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Laparoscopic rectal cancer surgery: Where do we stand?

World Journal of Gastroenterology 2012年第46期18卷 6747-6755页

作者： Mukta K Krane alessandro Fichera Department of Surgery University of Chicago Pritzker School of Medicine 5841 South Maryland Ave MC 5095 Chicago IL 60637 United States

Large comparative studies and multiple prospective randomized control trials (RCTs) have reported equivalence in short and long-term outcomes between the open and laparoscopic approaches for the surgical treatment of colon cancer which has heralded widespread acceptance for laparoscopic resection of colon cancer. In contrast, laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer has been welcomed with significantly less enthusiasm. While it is likely that patients with rectal cancer will experience the same benefits of early recovery and decreased postoperative pain from the laparoscopic approach, whether the same oncologic clearance, specifically an adequate TME can be obtained is of concern. The aim of the current study is to review the current level of evidence in the literature on laparoscopic rectal cancer surgery with regard to short-term and long-term oncologic outcomes. The data from 8 RCTs, 3 metaanalyses, and 2 Cochrane Database of Systematic Reviews was reviewed. Current data suggests that laparoscopic rectal cancer resection may benefit patients with reduced blood loss, earlier return of bowel function, and shorter hospital length of stay. Concerns that laparoscopic rectal cancer surgery compromises short-term oncologic outcomes including number of lymph nodes retrieved and circumferential resection margin and jeopardizes long-term oncologic outcomes has not conclusively been refuted by the available literature. Laparoscopic rectal cancer resection is feasible but whether or not it compromises short-term or long-term results still needs to be further studied.

关键词： Rectal cancer Laparoscopy Total mesorectal excision Anterior resection Abdominoperineal resection

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Ages of celiac disease: From changing environment to improved diagnostics

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World Journal of Gastroenterology 2011年第32期17卷 3665-3671页

作者： Alberto Tommasini Tarcisio Not alessandro Ventura Laboratory of Immunopathology Institute for Maternal and Child Health Scientific Institute for Research and Care Burlo Garofolo and University of Trieste Department of Pediatrics Institute for Maternal and Child Health Scientific Institute for Research and Care Burlo Garofolo and University of Trieste

From the time of Gee's landmark writings, the recent history of celiac disease (CD) can be divided into many ages, each driven by a diagnostic advance and a deeper knowledge of disease pathogenesis. At the same time, these advances were paralleled by the identification of new clinical patterns associated with CD and by a continuous redefinition of the prevalence of the disease in population. In the beginning, CD was considered a chronic indigestion, even if the causative food was not known; later, the disease was proven to depend on an intolerance to wheat gliadin, leading to typical mucosal changes in the gut and to a malabsorption syndrome. This knowledge led to curing the disease with a gluten-free diet. After the identification of antibodies to gluten (AGA) in the serum of patients and the identification of gluten-specific lymphocytes in the mucosa, CD was described as an immune disorder, resembling a chronic "gluten infection". The use of serological testing for AGA allowed identification of the higher prevalence of this disorder, revealing atypical patterns of presentation. More recently, the characterization of autoantibodies to endomysium and to transglutaminase shifted the attention to a complex autoimmune pathogenesis and to the increased risk of developing autoimmune disorders in untreated CD. New diagnostic assays, based on molecular technologies, will introduce new changes, with the promise of better defining the spectrum of gluten reactivity and the real burden of gluten related-disorders in the population. Herein, we describe the different periods of CD experience, and further developments for the next celiac age will be proposed.

关键词： Antibodies Autoimmunity Celiac disease Diagnostics History Intestinal mucosa

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Multimodal Imaging with 3D-Holograms for Preoperative Planning in Pediatric Cardiac Surgery:A Unique Case Report

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Congenital Heart Disease 2022年第4期17卷 491-494页

作者： Federica Caldaroni Massimo Chessa alessandro Varrica alessandro Giamberti Department of Congenital Cardiac Surgery IRCCS Policlinico San DonatoSan Donato MilaneseMilanItaly ACHD Unit–Pediatric and Adult Congenital Heart Centre IRCCS Policlinico San DonatoSan Donato MilaneseMilanItaly

Multimodal imaging,including augmented or mixed reality,transforms the physicians’interaction with clinical imaging,allowing more accurate data interpretation,better spatial resolution,and depth perception of the patient’s *** successfully overlay 3D holographic visualization to magnetic resonance imaging images for preoperative decision making of a complex case of cardiac tumour in a 7-year-old girl.

