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Proficiency score as a predictor of early trifecta achievement during the learning curve of robot-assisted radical prostatectomy for high-risk prostate cancer:Results of a multicentric series

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Current Urology 2024年第2期18卷 110-114页

作者： Umberto Anceschi Rocco Simone Flammia Antonio Tufano Michele Morelli Antonio Galfano lorenzo giuseppe luciani Leonardo Misuraca Paolo Dell’Oglio Gabriele Tuderti Aldo Brassetti Maria Consiglia Ferriero Alfredo Maria Bove Riccardo Mastroianni Francesco Prata Isabella Sperduti Giovanni Petralia SilviaSecco Ettore Di Trapani DanieleMattevi Tommaso Cai Aldo Massimo Bocciardi giuseppe Simone Department of Urology IRCCS“Regina Elena”National Cancer InstituteRomeItaly Urologic Clinic Department of Maternal-Child and Urologic SciencesSapienza University of RomeItaly Ospedale Niguarda Ca’Granda Department of UrologyMilanItaly Department of Urology APSS Santa Chiara Regional HospitalTrentoItaly Department of Biostatistical Unit IRCCS Regina Elena National Cancer InstituteRomeItaly

Background:Recently,an innovative tool called“proficiency score”was introduced to assess the learning curve for robot-assisted radical prostatectomy(RARP).However,the initial study only focused on patients with low-risk prostate cancer forwhompelvic lymph node dissection(PLND)was not *** address this issue,we aimed to validate proficiency scores of a contemporarymulticenter cohort of patients with high-risk prostate cancer treated with RARP plus extended PLND by trainee *** andmethods:Between 2010 and 2020,4 Italian institutional prostate-cancer datasets weremerged and queried for“RARP”and“high-risk prostate cancer.”High-risk prostate cancer was defined according to the most recent European Association of Urology guidelines as follows:prostate-specific antigen>20 ng/mL,International Society ofUrological Pathology≥4,and/or clinical stage(cT)≥2c on preoperative *** selected cohort(n=144)included clinical cases performed by trainee surgeons(n=4)after completing their RARP learning curve(50 procedures for low-risk prostate cancer).The outcome of interest,the proficiency score,was defined as the coexistence of all the following criteria:a comparable operation time to the interquartile range of the mentor surgeon at each center,absence of any significant perioperative complications Clavien-Dindo Grade 3–5,no perioperative blood transfusions,and negative surgical margins.A logistic binary regression model was built to identify the predictors of 1-year trifecta achievement in the trainee *** all statistical analyses,a 2-sided p<0.05 was considered ***:A proficiency score was achieved in 42.3%*** univariable level,proficiency score was associated with 1-year trifecta achievement(odds ratio,8.77;95%confidence interval,2.42–31.7;p=0.001).After multivariable adjustments for age,nerve-sparing,and surgical technique,the proficiency score independently predicted 1-year trifecta achievement(odds ratio,9.58;95%confidence i

关键词： Trifecta Learning curve Robot-assisted radical prostatectomy High-risk prostate cancer

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Multiallelic and multilocus simple sequence repeats(SSRs)to assess the genetic diversity of a Salix *** collection

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Journal of Forestry Research 2021年第1期32卷 263-271页

作者： Giorgia Carletti Luigi Cattivelli lorenzo Vietto giuseppe Nervo Council for Agricultural Research and Economics(CREA)-Research Centre for Forestry and Wood Casale MonferratoALItaly Council for Agricultural Research and Economics(CREA)-Research Centre for Genomics and Bioinformatics Fiorenzuola d’ArdaPCItaly

Salix L.(willow)is the largest genus of the family Salicaceae and plays an important role in riparian habitats,wetlands and in shrub *** to the diff erent implications for the species belonging to this family,it is fundamental to identify molecular tools characterizing relevant clones.A set of six multilocus and multiallelic simple sequence repeat(SSRs)markers are presented,leading to 390 polymorphic fragments considered as single dominant markers and able to discriminate successfully 92 *** *** 24 Salix *** polymorphic fragments have been used to perform genetic diversity studies,and to investigate population structures and cluster analysis in a germplasm *** results highlight the capability of the six SSRs to be powerful genetic resources in applied forestry research,both to distinguish *** clones from Salix *** to perform genetic population studies for breeding programs.

