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Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery

World Journal of Gastroenterology 2016年第13期22卷 3602-3610页

作者： Francesco Feroci Andrea Vannucchi Paolo Pietro Bianchi Stefano Cantafio Alessia Garzi giampaolo formisano Marco Scatizzi Department of General and Oncological Surgery Santo Stefano Hospital Department of General and Minimally Invasive Surgery Misericordia Hospital

AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer.METHODS: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision(TME) with curative intent between January 2008 and December 2014(robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage?Ⅰ-Ⅲ disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared.RESULTS: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME(L-TME) and 342 min for robotic TME(R-TME)(P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. Thepatients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients(8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group(18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients(1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between groups.CONCLUSION: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies.

关键词： Robotic surgery Laparoscopic surgery Rectal cancer Total mesorectal excision Minimally invasive surg

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A Double Assessment of Privacy Risks Aboard Top‑Selling Cars

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Automotive Innovation 2023年第2期6卷 146-163页

作者： giampaolo Bella Pietro Biondi Giuseppe Tudisco Dipartimento di Matematica e Informatica Universitàdegli Studi di CataniaCataniaItaly Osservatorio Astrofisico di Catania Istituto Nazionale di AstrofisicaCataniaItaly

The advanced and personalised experience that modern cars offer makes them more and more data-hungry.For example,the cabin preferences of the possible drivers must be recorded and associated to some identity,while such data could be exploited to deduce sensitive information about the driver’s health.Therefore,drivers’privacy must be taken seriously,requiring a dedicated risk assessment framework,as presented in this paper through a double assessment combining the asset-oriented ISO approach with the threat-oriented STRIDE approach.The framework is tailored to the level of specific car brand and demonstrated on the ten top-selling brands as well as,due to its innovative character,Tesla.The two approaches yield different,but complementary findings,demonstrating the additional insights gained through their parallel adoption.

关键词： Automotive Cyber physical systems Risk management ISO 27005 STRIDE

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Embedded fuzzing:a review of challenges,tools,and solutions

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Cybersecurity 2022年第4期5卷 1-18页

作者： Max Eisele Marcello Maugeri Rachna Shriwas Christopher Huth giampaolo Bella Safety Security and PrivacyRobert Bosch GmbHRenningenGermany Dept.of Math and Computer Science Universita degli Studi di CataniaCataniaItaly RBEl Robert Bosch GmbHBangaloreIndia.

Fuzzing has become one of the best-established methods to uncover software bugs.Meanwhile,the market of embedded systems,which binds the software execution tightly to the very hardware architecture,has grown at a steady pace,and that pace is anticipated to become yet more sustained in the near future.Embedded systems also beneft from fuzzing,but the innumerable existing architectures and hardware peripherals complicate the development of general and usable approaches,hence a plethora of tools have recently appeared.Here comes a stringent need for a systematic review in the area of fuzzing approaches for embedded systems,which we term'embedded fuzzing"for brevity.The inclusion criteria chosen in this article are semi-objective in their coverage of the most relevant publication venues as well as of our personal judgement.The review rests on a formal definition we develop to represent the realm of embedded fuzzing.It continues by discussing the approaches that satisfy the inclusion criteria,then defines the relevant elements of comparison and groups the approaches according to how the execution environment is served to the system under test.The resulting review produces a table with 42 entries,which in turn supports discussion suggesting vast room for future research due to the limitations noted.

