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Diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy

World Journal of Gastroenterology 2014年第37期20卷 13382-13401页

作者： Renato Costi Alessandro Gnocchi Francesco Di Mario leopoldo sarli Dipartimento di Scienze Chirurgiche Università di ParmaAzienda Ospedaliero-Universitaria di Parma Dipartimento Materno Infantile Unità Operativa di Gastroenterologia ed Endoscopia DigestivaAzienda Ospedaliero-Universitaria di Parma Dipartimento di Medicina Clinica e Sperimentale Università di ParmaAzienda Ospedaliero-Universitaria di Parma

Biliary lithiasis is an endemic condition in both Western and Eastern countries, in some studies affecting 20% of the general population. In up to 20% of cases, gallbladder stones are associated with common bile duct stones(CBDS), which are asymptomatic in up to one half of cases. Despite the wide variety of examinations and techniques available nowadays, two main open issues remain without a clear answer: how to cost-effectively diagnose CBDS and, when they are finally found, how to deal with them. CBDS diagnosis and management has radically changed over the last 30 years, following the dramatic diffusion of imaging, including endoscopic ultrasound(EUS) and magnetic resonance cholangiography(MRC), endoscopy and laparoscopy. Since accuracy, invasiveness, potential therapeutic use and costeffectiveness of imaging techniques used to identifyCBDS increase together in a parallel way, the concept of "risk of carrying CBDS" has become pivotal to identifying the most appropriate management of a specific patient in order to avoid the risk of "under-studying" by poor diagnostic work up or "over-studying" by excessively invasive examinations. The risk of carrying CBDS is deduced by symptoms, liver/pancreas serology and ultrasound. "Low risk" patients do not require further examination before laparoscopic cholecystectomy. Two main "philosophical approaches" face each other for patients with an "intermediate to high risk" of carrying CBDS: on one hand, the "laparoscopy-first" approach, which mainly relies on intraoperative cholangiography for diagnosis and laparoscopic common bile duct exploration for treatment, and, on the other hand, the "endoscopy-first" attitude, variously referring to MRC, EUS and/or endoscopic retrograde cholangiography for diagnosis and endoscopic sphincterotomy for management. Concerning CBDS diagnosis, intraoperative cholangiography, EUS and MRC are reported to have similar results. Regarding management, the recent literature seems to show better short and long term outcome of surgery in terms of re

关键词： Biliary lithiasis Choledocholithiasis Laparoscopy

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Effect of a triage course on quality of rating triage codes in a group of university nursing students:a before-after observational study

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World Journal of Emergency Medicine 2013年第1期4卷 20-25页

作者： Nicola Parenti Maria Letizia Bacchi Reggiani Diego Sangiorgi Vito Serventi leopoldo sarli University of Parma Italy University of Bologna Italy

BACKGROUND:Most current triage tools have been tested among hospital nurses groups but there are not similar studies in university setting.In this study we analyzed if a course on a new fourlevel triage model,triage emergency method(TEM),could improve the quality of rating in a group of nursing students.METHODS:This observational study was conducted with paper scenarios at the University of Parma,Italy.Fifty students were assigned a triage level to 105 paper scenarios before and after a course on triage and TEM.We used weighted kappa statistics to measure the inter-rater reliability of TEM and assessed its validity by comparing the students' predictions with the triage code rating of a reference standard(a panel of five experts in the new triage method).RESULTS:Inter-rater reliability was K=0.42(95%Cl:0.37-0.46) before the course on TEM,and K=0.61(95%CI:0.56-0.67) after.The accuracy of students' triage rating for the reference standard triage code was good:81%(95%Cl:71-90).After the TEM course,the proportion of cases assigned to each acuity triage level was similar for the student group and the panel of experts.CONCLUSION:Among the group of nursing students,a brief course on triage and on a new inhospital triage method seems to improve the quality of rating codes.The new triage method shows good inter-rater reliability for rating triage acuity and good accuracy in predicting the triage code rating of the reference standard.

