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Exploring the landscape of minimally invasive pancreatic surgery: Progress, challenges, and future directions

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World Journal of Gastrointestinal Surgery 2024年第10期16卷 3094-3103页

作者： greta Donisi Alessandro Zerbi Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20090MilanItaly Department of Pancreatic Surgery IRCCS Humanitas Research HospitalRozzano 20089MilanItaly

Minimally invasive surgery(MI)has become the standard of care for many surgical procedures aimed at reducing the burden on ***,its adoption in pancreatic surgery(PS)has been limited by the pancreas’s unique location and the complexity of the dissection and reconstruction *** factors continue to contribute to PS having one of the highest morbidity and mortality rates in general *** a rough start,MIPS has gained widespread acceptance in clinical practice *** evidence supports MI distal pancreatectomy safety,even in oncological cases,indicating its potential superiority over open ***,definitive evidence of MI pancre-aticoduodenectomy(MIPD)feasibility and safety,particularly for malignant lesions,is still ***,reports from high-volume centers are emer-ging,suggesting outcomes comparable to those of the open *** robotic PS increasing adoption,facilitated by the wider availability of robotic platforms,may further facilitate the transition to MIPD by overcoming the technical con-straints associated with laparoscopy and accelerating the learning ***-ough the MIPS implementation process cannot be stopped in this evolving world,ensuring patient safety through strict outcome monitoring is *** in younger surgeons with structured and recognized training programs can promote safe expansion.

关键词： Minimally invasive surgery Minimally invasive pancreatic surgery Pancreatic surgery Robotic Laparoscopic Pancreaticoduodenectomy Distal pancrea-tectomy

Effects of positive end-expiratory pressure on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in acute brain injury:Friend or foe?A scoping review

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Journal of Intensive Medicine 2024年第2期4卷 247-260页

作者： greta Zunino Denise Battaglini Daniel Agustin Godoy IRCCS Ospedale Policlinico San Martino GenovaItaly Dipartimento di Scienze Diagnostiche e Chirurgiche Integrate Universitàdegli Studi di GenovaGenovaItaly Neurointensive Care Unit Sanatorio PasteurCatamarcaArgentina

Background Patients with acute brain injury(ABI)are a peculiar population because ABI does not only affect the brain but also other organs such as the lungs,as theorized in brain–lung crosstalk *** patients often require mechanical ventilation(MV)to avoid the complications of impaired respiratory function that can follow ABI;MV should be settled with meticulousness owing to its effects on the intracranial compartment,especially regarding positive end-expiratory pressure(PEEP).This scoping review aimed to(1)describe the physiological basis and mechanisms related to the effects of PEEP in ABI;(2)examine how clinical research is conducted on this topic;(3)identify methods for setting PEEP in ABI;and(4)investigate the impact of the application of PEEP in ABI on the *** The five-stage paradigm devised by Peters et *** expanded by Arksey and O'Malley,Levac et al.,and the Joanna Briggs Institute was used for *** also adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)extension *** criteria:we compiled all scientific data from peer-reviewed journals and studies that discussed the application of PEEP and its impact on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in adult patients with *** criteria:studies that only examined a pediatric patient group(those under the age of 18),experiments conducted solely on animals;studies without intracranial pressure and/or cerebral perfusion pressure determinations,and studies with incomplete *** authors searched and screened for inclusion in papers published up to July 2023 using the PubMed-indexed online *** were presented in narrative and tubular *** The initial search yielded 330 references on the application of PEEP in ABI,of which 36 met our inclusion *** has recognized beneficial effects on gas exchange,but it produces hemodynamic changes that should be predicted to avoi

关键词： Acute brain injury Mechanical ventilation Positive end-expiratory pressure Intracranial pressure Brain-lung crosstalk Multimodal monitoring

Utilizing engineered extracellular vesicles as delivery vectors in the management of ischemic stroke:a special outlook on mitochondrial delivery

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Neural Regeneration Research 2025年第8期20卷 2181-2198页