关键词： Hologram augmented reality multimodal imaging 3D CHD cardiac tumour arrhythmia anatomy

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A Weighted Average Consensus Approach for Decentralized Federated Learning

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Machine Intelligence Research 2022年第4期19卷 319-330页

作者： alessandro Giuseppi Sabato Manfredi Antonio Pietrabissa Department of Computer Controland Management EngineeringUniversity of Rome La SapienzaRome 00185Italy Department of Electrical Engineering and Information Technology University of Naples Federico ⅡNaples 80125Italy

Federated learning(FedL)is a machine learning(ML)technique utilized to train deep neural networks(DeepNNs)in a distributed way without the need to share data among the federated training *** was proposed for edge computing and Internet of things(IoT)tasks in which a centralized server was responsible for coordinating and governing the training *** remove the design limitation implied by the centralized entity,this work proposes two different solutions to decentralize existing FedL algorithms,enabling the application of FedL on networks with arbitrary communication topologies,and thus extending the domain of application of FedL to more complex scenarios and new *** the two proposed algorithms,one,called FedLCon,is developed based on results from discrete-time weighted average consensus theory and is able to reconstruct the performances of the standard centralized FedL solutions,as also shown by the reported validation tests.

关键词： Federated learning(FedL) deep learning federated averaging(FedAvg) machine learning(ML) artificial intelligence discrete-time consensus distributed systems.

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Comparison between the seismic response of 2D and 3D models of rigid blocks

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Earthquake Engineering and Engineering Vibration 2014年第1期13卷 151-162页

作者： Angelo Di Egidio Daniele Zulli alessandro Contento Department of Civil Engineering Architecture and Environment(DICEAA)University of L'Aquila

A three-dimensional rigid body on the shape of a parallelepiped is modelled in order to rock on a side or a vertex of the base,in order to evaluate the seismic response of rigid blocks lying on a horizontal *** center of mass of the body is considered as eccentric with respect to its geometric *** seismic input,three Italian recorded accelerograms,with different spectral content,are *** study is mainly conducted to highlight the differences between the seismic response of 2D and 3D models of rigid blocks,with the aim to understand if,in some cases,the use of the 3D model of rigid block is required to obtain safer *** fact,the outcomes show that in some ranges of the geometrical and mechanical parameters that characterize the excitation and the body,a two-dimensional model,which is not able to consider the 3D rocking on a vertex,can provide unsafe *** particular,it is found that the overturning process of the three-dimensional block can occur under excitations which are lower than those which overturn a corresponding two-dimensional block.

关键词： seismic excitation 3D rigid block rectangular base rocking overturning

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Neoadjuvant chemoradiation therapy and pathological complete response in rectal cancer

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Gastroenterology Report 2015年第4期3卷 277-288,I0001页

作者： Linda Ferrari alessandro Fichera Division of General Surgery Department of SurgeryUniversity of Washington Medical CenterSeattleWashington 98195USA

The management of rectal cancer has evolved significantly in the last few *** improvements in local disease control were achieved in the 1990s,with the introduction of total mesorectal excision and neoadjuvant *** 1 evidence has shown that,with neoadjuvant chemoradiation therapy(CRT)the rates of local recurrence can be lower than 6%and,as a result,neoadjuvant CRT currently represents the accepted standard of *** approach has led to reliable tumor down-staging,with 15–27%patients with a pathological complete response(pCR)—defined as no residual cancer found on histological examination of the *** who achieve pCR after CRT have better long-term outcomes,less risk of developing local or distal recurrence and improved *** all these reasons,sphincter-preserving procedures or organ-preserving options have been suggested,such as local excision of residual tumor or the omission of surgery *** local recurrence rate has been stable at 5–6%with this multidisciplinary management method,distal recurrence rates for locally-advanced rectal cancers remain in excess of 25%and represent the main cause of death in these *** this reason,more recent trials have been looking at the administration of full-dose systemic chemotherapy in the neoadjuvant setting(in order to offer early treatment of disseminated micrometastases,thus improving control of systemic disease)and selective use of radiotherapy only in non-responders or for low rectal tumors smaller than 5 cm.

关键词： rectal cancer neoadjuvant chemoradiation therapy pathological complete response

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Parametric Transformation of Timed Weighted Marked Graphs:Applications in Optimal Resource Allocation

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IEEE/CAA Journal of Automatica Sinica 2021年第1期8卷 179-188页

作者： Zhou He Ziyue Ma Zhiwu Li alessandro Giua the College of Mechanical and Electrical Engineering Shaanxi University of Science and TechnologyXi’an 710021China Shaanxi Key Laboratory of Complex System Control and Intelligent Information Processing Xi’an University of TechnologyXi’an 710048China the School of Electro-Mechanical Engineering Xidian UniversityXi’an 710071China Institute of Systems Engineering Macao University of Science and TechnologyTaipa 999078MacaoChina the Department of Electrical and Electronic Engineering University of CagliariCagliari 09124Italy

Timed weighted marked graphs are a subclass of timed Petri nets that have wide applications in the control and performance analysis of flexible manufacturing *** to the existence of multiplicities(i.e.,weights)on edges,the performance analysis and resource optimization of such graphs represent a challenging *** this paper,we develop an approach to transform a timed weighted marked graph whose initial marking is not given,into an equivalent parametric timed marked graph where the edges have unitary *** order to explore an optimal resource allocation policy for a system,an analytical method is developed for the resource optimization of timed weighted marked graphs by studying an equivalent ***,we apply the proposed method to a flexible manufacturing system and compare the results with a previous heuristic *** analysis shows that the developed approach is superior to the heuristic approach.

