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Current role of hepatopancreatoduodenectomy for the management of gallbladder cancer and extrahepatic cholangiocarcinoma:A systematic review

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World Journal of Gastrointestinal Oncology 2021年第6期13卷 625-637页

作者： Alessandro Fancellu Valeria Sanna giulia deiana Chiara Ninniri Davide Turilli Teresa Perra Alberto Porcu Department of Medical Surgical and Experimental SciencesUniversity of SassariSassari 07100Italy Unit of Oncology AOU SassariSassari 07100Italy Unit of Radiology AOU SassariSassari 07100Italy

BACKGROUND Hepatopancreatoduodenectomy(HPD)is the simultaneous combination of hepatic resection,pancreaticoduodenectomy,and resection of the entire extrahepatic biliary *** is not a universally accepted due to high mortality and morbidity rates,as well as to controversial survival *** To evaluate the current role of HPD for curative treatment of gallbladder cancer(GC)or extrahepatic cholangiocarcinoma(ECC)invading both the hepatic hilum and the intrapancreatic common bile *** A systematic literature search using the PubMed,Web of Science,and Scopus databases was performed to identify studies reporting on HPD,using the following keywords:‘Hepatopancreaticoduodenectomy’,‘hepatopancreatoduodenectomy’,‘hepatopancreatectomy’,‘pancreaticoduodenectomy’,‘hepatectomy’,‘hepatic resection’,‘liver resection’,‘Whipple procedure’,‘bile duct cancer’,‘gallbladder cancer’,and‘cholangiocarcinoma’.RESULTS This updated systematic review,focusing on 13 papers published between 2015 and 2020,found that rates of morbidity for HPD have remained high,ranging between 37.0%and 97.4%,while liver failure and pancreatic fistula are the most serious ***,perioperative mortality for HPD has decreased compared to initial experiences,and varies between 0%and 26%,although in selected center it is well below 10%.Long term survival outcomes can be achieved in selected patients with R0 resection,although 5–year survival is better for ECC than *** The present review supports the role of HPD in patients with GC and ECC with horizontal spread involving the hepatic hilum and the intrapancreatic bile duct,provided that it is performed in centers with high experience in hepatobiliarypancreatic *** use of preoperative portal vein embolization,and preoperative biliary drainage in patients with obstructive jaundice,represent strategies for decreasing the occurrence and severity of postoperative *** is advisable to develop internationa

关键词： Hepatopancreatoduodenectomy Extrahepatic cholangiocarcinoma Gallbladder cancer Survival Morbidity Mortality

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Hepatopancreatoduodenectomy for the treatment of extrahepatic cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2023年第4期22卷 430-433页

作者： Alberto Porcu giulia deiana Claudio F Feo Chiara Ninniri Davide Turilli Lorena Tanda Alessandro Fancellu Department of Clinical Surgical and Experimental SciencesUnit of General Surgery 2–Clinica ChirurgicaUniversity of SassariSassariItaly Unit of Radiological Sciences AOU SassariSassariItaly Faculty of Medicine and Surgery University of SassariSassariItaly

To the Editor:Extrahepatic cholangiocarcinoma(ECC)is an uncommon neoplasm associated with a poor prognosis[1-3].Surgical resection represents the only curative approach,since systemic treatments have scarce efficacy in achieving disease ***,only 10%-40%of patients with ECC are resectable at diagnosis[1].Ma-jor hepatectomy and portal lymphadenectomy are usually required for hilar ECC,while pancreatoduodenectomy is the standard operation for distal ECC[3-5].However,ECC may spread horizon-tally along the biliary tree,causing tumor involvement of the entire extrahepatic biliary *** these circumstances,hep-atopancreatoduodenectomy(HPD)has been proposed as a pro-cedure with curative intent[2,6,7].

关键词： pancreatoduodenectomy extrahepatic involvement

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How the COVID-19 pandemic has affected the colorectal cancer screening in Italy:A minireview

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World Journal of Gastrointestinal Oncology 2022年第8期14卷 1490-1498页

作者： Alessandro Fancellu Simone Veneroni Antonio Santoru Arianna Meloni Valeria Sanna Giorgio C Ginesu giulia deiana Panagiotis Paliogiannis Chiara Ninniri Teresa Perra Alberto Porcu Department of Medical Surgicaland Experiemental SciencesUnit of General Surgery 2-Clinica ChirurgicaUniversity of SassariSassari 07100Italy Unit of Oncology AOU SassariSassari 07100Italy Department of Medical Surgicaland Experimental Sciences.Unit of PathologyUniversity of SassariSassari 07100Italy

