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Non-anatomical liver resection for hepatocellular carcinoma:the SegSubTe classification to overcome the problem of heterogeneity

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 265-271页

作者： Mattia Garancini Alessandro Fogliati mauro Alessandro Scotti Cristina Ciulli Francesca Carissimi Antonio Rovere Luca Gianotti Fabrizio romano Unit of Hepatobiliopancreatic Surgery Department of SurgeryASST-MonzaSan Gerardo HospitalUniversity of Milano-Bicoccavia Pergolesi 33MonzaMB 20052Italy Interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 33MonzaMB 20052Italy

Background:The superiority of anatomical resection(AR)***-anatomical resection(NAR)in the surgical management of hepatocellular carcinoma(HCC)is *** are well-defined procedures,whereas the lack of NAR standardization results in heterogeneous *** study aimed to introduce the SegSubTe classification for NAR detailing the appropriateness of the level of surgical section of the Glissonean pedicles feeding the ***:A single-center retrospective analysis of pre-and postoperative imaging of consecutive patients treated with NAR for single HCC between 2012 and 2020 was *** quality of surgery was assessed classifying the type of vascular supply and the level of surgical section(segmental,subsegmental or terminal next to the tumor)of vascular pedicles feeding the HCCs;then,the population was divided in“SegSubTe-IN”or“SegSubTe-OUT”groups,and the tumor recurrence and survival were ***:Ninety-seven patients who underwent NAR were included;76%were SegSubTe-IN and 24%were *** disease recurrence,local recurrence and cut-edge recurrence in the SegSubTe-IN ***-OUT groups were 50%vs.83%(P=0.006),20%vs.52%(P=0.003)and 16%vs.39%(P=0.020),***-OUT odds ratio for local recurrence was 4.1 at univariate regression ***-,three-,and five-year disease-free survival rates in the SegSubTe-IN ***-OUT groups were 81%,58%and 35%vs.46%,21%and 11%,respectively(P<0.001).Conclusions:The SegSubTe classification is a useful tool to stratify and standardize NAR for HCC,aiming at improving long-term oncological outcomes and reducing the heterogeneity of quality of NAR for HCC.

关键词： Hepatocellular carcinoma Intraoperative ultrasound Liver surgery Computed tomography Surgical procedure

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Antisense therapy:a potential breakthrough in the treatment of neurodegenerative diseases

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Neural Regeneration Research 2024年第5期19卷 1027-1035页

作者： Roberta romano Cecilia Bucci Department of Biological and Environmental Sciences and Technologies(DiSTeBA) University of SalentoLecceItaly

Neurodegenerative diseases are a group of disorders characterized by the progressive degeneration of neurons in the central or peripheral nervous ***,there is no cure for neurodegenerative diseases and this means a heavy burden for patients and the health system ***,it is necessary to find new therapeutic approaches,and antisense therapies offer this possibility,having the great advantage of not modifying cellular genome and potentially being *** preclinical and clinical studies aim to test the safety and effectiveness of antisense therapies in the treatment of neurodegenerative *** objective of this review is to summarize the recent advances in the development of these new technologies to treat the most common neurodegenerative diseases,with a focus on those antisense therapies that have already received the approval of the *** and Drug Administration.

关键词： Alzheimer’s disease amyotrophic lateral sclerosis antisense oligonucleotide Huntington’s disease neurodegenerative disorders Parkinson’s disease siRNA

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Comparison between the SAPIEN S3 and the SAPIEN XT transcatheter heart valves:A single-center experience

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World Journal of Cardiology 2016年第12期8卷 735-745页

作者： Fadi J Sawaya Marco Spaziano Thierry Lefèvre Andrew Roy Phillippe Garot Thomas Hovasse Antoinette Neylon Hakim Benamer mauro romano Thierry Unterseeh Marie-Claude Morice Bernard Chevalier Department of Cardiology Générale de SantéInstitut Cardiovasculaire Paris-Sud-Hopital Privé Jacques Cartier

AIM To investigate the clinical outcomes of transcatheter aortic valve implantation(TAVI) with the SAPIEN 3 transcatheter heart valve(S3-THV) vs the SAPIEN XT valve(XT-THV).METHODS We retrospectively analyzed 507 patients that underwent TAVI with the XT-THV and 283 patients that received the S3-THV at our institution between March 2010 and December *** Thirty-day mortality(3.5% vs 8.7%:OR=0.44,P=0.21) and 1-year mortality(25.7% vs 20.1%,P=0.55) were similar in the S3-THV and the XT-THV *** rates of both major vascular complication and paravalvular regurgitation(PVR)>1 were almost 4 times lower in the S3-THV group than the XT-THV group(major vascular complication: 2.8% vs 9.9%,P1: 2.4% vs 9.7%,P<0.0001).However,the rate of new pacemaker implantation was almost twice as high in the S3-THV group(17.3% vs 9.8%,P=0.03).In the S3 group,independent predictors of new permanent pacemaker were pre-procedural RBBB(OR=4.9:P=0.001),pre-procedural PR duration(OR=1.14,P=0.05) and device lack of coaxiality(OR=1.13:P=0.05) during *** The S3-THV is associated to lower rates of major vascular complications and PVR but higher rates of new pacemaker compared to the ***-optimal visualization of the S3-THV in relation to the aortic valvular complex during deployment is a predictor of new permanent pacemaker.

