Appropriate patient selection is crucial in ensuring acceptable outcomes from orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). The United Network for Organ Sharing (UNOS) has elected to prioritize HCC patients for OLT based on criteria of tumor burden. However, it is unclear whether these criteria correlate with outcome, or with the pathobiological features associated with tumor recurrence. Therefore, we analyzed 109 consecutive patients undergoing OLT for HCC at our center, to determine the utility of present selection criteria in predicting outcome. Pathologic tumor staging of the explanted liver was based on the American Tumor Study Group modified tumor node metastases (pTNM) classification system. Multifocality was defined as >4 tumor nodules on explant. Survival analysis was performed using Kaplan-Meier and Cox proportional hazards regression methods. At a median follow-up of 18.9 months, the overall mortality was 19% with 15 patients (14%) dying of recurrent HCC. Kaplan-Meier 1, 3 and 5-year survival rates were 89.5%, 68%, and 65%, respectively. Recurrence-free rates of 1, 3, and 5 years were 89%, 75%, and 65%, respectively. On univariate analysis, the factors found to be significantly associated with recurrence of HCC were explant features of macrovascular invasion, tumor size (per centimeter increase), pTNM stage (per 1-stage increase), and pre-transplant serum alphafetoprotein (AFP) >300 ng/mL. In defining a threshold level, we found that explant tumor diameter >3 cm, and those tumors classified as at least pT3 on pathological examination, were significantly associated with recurrence (P ‫؍‬ .01 and .03, respectively). Tumor size on explant was found to be strongly correlated with multifocality (P ‫؍‬ .017) and vascular invasion (P ‫؍‬ .02). Patients exceeding pathological UNOS criteria were 3.1 times more likely to have recurrence of HCC (P ‫؍‬ .03). In conclusion, we found that tumor size appears to be a surrogate marker for negative pathobiological predictors of outcome, i.e., vascular invasion and multifocality. Present UNOS selection criteria for HCC based on tumor burden appear to provide adequate discriminatory power in predicting outcome of OLT. (Liver Transpl 2004;10: 911-918.)

2 Background 3Osteoarthritis (OA) is a chronic condition characterised by pain, impaired function and reduced 4 quality of life. A number of risk factors for knee OA have been identified such as obesity, occupation 5 and injury. The association between physical activity or particular sports such as running and knee 6 OA is less clear. Previous reviews, and the evidence which informs them, present contradictory or 7 inconclusive findings. 8 Purpose 9This systematic review aimed to determine the association between running and the development 10 of knee OA. 11 Study Design 12Systematic review and meta-analysis. 13 Method 14Four electronic databases were searched, along with citations in eligible articles and reviews, and 15 the contents of recent journal issues. Two reviewers independently screened the titles and abstracts 16 using pre-specified eligibility criteria. Full-text articles were also independently assessed for 17 eligibility. Eligible studies were those in which running or running-related sports (e.g. triathlon or 18 orienteering) were assessed as a risk factor for the onset or progression of knee OA in adults. 19Relevant outcomes included 1) diagnosis of knee OA, 2) radiographic markers of knee OA, 3) knee 20 joint surgery for OA, 4) knee pain or 5) knee-associated disability. Risk of bias was judged using the 21 Newcastle-Ottowa scale. A random-effects meta-analysis was performed with case-control studies 22 investigating arthroplasty. 23 2 Results 24After de-duplication, the search returned 1322 records. 153 full-text articles were assessed. 25 were 25 eligible, describing 15 studies: 11 cohort (6 retrospective) and 4 case-control studies. Findings of 26 studies with a diagnostic OA outcome were mixed. There were some radiographic differences 27 observed in runners, but only at baseline within some subgroups. Meta-analysis suggested a 28 protective effect of running against surgery due to OA: pooled OR 0.46 (95% CI 0.30, 0.71). The I 2 29 was 0% (95% CI 0%, 73%). Evidence relating to symptomatic outcomes was sparse and inconclusive. 30 Conclusion 31On this evidence, it is not possible to conclude the role of running in knee OA. Moderate to low 32 quality evidence suggests: no association with OA diagnosis, a positive association with OA diagnosis, 33 and a negative association with knee OA surgery. Conflicting results may reflect methodological 34 heterogeneity. More well-designed, prospective evidence is needed to clarify the contradictions. 35

There has been growing interest in the potential of ‘big data’ to enhance our understanding in medicine and public health. Although there is no agreed definition of big data, accepted critical components include greater volume, complexity, coverage and speed of availability. Much of these data are ‘found’ (as opposed to ‘made’), in that they have been collected for non-research purposes, but could include valuable information for research. The aim of this paper is to review the contribution of ‘found’ data to obesity research to date, and describe the benefits and challenges encountered. A narrative review was conducted to identify and collate peer-reviewed research studies. Database searches conducted up to September 2017 found original studies using a variety of data types and sources. These included: retail sales, transport, geospatial, commercial weight management data, social media, and smartphones and wearable technologies. The narrative review highlights the variety of data uses in the literature: describing the built environment, exploring social networks, estimating nutrient purchases or assessing the impact of interventions. The examples demonstrate four significant ways in which ‘found’ data can complement conventional ‘made’ data: firstly, in moving beyond constraints in scope (coverage, size and temporality); secondly, in providing objective, quantitative measures; thirdly, in reaching hard-to-access population groups; and lastly in the potential for evaluating real-world interventions. Alongside these opportunities, ‘found’ data come with distinct challenges, such as: ethical and legal questions around access and ownership; commercial sensitivities; costs; lack of control over data acquisition; validity; representativeness; finding appropriate comparators; and complexities of data processing, management and linkage. Despite widespread recognition of the opportunities, the impact of ‘found’ data on academic obesity research has been limited. The merit of such data lies not in their novelty, but in the benefits they could add over and above, or in combination with, conventionally collected data.

Objectives: This study aimed to assess how menstrual cycle phase and extended menstrual cycle length influence the incidence of injuries in international footballers.Methods: Over a 4-year period, injuries from England international footballers at training camps or matches were recorded, alongside self-reported information on menstrual cycle characteristics at the point of injury. Injuries in eumenorrheic players were categorized into early follicular, late follicular, or luteal phase. Frequencies were also compared between injuries recorded during the typical cycle and those that occurred after the cycle would be expected to have finished. Injury incidence rates (per 1,000 person days) and injury incidence rate ratios were calculated for each phase for all injuries and injuries stratified by type.Results: One hundred fifty-six injuries from 113 players were eligible for analysis. Injury incidence rates per 1,000 person-days were 31.9 in the follicular, 46.8 in the late follicular, and 35.4 in the luteal phase, resulting in injury incidence rate ratios of 1.47 (Late follicular:Follicular), 1.11 (Luteal:Follicular), and 0.76 (Luteal:Late follicular). Injury incident rate ratios showed that muscle and tendon injury rates were 88% greater in the late follicular phase compared to the follicular phase, with muscle rupture/tear/strain/cramps and tendon injuries/ruptures occurring over twice as often during the late follicular phase compared to other phases 20% of injuries were reported as occurring when athletes were “overdue” menses.Conclusion: Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.