关键词： Embedded systems Dynamic analysis Vulnerability mining Embedded security Software security

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The “mitochondrial stress responses”: the “Dr. Jekyll and Mr. Hyde” of neuronal disorders

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Neural Regeneration Research 2022年第12期17卷 2563-2575页

作者： Simone Patergnani giampaolo Morciano Marianna Carinci Sara Leo Paolo Pinton Alessandro Rimessi Department of Medical Sciences Section of Experimental MedicineLaboratory for Technologies of Advanced TherapiesUniversity of FerraraFerraraItaly Center of Research for Innovative Therapies in Cystic Fibrosis University of FerraraFerraraItaly

Neuronal disorders are associated with a profound loss of mitochondrial functions caused by various stress conditions,such as oxidative and metabolic stress,protein folding or import defects,and mitochondrial DNA alteration.Cells engage in different coordinated responses to safeguard mitochondrial homeostasis.In this review,we will explore the contribution of mitochondrial stress responses that are activated by the organelle to perceive these dangerous conditions,keep them under control and rescue the physiological condition of nervous cells.In the sections to come,particular attention will be dedicated to analyzing how compensatory mitochondrial hyperfusion,mitophagy,mitochondrial unfolding protein response,and apoptosis impact human neuronal diseases.Finally,we will discuss the relevance of the new concept:the“mito-inflammation”,a mitochondria-mediated inflammatory response that is recently found to cover a relevant role in the pathogenesis of diverse inflammatory-related diseases,including neuronal disorders.

关键词： Alzheimer’s disease apoptosis mitochondrial dynamics mito-inflammation mitophagy multiple sclerosis neurodegeneration Parkinson’s disease UPRmt

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Morbidity and psychological impact of prostate biopsy： the future calls for a change

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Asian Journal of Andrology 2014年第3期16卷 415-417页

作者： Andrea Minervini Gianni Vittori giampaolo Siena Marco Carini Department of Urology University of FlorenceCareggi Hospital Florence Italy.

Currently transrectal ultrasound-guided prostate biopsy （TRUS-Bx） is one of the most common urological procedures, with more than 1 million performed per year in Europe and the United States. Among patients undergoing TRUS-Bx, approximately one-third will receive a diagnosis of prostate cancer （PCa）, while two-thirds receive a negative result on initial biopsy. Negative biopsy patients maintain an estimated risk of repeated biopsy of 12% at I year and 38% at 5 years. 2 Standard TRUS-Bx is likely to systematically miss significant tumors, particularly in the anterior and apical parts of the gland.3 A crucial aim of urologists in the next decade is to increase the accuracy of the procedure and avoid the use of inappropriate biopsies.

关键词： Morbidity psychological impact prostate biopsy

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Management of single pulmonary metastases from colorectal cancer:State of the art

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World Journal of Gastrointestinal Oncology 2022年第4期14卷 820-832页

作者： Marco Chiappetta Lisa Salvatore Maria Teresa Congedo Maria Bensi Viola De Luca Leonardo PetraccaCiavarella Floriana Camarda Jessica Evangelista Vincenzo Valentini giampaolo Tortora StefanoMargaritora Filippo Lococo Department of Thoracic Surgery Fondazione Policlinico Universitario Agostino Gemelli IRCCS-UniversitàCattolica del Sacro CuoreRome 00168Italy Oncologia Medica Comprehensive Cancer Center Fondazione Policlinico Universitario Agostino Gemelli IRCCS-UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Radiation Therapy Fondazione Policlinico Universitario Agostino Gemelli IRCCS-UniversitàCattolica del Sacro CuoreRome 00168Italy

Colorectal cancer(CRC)is one of the most common causes of death from cancer.Lung seeding occurs in approximately 10%of patients surgically treated for primary CRC with radical intent:the lung is the most common site of metastases after the liver.While surgical treatment of liver metastases is widely accepted to affect long-term outcomes,more controversial and not standardized is the therapy for CRC patients developing lung metastases.Experience suggests the potential curative role of pulmonary metastasectomy,especially in oligometastatic disease.However,the optimal strategy of care and the definition of prognostic factors after treatment still need to be defined.This review focused on the uncommon scenario of single pulmonary metastases from CRC.We explored pertinent literature and provide an overview of the epidemiology,clinical characteristics and imaging of single pulmonary metastases from CRC.Additionally,we identified the best available evidence for overall management.In particular,we analyzed the role and results of locoregional approaches(surgery,radiotherapy or ablative procedures)and their integration with systemic therapy.

