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Conversion of laparoscopic colorectal resection for cancer: What is the impact on short-term outcomes and survival?

World Journal of Gastroenterology 2016年第37期22卷 8304-8313页

作者： Marco E Allaix Edgar JB Furnée Massimiliano Mistrangelo alberto arezzo Mario Morino Department of Surgical Sciences University of Torino

Laparoscopic resection for colon and rectal cancer is associated with quicker return of bowel function, reduced postoperative morbidity rates and shorter length of hospital stay compared to open surgery, with no differences in long-term survival. Conversion to open surgery is reported in up to 30% of patients enrolled in randomized control trials comparing open and laparoscopic colorectal resection for cancer. In this review, reasons for conversion are anatomical-related factors, disease-related-factors and surgeon-related factors. Body mass index, local tumour extension and co-morbidities are independent predictors of conversion. The current evidence has shown that patients with converted resection for colon cancer have similar outcomes compared to patients undergoing a laparoscopic completed or open resection. The few studies that have assessed the outcomes after conversion of laparoscopic rectal resection reported significantly higher rates of complications and longer length of hospital stay in converted patients compared to laparoscopically treated patients. No definitive conclusions can be drawn when converted and open rectal resections are compared. Early and pre-emptive conversion appears to have more favourable outcomes than reactive conversion; however, further large studies are needed to better define the optimal timing of conversion. With regard to long-term oncologic outcome, overall and disease-free survival in the case of conversion in laparoscopic colorectal cancer surgery seems to be worse than those achieved in patients in whom resection was successfully completed by laparoscopy. Although a worse long-term oncologic outcome has been suggested, it remains difficult to draw a proper conclusion due to the heterogeneity of the long-term outcomes as well as the inclusion of both colon and rectal cancer patients in most of the studies. Therefore, we discuss the currently available evidence of the impact of conversion in laparoscopic resection for colon and rectal cancer on both short-term outcomes and

关键词： Conversion Laparoscopy Open surgery Colon cancer Rectal cancer Morbidity Mortality Predictors Recurrence Survival

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Indications and outcomes of endoscopic resection for nonpedunculated colorectal lesions:A narrative review

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World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 275-295页

作者： Endrit Shahini Diogo Libanio Giacomo Lo Secco Antonio Pisani alberto arezzo Department of Gastroenterology and Digestive Endoscopy Unit National Institute of Research“Saverio De Bellis”Castellana Grotte(Bari)70013Italy Department of Gastroenterology Portuguese Oncology InstitutePorto 4200-072Portugal Department of Surgical Sciences University of TorinoTurin 10126Italy

In the last years,endoscopic techniques gained a crucial role in the treatment of colorectal flat lesions.At the same time,the importance of a reliable assessment of such lesions to predict the malignancy and the depth of invasion of the colonic wall emerged.The current unsolved dilemma about the endoscopic excision techniques concerns the necessity of a reliable submucosal invasive cancer assessment system that can stratify the risk of the post-procedural need for surgery.Accordingly,this narrative literature review aims to compare the available diagnostic strategies in predicting malignancy and to give a guide about the best techniques to employ.We performed a literature search using electronic databases(MEDLINE/PubMed,EMBASE,and Cochrane Library).We collected all articles about endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)registering the outcomes.Moreover,we analyzed all meta-analyses comparing EMR vs ESD outcomes for colorectal sessile or nonpolypoid lesions of any size,preoperatively estimated as non-invasive.Seven meta-analysis studies,mainly Eastern,were included in the analysis comparing 124 studies and overall 22954 patients who underwent EMR and ESD procedures.Of these,eighty-two were retrospective,twenty-four perspective,nine casecontrol,and six cohorts,while three were randomized clinical trials.A total of 18118 EMR and 10379 ESD were completed for a whole of 28497 colorectal sessile or non-polypoid lesions>5-10 mm in size.In conclusion,it is crucial to enhance the preoperative diagnostic workup,especially in deciding the most suitable endoscopic method for radical resection of flat colorectal lesions at risk of underlying malignancy.Additionally,the ESD necessitates further improvement because of the excessively time-consuming as well as the intraprocedural technical hindrances and related complications.We found a higher rate of en bloc resections and R0 for ESD than EMR for non-pedunculated colorectal lesions.Nevertheless,despite the lower local recurrence rates,ESD had

关键词： Colorectal cancer Adenoma detection High-resolution colonoscopy Chromoendoscopy Pit pattern Dysplasia

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Over-the-scope clips in the treatment of gastrointestinal tract iatrogenic perforation: A multicenter retrospective study and a classification of gastrointestinal tract perforations

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World Journal of Gastrointestinal Surgery 2016年第4期8卷 315-320页

