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Approaching the Sarcopenic Patient with Nonalcoholic Steatohepatitis-related Cirrhosis

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Journal of Clinical and Translational Hepatology 2024年第3期12卷 278-286页

作者： Paolo Gallo Valentina Flagiello Andrea Falcomatà Giulia Di pasquale Giorgio D’Avanzo Francesca Terracciani antonio Picardi Umberto Vespasiani-Gentilucci Operative Research Unit of Clinical Medicine and Hepatology Fondazione Policlinico Universitario Campus Bio-MedicoVia Alvaro del PortilloRomaItaly Research Unit of Hepatology Department of Medicine and SurgeryUniversitàCampus Bio-Medico di RomaVia Alvaro del PortilloRomaItaly

Sarcopenia is a well-known complication of chronic liver disease(CLD),and it is almost always observed in patients with cirrhosis,at least in those with decompensated *** nonalcoholic fatty liver disease(NAFLD),recently renamed metabolic dysfunction-associated steatotic liver disease(MASLD),is becoming the leading cause of end-stage liver disease,a new scenario characterized by the frequent coexistence of NAFLD,obesity,and sarcopenia is *** it is not yet resolved whether the bidirectional relationship between sarcopenia and NAFLD subtends causal determinants,it is clear that the interaction of these two conditions is associated with an increased risk of poor ***,during the course of CLD,deregulation of the liver-muscle-adipose tissue axis has been ***,owing to the lack of properly designed studies,specific therapeutic guidelines for patients with sarcopenia in the context of NAFLD-related CLD have not yet been *** aimed to induce the loss of fat mass together with the maintenance of lean body mass seem most *** can be achieved by properly designed diets integrated with specific nutritional supplementations and accompanied by adequate physical *** studies aiming to add to the knowledge of the correct assessment and approach to sarcopenia in the context of NAFLD-related CLD are eagerly awaited.

关键词： NAFLD MASLD Cirrhosis Sarcopenia Sarcopenic obesity

Bayesian bootstrap quantile regression for probabilistic photovoltaic power forecasting

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Protection and Control of Modern Power Systems 2020年第1期5卷 238-249页

作者： Mokhtar Bozorg antonio Bracale Pierluigi Caramia Guido Carpinelli Mauro Carpita pasquale De Falco Institute of Energy and Electrical Systems School of Management and Engineering VaudUniversity of applied sciences Western Switzerland(HES-SO)Yverdon-les-BainsSwitzerland Department of Engineering University of Naples ParthenopeNaplesItaly Department of Electrical Engineering and Information Technology University of Naples Federico IINaplesItaly

Photovoltaic(PV)systems are widely spread across MV and LV distribution systems and the penetration of PV generation is solidly *** of the uncertain nature of the solar energy resource,PV power forecasting models are crucial in any energy management system for smart distribution *** point forecasts can suit many scopes,probabilistic forecasts add further flexibility to an energy management system and are recommended to enable a wider range of decision making and optimization *** paper proposes methodology towards probabilistic PV power forecasting based on a Bayesian bootstrap quantile regression model,in which a Bayesian bootstrap is applied to estimate the parameters of a quantile regression model.A novel procedure is presented to optimize the extraction of the predictive quantiles from the bootstrapped estimation of the related coefficients,raising the predictive ability of the final *** experiments based on actual data quantify an enhancement of the performance of up to 2.2%when compared to relevant benchmarks.

关键词： Bayesian bootstrap,Photovoltaic systems,Probabilistic forecasting,Renewable generation smart grids

Fluoroquinolone-based protocols for eradication of Helicobacter pylori

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World Journal of Gastroenterology 2014年第27期20卷 8947-8956页

作者： antonio Rispo Pietro Capone fabiana Castiglione Luigi pasquale Matilde Rea Nicola Caporaso Division of Gastroenterology Department of Clinical Medicine and Surgery-University "Federico Ⅱ" of Naples 80131 Napoli Italy Division of Gastroenterology P.O. "Sant’ Ottone Frangipane" Ariano Irpino 80131 Napoli Italy

Helicobacter pylori (H. pylori) is a widespread pathogen infecting about 40% of people living in urban areas and over 90% of people living in the developing regions of the world. H. pylori is well-documented as the main factor in the pathogenesis of peptic ulcer disease, chronic gastritis, and gastric malignancies such as cancer and mucosa-associated lymphoid tissue-lymphoma; hence, its eradication is strongly recommended. The Maastricht IV consensus, which focused on the management of H. pylori infection, set important new strategies in terms of treatment approaches, particularly with regards to first- and second-line treatment protocols and led to improved knowledge and understanding of H. pylori resistance to antibiotics. In recent years, various fluoroquinolone-based protocols, mainly including levofloxacin, have been proposed and effectively tested at all therapeutic lines for H. pylori eradication. The aim of the present paper is to review the scientific literature focused on the use of fluoroquinolones in eradicating H. pylori.

