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Development of a warning score for early detection of colorectal anastomotic leakage:Hype or hope?

World Journal of Gastrointestinal Surgery 2022年第11期14卷 1297-1309页

作者： Nuno J G Rama Óscar Lourenço Patrícia C Motta Lima Maria Pedro S Guarino diana parente Ricardo Castro Ana Bento Anabela Rocha Fernando Castro-Poças João Pimentel Division of Colorectal Surgical Leiria Hospital CentreLeiria 2410-021Portugal Abel Salazar Biomedical Institute University of OportoOporto 4099-002Portugal Center for Innovative Care and Health Technology(ciTechCare) Polytechnic of LeiriaLeiria 2410-541Portugal Faculty of Economics CeBERUniversity of CoimbraCoimbra 3000-137Portugal Division of Clinical Pathology Leiria Hospital CentreLeiria 2410-541Portugal Division of Surgical Oporto Hospital CentreOporto 4099-001Portugal Department of Gastroenterology Santo António HospitalPorto Hospital CenterOporto 4099-001Portugal Institute of Biomedical Sciences Abel Salazar University of OPortoOporto 4099-001Portugal Faculty of Medicine University of CoimbraCoimbra 3004-531Portugal Division of Surgical Montes Claros HospitalCoimbra 3030-320Portugal

BACKGROUND Colorectal anastomotic leakage(CAL),a severe postoperative complication,is associated with high morbidity,hospital readmission,and overall healthcare *** detection of CAL remains a challenge in clinical ***,some decision models have been developed to increase the diagnostic accuracy of this *** To develop a score based on easily accessible variables to detect CAL *** Based on the least absolute shrinkage and selection operator method,a predictive classification system was developed[Early ColoRectAL Leakage(E-CRALL)score]from a prospective observational,single center cohort,carried out in a colorectal division from a non-academic *** score performance and CAL threshold from postoperative day(POD)3 to POD5 were *** on a precise analytical decision model,the standard clinical practice was compared with the E-CRALL adoption on POD3,POD4,or POD5.A cost-minimization analysis was conducted,on the assumption that all alternatives delivered similar health-related *** In this study,396 patients who underwent colorectal resection surgery with anastomosis,and 6.3%(n=25)developed *** of the patients who developed CAL(n=23;92%)were diagnosed during the first hospital admission,with a median time of diagnosis of 9.0±6.8 *** POD3 to POD5,the area under the receiver operating characteristic curve of the E-CRALL score was 0.82,0.84,and 0.95,*** POD5,if a threshold of 8.29 was chosen,87.4%of anastomotic failures were identified with E-CRALL ***,score usage could anticipate CAL diagnosis in an average of 5.2 d and 4.1 d,if used on POD3 and POD5,*** of score adoption,episode comprehensive costs were markedly greater(up to four times)in patients who developed CAL in comparison with patients who did not develop ***,the use of the E-CRALL warning score was associated with cost savings of€421442.20,with most(92.9%)of the savings from patients

关键词： Anastomotic leakage Colorectal Surgery Biomarkers Score Costs

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Usefulness of serum C-reactive protein and calprotectin for the early detection of colorectal anastomotic leakage:A prospective observational study

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World Journal of Gastroenterology 2022年第24期28卷 2758-2774页

作者： Nuno J G Rama Marlene C C Lages Maria Pedro S Guarino Óscar Lourenço Patrícia C Motta Lima diana parente Cândida S G Silva Ricardo Castro Ana Bento Anabela Rocha Fernando Castro-Pocas João Pimente Colorectal Surgical Division Leiria Hospital CentreLeiria 2410-021Portugal Abel Salazar Biomedical Institute(ICBAS) University of OportoOporto 4099-002Portugal Center for Innovative Care and Health Technology(ciTechCare) Polytechnic of LeiriaLeiria 2410-541Portugal Faculty of Economics CeBERUniversity of CoimbraCoimbra 3000-137Portugal Clinical Pathology Division Leiria Hospital CentreLeiria 2410-541Portugal Surgical Division Oporto Hospital CentreOporto 4099-001Portugal Department of Gastroenterology Santo António HospitalPorto Hospital CenterPorto 4099-001Portugal Institute of Biomedical Sciences Abel Salazar University of PortoPorto 4099-001Portugal Faculty of Medicine University of CoimbraCoimbra 3004-531Portugal Surgical Division Montes Claros HospitalCoimbra 3030-320Portugal