关键词： Discrete event system resource allocation timed Petri net weighted marked graph

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Non-toxic, high selectivity process for the extraction of precious metals from waste printed circuit boards

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Frontiers of Environmental Science & Engineering 2023年第10期17卷 65-74页

作者： Giulia Merli alessandro Becci Alessia Amato Francesca Beolchini Department of Life and Environmental Sciences Polytechnic University of MarcheAncona 60131Italy

The work presented here focused on the extraction of gold (Au), silver (Ag) and palladium (Pd) from electronic waste using a solution of ammonium thiosulfate. Thiosulfate was used as a valid alternative to cyanide for precious metal extractions, due to its non-toxicity and high selectivity. The interactions between sodium thiosulfate, total ammonia/ammonium, precious metal concentrations and the particle size of the waste printed circuit boards (WPCBs) were studied by the response surface methodology (RSM) and the principal component analysis (PCA) to maximize precious metal mobilization. Au extraction reached a high efficiency with a granulometry of less than 0.25 mm, but the consumption of reagents was high. On the other hand, Ag extraction depended neither on thiosulfate/ammonia concentration nor granulometry of WPCBs and it showed efficiency of 90% also with the biggest particle size (0.50 < Ø < 1.00 mm). Pd extraction, similarly to Au, showed the best efficiency with the smallest and the medium WPCB sizes, but required less reagents compared to Au. The results showed that precious metal leaching is a complex process (mainly for Au, which requires more severe conditions in order to achieve high extraction efficiencies) correlated with reagent concentrations, precious metal concentrations and WPCB particle sizes. These results have great potentiality, suggesting the possibility of a more selective recovery of precious metals based on the different granulometry of the WPCBs. Furthermore, the high extraction efficiencies obtained for all the metals bode well in the perspective of large-scale applications.

关键词： Thiosulfate Printed circuit boards Precious metals Leaching Hydrometallurgy

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Regeneration of the central nervous system-principles from brain regeneration in adult zebrafish

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World Journal of Stem Cells 2020年第1期12卷 8-24页

作者： alessandro Zambusi Jovica Ninkovic Helmholtz Center Munich Biomedical CenterInst Stem Cell ResInstitute of Stem Cell ResearchDepartment of Cell Biology and AnatomyUniversity of Munich

Poor recovery of neuronal functions is one of the most common healthcare challenges for patients with different types of brain injuries and/or neurodegenerative *** interventions face two major challenges:(1)How to generate neurons de novo to replenish the neuronal loss caused by injuries or neurodegeneration(restorative neurogenesis)and(2)How to prevent or limit the secondary tissue damage caused by long-term accumulation of glial cells,including microglia,at injury site(glial scar).In contrast to mammals,zebrafish have extensive regenerative capacity in numerous vital organs,including the brain,thus making them a valuable model to improve the existing therapeutic approaches for human brain *** response to injuries to the central nervous system(CNS),zebrafish have developed specific mechanisms to promote the recovery of the lost tissue architecture and functionality of the damaged *** mechanisms include the activation of a restorative neurogenic program in a specific set of glial cells(ependymoglia)and the resolution of both the glial scar and inflammation,thus enabling proper neuronal specification and *** this review,we discuss the cellular and molecular mechanisms underlying the regenerative ability in the adult zebrafish brain and conclude with the potential applicability of these mechanisms in repair of the mammalian CNS.

关键词： Zebrafish Central nervous system Brain injury Glial scar Regeneration Restorative neurogenesis Neural stem cells Inflammation

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Complete pancreatic heterotopia of gallbladder with hypertrophic duct simulating an adenomyoma

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World Journal of Gastroenterology 2006年第11期12卷 1786-1787页

作者： Luca Pilloni alessandro Cois alessandro Uccheddu Rossano Ambu Pierpaolo Coni Gavino Faa Istituto di Anatomia Patologica Dipartimento di Citomorfologia Universita degli Studi di CagliariItaly Semeiotica Chirurgica Dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini Università degli Studi di CagliariItaly Istituto di Anatomia Patologica Dipartimento di Citomorfologia Università degli Studi di CagliariItaly

The gallbladder is an unusual location of pancreatic heterotopia, defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of the gland. A 28-year-old man presented with anorexia, nausea and pain in the right upper abdomen. On physical examination, the abdomen was tender to palpation and Murphy sign was positive. The patient underwent a cholecystecomy. This case, in our opinion, is very interesting since it permits to consider a controversial issue in the pathology of the gallbladder. The histological appearance of ductal structure in pancreatic heterotopia resembles the histological picture of both Aschoff-Rokitansky （AR） sinuses and adenomyomas. This finding suggests that these lesions are linked by a common histogenetic origin. We suggest that the finding of an adenomyoma in the gallbladder should prompt an extensive sampling of the organ in order to verify the coexistence of pancreatic rests.

关键词： Pancreatic heterotopia Gallbladder Hypertrophic duct Adenomyoma Aschoff-Rokitansky sinuses

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