关键词： Helicobacter pylori eradication fluoroquinolone therapy

Thrombocytopenia in chronic liver disease:Physiopathology and new therapeutic strategies before invasive procedures

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World Journal of Gastroenterology 2022年第30期28卷 4061-4074页

作者： Paolo Gallo Francesca Terracciani Giulia Di pasquale Matteo Esposito antonio Picardi Umberto Vespasiani-Gentilucci Clinical Medicine and Hepatology Unit Campus Bio-Medico UniversityRoma 00128Italy

Chronic liver disease is characterized by several hematological derangements resulting in a complex and barely rebalanced haemostatic *** is the most common abnormality observed in these patients and recent advances have led to researchers focus the attention on the multifactorial origin of thrombocytopenia and on the key role of thrombopoietin(TPO)in its *** thrombocytopenia(platelet count<50000/μL)complicates the management of patients with chronic liver disease by increasing the potential risk of bleeding for invasive procedures,which may be therefore delayed or canceled even if *** the very last years,the development of new drugs which exceed the limits of the current standard of care(platelet transfusions,either immediately before or during the procedure)paves the way to a new scenario in the management of this population of *** agents,such as the TPOreceptor agonists avatrombopag and lusutrombopag,have been developed in order to increase platelet production as an alternative to platelet *** agents have demonstrated a good profile in terms of efficacy and safety and will hopefully allow reducing limitations and risks associated with platelet transfusion,without any delay in scheduled ***,it is expected that patients with chronic liver disease will be able to face invasive procedures with one more string in their bow.

关键词： Thrombocytopenia Chronic liver disease Thrombopoietin agonists Platelet transfusions Avatrombopag Lusutrombopag

A MULTI-AGENT SYSTEM FOR MANAGING THE QUALITY OF SERVICE IN TELECOMMUNICATIONS NETWORKS

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Journal of Systems Science and Systems Engineering 2005年第2期14卷 129-158页

作者： pasquale DE MEO antonio IERA Giorgio TERRACINA Domenico URSINO Università ''Mediterranea'' di Reggio Calabria Via Graziella Località Feo di Vito89060 Reggio CalabriaItaly Dipartimento di Matematica Università della Calabria Via Pietro Bucci87036 Rende (CS)Italy

In this paper we propose X-MAQoS, a novel XML-based multi-agent system for the QoS management in telecommunications networks. This system is characterized by the following features: (i) it handles a user profile and exploits it jointly with suitable network resource management techniques to maximize user satisfaction; (ii) it is capable of operating in a large variety of telecommunications networks; (iii) it is semi-automatic; (iv) it exploits XML for guaranteeing a light, versatile and standard mechanism for information representation, storing and exchange. In this paper the basic features of the system are discussed in details. Furthermore, the main results of a performance evaluation study in UMTS environment, aiming at comparing X-MAQoS with alternative agent-based approaches for handling user access to telecommunications networks, are reported.

关键词： Intelligent agents XML QoS management in telecommunications Networks

Intermediate-term oncological and functional outcomes in prostate cancer patients treated with perineal robot-assisted radical prostatectomy:A single center analysis

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Asian Journal of Urology 2023年第4期10卷 423-430页

作者： Umberto Carbonara Giuseppe Lippolis Luciano Rella Paolo Minafra Giuseppe Guglielmi antonio Vitarelli Giuseppe Lucarelli pasquale Ditonno Department of Emergency and Organ Transplantation Urology UnitAldo Moro UniversityBariItaly

Objective:In the last 10 years,robotic platforms allowed to resume of some alternative surgical approaches,including perineal robot-assisted radical prostatectomy(p-RARP).Herein,we present in detail the oncological and functional outcomes of patients who underwent p-RARP with a median follow-up of 30 ***:Patients presenting low-or intermediate-risk prostate cancer and prostate volume up to 60 mL who underwent p-RARP between November 2018 and November 2022 were ***,intraoperative,pathological,and postoperative data were collected and then ***:Thirty-seven p-RARP cases were *** patients presented mean age of 62 years and a mean Charlson comorbidity index of *** mass index of≥25 kg/m^(2)was reported by 24(64.9%)patients,as well as 7(18.9%)patients reported a past surgical *** prostate volume and median prostate-specific antigen were 41 mL and 6.2 ng/mL,*** median operative time was 242 *** positive surgical margin rate was 45.9%.In terms of postoperative complications,10 patients reported complications with any grade;however,a single case(2.7%)of major(Clavien-Dindo grade≥3)complication was *** patient with biochemical recurrence or distant metastasis was reported at 2 years of *** of continence rates were 67.6%,75.7%,and 92.9%,at 6 months,12 months,and 24 months after surgery,respectively.

