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Corneal collagen cross-linking in patients with keratoconus from the Dresden protocol to customized solutions:theoretical basis

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 951-962页

作者： Ciro Caruso Luca D’andrea Mario Troisi Michele Rinaldi Raffaele Piscopo salvatore Troisi Ciro Costagliola Corneal Transplant Center Pellegrini HospitalVia Portamedina alla Pignasecca 41Napoli 80127Italy Eye Clinic Department of NeurosciencesReproductive and Odontostomatological SciencesUniversity of Naples Federico IINaples 80131Italy Public Health Department University of Naples Federico IINaples 80131Italy Salerno Hospital University Ophthalmologic UnitBaronissiCampania 84131Italy

Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.

关键词： corneal collagen cross linking keratoconus custom fast protocol Dresden protocol lambert-beer law Bunsen-roscoe law

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May ChatGPT be a tool producing medical information for common inflammatory bowel disease patients’questions?An evidencecontrolled analysis

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World Journal of Gastroenterology 2024年第1期30卷 17-33页

作者： Antonietta Gerarda Gravina Raffaele Pellegrino Marina Cipullo Giovanna Palladino Giuseppe Imperio andrea Ventura salvatore Auletta Paola Ciamarra Alessandro Federico Division of Hepatogastroenterology Department of Precision MedicineUniversity of Campania Luigi VanvitelliNaples 80138Italy

Artificial intelligence is increasingly entering everyday healthcare.Large language model(LLM)systems such as Chat Generative Pre-trained Transformer(ChatGPT)have become potentially accessible to everyone,including patients with inflammatory bowel diseases(IBD).However,significant ethical issues and pitfalls exist in innovative LLM tools.The hype generated by such systems may lead to unweighted patient trust in these systems.Therefore,it is necessary to understand whether LLMs(trendy ones,such as ChatGPT)can produce plausible medical information(MI)for patients.This review examined ChatGPT’s potential to provide MI regarding questions commonly addressed by patients with IBD to their gastroenterologists.From the review of the outputs provided by ChatGPT,this tool showed some attractive potential while having significant limitations in updating and detailing information and providing inaccurate information in some cases.Further studies and refinement of the ChatGPT,possibly aligning the outputs with the leading medical evidence provided by reliable databases,are needed.

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel disease Chat Generative Pre-trained Transformer Large language model Artificial intelligence

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Single vs.Recurrent Episodes of Preeclampsia-population-based Epidemiological and Clinical Characteristics

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Maternal-Fetal Medicine 2021年第3期3卷 190-196页

作者： salvatore andrea mastrolia Boris Taran Eric Kachko Omer Mor Ruth Beer-Wiesel Tamar Eshkoli Doron Dukler Shayna Miodownik Offer Erez Department of Obstetrics and Gynecology Ospedale dei Bambini"Vittore Buzzi"University of MilanoMilano 20154Italy Department of Obstetrics and Gynecology Soroka University Medical CenterSchool of MedicineFaculty of Health SciencesBen Gurion University of the NegevBeer Sheva 84101Israel Clinical Research Center Soroka University Medical CenterBen Gurion University of the NegevBeer Sheva 84101Israel Medical School for International Health Faculty of Health SciencesBen-Gurion University of the NegevBeer-Sheva 84101Israel

Objective:The aims of this study were to determine the differences between women with single vs.recurrent episodes of preeclampsia in term of:(1)the outcome of the first pregnancy affected by preeclampsia;and(2)the perinatal outcomes of subsequent pregnancies.Methods:This population based retrospective cohort study included all multiparous patients with a singleton gestation who delivered at Soroka University Medical Center(Beer Sheva,Israel)from January 1988 until December 2012,meeting the inclusion criteria,those who had fetuses with chromosomal or anatomical abnormalities were exclude.Our cohort included 213,558 deliveries that met the inclusion criteria,of them 208,017 had normotensive pregnancies and 5541 had preeclampsia.The latter group was further divided into those who had a single episode of preeclampsia followed by normotensive gestations(n=3879),and women who had recurrent preeclampsia(n=1662).We used parametric and non-parametric statistics as appropriate.Results:(1)Women with recurrent preeclampsia had an increased rate of early((130/1662)7.8%vs.(171/3879)4.4%,P<0.001)and late((268/1662)16.1%vs.(438/3879)11.3%,P<0.001)preterm deliveries than a single episode of preeclampsia;(2)of interest,the rate of chronic hypertension is higher in the first pregnancy of those with a single preeclampsia episode(P<0.001),while women with recurrent preeclampsia developed It in the subsequent gestations(P<0.001);(3)the rate of small for gestational age neonates in the index pregnancy was higher in those with recurrent rather than a single episode of preeclampsia(single episode 450/3879,11.6%,recurrent preeclampsia 244/1662,14.7%,P=0.002);(4)patients with recurrent disease had an increased rate of cesarean deliveries in the subsequent pregnancies(P<0.001);and(5)patients who developed severe preeclampsia in the subsequent gestations had lower mean birthweight(P<0.001),a higher rate of perinatal mortality(P<0.001),and a lower Apgar score at 1 and 5 minutes(P<0.001),than those who developed mild preeclampsia in subsequen