关键词： Colorectal cancer Pulmonary metastases Oligometastases Chemotherapy Surgery Radiotherapy

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B cell development is critically dependent on NFATc1 activity

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Cellular & Molecular Immunology 2019年第5期16卷 508-520页

作者： Sabrina giampaolo Gabriela Wojcik Stefan Klein-Hessling Edgar Serfling Amiya K.Patra Department of Molecular Pathology Institute of PathologyUniversity of WürzburgJosef Schneider-Str.297080 WürzburgGermany Institute of Translational and Stratified Medicine Faculty of Medicine and DentistryUniversity of PlymouthPlymouth PL68BUUK Comprehensive Cancer Center Mainfranken University of WürzburgJosef Schneider-Str.697080 WürzburgGermany

B cell development in bone marrow is a precisely regulated complex process.Through successive stages of differentiation,which are regulated by a multitude of signaling pathways and an array of lineage-specific transcription factors,the common lymphoid progenitors ultimately give rise to mature B cells.Similar to early thymocyte development in the thymus,early B cell development in bone marrow is critically dependent on IL-7 signaling.During this IL-7-dependent stage of differentiation,several transcription factors,such as E2A,EBF1,and Pax5,among others,play indispensable roles in B lineage specification and maintenance.Although recent studies have implicated several other transcription factors in B cell development,the role of NFATc1 in early B cell developmental stages is not known.Here,using multiple gene-manipulated mouse models and applying various experimental methods,we show that NFATc1 activity is vital for early B cell differentiation.Lack of NFATc1 activity in pro-B cells suppresses EBF1 expression,impairs immunoglobulin gene rearrangement,and thereby preBCR formation,resulting in defective B cell development.Overall,deficiency in NFATc1 activity arrested the pro-B cell transition to the pre-B cell stage,leading to severe B cell lymphopenia.Our findings suggest that,along with other transcription factors,NFATc1 is a critical component of the signaling mechanism that facilitates early B cell differentiation.

关键词： Differentiation EBF1 NFATc1 Pro-B Pre-B

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Occult and obscure gastrointestinal bleeding:Causes and diagnostic approach in 2009

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World Journal of Gastrointestinal Endoscopy 2009年第1期1卷 3-6页

作者： giampaolo Bresci UO Gastroenterrologia AOUPisanaPisa 56125Italy

Gastrointestinal bleeding can be obscure or occult(OGIB),the causes and diagnostic approach will be discussed in this editorial.The evaluation of OGIB consists on a judicious search of the cause of bleeding,which should be guided by the clinical history and physical findings.The standard approach to patients with OGIB is to directly evaluate the gastrointestinal tract by endoscopy,abdominal computed tomography,angiography,radionuclide scanning,capsule endoscopy.The source of OGIB can be identified in 85%-90%,no bleeding sites will be found in about 5%-10% of cases.Even if the bleedings originating from the small bowel are not frequent in clinical practice(7.6% of all digestive haemorrhages,in our casuistry),they are notoriously difficult to diagnose.In spite of progress,however,a number of OGIB still remain problematic to deal with at present in the clinical context due to both the difficulty in exactly identifying the site and nature of the underlying source and the difficulty in applying affective and durable diagnostic approaches so no single technique has emerged as the most efficient way to evaluate OGIB.

关键词： Occult gastrointestinal bleeding Obscure gastrointestinal bleeding Bleeding Gastrointestinal endoscopy

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Environmental benefits for a geothermal power plant with CO_(2) reinjection:case study of the Kizildere 3 U1 geothermal power plant

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Energy Storage and Saving 2023年第4期2卷 631-638页

作者： María Dolores Mainar-Toledo Ural Halaçoglu Hakan Alp Sahiller Tugrul Hazar Claudio Zuffi Maryori Díaz-Ramírez giampaolo Manfrida Research Centre for Energy Resources and Consumption(CIRCE) Zaragoza50018Spain CIRCE Institute University of ZaragozaZaragoza50009Spain Zorlu Enerji Istanbul34394Türkiye Department of Industrial Engineering University of FlorenceFirenze50134Italy

