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Short-term clinical outcomes of laparoscopic vs open rectal excision for rectal cancer: A systematic review and metaanalysis

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World Journal of Gastroenterology 2017年第44期23卷 7906-7916页

作者： Aleix Martínez-Pérez Maria Clotilde Carra francesco brunetti Nicola de'Angelis Department of Digestive Hepatobiliary Surgery and Liver Transplantation Henri Mondor University Hospital AP-HP Université Paris Est - UPEC Department of General and Digestive Surgery Hospital Universitario Doctor Peset Rothschild Hospital AP-HP Université Paris VII

AIM To review evidence on the short-term clinical outcomes of laparoscopic(LRR) vs open rectal resection(ORR) for rectal *** A systematic literature search was performed using Cochrane Central Register, MEDLINE, EMBASE, Scopus, Open Grey and Clinical *** register for randomized clinical trials(RCTs) comparing LRR vs ORR for rectal cancer and reporting short-term clinical outcomes. Articles published in English from January 1, 1995 to June, 30 2016 that met the selection criteria were retrieved and reviewed. The Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) statements checklist for reporting a systematic review was followed. Random-effect models were used to estimate mean differences and risk ratios. The robustness and heterogeneity of the results were explored by performing sensitivity analyses. The pooledeffect was considered significant when P < *** Overall, 14 RCTs were included. No differences were found in postoperative mortality(P = 0.19) and morbidity(P = 0.75) rates. The mean operative time was 36.67 min longer(95%CI: 27.22-46.11, P < 0.00001), the mean estimated blood loss was 88.80 ml lower(95%CI:-117.25 to-60.34, P < 0.00001), and the mean incision length was 11.17 cm smaller(95%CI:-13.88 to-8.47, P < 0.00001) for LRR than ORR. These results were confirmed by sensitivity analyses that focused on the four major RCTs. The mean length of hospital stay was 1.71 d shorter(95%CI:-2.84 to-0.58, P < 0.003) for LRR than ORR. Similarly, bowel recovery(i.e., day of the first bowel movement) was 0.68 d shorter(95%CI:-1.00 to-0.36, P < 0.00001) for LRR. The sensitivity analysis did not confirm a significant difference between LRR and ORR for these latter two parameters. The overall quality of the evidence was rated as high. CONCLUSION LRR is associated with lesser blood loss, smaller incision length, and longer operative times compared to ORR. No differences are observed for postoperative morbidity and mortality.

关键词： Laparoscopic rectal resection Open rectal resection Laparoscopy Rectal cancer Postoperative morbidity Short-term outcomes Systematic review Meta-analysis

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Pharmacogenetics of type 2 diabetes mellitus: An example of success in clinical and translational medicine

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World Journal of Translational Medicine 2014年第3期3卷 141-149页

作者： Antonio brunetti francesco S brunetti Eusebio Chiefari Department of Health Sciences University "Magna Gr?cia" of Catanzaro Department of Medical and Surgical Sciences University ‘‘Magna Gr?cia’’ of Catanzaro

The pharmacological interventions currently available to control type 2 diabetes mellitus(T2DM) show a wide interindividual variability in drug response, emphasizing the importance of a personalized, more effective medical treatment for each individual patient. In this context, a growing interest has emerged in recent years and has focused on pharmacogenetics, a discipline aimed at understanding the variability in patients' drug response, making it possible to predict which drug is best for each patient and at what doses. Recent pharmacological and clinical evidences indicate that genetic polymorphisms(or genetic variations) of certain genes can adversely affect drug response and therapeutic efficacy of oral hypoglycemic agents in patients with T2 DM, through pharmacokinetic- and/or pharmacodynamic-based mechanisms that may reduce the therapeutic effects or increase toxicity. For example, genetic variants in genes encoding enzymes of the cytochrome P-450 superfamily, or proteins of the ATP-sensitive potassium channel on the beta-cell of the pancreas, are responsible for the interindividual variability of drug response to sulfonylureas in patients with T2 DM. Instead, genetic variants in the genes that encode for the organic cation transporters of metformin have been related to changes in both pharmacodynamic and pharmacokinetic responses to metformin in metformin-treated patients. Thus, based on the individual's genotype, the possibility, in these subjects, of a personalized therapy constitutes the main goal of pharmacogenetics, directly leading to the development of the right medicine for the right patient. Undoubtedly, this represents an integral part of the translational medicine network.