关键词： Cesarean section Fetal death IUGR Pre-eclampsia Preterm delivery

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Laparoscopic appendectomy,stump closure and endoloops:A meta-analysis

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World Journal of Gastrointestinal Surgery 2022年第9期14卷 1060-1071页

作者： Noemi Zorzetti Augusto Lauro Maria Irene Bellini Samuele Vaccari Barbara Dalla Via Maurizio Cervellera Roberto Cirocchi salvatore Sorrenti Vito D’andrea Valeria Tonini Department of General Surgery Ospedale Civile A CostaPorretta Terme 40046Italy Department of Surgical Sciences Sapienza UniversityRome 00161Italy Department of General Surgery Ospedale di BentivoglioBologna 40010Italy Department of Emergency Surgery St Orsola University HospitalBologna 40138Italy Department of General Surgery Ospedale Santissima AnnunziataTaranto 74121Italy Department of General Surgery Ospedale di TerniUniversitàdi PerugiaTerni 05100Italy

BACKGROUND Acute appendicitis(AA)is one of the main indications for urgent surgery.Laparoscopic appendectomy(LA)has shown advantages in terms of clinical results and cost-effectiveness,even if there is still controversy about different devices to utilize,especially with regards to the endoloop(EL)vs endostapler(ES)when it comes to stump closure.AIM To compare safety and cost-effectiveness of EL vs ES.METHODS From a prospectively maintained database,data of 996 consecutive patients treated by LA with a 3 years-follow up in the department of Emergency General Surgery-St Orsola University Hospital,Bologna(Italy)were retrieved.A metaanalysis was performed in terms of surgical complications,in comparison to the international literature published from 1995 to 2021.RESULTS The meta-analysis showed no evidence regarding wound infections,abdominal abscesses,and total post-operative complications,in terms of superiority of a surgical technique for the stump closure in LA.CONCLUSION Even when AA is complicated,the routine use of EL is safe in most patients.

关键词： Acute appendicitis Laparoscopic appendectomy Endoloops Stapler Post-operative complications

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Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The“BE-FIT-IBD”study

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World Journal of Gastroenterology 2023年第41期29卷 5668-5682页

作者： Antonietta Gerarda Gravina Raffaele Pellegrino Tommaso Durante Giovanna Palladino Rossella D’Onofrio Simone Mammone Giusi Arboretto salvatore Auletta Giuseppe Imperio andrea Ventura Mario Romeo Alessandro Federico Department of Precision Medicine Hepatogastroenterology UnitUniversity of Campania Luigi VanvitelliNaples 80138Italy Mental Health Department S.Pio HospitalBenevento 82100Italy

BACKGROUND The place regular physical activity(PA)should occupy in managing patients with inflammatory bowel diseases(IBD)is unclear.AIM To assess PA levels and barriers in a southern Italian IBD population.METHODS IBD patients with non-severe disease activity[assessed with partial Mayo score for ulcerative colitis(UC)and Harvey-Bradshaw index for Crohn’s disease]were approached to receive an anonymous online questionnaire to assess PA levels using the International Physical Activity Questionnaire(IPAQ)and to assess disease activity as patient-reported outcomes 2(PRO-2)and finally to assess habits,beliefs and barriers in conducting regular PA.Clinical,anthropometric and demographic data of patients were also collected.PA was expressed as continuous units of resting metabolic rate(Met)in min/wk.Three PA groups were identified:Inactive(2500 Met min/wk)patients.RESULTS Included patients(219)showed overall PA levels of 834.5 Met min/wk,with a large proportion(94,42.9%)classified as inactive while only a minority(9,4.1%)as health-enhancing PA.Patients without dyslipidaemia(P0.05).Active patients expressed the need to discuss PA with their gastroenterologist.Some barriers(e.g.,diagnosis of IBD and fear of flare-ups after PA)are significantly more reported by inactive patients.CONCLUSION A significant rate of physical inactivity was recorded in this setting.IPAQ showed good feasibility.PA should be an element of discussion in IBD visits assessed quickly with non-invasive questionnaires.