The coronavirus disease 2019(COVID-19)pandemic has caused detrimental effects on many aspects of healthcare *** programs for the commonest malignancies,namely colorectal cancer(CRC),breast cancer and cervical cancer have been discontinued or interrupted since the beginning of restriction measures aimed to limit transmission of the new coronavirus *** evidence exists in favour of the role of screening campaigns in reducing mortality from *** fact,the majority of pre-malignant lesions of the colon and rectum can be diagnosed with colonoscopy and treated by endoscopic or surgical ***,colonoscopy screening allows the diagnosis of CRCs in their pre-clinical *** was one of the first European countries where a high level of COVID-19 infections and deaths was observed,and one of the first where lockdowns and strict measures were adopted to reduce the risk of COVID-19 diffusion among the population.A systematic review of the literature was performed,including the PubMed,Scopus,Web of Sciences,and Reference Citation Analysis databases,with the aim of critically evaluating the impact of the COVID-19 pandemic on CRC screening in *** found that reduction of CRC screening activity surpassed 50%in most endoscopic units,with almost 600000 fewer CRC screening exams conducted in the first 5 mo of 2020 vs the same period of *** the consequences of the discontinuation of endoscopy screening for the prognosis and mortality of CRC will be evident in the next few years,recent data confirm that CRC is currently treated at a more advanced stage than in the pre-COVID-19 *** delays in CRC prevention and early diagnosis may translate to increased CRC-specific mortality,world healthcare systems should adopt strategies to maintain the regularity of CRC screening during subsequent peaks of the COVID-19 pandemic,or future events that might hamper screening programs.

关键词： COVID-19 Colorectal cancer screening Italy Minireview

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Edmonton Symptom Assessment Scale may reduce medical visits in patients undergoing chemotherapy for breast cancer

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World Journal of Clinical Oncology 2022年第7期13卷 577-586页

作者： Valeria Sanna Palma Fedele giulia deiana Maria G Alicicco Chiara Ninniri Anna N Santoro Antonio Pazzola Alessandro Fancellu Unit of Medical Oncology A.O.U.SassariSassari 07100Italy Unit of Medical Oncology Hospital“D.Camberlingio”Francavilla Fontana 72100BrindisiItaly Department of Medical Surgical and Experimental SciencesUnit of General Surgery 2-Clinica ChirurgicaUniversity of SassariSassari 07100Italy

BACKGROUND Adjuvant chemotherapy is recommended in high-risk breast cancer. However, no universally accepted guidelines exist on pre-chemotherapy assessment. In particular, the number and frequency of medical visits vary according to each institution’s policy. We hypothesised that the Edmonton Symptom Assessment Scale(ESAS) may have a favourable impact on the pre-treatment assessment in candidates for adjuvant *** To investigate whether the ESAS can be used to safely reduce the number of medical visits in women with breast cancer undergoing adjuvant *** In a retrospectively prospective matched-pair analysis, 100 patients who completed the ESAS questionnaire before administration of adjuvant chemotherapy(ESAS Group) were compared with 100 patients who underwent chemotherapy according to the traditional modality, without ESAS(no-ESAS Group). Patients of the ESAS Group received additional visits before treatment if their ESAS score was > 3. The primary endpoint was the total number of medical visits during the entire duration of the chemotherapy period. The secondary endpoints were the occurrence of severe complications(grade 3-4) and the number of unplanned visits during the chemotherapy *** The study variables did not statistically differ between patients of the ESAS Group and no-ESAS Group(age P = 0.880;breast cancer stage P = 0.56;cancer histology P = 0.415;tumour size P = 0.258;lymph node status P = 0.883;immunohistochemical classification P = 0.754;type of surgery P = 0.157), except for premenopausal status(P = 0.015). The study variables did not statistically differ between patients of the ESAS Group and no-ESAS Group regarding age, cancer stage, histology, tumour size, lymph node status, immunohistochemical classification, and type of surgery. Unplanned visits during the entire duration of chemotherapy were 8 in the ESAS Group and 18 in the no-ESAS Group visits(P = 0.035). Grade 3-4 toxicity did not differ between the st

关键词： Edmonton system assessment scale Adjuvant chemotherapy Breast cancer Medical visits Patient-reported outcomes

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A systematic review of progenitor survival and maturation in Parkinsonian models

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Neural Regeneration Research 2025年第11期20卷 3172-3178页