关键词： Type 2 diabetes Anti-diabetic drugs Personalized therapy Genetic variants Genome-wide association study

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Comparison between open and laparoscopic reversal of Hartmann’s procedure for diverticulitis

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World Journal of Gastrointestinal Surgery 2013年第8期5卷 245-251页

作者： Nicola de’Angelis francesco brunetti Riccardo Memeo Jose Batista da Costa Anne Sophie Schneck Maria Clotilde Carra Daniel Azoulay Digestive and Transplant Liver Surgery Unit Henri-Mondor HospitalUniversité Paris Est Department of Dentistry Rothschild Hospital

AIM: To compare the open and laparoscopic Hartmann’s reversal in patients first treated for complicated ***: Forty-six consecutive patients with diverticular disease were included in this retrospective,singlecenter study of a prospectively maintained colorectal surgery *** patients underwent conventional Hartmann’s procedures for acute complicated *** indications for Hartmann’s procedures were *** underwent open(OHR) or laparoscopic Hartmann’s reversal(LHR) between 2000 and 2010,and received the same pre-and post-operative protocols of *** variables,length of stay,short-(at 1 mo) and long-term(at 1 and 3 years) postoperative complications,and surgery-related costs were compared between ***: The OHR group consisted of 18 patients(13 males,mean age ± SD,61.4 ± 12.8 years),and the LHR group comprised 28 patients(16 males,mean age 54.9 ± 14.4 years).The mean operative time and the estimated blood loss were higher in the OHR group(235.8 ± 43.6 min vs 171.1 ± 27.4 min;and 301.1 ± 54.6 mL vs 225 ± 38.6 mL respectively,P = 0.001).Bowel function returned in an average of 4.3 ± 1.7 d in the OHR group,and 3 ± 1.3 d in the LHR group(P = 0.01).The length of hospital stay was significantly longer in the OHR group(11.2 ± 5.3 d vs 6.7 ± 1.9 d,P < 0.001).The 1 mo complication rate was 33.3% in the OHR(6 wound infections) and 3.6% in the LHR group(1 hemorrhage)(P = 0.004).At 12 mo,the complication rate remained significantly higher in the OHR group(27.8% vs 10.7%,P = 0.03).The anastomotic leak and mortality rates were *** 3 years,no patient required re-intervention for surgical *** OHR procedure had significantly higher costs(+56%) compared to the LHR procedure,when combining the surgery-related costs and the length of hospital ***: LHR appears to be a safe and feasible procedure that is associated with reduced hospitality stays,complication rates,and costs compared to OH

关键词： Hartmann’s procedure Hartmann’ s reversal Diverticular disease Laparoscopy Healthcare-related costs Colorectal surgery

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Radiomics and artificial intelligence applications in pediatric brain tumors

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World Journal of Pediatrics 2024年第8期20卷 747-763页

作者： francesco Pacchiano Mario Tortora Chiara Doneda Giana Izzo Filippo Arrigoni Lorenzo Ugga Renato Cuocolo Cecilia Parazzini Andrea Righini Arturo brunetti Department of Precision Medicine University of Campania“L.Vanvitelli”CasertaItaly Department of Advanced Biomedical Sciences University of Naples“Federico Ⅱ”Via Pansini 580131NaplesItaly Department of Head and Neck Neuroradiology UnitAORN MoscatiAvellinoItaly Department of Pediatric Radiology and Neuroradiology V.Buzzi Children’s HospitalMilanItaly Department of Medicine Surgery and DentistryUniversity of SalernoBaronissiItaly