作者： Benedetto Mangiavillano Angelo Caruso Raffaele Manta Roberto Di Mitri alberto arezzo Nico Pagano Giuseppe Galloro Filippo Mocciaro Massimiliano Mutignani Carmelo Luigiano Enrico Antonucci Rita Conigliaro Enzo Masci Gastroenterology and Gastrointestinal Endoscopy Borea Hospital Gastroenterology and Gastroin-testinal Endoscopy Sant’Agostino Estense Gastrointestinal Endoscopy Operative Endoscopy Unit Niguarda-Ca Granda Hospital Gastroenterology and Endo-scopy Unit ARNAS Civico Hospital Department of Surgical Sciences University of Torino Unit of Gastroenterology S.Orsola-Malpighi Univer-sity Hospital Department of Clinical Medicine and Surgery Special Unit of Surgical Digestive Endoscopy University of Naples Federico Ⅱ - School of Medicine Gastrointestinal Endoscopy San Paolo Univer-sitary Hospital Division of Surgical and Gastrointetsinal Products Euromedical s.r.l Gastroenterology and Gastrointestinal Endoscopy National Tumori Institute

AIM: To determine the outcome of the management of iatrogenic gastrointestinal tract perforations treated by over-the-scope clip(OTSC) placement.METHODS: We retrospectively enrolled 20 patients(13 female and 7 male; mean age: 70.6 ± 9.8 years) in eight high-volume tertiary referral centers with upper or lower iatrogenic gastrointestinal tract perforation treated by OTSC placement. Gastrointestinal tract perforation could be with oval-shape or with round-shape. Ovalshape perforations were closed by OTSC only by suction and the round-shape by the "twin-grasper" plus suction. RESULTS: Main perforation diameter was 10.1 ± 4.3 mm(range 3-18 mm). The technical success rate was 100%(20/20 patients) and the clinical success rate was 90%(18/20 patients). Two patients(10%) who did not have complete sealing of the defect underwent surgery. Based upon our observations we propose two types of perforation: Round-shape "type-1 perforation" and oval-shape "type-2 perforation". Eight(40%) out of the 20 patients had a type-1 perforation and 12 patients a type-2(60%). CONCLUSION: OTSC placement should be attempted after perforation occurring during diagnostic or therapeutic endoscopy. A failed closure attempt does not impair subsequent surgical treatment.

关键词： Over-the-scope clip OVESCO Perforation Gastrointestinal tract

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Extracorporeal shockwave lithotripsy in the management of urinary stones: New concepts and techniques to improve outcomes

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Asian Journal of Urology 2024年第2期11卷 143-148页

作者： Pilar Bahilo-Mateu alberto Budia-Alba Lithotripsy and Endourology Unit La Fe University and Polytechnic HospitalValenciaSpain Lithotripsy and Endourology Unit Urology DepartmentLa Fe University and Polytechnic HospitalValenciaSpain

Objective: Extracorporeal shockwave lithotripsy (SWL) currently plays an important role in the treatment of urinary tract lithiasis. The purpose of this article was to describe new concepts and procedural strategies that would improve results using SWL as a treatment for urolithiasis, thereby achieving better clinical practice.Methods: A systematic review process was carried in PubMed/PMC from January 2003 to March 2023. A narrative synthesis of the most important aspects has been made.Results: The important recommendations for the adequate selection of the candidate patient for treatment with SWL are summarized, as well as the new strategies for a better application of the technique. Aspects about intraoperative position, stone localization and monitoring, analgesic control, machine and energy settings, and measures aiming at reduced risk of complications are described.Conclusion: To achieve the therapeutic goal of efficient stone disintegration without increasing the risk of complications, it is necessary to make an adequate selection of patients and to pay special attention to several important factors in the application of treatment. Technological development in later generation devices will help to improve current SWL results.

关键词： Lithotripsy Extracorporeal shockwave Stone disease Treatment Urinary stone

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An Optimization Model for Reliability Improvement and Cost Reduction Through EV Smart Charging

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Journal of Modern Power Systems and Clean Energy 2024年第2期12卷 608-620页

作者： Jinping Zhao Ali Arefi alberto Borghetti Gerard Ledwich School of Engineering and Energy Murdoch UniversityPerthAustralia Department of Electrical Electronicand Information EngineeringUniversity of BolognaBologna40126Italy School of Electrical Engineering and Robotics Queensland University of TechnologyBrisbaneQLD 4000Australia

There is a general concern that the increasing penetration of electric vehicles(EVs)will result in higher aging failure probability of equipment and reduced network reliability.The electricity costs may also increase,due to the exacerbation of peak load led by uncontrolled EV charging.This paper proposes a linear optimization model for the assessment of the benefits of EV smart charging on both network reliability improvement and electricity cost reduction.The objective of the proposed model is the cost minimization,including the loss of load,repair costs due to aging failures,and EV charging expenses.The proposed model incorporates a piecewise linear model representation for the failure probability distributions and utilizes a machine learning approach to represent the EV charging load.Considering two different test systems(a 5-bus network and the IEEE 33-bus network),this paper compares aging failure probabilities,service unavailability,expected energy not supplied,and total costs in various scenarios with and without the implementation of EV smart charging.