关键词： Emergency Reliability Triage Triage system Validity

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Using satellite-derived land surface temperatures to clarify the spatiotemporal warming trends of the Alborz Mountains in northern Iran

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Journal of Mountain Science 2024年第2期21卷 449-469页

作者： ROSHAN Gholamreza sarli Reza GHANGHERMEH Abdolazim TAHERIZADEH Mehrnoosh NIKNAM Arman Department of Geography Golestan UniversityGorgan 49138-15759Iran Department of Forest Resources Management Faculty of ForestryUniversity of Agriculture in KrakowAL.29 Listopada 4631-425 KrakówPoland Department of Geoinformatics Physical and Environmental GeographyUniversity of SzegedSzeged 6722Hungary

The Alborz Mountains are some of the highest in Iran,and they play an important role in controlling the climate of the country’s northern regions.The land surface temperature(LST)is an important variable that affects the ecosystem of this area.This study investigated the spatiotemporal changes and trends of the nighttime LST in the western region of the Central Alborz Mountains at elevations of 1500-4000 m above sea level.MODIS data were extracted for the period of 2000-2021,and the Mann-Kendall nonparametric test was applied to evaluating the changes in the LST.The results indicated a significant increasing trend for the monthly average LST in May-August along the southern aspect.Both the northern and southern aspects showed decreasing trends for the monthly average LST in October,November,and March and an increasing trend in other months.At all elevations,the average decadal change in the monthly average LST was more severe along the southern aspect(0.60°C)than along the northern aspect(0.37°C).The LST difference between the northern and southern aspects decreased in the cold months but increased in the hot months.At the same elevation,the difference in the lapse rate between the northern and southern aspects was greater in the hot months than in the cold months.With increasing elevation,the lapse rate between the northern and southern aspects disappeared.Climate change was concluded to greatly decrease the difference in LST at different elevations for April-July.

关键词： Global warming Mountainous areas Lapse rate Surface air temperatures Alborz

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Extreme Wind Variability and Wind Map Development in Western Java,Indonesia

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International Journal of Disaster Risk Science 2022年第3期13卷 465-480页

作者： Muhammad Rais Abdillah Prasanti Widyasih sarli Hafidz Rizky Firmansyah Anjar Dimara Sakti Faiz Rohman Fajary Robi Muharsyah Gian Gardian Sudarman Atmospheric Science Research Group Faculty of Earth Science and TechnologyInstitut Teknologi BandungBandung40132Indonesia Structural Engineering Research Group Faculty of Civil and Environmental EngineeringInstitut Teknologi BandungBandung40132Indonesia Center for Infrastructures and Built Environment Institut Teknologi BandungBandung40132Indonesia Civil Engineering Department Faculty of Civil and Environmental EngineeringInstitut Teknologi BandungBandung40132Indonesia Remote Sensing and Geographic Information Science Research Group Faculty of Earth Sciences and TechnologyInstitut Teknologi BandungBandung40132Indonesia Center for Remote Sensing Institut Teknologi BandungBandung40132Indonesia Center for Climate Change and Information The Agency for MeteorologyClimatology and Geophysics of the Republic of Indonesia(BMKG)Jakarta10720Indonesia Subdivision for Executive Secretary Administration The Agency for MeteorologyClimatology and Geophysics of the Republic of Indonesia(BMKG)Jakarta10720Indonesia Earth Science Department Faculty of Earth Science and TechnologyInstitut Teknologi BandungBandung40132Indonesia

Wind-related disasters are one of the most frequent disasters in Indonesia.It can cause severe damages of residential construction,especially in the world's most populated island of Java.Understanding the characteristics of extreme winds is crucial for mitigating the disasters and for defining structural design standards.This study investigated the spatiotemporal variations of extreme winds and pioneered a design wind map in Indonesia by focusing on western Java.Based on gust data observed in recent years from 24 stations,the extreme winds exhibit a clear annual cycle where northwestern and southeastern sides of western Java show out-of-phase relationship due to reversal monsoons.Meanwhile,extreme wind occurrences are mostly affected by small-scale weather systems,regardless of seasons and locations.To build the wind map,we used bias-corrected gust from ERA5 and applied the Gumbel method to predict extreme winds with different return periods.The wind map highlights some drawbacks of the current national design standards,which use single wind speed values regardless of location and return period.Beside a fundamental improvement for wind design,this study will benefit disaster risk mapping and other applications that require extreme wind speed distribution.

关键词： ERA5 reanalysis Extreme wind Mixed weather system Tropical climate

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Corrosion Resistance of Steel/Zinc with Silicate Nanoparticles/Polyurethane Paint Systems in NaCl Solution

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材料科学与工程（中英文A版） 2012年第11期2卷 693-711页

作者： Celia Regina Tomachu Cecilia Ines Eisner Alejandro Ramon Di sarli Energy and Nuclear Research Institute IPEN/CNEN-SP CCTM 2242 CEP 05508-000 Cidade Universit6ria Sao Paulo SPBrazil CIDEPINT: Research and Development Center in Paint Technology (CICPBA-CONICET) Av. 52 s/n entre 121 y 122. CP.B1900A YB La Plata-Argentina Engineering School National University of La Plata Av. 1 Esq. 47. CP. B I 9OOTAG La Plata-Argentina

