) have a typically prolonged natural history compared with other gastrointestinal tract cancers, at least 40% of patients develop liver metastases. This study aims to identify whether liver resection improves the overall survival of patients with liver metastases from NEN. Materials and Methods: We conducted a retrospective study at “Fundeni” Clinical Institute over a time period of 15 years; we thereby identified a series of 93 patients treated for NEN with liver metastases, which we further divided into 2 groups as follows: A (45 patients) had been subjected to liver resection complemented by systemic therapies, and B (48 patients) underwent systemic therapy alone. To reduce the patient selection bias we performed at first a propensity score matching. This was followed by a bootstrapping selection with Jackknife error correction, with the purpose of getting a statistically illustrative sample. Results: The overall survival of the matched virtual cohort under study was 41 months (95% CI 37–45). Group A virtual matched patients showed a higher survival rate (52 mo., 95% CI: 45–59) than B (31 mo., 95% CI: 27–35), (p < 0.001, Log-Rank test). Upon multivariate analysis, seven independent factors were identified to have an influence on survival: location (midgut) and primary tumor grading (G3), absence of concomitant LM, number (2–4), location (unilobar), grading (G3) of LM, and 25–50% hepatic involvement at the time of the metastatic disease diagnosis. Conclusions: Hepatic resection is nowadays the main treatment providing potential cure and prolonged survival, for patients with NEN when integrated in a multimodal strategy based on systemic therapy.

Central pancreatectomy is a pancreas-sparing alternative to standard pancreatic resections in selected cases. Although associated with high morbidity, the risk factors for surgical complications of this procedure are not yet defined. The clinicopathological and perioperative data of 24 patients who underwent central pancreatectomies (2002-2010) were correlated with surgical complications. The overall morbidity rate was 54% (pancreatic fistula, 40%). In a univariate analysis, age over 40 years, body mass index ≥30kg/m2, smoking and American Society of Anesthesiologists III scores were significantly correlated with increased morbidity. In a multivariate analysis, a significant correlation with the development of complications was found for body mass index ≥30kg/m2 and age over 40 years. Certain patient-related factors (older age, obesity and smoking) appear to have a negative impact on early postoperative outcome after central pancreatectomy. For patients with these factors, an alternative distal pancreatectomy should be considered. Central pancreatectomy should be tailored not only to the pathology but also to the patient profile.