BACKGROUND Colorectal anastomotic leakage(CAL)is one of the most dreaded complications after colorectal surgery,with an incidence that can be as high as 27%.This event is associated with increased morbidity and mortality;therefore,its early diagnosis is crucial to reduce clinical consequences and *** biomarkers have been suggested as laboratory tools for the diagnosis of *** To assess the usefulness of plasma C-reactive protein(CRP)and calprotectin(CLP)as early predictors of *** A prospective monocentric observational study was conducted including patients who underwent colorectal resection with anastomosis,from March 2017 to August *** were divided into three groups:G1–no complications;G2–complications not related to CAL;and G3–*** biomarkers were measured and analyzed in the first 5 postoperative days(PODs),namely white blood cell(WBC)count,eosinophil cell count(ECC),CRP,CLP,and procalcitonin(PCT).Clinical criteria,such as abdominal pain and clinical condition,were also *** correlation between biomarkers and CAL was *** operating characteristic(ROC)curve analysis was used to compare the accuracy of these biomarkers as predictors of CAL,and the area under the ROC curve(AUROC),specificity,sensitivity,positive predictive value,and negative predictive value(NPV)during this period were *** In total,25 of 396 patients developed CAL(6.3%),and the mean time for this diagnosis was 9.0±6.8 *** operative characteristics,such as surgical approach,blood loss,intraoperative complications,and duration of the procedure,were notably related to the development of *** length of hospital stay was markedly higher in the group that developed CAL compared with the group with complications other than CAL and the group with no complications(median of 21 d vs 13 d and 7 d respectively;P<0.001).For abdominal pain,the best predictive performance was on POD4 and POD5,with the largest AUROC of 0.84 on ***

关键词： Anastomotic leakage Colorectal Surgery Biomarkers C-reactive protein Calprotectin

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Routine utilization of machine perfusion in liver transplantation:Ready for prime time?

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World Journal of Gastroenterology 2024年第11期30卷 1488-1493页

作者： Alessandro parente Keyue Sun Philipp Dutkowski AM James Shapiro Andrea Schlegel Department of Surgery Division of TransplantationUniversity of Alberta HospitalEdmonton T6G 2B7Canada Immunity and Inflammation Lerner Research InstituteClevelandOH 44195United States Swiss Hepato-Pancreato-Biliary Center Department of Visceral and Transplantation SurgeryUniversity Hospital ZurichZurich 8091Switzerland Immunity and Inflammation Digestive Disease and Surgery InstituteClevelandOH 44195United States

The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver *** evidence from numerous randomized controlled trials has been pooled by meta-analyses,providing the highest available evidence on the protective effect of machine perfusion(MP)over static cold storage in liver transplantation(LT).Based on a protective effect with less complications and improved graft survival,the field has seen a paradigm shift in organ *** editorial focuses on the role of MP in LT and how it could become the new“gold standard”.Strong collaborative efforts are needed to explore its effects on long-term outcomes.

关键词： Liver transplantation Machine perfusion Viability assessment Hypothermic oxygenated perfusion Normothermic machine perfusion

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Nrf2 and Her3 co-expression in cholangiocarcinoma:Possible biological pathways for potential therapeutic approach

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 317-321页

作者： Paola parente Valentina Angerilli Giuseppe Zamboni Angelo Sparaneo Fabiola Fiordelisi Leonarda Di Candia Matteo Fassan Paolo Graziano Pathology Unit Fondazione IRCCS Casa Sollievo della Sofferenza71013San Giovanni Rotondo(Foggia)Italy Department of Medicine(DIMED) Surgical Pathology UnitUniversity of Padua35128Padua(Padua)Italy Pathology Unit IRCCS Ospedale Sacro Cuore Don Calabria37024Negrar(Verona)Italy Laboratory of Oncology Fondazione IRCCS Casa Sollievo della Sofferenza71013San Giovanni Rotondo(Foggia)Italy Veneto Institute of Oncology IOV-IRCCS 35124Padua(Padua)Italy

To the Editor:Cholangiocarcinomas(CCAs)are heterogeneous group of malignancies,encompassing intrahepatic CCA(iCCA),and extrahepatic CCA(eCCA);they are also classified into common hepatic duct cholangiocarcinoma(CHDCCA),choledocus extrapancreatic cholangiocarcinoma(EPCCA)and choledocus intrapancreatic cholangiocarcinoma(IPCCA)and,finally,gallbladder carcinoma(GBCCA).CCAs are relatively uncommon but.