作者： giulia Comini Eilís Dowd Pharmacology&Therapeutics and Galway Neuroscience Center University of GalwayGalwayIreland

Stem cell-based brain repair is a promising emergent therapy for Parkinson's disease based on years of foundational research using human fetal donors as a cell *** current therapeutic options for patients,this approach has the potential to provide longterm stem cell–derived reconstruction and restoration of the dopaminergic input to denervated regions of the brain allowing for restoration of certain functions to *** ultimate clinical success of stem cell–derived brain repair will depend on both the safety and efficacy of the approach and the latter is dependent on the ability of the transplanted cells to survive and differentiate into functional dopaminergic neurons in the Parkinsonian *** the pre-clinical literature suggests that there is considerable variability in survival and differentiation between studies,the aim of this systematic review was to assess these parameters in human stem cell-derived dopaminergic progenitor transplant studies in animal models of Parkinson's disease.A defined systematic search of the PubMed database was completed to identify relevant studies published up to March *** screening,76 articles were included in the analysis from which 178 separate transplant studies were *** these,graft survival could be assessed in 52 studies and differentiation in 129 ***,we found that graft survival ranged from<1% to 500% of cells transplanted,with a median of 51%of transplanted cells surviving in the brain;while dopaminergic differentiation of the cells ranged from 0% to 46% of cells transplanted with a median of 3%.This systematic review suggests that there is considerable scope for improvement in the differentiation of stem cell-derived dopaminergic progenitors to maximize the therapeutic potential of this approach for patients.

关键词： cell replacement therapy differentiation embryonic stem cells graft induced pluripotent stem cells Parkinson's disease survival transplant

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The loaded matrix:neurotrophin-enriched hydrogels for stem cell brain repair in Parkinson's disease

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Neural Regeneration Research 2025年第8期20卷 2315-2316页

作者： giulia Comini Eilis Dowd Pharmacology&Therapeutics University of GalwayGalwayIreland

More than 200 years after Parkinson's disease was first described by the English surgeon whose name would eventually be given to the condition,available treatments remain purely symptomatic,leaving a critical unmet cl... 详细信息

关键词： clinical loaded eventually

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Multifaceted superoxide dismutase 1 expression in amyotrophic lateral sclerosis patients:a rare occurrence?

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Neural Regeneration Research 2025年第1期20卷 130-138页

作者： Ilaria Martinelli Jessica Mandrioli Andrea Ghezzi Elisabetta Zucchi giulia Gianferrari Cecilia Simonini Francesco Cavallieri Franco Valzania Department of Neurosciences Azienda Ospedaliero Universitaria di ModenaModenaItaly Clinical and Experimental Medicine Ph.D.Program University of Modena and Reggio EmiliaModenaItaly Department of Biomedical Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly Neurology Unit Neuromotor&Rehabilitation DepartmentAzienda USL-IRCCS di Reggio EmiliaReggio EmiliaItaly

Amyotrophic lateral sclerosis(ALS)is a neuromuscular condition resulting from the progressive degeneration of motor neurons in the cortex,brainstem,and spinal *** the typical clinical phenotype of ALS involves both upper and lower motor neurons,human and animal studies over the years have highlighted the potential spread to other motor and non-motor regions,expanding the phenotype of *** superoxide dismutase 1(SOD1)mutations represent a minority of ALS cases,the SOD1 gene remains a milestone in ALS research as it represents the first genetic target for personalized *** numerous single case reports or case series exhibiting extramotor symptoms in patients with ALS mutations in SOD1(SOD1-ALS),no studies have comprehensively explored the full spectrum of extramotor neurological manifestations in this *** this narrative review,we analyze and discuss the available literature on extrapyramidal and non-motor features during *** multifaceted expression of SOD1 could deepen our understanding of the pathogenic mechanisms,pointing towards a multidisciplinary approach for affected patients in light of new therapeutic strategies for SOD1-ALS.