关键词： Crohn’s disease Inflammatory bowel disease International Physical Activity Questionnaire Physical activity Ulcerative colitis

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Nonalcoholic fatty liver disease and diabetes

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World Journal of Diabetes 2022年第9期13卷 668-682页

作者： Maria Irene Bellini Irene Urciuoli Giovanni Del Gaudio Giorgia Polti Giovanni Iannetti Elena Gangitano Eleonora Lori Carla Lubrano Vito Cantisani salvatore Sorrenti Vito D’andrea Department of Surgical Sciences Sapienza University of RomeRome 00161Italy Department of Radiological Sciences Oncology and PathologySapienza University of RomeRome 00161Italy Department of Experimental Medicine Section of Medical PhysiopathologyFood Science and EndocrinologySapienza University of RomeRome 00161Italy

Nonalcoholic fatty liver disease(NAFLD)is the most prevalent chronic liver disease in the world and represents a clinical-histopathologic entity where the steatosis component may vary in degree and may or may not have fibrotic progression.The key concept of NAFLD pathogenesis is excessive triglyceride hepatic accumulation because of an imbalance between free fatty acid influx and efflux.Strong epidemiological,biochemical,and therapeutic evidence supports the premise that the primary pathophysiological derangement in most patients with NAFLD is insulin resistance;thus the association between diabetes and NAFLD is widely recognized in the literature.Since NAFLD is the hepatic manifestation of a metabolic disease,it is also associated with a higher cardiovascular risk.Conventional B-mode ultrasound is widely adopted as a first-line imaging modality for hepatic steatosis,although magnetic resonance imaging represents the gold standard noninvasive modality for quantifying the amount of fat in these patients.Treatment of NAFLD patients depends on the disease severity,ranging from a more benign condition of nonalcoholic fatty liver to nonalcoholic steatohepatitis.Abstinence from alcohol,a Mediterranean diet,and modification of risk factors are recommended for patients suffering from NAFLD to avoid major cardiovascular events,as per all diabetic patients.In addition,weight loss induced by bariatric surgery seems to also be effective in improving liver features,together with the benefits for diabetes control or resolution,dyslipidemia,and hypertension.Finally,liver transplantation represents the ultimate treatment for severe nonalcoholic fatty liver disease and is growing rapidly as a main indication in Western countries.This review offers a comprehensive multidisciplinary approach to NAFLD,highlighting its connection with diabetes.

关键词： Bariatric surgery Diabetes Hepatic steatosis Liver fibrosis Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis

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Hericium erinaceus,a medicinal fungus with a centuries-old history:Evidence in gastrointestinal diseases

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World Journal of Gastroenterology 2023年第20期29卷 3048-3065页

作者： Antonietta Gerarda Gravina Raffaele Pellegrino salvatore Auletta Giovanna Palladino Giovanni Brandimarte Rossella D'Onofrio Giusi Arboretto Giuseppe Imperio andrea Ventura Marina Cipullo Marco Romano Alessandro Federico Department of Precision Medicine University of Campania“Luigi Vanvitelli”Naples 80138Italy Division of Internal Medicine and Gastroenterology Cristo Re HospitalRome 00167Italy

Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for centuries.Several studies have highlighted its therapeutic potential for gastrointestinal disorders such as gastritis and inflammatory bowel diseases.In addition,some components of this mushroom appear to possess strong antineoplastic capabilities against gastric and colorectal cancer.This review aims to analyse all available evidence on the digestive therapeutic potential of this fungus as well as the possible underlying molecular mechanisms.

关键词： Hericium erinaceus Fungus Gastritis Inflammatory bowel diseases Gastric cancer Colorectal cancer

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A multi-agent system for itinerary suggestion in smart environments

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CAAI Transactions on Intelligence Technology 2021年第4期6卷 377-393页

作者： Alessandra De Paola salvatore Gaglio andrea Giammanco Giuseppe Lo Re Marco Morana Universita degzi studi di Palermo PalermoItaly Srart Cities and Comtnunitics Natioral Jab CINI-Consorzio Interuniversitario Nazionale per l'Infortnatica PalerinoItaly

Modem smart environments pose several challenges,among which the design of intelligent algorithms aimed to assist the users.When a variety of points of interest are available,for instance,trajectory recommendations are needed to suggest users the most suitable itineraries based on their interests and contextual constraints.Unfortunately in many cases,these interests must be explicitly requested and their lack causes the so-called cold-start problem.Moreover,lengthy travelling distances and excessive crowdedness of specific points of interest make itinerary planning more difficult.To address these aspects,a multi-agent itinerary suggestion system that aims at assisting the users in an online and collaborative way is proposed.A profiling agent is responsible for the detection of groups of users whose movements are characterised by similar semantic,spatial and temporal features;then,a recommendation agent leverages contextual information and dynamically associates the current user with the trajectory clusters according to a Multi-Armed Bandit policy;Framing the trajectory recommendation as a reinforcement learning problem permits to provide high-quality suggestions while avoiding both cold-start and preference elicitation issues.The effectiveness of the approach is demonstrated by some deployments in real-life scenarios,such as smart campuses and theme parks.