Geothermal power plants(GPP)with high non condensable gases(NCG)content geothermal fluid have shown to be environmental impacting relating to their energy production,which could be critical if no corrective actions are achieved.The GPP of Kizildere 3 U1,located in Türkiye(Denizli),in where the geothermal fluid contains high percentage of CO_(2),99%of the NCG fraction,which represents the 3%of the geothermal fluid mass,is taken as a relevant case study to implement a new innovation consisting of NCG reinjection to reduce the amount of NCGs released to the atmosphere.In order to calculate the present environmental impacts which the plant is causing(baseline);and the potential reduction of environmental impacts which can be achieved with the innovation(reinjection),a life cycle assessment(LCA)calculation were developed.Primary data were collected for all the relevant stages of the energy conversion cycle and complemented where necessary with secondary data from other geothermal power plants studies.The main results of the baseline environmental assessment show that the construction phase is the most impacting phase due to the materials used in the power plant building construction,electrical generation equipment and distributed machinery and infrastructures;the effects in the operation phase are dominated by the geothermal fluid composition.In this sense,the application of CO_(2) reinjection at the Turkish site into the reservoir will prevent the emission of 1,700 tons⋅year􀀀1 in the pilot site and 10%of the total emissions released along the life span of the GPP.

关键词： Life cycle assessment Geothermal energy Non-condensable gases Reinjection CO_(2)emissions avoided

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Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging

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Hepatobiliary & Pancreatic Diseases International 2008年第2期7卷 192-195页

作者： Lucia Calculli Raffaele Pezzilli Marta Fiscaletti Riccardo Casadei Carla Brindisi giampaolo Gavelli Departments of Radiology Digestive Diseases and Internal Medicineand General SurgerySant'Orsola-Malpighi Hospital Bologna Italy

BACKGROUND:Magnetic resonance cholangiopancreato-graphy (MRCP) is useful to assess exocrine pancreatic function by combining rapid imaging acquisition with the administration of secretin, a gastrointestinal hormone that stimulates the secretion of bile and pancreatic juice. However, extensive data on this method are lacking. This study aimed to determine whether MRCP with secretin administration is able to simultaneously detect alterations of both the pancreatic ducts and exocrine pancreatic function. METHODS:All subjects older than 18 years who underwent magnetic resonance imaging (MRI) and cholangio-Wirsung magnetic resonance imaging (CWMRI) for suspicion of benign or malignant pancreatic diseases from January 2006 to December 2006 were enrolled in the study. MRI and CWMRI were carried out using a dedicated apparatus. RESULTS:Eighty-seven patients (46 males, 41 females, mean age 59.7±14.6, range 27-87 years) were enrolled. Of the 87 patients, 39 had a normal pancreas on imaging, 20 had an intrapapillary mucinous tumor (IPMT), and the rest had chronic pancreatitis (7), serous cystadenoma (6), a previous attack of acute biliary pancreatitis (5), congenital ductal abnormalities (5), mucinous cystadenoma (3), previous pancreatic head resection for autoimmune pancreatitis (1), or cholangiocarcinoma (1). Morphologically, we found two pseudocysts (one of the 7 patients with chronic pancreatitis, and one of the 5 patients after an attack of acute pancreatitis;the latter pseudocyst communicated with the main pancreatic duct). Calcifications were found in 3 of the 7 patients with chronic pancreatitis. All patients with IPMT and mucinous cystadenoma and 3 patients with serous cystadenoma were histologically confirmed. The remaining patients were followed up adequately to confirm the diagnosis by imaging. According to the Matos criteria, 73 patients (83.9%) were of grade 3, 8 grade 2, 4 grade 1, and 2 grade 0. The only pancreatic diseases which impaired the exocrine pancreatic secretion stimulated by secretin were chronic

关键词： chronic pancreatitis magnetic resonance cholangiopancreatography pancreatic neoplasms pancreatic insufficiency

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