关键词： Aging failure electric vehicle(EV) EV charging power system reliability expected energy not supplied distribution network.

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Distributed Energy and Reserve Scheduling in Local Energy Communities Using L-BFGS Optimization

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CSEE Journal of Power and Energy Systems 2024年第3期10卷 942-952页

作者： Mohammad Dolatabadi Alireza Zakariazadeh alberto Borghetti Pierluigi Siano Department of Management&Innovation Systems University of SalernoSalernoItaly Department of Electrical Electronicand Information EngineeringUniversity of BolognaBolognaItaly University of Science and Technology of Mazandaran BehshahrIran Department of Power Systems National University of Science and Technology POLITEHNICA BucharestBucharestRomania IEEE

Encouraging citizens to invest in small-scale renewable resources is crucial for transitioning towards a sustainable and clean energy system.Local energy communities(LECs)are expected to play a vital role in this context.However,energy scheduling in LECs presents various challenges,including the preservation of customer privacy,adherence to distribution network constraints,and the management of computational burdens.This paper introduces a novel approach for energy scheduling in renewable-based LECs using a decentralized optimization method.The proposed approach uses the Limitedmemory Broyden–Fletcher–Goldfarb–Shanno(L-BFGS)method,significantly reducing the computational effort required for solving the mixed integer programming(MIP)problem.It incorporates network constraints,evaluates energy losses,and enables community participants to provide ancillary services like a regulation reserve to the grid utility.To assess its robustness and efficiency,the proposed approach is tested on an 84-bus radial distribution network.Results indicate that the proposed distributed approach not only matches the accuracy of the corresponding centralized model but also exhibits scalability and preserves participant privacy.

关键词： Distributed optimization flexibility services L-BFGS method local energy community renewables reserve

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Identification and functional characterization of fish IL‑17 receptors suggest important roles in the response to nodavirus infection

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Marine Life Science & Technology 2024年第2期6卷 252-265页

作者： Carmen González‑Fernández Miguel A.García‑Álvarez alberto Cuesta Department of Cell Biology and Histology Faculty of BiologyUniversity of Murcia30100 MurciaSpain Laboratoire d’écotoxicologie Centre de Lyon-VilleurbanneINRAEUR RiverLy69625 VilleurbanneFrance

Th17 is a lymphocyte T helper(Th)subpopulation relevant in the control and regulation of the immune response characterized by the production of interleukin(IL)-17.This crucial cytokine family acts through their binding to the IL-17 receptors(IL-17R),having up to six members.Although the biology of fish Th17 is well-recognized,the molecular and functional characterization of IL-17 and IL-17R has been limited.Thus,our aim was to identify and characterize the IL-17R repertory and regulation in the two main Mediterranean cultured fish species,the gilthead seabream(Sparus aurata)and the European sea bass(Dicentrarchus labrax).Our in silico results showed the clear identification of six members in each fish species,from IL-17RA to IL-17RE-like,with well-conserved gene structure and protein domains with their human orthologues.All of them showed wide and constitutive transcription in naïve tissues but with highest levels in mucosal tissues,namely skin,gill or intestine.In leucocytes,T mitogens showed the strongest up-regulation in most of the il17 receptors though il17ra resulted in inhibition by most stimulants.Interestingly,in vivo nodavirus infection resulted in alterations on the transcription of il17 receptors.While nodavirus infection led to some increments in the il17ra,il17rb,il17rc and il17rd transcripts in the susceptible European sea bass,many down-regulations were observed in the resistant gilthead seabream.Our data identify the presence and conservation of six coding IL-17R in gilthead seabream and European sea bass as well as their differential regulation in vitro and upon nodavirus infection.