关键词： SAPIEN-3 valve Vascular complications Permanent pacemaker Lack of coaxiality Paravalvular regurgitation

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Management of cerebral amyloid angiopathy and atrial fibrillation:We are still far from precision medicine

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World Journal of Cardiology 2024年第5期16卷 231-239页

作者： Liuba Fusco Zefferino Palamà Antonio Scarà Alessio Borrelli Antonio Gianluca Robles Gabriele De Masi DeLuca Silvio romano Luigi Sciarra Department of Cardiology University Hospital of NorthamptonshireNorthampton NN15BDUnited Kingdom Department of Cardiology Casa di Cura Villa VerdeTaranto 70124Italy Department of Life Health and Environmental SciencesUniversity of l'AquilaL'Aquila 67100Italy Department of Cardiology GVM Care and ResearchSan Carlo di Nancy HospitalRome 00100Italy

The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrillation(AF).In fact,CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral ***,many AF patients require oral systemic dose-adjusted warfarin,direct oral anticoagulants(such as factor Xa inhibitors)or direct thrombin inhibitors to control often associated with cardioembolic stroke *** prevalence of both CAA and AF is expected to rise,due to the aging of the *** clinical dilemma is becoming increasingly *** patients with coexisting AF and CAA,the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific *** review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm.

关键词： Anticoagulation Atrial fibrillation Cerebral amyloid angiopathy Intracerebral hemorrhage Stroke Watchman Secondary prevention Left atrial appendage closure

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Duodenal duplication cyst causing severe pancreatitis:Imaging findings and pathological correlation

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World Journal of Gastroenterology 2006年第10期12卷 1630-1633页

作者： Alessandro Guarise Niccolo' Faccioli mauro Ferrari Luigi romano Alice Parisi Massimo Falconi Department of Radiology Negrar VeronaItaly Department of Surgery University of Verona VeronaItaly Department of Pathology University of Verona VeronaItaly Department of Radiology University of Verona VeronaItaly

We here report a case of a 18-year-old man with a history of recurrent abdominal pain and a previous episode of severe acute pancreatitis. Abdominal ultrasonography, contrast enhanced multislice computer tomography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography and magnetic resonance imaging demonstrated a cystic mass lesion. Only on delayed phase magnetic resonance images after GadoliniumBOPTA injection, it was possible to demonstrate the lesion's relationship with the biliary tree, differentiating the lesion from intraluminal duodenal diverticulum, and to achieve the diagnosis of duodenal duplication cyst, a recognized rare cause of acute pancreatitis. The diagnosis was confirmed by histology.

关键词： Pancreatitis Congenital anomalies Duodenal duplication cyst Ultrasonography Computed Tomography Cholangiopancreatography Magnetic Resonance Imaging

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Rethinking the Barcelona clinic liver cancer guidelines:Intermediate stage and Child-Pugh B patients are suitable for surgery?

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World Journal of Gastroenterology 2021年第21期27卷 2784-2794页

作者： Fabrizio romano Marco Chiarelli Mattia Garancini mauro Scotti mauro Zago Gerardo Cioffi Matilde De Simone Ugo Cioffi Department of Surgery School of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy Emergency and Robotic Surgery A.Manzoni HospitalASST LeccoLecco 23900Italy Department of General Surgery San Gerardo HospitalMonza 20900Italy Department of Sciences and Technologies Universitàdegli Studi del Sannio di BeneventoBenevento 82100Italy Department of Surgery University of MilanMilano 20122Italy

According to Barcelona Clinic Liver Cancer recommendations,intermediate stage hepatocellular carcinomas(stage B)are excluded from liver resection and are referred to palliative ***,Child-Pugh B patients are not usually candidates for liver ***,many hepatobiliary centers in the world manage patients with intermediate stage hepatocellular carcinoma or Child-Pugh B cirrhosis with liver resection,maintaining that hepatic resection is not contraindicated in selected patients with non–early-stage hepatocellular carcinoma and without normal liver *** studies demonstrate that resection provides the best survival benefit for selected patients in very early/early and even in intermediate stages of Barcelona Clinic Liver Cancer classification,and this treatment gives good results in the setting of multinodular,large tumors in patients with portal hypertension and/or Child-Pugh B *** this review we explore this controversial topic,and we show through the literature analysis how liver resection may improve the short-and long-term survival rate of carefully selected Barcelona Clinic Liver Cancer B and Child-Pugh B hepatocellular carcinoma ***,other large clinical studies are needed to clarify which patients with intermediate stage hepatocellular carcinoma are most likely to benefit from liver resection.