关键词： carcinoma gallbladder Nrf2

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Prophylactic drains in totally laparoscopic distal gastrectomy:are they always necessary?

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World Journal of Gastroenterology 2022年第3期28卷 399-401页

作者： Tommaso Maria Manzia Alessandro parente Roberta Angelico HPB and Transplant Unit Department of Surgery ScienceUniversity of Rome Tor VergataRome 00133Italy Queen Elizabeth Hospital Liver UnitUniversity of BirminghamBirmingham UK and HPB and Transplant UnitDepartment of Surgery ScienceUniversity of Rome Tor VergataRome 00133Italy

Prophylactic drains have always been a useful tool to detect early complications and prevent postoperative fluid collections,particularly in gastrointestinal ***,the utilization of such drains has been debated,due to mounting evidence that they could be harmful rather than *** on recent published articles,Liu et al reported that the routine use of prophylactic drains in total laparoscopic distal gastrectomy might not be necessary for all ***,we express our opinion regarding this interesting publication.

关键词： Gastric cancer Prophylactic drainage Totally laparoscopic gastrectomy Enhanced recovery after surgery Minimally invasive surgery Early gastric cancer

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Assessment of advanced age candidates for liver transplantation warrants more caution

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World Journal of Transplantation 2022年第2期12卷 24-26页

作者： Alessandro parente Vincenzo Ronca Liver Unit Queen Elizabeth Hospital University Hospital Birmingham NHS Foundation TrustBirmingham B152THUnited Kingdom Centre for Liver and Gastrointestinal Research Institute of Immunology and Immunotherapy University of BirminghamBirmingham B152TTUnited Kingdom

For patients with fulminant liver failure and end-stage liver disease,liver transplantation remains the only effective *** the years,as a result of the ageing population,the average age of liver transplant donors and recipients has increased and currently about one quarter of patients receiving transplantation in the United States are above the age of ***,a study reported that patients aged 65 years or older had lower one-year survival compared to a younger ***,we express our opinion about this interesting publication.

关键词： Liver transplantation Elderly patients Age in liver transplantation Frailty Transplant assessment Liver transplant outcomes

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Comparison of fusion methods based on DST and DBN in human activity recognition

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控制理论与应用（英文版） 2011年第1期9卷 18-27页

作者： Andrei TOLSTIKOV Jit BISWAS Chris NUGENT Guido parente Institute for Infocomm Research Networking Protocols Department1 Fusionopolis Way#21-01Singapore 138632 School of Computing and Mathematics University of UlsterShore RoadNewtownabbeyBT37 0QBU.K.

Ambient assistive living environments require sophisticated information fusion and reasoning techniques to accurately identify activities of a person under care. In this paper, we explain, compare and discuss the application of two powerful fusion methods, namely dynamic Bayesian networks (DBN) and Dempster-Shafer theory (DST), for human activity recognition. Both methods are described, the implementation of activity recognition based on these methods is explained, and model acquisition and composition are suggested. We also provide functional comparison of both methods as well as performance comparison based on the publicly available activity dataset. Our findings show that in performance and applicability, both DST and DBN are very similar; however, significant differences exist in the ways the models are obtained. DST being top-down and knowledge-based, differs significantly in qualitative terms, when compared with DBN, which is data-driven. These qualitative differences between DST and DBN should therefore dictate the selection of the appropriate model to use, given a particular activity recognition application.