作者： Jiali Chen Yiyang Li Xingping Quan Jinfen Chen Yan Han Li Yang Manfei Zhou greta Seng Peng Mok Ruibing Wang Yonghua Zhao Institute of Chinese Medical Sciences State Key Laboratory of Quality Research in Chinese MedicineUniversity of MacaoTaipaMacao Special Administrative RegionChina Department of Pharmacy Hunan Provincial People’s Hospitalthe First Affiliated Hospital of Hunan Normal UniversityChangshaHunan ProvinceChina Department of Electrical and Computer Engineering University of MacaoTaipaMacao Special Administrative RegionChina Department of Pharmaceutical Sciences Faculty of Health SciencesUniversity of MacaoTaipaMacao Special Administrative RegionChina

Ischemic stroke is a secondary cause of mortality worldwide,imposing considerable medical and economic burdens on *** vesicles,serving as natural nanocarriers for drug delivery,exhibit excellent biocompatibility in vivo and have significant advantages in the management of ischemic ***,the uncertain distribution and rapid clearance of extracellular vesicles impede their delivery *** utilizing membrane decoration or by encapsulating therapeutic cargo within extracellular vesicles,their delivery efficacy may be greatly ***,previous studies have indicated that microvesicles,a subset of large-sized extracellular vesicles,can transport mitochondria to neighboring cells,thereby aiding in the restoration of mitochondrial function post-ischemic *** extracellular vesicles have also demonstrated the capability to transfer mitochondrial components,such as proteins or deoxyribonucleic acid,or their sub-components,for extracellular vesicle-based ischemic stroke *** this review,we undertake a comparative analysis of the isolation techniques employed for extracellular vesicles and present an overview of the current dominant extracellular vesicle modification *** the complex facets of treating ischemic stroke,we also delineate various extracellular vesicle modification approaches which are suited to different facets of the treatment ***,given the burgeoning interest in mitochondrial delivery,we delved into the feasibility and existing research findings on the transportation of mitochondrial fractions or intact mitochondria through small extracellular vesicles and microvesicles to offer a fresh perspective on ischemic stroke therapy.

关键词： delivery engineering extracellular vesicles identification ischemic stroke isolation mitochondria targeting strategy therapeutic effects

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为什么我们常常会受环境的影响?

求学 2024年第6期 73-74页

作者：姚姚伞greta

在上晚自习时，只要周围有几个同学在说话，你就会被他们影响，甚至影响你整晚的学习状态。又有一次，你计划好今天一定要完成数学作业，但隔壁邻居的装修声影响了你。你开始苦恼、生气和反思，为什么“我”就是不能忽略噪音，静下心来...

在上晚自习时，只要周围有几个同学在说话，你就会被他们影响，甚至影响你整晚的学习状态。又有一次，你计划好今天一定要完成数学作业，但隔壁邻居的装修声影响了你。你开始苦恼、生气和反思，为什么“我”就是不能忽略噪音，静下心来学习呢？以上这些情景时常发生在我们的生活中，因此有同学会产生疑问，为什么我们那么容易受环境的影响呢？笔者一查，发现还真有心理学家对此做了研究，还给出了相应的对策。我们一起来看看吧！

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IR780/Gemcitabine-conjugated metal-phenolic network enhanced photodynamic cancer therapy

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Chinese Chemical Letters 2024年第1期35卷 305-309页

作者： Songtao Zhou Hao Tian Jie Yan Zhan Zhang Guohao Wang Xinying Yu Wei Sang Bei Li greta S.P.Mok Jie Song Yunlu Dai Cancer Center and Institute of Translational Medicine Faculty of Health SciencesUniversity of MacaoMacao 999078China MoE Frontiers Science Center for Precision Oncology University of MacaoMacao 999078China Institute of Basic Medicine and Cancer(IBMC) Chinese Academy of SciencesThe Cancer Hospital of the University of Chinese Academy of SciencesHangzhou 310022China Biomedical Imaging Laboratory(BIG) Department of Electrical and Computer EngineeringFaculty of Science and TechnologyUniversity of MacaoMacao 999078China

Photodynamic therapy (PDT) is a clinically approved cancer treatment that uses energy of light to generate active substances that cause damage to the cancer. Photosensitizers are employed to absorb light and generate toxic reactive oxygen species (ROS) to damage biomolecules like DNA. At the same time, some chemotherapy drugs like nucleotide analogues can provide mechanism-guided promotion in the treatment efficacy of PDT. However, the photosensitizer and chemotherapy drugs used in PDT is usually organic molecules, which suffers from bad solubility, fast clearance, and acute toxicity. To achieve targeted treatment, a reasonable delivery system is necessary. Therefore, we reported a metal-phenolic network where IR780 and gemcitabine were coupled chemically to overcome these shortcomings. The enhanced PDT effects can be realized by the promoted cell death both in vitro and in vivo. Moreover, the synergistic therapy also induced T-cell mediated anti-tumor immune response, which was significant for the inhibition of distant tumor growth. This work expanded the biomedical application of metal-phenolic materials and contribute to the wider application of photodynamic cancer therapy.