Surface characteristics and corrosion behaviour of bare electrogalvanized steel coated with polymer/nano-silicate particles added to the electrogalvanizing bath were studied by scanning electron microscopy (SEM), energy dispersive spectrometer (EDXS) and electrochemical impedance spectroscopy (EIS). After applying a barrier polyurethane paint, the paint hardness, porosity, flexibility, colour, gloss, blistering and rusting degrees, and anticorrosive protective properties in 0.05 mol·L-1 NaCl solution were also evaluated. The results correlated well and, being demonstrative of the very slow deterioration rate of the immersed coated electrogalvanized steel, they enabled to assume that if a chemically analogous but thicker coating system was applied; it could be an acceptable alternative in real service conditions.

关键词：电镀锌钢板 NaCl溶液聚氨酯涂料纳米颗粒涂料系统硅酸盐耐腐蚀性能扫描电子显微镜

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Anti-Corrosion Performance of Cr+6-Free Passivating Layers Applied on Electrogalvanized

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Materials Sciences and Applications 2010年第4期1卷 202-209页

作者： Célia Regina Tomachuk Alejandro Ramón Di sarli Cecilia Inés Elsner 不详

Hexavalent chromium-based passivation treatments have been successfully used as promoters of conversion coatings for many years. Their effectiveness is without question although there are many problems with regard to their environmental suitability. Hexavalent chromium compounds are carcinogenic and toxic. These problems have lead researchers to evaluate other potential systems, with lower toxicity, to ascertain if they can replace chromates as effective passivators. Researchers have proposed several alternative passivation treatments;these are processes based on molybdates, permanganates, titanates, rare earth metal and Cr3+ (considered to be non-carcinogenic) compounds. In this work, zinc coatings obtained from free-cyanide alkaline bath and submitted to a Cr3+ based passivation treatment with different colors were studied. The corrosion behavior was studied by polarization measurements and mainly by electrochemical impedance spectroscopy in 0.6 N NaCl solution. Morphological observations on the coatings surface were also performed. The results indicate that the green-colored Cr3+ passivated coatings have a good corrosion resistance followed by yellow and blue-colored passivation respectively. They could be a less polluting alternative to the traditional chromated coatings.

关键词： Zinc Conversion Treatment Impedance Spectroscopy Salt Spray Corrosion

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Collecting Landraces of Vegetable Crop Species in the South-West Romania

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Journal of Environmental Science and Engineering(B) 2016年第1期5卷 17-25页

作者： sarli Giulio Tigan Eugenia Bitonte Domenico Montemurro Francesco Montesano Vincenz Laghetti Gaetano Hammer Karl Institute of Biosciences and BioResources National Research Council (IBBR-CNR) Bari 70126 Italy Faculty of Food Engineering Tourism and Environmental Protection University "A urel Vlaicu" o fArad Arad 310130 Romania

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Corrosion Performance of Conversion Treatments for Electrogalvanised Steel Sheet

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Journal of Minerals and Materials Characterization and Engineering 2019年第5期7卷 307-329页

作者： A. R. Di sarli C. I. Elsner L. E. M. Palomino C. R. Tomachuk Centro de Investigación y Desarrollo en Tecnología de Pinturas (CICPBA-CONICET-UNLP) La Plata Argentina Facultad de Ingeniería UNLP La Plata Argentina Environmental and Basic Sciences Department Engineering School of Lorena University of Sao Paulo Lorena Brazil

Chromate conversion treatments have been widely used due to their excellent corrosion resistance properties;however, their use is increasingly restricted because of the highly toxic chromic acid solutions required, with consequent effluent disposal and ecological problems. The removal of these toxic chemicals is considered a priority within most of the developed countries. In this work, the corrosion resistance of different alternative pretreatments applied on electrogalvanised steel sheet: 1) Cr(III) and Zr complexes layer, 2) Ce(III) layer, 3) Ce(III)/Ce(IV) double layer, 4) Cr(VI) chromating was investigated, and its results compared with those from the tests performed using bare electrogalvanized steel sheets as a substrate. These samples were exposed to aerated 0.05 mol/L NaCl or 0.1 mol/L Na2SO4 solutions. The electrochemical behavior of samples was studied by electrochemical techniques. For three days of immersion in the solution test, the experimental results have shown that, compared with the Cr(VI) protective properties, the Cr(III) + Zr complex layer presented similar performance. Even though the initial corrosion resistance was offered by the Ce(III) and Ce(VI)/Ce(III) conversion coatings was relatively good, it quickly decreased as a function of the exposure time.

关键词： Pre-Treatments Conversion Coatings Corrosion EIS Electrogalvanised Steel

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