关键词： Dynamic Bayesian networks Dempster-Shafer theory Healthcare monitoring Ambient assisted living Activity recognition

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Prediction of ground-borne vibration induced by impact pile driving:numerical approach and experimental validation

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Earthquake Engineering and Engineering Vibration 2023年第4期22卷 921-935页

作者： A.Colaço P.Alves Costa C.Ferreira C.parente J.Fernandez-Ruiz CONSTRUCT-FEUP University of PortoRua Dr.Roberto Frias4200-465 PortoPortugal University of La Coruña Department of Civil EngineeringCampus de Elviña 15071La CoruñaSpain

Deep foundations are currently used in engineering practice to solve problems caused by weak geotechnical characteristics of the *** pile driving is an interesting and viable solution from economic and technical points of ***,it is necessary to ensure that the environmental drawbacks,namely ground-borne vibration,are adequately *** this purpose,the authors propose an axisymmetric finite element method-perfectly matched layer(FEM-PML)approach,where the nonlinear behavior of the soil is addressed through an equivalent linear *** the complexity of the problem,an experimental test site was developed and fully *** experimental work comprised in-situ and laboratory soil characterization,as well as the measurement of vibrations induced during pile *** comparison between experimental and numerical results demonstrated a very good agreement,from which it can be concluded that the proposed numerical approach is suitable for the prediction of vibrations induced by impact pile *** experimental database is available as supplemental data and may be used by other researchers in the validation of their prediction models.

关键词： pile driving ground-borne vibrations numerical modeling experimental validation

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Left abdominal mass with carcinosis:Unusual presentation of pancreatic acinar cell carcinoma

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Hepatobiliary & Pancreatic Diseases International 2023年第4期22卷 412-414页

作者： Davide Ciardiello Filomena Urbano Giuseppe Zamboni Nicola Palladino Francesca Bazzocchi Paola parente Oncology Unit Fondazione IRCCS Ospedale Casa Sollievo della SofferenzaViale CappucciniSan Giovanni Rotondo 71013Italy Radiology Unit Fondazione IRCCS Ospedale Casa Sollievo della SofferenzaViale CappucciniSan Giovanni Rotondo 71013Italy Pathology Unit Ospedale Sacro Cuore Don Calabriavai SempreboniNegrar and University of VeronaNegrar 37024VRItaly Abdominal Surgical Unit Fondazione IRCCS Ospedale Casa Sollievo della SofferenzaViale CappucciniSan Giovanni Rotondo 71013Italy Pathology Unit Fondazione IRCCS Ospedale Casa Sollievo della SofferenzaViale CappucciniSan Giovanni Rotondo 71013Italy

Acinar cell carcinoma(ACC)is a rare malignant epithelial neoplasm accounting for 1%-2%of all pancreatic exocrine neoplasm,affecting more frequently man with an age between 50 and 70 *** patients present with nonspecific symptoms,which may give rise to difficulties in clinical diagnosis[1].ACC can manifest with diarrhea,weight loss,abdominal pain and,in up to 10%-15%,with lipase hypersecretion syndrome,characterized by elevated lipase production,diffuse subcutaneous fat necrosis and polyarthralgia[1,2].Biliary obstruction and jaundice are infre-quent clinical manifestations,unlike ductal adenocarcinoma,due to pushing rather than infiltrating growth of ACC.

关键词： abdominal clinical elevated

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Mismatch repair proteins and microsatellite instability in solid pseudopapillary neoplasm of the pancreas

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Hepatobiliary & Pancreatic Diseases International 2019年第5期18卷 491-492页

作者： Claudia Covelli Paola parente Francesco Pepe Pasquale Pisapia Fabiola Fiordelisi Umberto Malapelle UOC di Anatomia Patologica Fondazione Casa Sollievo della SofferenzaViale Cappuccini 171013 San Giovanni RotondoFGItaly Department of Public Health University of Naples Federico ⅡVia Pansini 580131 NapoliItaly

Solid pseudopapillary neoplasms (SPNs) are rare solid pancreatic tumors mainly affecting young women. Despite the high percentage of favorable prognosis, they are considered as low grade malignant neoplasms, and metastases occur in 5%-15% of patients. Almost all SPNs (95%) have somatic activating mutations in the β-catenin gene [1].

关键词： Solid pseudopapillary neoplasms (SPNs) Mismatch repair proteins microsatellite instability

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