Background The study of central nervous system(CNS)tumors is particularly relevant in the pediatric population because of their relatively high frequency in this demographic and the significant impact on disease-and treatment-related morbidity and *** both morphological and non-morphological magnetic resonance imaging techniques can give important information concerning tumor characterization,grading,and patient prognosis,increasing evidence in recent years has highlighted the need for personalized treatment and the development of quantitative imaging parameters that can predict the nature of the lesion and its possible *** this purpose,radiomics and the use of artificial intelligence software,aimed at obtaining valuable data from images beyond mere visual observation,are gaining increasing *** brief review illustrates the current state of the art of this new imaging approach and its contributions to understanding CNS tumors in *** sources We searched the PubMed,Scopus,and Web of Science databases using the following key search terms:(“radiomics”AND/OR“artificial intelligence”)AND(“pediatric AND brain tumors”).Basic and clinical research literature related to the above key research terms,i.e.,studies assessing the key factors,challenges,or problems of using radiomics and artificial intelligence in pediatric brain tumors management,was *** A total of 63 articles were *** included ones were published between 2008 and *** nervous tumors are crucial in pediatrics due to their high frequency and impact on disease and *** serves as the cornerstone of neuroimaging,providing cellular,vascular,and functional information in addition to morphological features for brain *** can provide a quantitative approach to medical imaging analysis,aimed at increasing the information obtainable from the pixels/voxel grey-level values and their ***“radiomic workflow”in

关键词： Machine learning Neuroradiology Pediatric brain tumors Radiomics

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Graphene-Oxide Mediated Chemodivergent Ring-Opening of Cyclobutanols

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Chinese Journal of Chemistry 2023年第11期41卷 1333-1340页

作者： Andrea brunetti Angela Pintus Lorenzo Lombardi Alessandro Kovtun Federico Mascietti francesco Bruno Enrico Ravera Manuela Melucci Giulio Bertuzzi Marco Bandini Dipartimento di Chimica“Giacomo Ciamician” Alma Mater StudiorumUniversitàdi BolognaVia Selmi 240126BolognaItaly Istituto per la Sintesi e la Fotoreattività(ISOF)–CNR Via Gobetti10140129BolognaItaly Magnetic Resonance Center(CERM) University of FlorenceVia L.Sacconi 650019 Sesto FiorentinoItaly Department of Chemistry“Ugo Schiff” University of FlorenceVia della Lastruccia 350019 Sesto FiorentinoItaly Center for Chemical Catalysis–C3 Alma Mater StudiorumUniversitàdi Bolognavia Selmi 240126BolognaItaly

The chemodivergent ring-opening of cyclobutanols is described under the carbocatalytic assistance of graphene oxide(GO).The protocol enables the synthesis of diversely functionalized dienes or indenes(26 examples)based on the amount of GO ***(XPS and ssNMR)as well as experimental investigations revealed a direct involvement of theπ-domains of GO in tuning the stability of carbocationic intermediates during the reaction.

关键词： Carbocatalysis C-C activation Graphene Carbocations Methodology and reactions

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Adopting the margin of stability for space–time landslide prediction–A data-driven approach for generating spatial dynamic thresholds

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Geoscience Frontiers 2024年第5期15卷 75-92页

作者： Stefan Steger Mateo Moreno Alice Crespi Stefano Luigi Gariano Maria Teresa brunetti Massimo Melillo Silvia Peruccacci francesco Marra Lotte de Vugt Thomas Zieher Martin Rutzinger Volkmar Mair Massimiliano Pittore GeoSphere Austria ViennaAustria Center for Climate Change and Transformation Eurac ResearchBolzanoItaly Faculty of Geo-information Science and Earth Observation(ITC) University of TwenteEnschedethe Netherlands Research Institute for Geo-Hydrological Protection National Research Council(CNR-IRPI)PerugiaItaly Department of Geosciences University of PaduaPaduaItaly Institute of Atmospheric Sciences and Climate National Research Council(CNR-ISAC)BolognaItaly Department of Geography University of InnsbruckInnsbruckAustria Department of Natural Hazards Austrian Research Centre for Forests(BFW)InnsbruckAustria Office for Geology and Building Materials Testing Autonomous Province of Bolzano-South TyrolCardanoItaly