关键词： Metal phenolic network IR780 Photodynamic therapy Breast cancer Gemcitabine

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The Political-economy Key Factor in Human Resources Management

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The Political-economy Key Factor in Human Resources Manageme...

作者： greta Pesce 上海交通大学

学位级别：硕士

As China opened the door to foreign investments,numerous opportunities appear for Italian companies in ***,for many enterprises,has also to face some threats,especially when dealing with human resources *** a consequence,our research is investigating this field,but contrary to mainstream international business approaches,that tend to advance ethnocentrism and concentrate on Western power-holders,we put power and politics at the centre of our *** as theoretical framework the EPG model by Perlmutter,through an empiric study we prove that a mix of ethnocentric and polycentric approach is fundamental for Italian International Ventures in Shanghai because: 1)Important features of the post-economic reforms transformation have evolved through a process of institution building,socially constructed from the bottom up by economic actors working within structures of international business.2)Despite the structure of domination on the asymmetric transnational site,knowledge,learning and institution building processes depend on the interaction between Italian companies and local *** aim of this research is to develop a conceptual framework that improves our understanding about how ventures between Chinese enterprises and Italian multinational companies（MNCs）are institutionally constructed within the wider context of the post-economic reforms.

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Borderline resectable pancreatic cancer:Certainties and controversies

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World Journal of Gastrointestinal Surgery 2021年第6期13卷 516-528页

作者： Gennaro Nappo greta Donisi Alessandro Zerbi Pancreatic Surgery Unit Humanitas Clinical and Research Center-IRCCSRozzano 20089Italy

Borderline resectable(BR)pancreatic ductal adenocarcinoma(PDAC)is currently a well-recognized entity,characterized by some specific anatomic,biological and conditional features:It includes patients with a stage of disease intermediate between the resectable and the locally advanced *** term BR identifies a tumour with an aggressive biological behaviour,on which a neoadjuvant approach instead of an upfront surgery one should be preferred,in order to obtain a radical resection(R0)and to avoid an early recurrence after *** if during the last decades several studies on this topic have been published,some aspects of BR-PDAC still represent a matter of *** aim of this review is to critically analyse the available literature on this topic,particularly focusing on:The problem of the heterogeneity of definition of BR-PDAC adopted,leading to a misinterpretation of published data;its current management(neoadjuvant vs upfront surgery);which neoadjuvant regimen should be preferably adopted;the problem of radiological restaging and the determination of resectability after neoadjuvant therapy;the post-operative outcomes after surgery;and the role and efficacy of adjuvant treatment for resected patients that already underwent neoadjuvant therapy.

关键词： Borderline resectable pancreatic cancer Pancreatic cancer Neoadjuvant treatment Chemotherapy Radiotherapy Pancreatic tumour

Benthic diatom community response to metal contamination from an abandoned Cu mine:Case study of the Gromolo Torrent(Italy)

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Journal of Environmental Sciences 2019年第1期31卷 233-246页

作者： Raffaella Tolotti Sirio Consani Cristina Carbone greta Vagge Marco Capello Laura Cutroneo Department of Earth Environment and Life Sciences University of Genoa

Environmental contamination has become a global problem of increasing intensity due to the exponential growth of industrialization. One main debated issue is the metal contamination of rivers receiving Acid Mine Drainage(AMD) from active/abandoned mines. In order to assess the quality of lotic systems, diatoms are commonly used, as their assemblage modifies on the basis of changes in environmental parameters. Benthic diatom changes were analyzed along the metal-impacted Gromolo Torrent(Liguria, NW Italy) with the aim of understanding the effects of input from the abandoned Libiola Cu mine. The results support the hypothesis that metals from AMD lead to massive changes in diatoms, resulting in low biological diversity and in a shift of dominance, passing from the genera Cymbella and Cocconeis to more tolerant and opportunistic species, such as Achnanthidium minutissimum and Fragilaria rumpens. The high concentrations of labile metals, measured through Diffusion Gradients in Thin-films(DGT) immediately downstream of the two AMD inputs in the torrent, corresponded to a sudden decrease in the presence of diatoms, indicating the possible reaching of acute toxic levels. In particular,A. minutissimum dominated the mining area and was positively correlated with Cu and Zn;whereas F. rumpens bloomed downstream of this area, where the metal content was diluted,and was positively correlated with As and Pb. Finally, an important abundance of Nitzschia palea and teratological forms of A. minutissimum and F. rumpens were observed downstream from the mine, indicating that metals may have an important impact on diatoms up to the torrent mouth.