关键词： Th17 cells IL-17 receptors Immunity Teleost fish Nodavirus(NNV) Aquaculture

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Intelligent speed adaptation for visibility technology affects drivers’speed selection along curves with sight limitations

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Journal of Traffic and Transportation Engineering(English Edition) 2024年第1期11卷 16-27页

作者： Abrar Hazoor alberto Terrafino Leandro L.Di Stasi Marco Bassani Department of Environment Landand Infrastructure EngineeringPolitecnico di TorinoTorino 10129Italy Road Traffic Division Nord UniversityStjørdal 7502Norway Mind Brainand Behavior Research Centre(CIMCYC)University of GranadaGranada 18071Spain

Sight obstructions along road curves can lead to a crash if the driver is not able to stop the vehicle in time.This is a particular issue along curves with limited available sight,where speed management is necessary to avoid unsafe situations(e.g.,driving off the road or invading the other traffic lane).To solve this issue,we proposed a novel intelligent speed adaptation(ISA)system for visibility,called V-ISA(intelligent speed adaptation for visibility).It estimates the real-time safe speed limits based on the prevailing sight conditions.V-ISA comes with three variants with specific feedback modalities(1)visual and(2)auditory information,and(3)direct intervention to assume control over the vehicle speed.Here,we investigated the efficiency of each of the three V-ISA variants on driving speed choice and lateral behavioural response along road curves with limited and unsafe available sight distances,using a driving simulator.We also considered curve road geometry(curve direction:rightward vs.leftward).Sixty active drivers were recruited for the study.While half of them(experimental group)tested the three V-ISA variants(and a V-ISA off condition),the other half always drove with the V-ISA off(validation group).We used a linear mixed-effect model to evaluate the influence of V-ISA on driver behaviour.All V-ISA variants were efficient at reducing speeds at entrance points,with no discernible negative impact on driver lateral behaviour.On rightward curves,the V-ISA intervening variant appeared to be the most effective at adapting to sight limitations.Results of the current study implies that V-ISA might assist drivers to adjust their operating speed as per prevailing sight conditions and,consequently,establishes safer driving conditions.

关键词： Sight distance Intelligent speed adaptation Driver behaviour Road safety Driving simulation Advanced driver assistance systems

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Molecular and cellular mechanisms of neuroprotection by oligopeptides from snake venoms

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BIOCELL 2024年第6期48卷 897-904页

作者： CARLOS alberto-SILVA BRENDA RUFINO DA SILVA Natural and Humanities Sciences Center Experimental Morphophysiology LaboratoryFederal University of ABC(UFABC)São Bernardo do CampoSão PauloBrazil

Venom snake-derived peptides have multiple biochemical,pharmacological,and toxicological proﬁles,allowing for the discovery of new medicinal products and therapeutic applications.This review speciﬁcally examines the fundamental elements of neuroprotection offered by different oligopeptides derived from snake venom.It also includes a brief evaluation of short peptides that are being considered as potential therapeutic agents.Proline-rich peptides and tryptophyllin family peptides isolated from the crude venom of Viperidae family snakes,speciﬁcally Bothrops atrox,Bothrops jararaca,and Bothrops moojeni,have been shown to have pro-survival properties,the ability to reduce oxidative stress,and the ability to promote cell viability and mitochondrial functions.Three signiﬁcant mechanisms are related to the neuroprotection mediated by snake venom oligopeptides:(1)Activation of the L-arginine metabolite pathway,such as polyamines from ornithine metabolism,which reduces N-methyl-D-aspartate(NMDA)-type glutamate receptor activity;(2)Enhancement of cell viability by activating the nerve growth factor-signaling pathway;and(3)Activation of the Muscarinic acetylcholine receptor subtype M1(mAChR-M1).These small peptides show promise as neuroprotective agents against a variety of neurodegenerative disorders.

关键词： Neuroprotective peptides Neurodegenerative disease Oxidative stress Reactive oxygen species Biopeptides

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Digital twin-and extended reality-based telepresence for collaborative robot programming in the 6G perspective

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Digital Communications and Networks 2024年第2期10卷 315-327页

作者： Davide Calandra F.Gabriele Pratticò alberto Cannavò Claudio Casetti Fabrizio Lamberti Politecnico di Torino Department of Control and Computer EngineeringCorso Duca Degli Abruzzi2410129TurinItaly

In the context of Industry 4.0,a paradigm shift from traditional industrial manipulators to Collaborative Robots(CRs)is ongoing,with the latter serving ever more closely humans as auxiliary tools in many production processes.In this scenario,continuous technological advancements offer new opportunities for further innovating robotics and other areas of next-generation industry.For example,6G could play a prominent role due to its human-centric view of the industrial domains.In particular,its expected dependability features will pave the way for new applications exploiting highly effective Digital Twin(DT)-and eXtended Reality(XR)-based telepresence.In this work,a novel application for the above technologies allowing two distant users to collaborate in the programming of a CR is proposed.The approach encompasses demanding data flows(e.g.,point cloud-based streaming of collaborating users and robotic environment),with network latency and bandwidth constraints.Results obtained by analyzing this approach from the viewpoint of network requirements in a setup designed to emulate 6G connectivity indicate that the expected performance of forthcoming mobile networks will make it fully feasible in principle.

关键词： 6G Digital twin Telepresence Collaborative robots Industry 4.0 Augmented reality Virtual reality Point cloud streaming

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