关键词： amyotrophic lateral sclerosis(ALS) autonomic extramotor genotype-phenotype multisystem involvement Parkinson’s disease sensory SOD1 superoxide dismutase 1 urinary vocal cord palsy

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Multisensory mechanisms of gait and balance in Parkinson’s disease:an integrative review

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Neural Regeneration Research 2025年第1期20卷 82-92页

作者： Stiven Roytman Rebecca Paalanen giulia Carli Uros Marusic Prabesh Kanel Teus van Laar Nico I.Bohnen Department of Radiology University of MichiganAnn ArborMIUSA Department of Neurology University of MichiganAnn ArborMIUSA Morris K.Udall Center of Excellence for Parkinson’s Disease Research University of MichiganAnn ArborMIUSA Institute for Kinesiology Research Science and Research Centre KoperKoperSlovenia Department of Health Sciences Alma Mater Europaea–ECMMariborSlovenia Parkinson’s Foundation Research Center of Excellence University of MichiganAnn ArborMIUSA Department of Neurology University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands Neurology Service and GRECC VA Ann Arbor Healthcare SystemAnn ArborMIUSA

Understanding the neural underpinning of human gait and balance is one of the most pertinent challenges for 21st-century translational neuroscience due to the profound impact that falls and mobility disturbances have on our aging *** and gait control does not happen automatically,as previously believed,but rather requires continuous involvement of central nervous *** effectively exert control over the body,the brain must integrate multiple streams of sensory information,including visual,vestibular,and somatosensory *** mechanisms which underpin the integration of these multisensory signals are the principal topic of the present *** multisensory integration theories focus on how failure of cognitive processes thought to be involved in multisensory integration leads to falls in older *** emphasis,however,has been placed on specific contributions of individual sensory modalities to multisensory integration processes and cross-modal interactions that occur between the sensory modalities in relation to gait and *** the present work,we review the contributions of somatosensory,visual,and vestibular modalities,along with their multisensory intersections to gait and balance in older adults and patients with Parkinson’s *** also review evidence of vestibular contributions to multisensory temporal binding windows,previously shown to be highly pertinent to fall risk in older ***,we relate multisensory vestibular mechanisms to potential neural substrates,both at the level of neurobiology(concerning positron emission tomography imaging)and at the level of electrophysiology(concerning electroencephalography).We hope that this integrative review,drawing influence across multiple subdisciplines of neuroscience,paves the way for novel research directions and therapeutic neuromodulatory approaches,to improve the lives of older adults and patients with neurodegenerative diseases.

关键词： aging balance encephalography functional magnetic resonance imaging gait multisensory integration Parkinson’s disease positron emission tomography somatosensory vestibular visual

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Multilevel Techniques for the Solution of HJB Minimum-Time Control Problems

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Journal of Systems Science & Complexity 2021年第6期34卷 2069-2091页

作者： CIARAMELLA Gabriele FABRINI giulia Department of Mathematics and Statistics University of KonstanzKonstanz 78464Germany

The solution of minimum-time feedback optimal control problems is generally achieved using the dynamic programming approach,in which the value function must be computed on numerical grids with a very large number of *** numerical strategies,such as value iteration(VI)or policy iteration(PI)methods,become very inefficient if the number of grid points is *** is a strong limitation to their use in real-world *** address this problem,the authors present a novel multilevel framework,where classical VI and PI are embedded in a full-approximation storage(FAS)*** fact,the authors will show that VI and PI have excellent smoothing properties,a fact that makes them very suitable for use in multilevel ***,a new smoother is developed by accelerating VI using Anderson’s extrapolation *** effectiveness of our new scheme is demonstrated by several numerical experiments.

关键词： Anderson acceleration FAS Hamilton-Jacobi equation minimum-time problem multi-level acceleration methods policy iteration value iteration

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Tunable ferroelectricity in oxygen-deficient perovskites with Grenier structure

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npj Computational Materials 2023年第1期9卷 118-125页

作者： Yongjin Shin giulia Galli Pritzker School of Molecular Engineering University of ChicagoChicagoIL 60637USA Department of Chemistry University of ChicagoChicagoIL 60637USA Center for Molecular Engineering and Materials Science Division Argonne National LaboratoryLemontIL 60439USA

Using first-principles calculations,we predict that tunable ferroelectricity can be realized in oxide perovskites with the Grenier structure and ordered oxygen ***,we show that R_(1/3)A_(2/3)FeO_(2.67) solids(where R is a rare-earth ion and A an alkaline-earth cation)exhibit polar phases,with a spontaneous polarization tunable by an appropriate choice of R and *** find that larger cations combined with small R elements lead to a maximum in the polarization and to a minimum in the energy barriers required to switch the sign of the *** arises from cooperative distortions of octahedral and tetrahedral units,where a combination of rotational and sliding modes controls the emergence of polarization within three-dimensional connected *** results indicate that polar Grenier phases of oxide perovskites are promising materials for microelectronic applications and,in general,for the study of phenomena emerging from breaking inversion symmetry in solids.

关键词： polarization ferroelectric structure

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