Shallow landslide initiation typically results from an interplay of dynamic triggering and preparatory conditions along with static predisposition *** data-driven methods for assessing landslide susceptibility or for establishing rainfall-triggering thresholds are prevalent,integrating spatiotemporal information for dynamic large-area landslide prediction remains a *** main aim of this research is to generate a dynamic spatial landslide initiation model that operates at a daily scale and explicitly counteracts potential errors in the available landslide *** previous studies focusing on space–time landslide modelling,it places a strong emphasis on reducing the propagation of landslide data errors into the modelling results,while ensuring interpretable *** introduces also other noteworthy innovations,such as visualizing the final predictions as dynamic spatial thresholds linked to true positive rates and false alarm rates and by using animations for highlighting its application potential for hindcasting and *** initial step involves the creation of a spatio-temporally representative sample of landslide presence and absence observations for the study area of South Tyrol,Italy(7400 km2)within well-investigated *** setup entails integrating landslide controls that operate on various temporal scales through a binomial Generalized Additive Mixed *** relationships are then interpreted based on variable importance and partial effect plots,while predictive performance is evaluated through various crossvalidation *** and user-defined probability cutpoints are used to establish quantitative thresholds that reflect both,the true positive rate(correctly predicted landslides)and the false positive rate(precipitation periods misclassified as landslide-inducing conditions).The resulting dynamic maps directly visualize landslide threshold *** model demonstrates high predictive performanc

关键词： Early warning Space-time model Rainfall thresholds Landslide susceptibility,Generalized Additive Mixed Model Forecasting

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Expression of matrix metalloproteinase-11 is increased under conditions of insulin resistance

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World Journal of Diabetes 2017年第9期8卷 422-428页

作者： Biagio Arcidiacono Eusebio Chiefari Anna Elisa Laria Sebastiano Messineo francesco Luciano Bilotta Domenico Britti Daniela Patrizia Foti Anna Foryst-Ludwig Ulrich Kintscher Antonio brunetti Department of Health Sciences University"Magna Gr█cia"of Catanzaro Institute of Phar-macology Center for Cardiovascular Research

AIM To investigate matrix metalloproteinase-11(MMP-11) expression in adipose tissue dysfunction, using in vitro and in vivo models of insulin *** Culture of mouse 3T3-L1 preadipocytes were induced to differentiation into mature 3T3-L1 adipocytes. Cellular insulin resistance was induced by treating differentiated cultured adipocytes with hypoxia and/or tumor necrosis factor(TNF)-α, and transcriptional changes were analyzed in each condition thereafter. For the in vivo studies, MMP-11 expression levels were measured in white adipose tissue(WAT) from C57BL/6J mice that underwent low fat diet or high-fat feeding in order to induce obesity and obesity-related insulin resistance. Statistical analysis was carried out with GraphP ad Prism *** MMP-11 m RNA expression levels were significantly higher in insulin resistant 3T3-L1 adipocytes compared to control cells(1.46±0.49vs0.83±0.21, respectively;P<0.00036). The increase in MMP-11 expression was observed even in the presence of TNF-α alone(3.79±1.11vs1±0.17, P<0.01) or hypoxia alone(1.79±0.7vs0.88±0.1, P<0.00023). The results obtained in in vitro experiments were confirmed in the in vivo model of insulin resistance. In particular, MMP-11 m RNA was upregulated in WAT from obese mice compared to lean mice(5.5±2.8vs1.1±0.7, respectively; P<3.72E-08). The increase in MMP-11 levels in obese mice was accompanied by the increase in typical markers of fibrosis, such as collagen type Ⅵ alpha 3(Col6_α3), and fibroblast-specific protein *** Our results indicate that dysregulation of MMP-11 expression is an early process in the adipose tissue dysfunction, which leads to obesity and obesity-related insulin resistance.

关键词： Metalloproteinase-11 Insulin resistance Type 2 diabetes Fibrosis Hypoxia Tumor necrosis factor-α Inflammation

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