关键词： Prostate cancer Robotic Perineal Radical prostatectomy Continence Robot-assisted radical prostatectomy Nerve-sparing

Burden of severe infections due to carbapenem-resistant pathogens in intensive care unit

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World Journal of Clinical Cases 2023年第13期11卷 2874-2889页

作者： Maria Caterina Pace antonio Corrente Maria Beatrice Passavanti pasquale Sansone Stephen Petrou Sebastiano Leone Marco Fiore Department of Women Child and General and Specialized SurgeryUniversity of Campania"Luigi Vanvitelli"Naples 80138Italy Department of Emergency Medicine University of California San FranciscoSan FranciscoCA 94143United States Division of Infectious Diseases “San Giuseppe Moscati”HospitalAvellino 83100Italy

Intensive care units(ICU)for various reasons,including the increasing age of admitted patients,comorbidities,and increasingly complex surgical procedures(e.g.,transplants),have become"the epicenter"of nosocomial infections,these are characterized by the presence of multidrug-resistant organisms(MDROs)as the cause of ***,the perfect match of fragile patients and MDROs,as the cause of infection,makes ICU mortality very ***,carbapenems were considered for years as last-resort antibiotics for the treatment of infections caused by MDROs;unfortunately,nowadays carbapenem resistance,mainly among Gram-negative pathogens,is a matter of the highest concern for worldwide public *** comprehensive review aims to outline the problem from the intensivist's perspective,focusing on the new definition and epidemiology of the most common carbapenem-resistant MDROs(Acinetobacter baumannii,Pseudomonas aeruginosa and Enterobacterales)to emphasize the importance of the problem that must be permeating clinicians dealing with these diseases.

关键词： Antimicrobial resistance Multidrug-resistant PDR Carbapenem-resistance Multidisciplinary critical care Intensive care unit

Clinical audit,a valuable tool to improve quality of care:General methodology and applications in nephrology

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World Journal of Nephrology 2014年第4期3卷 249-255页

作者： pasquale Esposito antonio Dal Canton Unit of Nephrology Dialysis and TransplantationFondazione IRCCS Policlinico San Matteo and University of Pavia

Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and fnancing. Different tools have been developed, includ-ing incident analysis, health technology assessment and clinical audit. The clinical audit consist of mea-suring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the ef-fectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings.

关键词： Clinical audit Evidence-based medicine Quality improvement Nephrology Hemodialysis

Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma:A cohort study

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World Journal of Gastroenterology 2009年第15期15卷 1843-1848页

作者： Rodolfo Sacco Marco Bertini pasquale Petruzzi Michele Bertoni Irene Bargellini Giampaolo Bresci Graziana Federici Luigi Gambardella Salvatore Metrangolo Giuseppe Parisi antonio Romano antonio Scaramuzzino Emanuele Tumino Alessandro Silvestri Emanuele Altomare Claudio Vignali Alfonso Capria Gastroenterology Department Pisa University Hospital Institute of Interna Medicine University of Foggia Department of Diagnostic and Interventional Radiology Pisa University Hospital

AIM： To prospectively long term clinical impact evaluate the short and of selective transarterial chemoembolization （TACE） on fiver function in patients with hepatocellular carcinoma （HCC）. To assess side effects in relation to treatments. To analyze the overall survival and HCC progression free survival probability. METHODS： One hundred and seventeen cirrhotic patients with HCC were enrolled. Baseline liver function included Child-Pugh score and serum levels of alanine- aminotransferase （ALT）, prothrombin time （PT） and bilirubin. According to Cancer Liver Italian Program （CLIP） and Barcelona Clinic Liver Cancer （BCLC） staging systems, 71 patients were eligible for TACE; 32 had previously received treatment for HCC. No significant differences in liver function were observed between previously treated and not treated patients. TACE was performed by selective catheterization of the arteries nourishing the lesions. While hospitalized, patients underwent clinical, hematologic and ultrasonographic assessments. One month after TACE a CT scan was performed to assess tumor response. A second TACE was performed ＂on demand＂ Liver function tests were checked in all patients every four months. RESULTS： After first TACE, the mean Child-Pugh score increased from a mean baseline 5.62 ±1.12 to 6.11 ±1.57 at discharge time （P 〈 0.0001）, decreasing after four months to 5.81 ± 0.73 （not significant）. ALT, PT and bilirubin significantly （P 〈 0.0001） increased 24 h after TACE and progressively decreased until discharge. After the second TACE, variations in Child-Pugh score, ALT, PT and bilirubin were comparable to that described after the first TACE. No major complications were observed. The mean follow-up was 14.7 ＋ 6.3 mo （median： 16 mo）. Only one patient died. No other patient experienced important long term worsening of clinical status. The overall survival probability at twenty-four months was 98.18% with a correspondent HCC progression free survival probability of 69%. CONCLUSION：

关键词： Hepatocellular carcinoma Transarterialchemoembolization Liver function Liver cirrhosis Child-Pugh score