关键词： Liver surgery Hepatocellular carcinoma Barcelona liver clinic cancer Child B Intermediate stage

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Branching patterns of the left portal vein and consequent implications in liver surgery:The left anterior sector

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 399-402页

作者： Mattia Garancini mauro Alessandro Scotti Luca Gianotti Antonio Rovere Fabio Uggeri Marco Braga Fabrizio romano Unit of Hepatobiliary Pancreatic Surgery Department of General Surgery 1ASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 3320900 MonzaMBItaly Unit of Interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 3320900 MonzaMBItaly

To the Editor: There are still some open issues about the systematization of the knowledge of the branching of the left portal vein(LPV) and the division in anatomo-functional units within the left liver. The first controversial topic concerns the division of S4 in subsegments. The Brisbane 20 0 0 system of Nomenclature of Hepatic Anatomy and Resections(B20 0 0) [1] does not mention such subdivision, but in literature this is still a matter of discussion.

关键词： branching portal discussion

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Bone alterations in inflammatory bowel diseases

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World Journal of Clinical Cases 2019年第15期7卷 1908-1925页

作者： Dolores Sgambato Francesca Gimigliano Cristiana De Musis Antimo Moretti Giuseppe Toro Emanuele Ferrante Agnese Miranda Domenico De mauro Lorenzo romano Giovanni Iolascon Marco romano Departments of Precision Medicine and Polyspecialistic Internal Medicine University of Campania "Luigi Vanvitelli" and University HospitalNaples 80131Italy Department of Physical and Mental Health University of Campania“Luigi Vanvitelli”Naples 80131Italy Department of Medical and Surgical Specialties and Dentistry University of Campania“Luigi Vanvitelli”Naples 80131Italy Surgical Digestive Endoscopy Department of Clinical Medicine and SurgeryFederico Ⅱ UniversityNaples 80131Italy

Inflammatory bowel diseases(IBDs)are characterized by a multifactorial partially unknown etiology that involves genetic,immunological and environmental *** to 50%of IBD patients experience at least one extraintestinal manifestation;among them is the involvement of bone density which is referred to as metabolic bone disease(MBD),including osteopenia and *** alterations in IBDs population appear to have a multifactorial etiology:Decreased physical activity,inflammation-related bone resorption,multiple intestinal resections,dietary malabsorption of minerals and vitamin D deficiency,genetic factors,gut-bone immune signaling interaction,steroid treatment,microbiota and pathogenic micro-organisms interaction,and dietary malabsorption of minerals,that,all together or individually,may contribute to the alteration of bone mineral *** review aims to summarize the prevalence and pathophysiology of metabolic bone alterations in IBD subjects outlining the main risk factors of bone *** also want to underline the role of the screening and prophylaxis of bone alterations in Crohn’s disease and ulcerative colitis patients and the importance of treating appropriately MBD.

关键词： Inflammatory bowel diseases Bone alterations Bone mineral density Osteoporosis Osteopenia Ulcerative colitis Crohn’s disease

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Federated learning framework for mobile edge computing networks

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CAAI Transactions on Intelligence Technology 2020年第1期5卷 15-21页

作者： romano Fantacci Benedetta Picano Department of Information Engineering University of FlorenceFlorenceItaly

The continuous growth of smart devices needing processing has led to moving storage and computation from cloud to the network edges,giving rise to the edge computing *** to the limited capacity of edge computing nodes,the presence of popular applications in the edge nodes results in significant improvements in users’satisfaction and service ***,the high variability in the content requests makes prediction demand not trivial and,typically,the majority of the classical prediction approaches require the gathering of personal users’information at a central unit,giving rise to many users’privacy *** this context,federated learning gained attention as a solution to perform learning procedures from data disseminated across multiple users,keeping the sensitive data *** study applies federated learning to the demand prediction problem,to accurately forecast the more popular application types in the *** proposed framework reaches high accuracy levels on the predicted applications demand,aggregating in a global and weighted model the feedback received by users,after their local *** validity of the proposed approach is verified by performing a virtual machine replica copies and comparison with the alternative forecasting approach based on chaos theory and deep learning.

关键词： prediction forecasting framework

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Multi-User Semantic Communications System with Spectrum Scarcity

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Journal of Communications and Information Networks 2022年第4期7卷 375-382页

作者： romano Fantacci Benedetta Picano Via di Santa Marta 3 Florence 50139Italy

Nowadays,the emerging paradigm of semantic communications seems to offer an attractive opportunity to improve the transmission reliability and efficiency in new generation communication *** particular,focusing on spectrum scarcity,expected to afflict the upcoming sixth generation(6G)networks,this paper analyses the semantic communications behavior in the context of a cell-dense scenario,in which users belonging to different small base station areas may be allocated on a same channel giving rise to a non-negligible interference that severely affects the communications *** such a context,artificial intelligence methodologies are of paramount importance in order to speed up the switch from traditional communication to the novel semantic communication *** a consequence,a deep-convolution neural networks based encoder-decoder architecture has been exploited here in the definition of the proposed semantic communications ***,extensive numerical simulations have been performed to test the advantages of the proposed framework in different interfering scenarios and in comparison with different traditional or semantic alternatives.

关键词： semantic communication terahertz communications machine learning

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