关键词： artificial intelligence pattern recognition

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Deep Learning and Time Series-to-Image Encoding for Financial Forecasting

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IEEE/CAA Journal of Automatica Sinica 2020年第3期7卷 683-692页

作者： Silvio Barra salvatore Mario Carta andrea Corriga Alessandro Sebastian Podda Diego Reforgiato Recupero Department of Mathematics and Computer Science University of CagliariCagliari 09121Italy

In the last decade,market financial forecasting has attracted high interests amongst the researchers in pattern recognition.Usually,the data used for analysing the market,and then gamble on its future trend,are provided as time series;this aspect,along with the high fluctuation of this kind of data,cuts out the use of very efficient classification tools,very popular in the state of the art,like the well known convolutional neural networks(CNNs)models such as Inception,Res Net,Alex Net,and so on.This forces the researchers to train new tools from scratch.Such operations could be very time consuming.This paper exploits an ensemble of CNNs,trained over Gramian angular fields(GAF)images,generated from time series related to the Standard&Poor's 500 index future;the aim is the prediction of the future trend of the U.S.market.A multi-resolution imaging approach is used to feed each CNN,enabling the analysis of different time intervals for a single observation.A simple trading system based on the ensemble forecaster is used to evaluate the quality of the proposed approach.Our method outperforms the buyand-hold(B&H)strategy in a time frame where the latter provides excellent returns.Both quantitative and qualitative results are provided.

关键词： Convolutional neural networks(CNNs) ensemble of CNNs financial forecasting Gramian angular fields(GAF)imaging

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Intramuscular vs intradermal route for hepatitis B booster vaccine in celiac children

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World Journal of Gastroenterology 2012年第40期18卷 5729-5733页

作者： salvatore Leonardi andrea Domenico Praticò Elena Lionetti Massimo Spina Giovanna Vitaliti Mario La Rosa Department of Pediatrics University of Catania

AIM:To compare intradermal(ID) and intramuscular(IM) booster doses,which have been used in healthy and high risk subjects,such as healthcare workers,haemodialysis patients,human immunodeficiency virus patients,and renal transplant recipients unresponsive to initial hepatitis B vaccination,in celiac individuals.METHODS:We conducted our study on 58 celiac patients,vaccinated in the first year of life,whose blood analysis had showed the absence of protective hepatitis B virus(HBV) antibodies.All patients had received the last vaccine injection at least one year before study enrolment and they had been on a gluten free diet for at least 1 year.In all patients we randomly performed an HBV vaccine booster dose by ID or IM route.Thirty celiac patients were revaccinated with recombinant hepatitis B vaccine(Engerix B) 2 g by the ID route,while 28 celiac patients were revaccinated with Engerix B 10 g by the IM route.Four weeks after every booster dose,the anti-hepatitis B surface(HBs) antibody titer was measured by an enzyme-linked immuneadsorbent assay.We performed a maximum of three booster doses in patients with no anti-HBs antibodies after the first or the second vaccine dose.The cut off value for a negative anti-HBs antibody titer was 10 IU/L.Patients with values between 10 and 100 IU/L were considered "low responders" while patients with an antibody titer higher than 1000 IU/L were considered "high responders".RESULTS:No significant difference in age,gender,duration of illness,and years of gluten intake was found between the two groups.We found a high percentage of "responders" after the first booster dose(ID = 76.7%,IM = 78.6%) and a greater increase after the third dose(ID = 90%,IM = 96.4%) of vaccine in both groups.Moreover we found a significantly higher number of high responders(with an anti-HBs antibody titer > 1000 IU/L) in the ID(40%) than in the IM(7.1%) group,and this difference was evident after the first booster dose of vaccination(P < 0.01).No side effects were recorded in performing delivery of the vacc

关键词：乙肝疫苗助推器皮内注射腹腔人类免疫缺陷病毒乙型肝炎病毒酶联免疫吸附法抗体滴度

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