关键词： Benthic diatom community Biomarkers Metal contamination Diatom teratologies Acid Mine Drainage Libiola mine (Liguria,NW Italy)

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Is the Bond Market the Way Forward to Project Finance? The Role of the Project Bond Market in the Resurgence of Project Financing:A Comparison between Europe, Asia-Pacific and Latin America

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Is the Bond Market the Way Forward to Project Finance? The R...

作者： greta ALBERICI 复旦大学

学位级别：硕士

项日融资行业的收缩可能会阻碍全世界的发达国家和发展中国家未来的发展。在新建基础设施项日的持续投资将推动许多政府计划的议程,但全世界范围内在金融资源的需求和所提供的项日实现之间有资金缺口。经济衰退后,并且随着巴塞尔协议Ⅲ... 详细信息

项日融资行业的收缩可能会阻碍全世界的发达国家和发展中国家未来的发展。在新建基础设施项日的持续投资将推动许多政府计划的议程,但全世界范围内在金融资源的需求和所提供的项日实现之间有资金缺口。经济衰退后,并且随着巴塞尔协议Ⅲ的采用,商业银行已审慎的降低长期融资或增加借贷成本。开发一个可替代的资金来源,项目债券可能使项目融资行业再度复苏,成为全球基础设施建设的一个核心支柱。通过对在欧洲、亚太地区和拉丁美洲的项日债券市场动态的观察和比较,显而易见的是资木市场在基础设施融资中扮演着不同的角色。即使可能找出一些主导市场的主要趋势,并认识到影响全球定价的变量,债券信用价差的决定因素将根据不同的项目位置有不同的强度。实证分析表明,债券定价的决定因素在三个宏观地域是不一样的。项日债券在提供所需资金方面的成功取决于使这些变量起作用的能力,以致使债券融资成为发行人的一个方便的选择。通过了解评级在债券定价问题方面的重要性,欧盟委员会提出了项日债券市场的倡议,目标是增强项目债券发行的信用。由于债券评级和债券利差之间的联系是如此强烈,该倡议具有良好的前瞻性,如果正确地将其付诸实施,其能够实现刺激私营部门在基础设施项日融资的目标。欧盟的倡议在吸引保险公司和养老基金方面的成功是至关重要的,能够推动基础设施在欧洲的发展,尤其是在政府开支受紧缩政策的限制的时候。与欧洲不同的是,在亚洲的主要问题不是评级,而是与把基础设施带入市场相联系。大量的资金在亚洲投资者的手中,因为无法使这些资金流向基础设施,所以引发了项目融资行业的增长。此外,新建项目的高风险和不断变化的市场规则阻碍投资者支持亚洲基础设施的发展。不同于欧洲,在亚洲债券市场已经发展,而且需要扩大,多数亚洲国家是领先一步的,开发项日债券市场必须在建立一个强有力的框架政策之前。项目债券市场在拉丁美洲一直比在亚太地区活跃,增长的驱动者一直是项目融资市场的变化能力。如今,主要的趋势是新的资金来源一直参与基础设施项目,包括本地及国际资本市场和多边的中国银行。降低施工风险能力可以推动债券市场的未来发展的。拉丁美洲有基础设施赤字,政府意识到赤字可能是生产力和经济增长的障碍,因此他们已经把重大基础设施计划与公共和私人资金相结合。结论是,欧洲的主要问题是债券评级;亚洲需要在有一个适当的政策框架之前支持债券市场的发展;拉丁美洲构建一个协议组合的能力,给赞助商带来管理项目的灵活性,给投资者在抵抗施工风险方面充分的保护。

关键词：项目债券基础设施信用价差项目融资信用增级资本市场巴塞尔协议Ⅲ