关键词： Microsatellites Salix Genetic diversity

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Direct carotid puncture in acute ischaemic stroke intervention

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Stroke & Vascular Neurology 2020年第1期5卷 71-79页

作者： Elisa Colombo lorenzo Rinaldo giuseppe Lanzino Neurologic Surgery Mayo ClinicRochesterMinnesotaUSA

Endovascular intervention for acute ischaemic stroke care is mostly performed in older patients,often with unfavourable aortic and supra-aortic anatomy,as well as cardiovascular comorbidities.A significant subset of them may benefit from transcervical access as the initial approach for mechanical *** fact,direct carotid artery puncture in these cases has the advantage to bypass the anatomical obstacles and achieve faster *** is advised when common carotid artery access is pursued in order to avoid adverse events,including haematoma formation,iatrogenic arterial dissection and sheath *** spite of potential complications,direct carotid puncture in acute ischaemic stroke intervention overcomes challenging angioarchitecture and may reduce the rate of poor clinical outcomes associated with delayed revascularisation in certain cases.

关键词： carotid puncture anatomy

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Breakthroughs and challenges in the management of pediatric viral hepatitis

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World Journal of Gastroenterology 2021年第20期27卷 2474-2494页

作者： Emanuele Nicastro lorenzo Norsa Angelo Di Giorgio giuseppe Indolfi lorenzo D'Antiga Department of Pediatric Gastroenterology Hepatology and Transplantation ASST Papa Giovanni XXIIIBergamo 24127Italy Department of Neurofarba Meyer Children's University Hospital of FlorenceFlorence 50137Italy

Chronic infections by hepatitis B virus(HBV)and hepatitis C virus(HCV)major causes of advanced liver disease and mortality *** regarded as benign infections in children,their persistence through adulthood is undoubtedly of *** advances in HCV treatment have restored the visibility of these conditions and raised expectations for HBV treatment,which is currently far from being *** we describe direct-acting antivirals available for pediatric HCV(sofosbuvir/ledipasvir,sofosbuvir/velpatasvir,glecaprevir/pibrentasvir)and their real-world use.A critical review of the HBV pediatric classification is ***-HBV investigational compounds are reviewed in light of the pathophysiology in the pediatric population,including capsid assembly modulators,antigen secretion inhibitors,silencing RNAs,and immune *** for screening and management of immunosuppressed children or those with other risk factors or comorbidities are also summarized.

关键词： Hepatitis C Hepatitis B Direct acting antivirals Liver cirrhosis Children

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Cooling performance of earth-to-air heat exchangers applied to a poultry barn in semi-desert areas of south Iraq

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International Journal of Agricultural and Biological Engineering 2018年第3期11卷 47-53页

作者： Wasseem Morshed lorenzo Leso Leonardo Conti giuseppe Rossi Stefano Simonini Matteo Barbari Department of Agricultural Food and Forestry SystemsUniversity of FirenzeVia San Bonaventura13.50145 FirenzeItaly

Earth-to-air heat exchangers(EAHE)can reduce the energy consumption required for heating and cooling of *** composition and the thermal characteristics of the soil influence the heat exchange capacity,and the soil moisture can furthermore affect thermal performance of *** aim of this study was to compare the thermal performance of EAHE in dry and artificially wetted *** were carried out in the Basra Province(Iraq),in a semi-desert *** experimental EAHE were built in a poultry barn and tested from June 2013 to September *** pipe exchangers were buried at 2 m *** heat exchanger operated in dry soil(DE),while the other one operated in artificially wetted soil(WE).In the WE system,a drip tubing placed 10 cm above the air pipe wetted the soil around the *** temperatures at the inlet and at the outlet of both the exchangers as well as soil temperature at 2 m deep were continuously *** experimental results confirmed that wetting the soil around EAHE improves the general heat exchange *** coefficient of cooling performance(COP)of the earth-to-air heat exchangers system was evaluated on the basis of the ratio between the heat removed from the air or added to the air and the energy *** the day,with an average COP of 6.41,the WE system cooled the air more than the DE system,which reported a value of *** average,in the hottest hours of the day,the outlet temperature of the WE was 37.35℃ while in the DE it was 38.91℃.Moreover,during the nighttime,the WE system warmed the air more than the DE system.

关键词： Earth-to-air heat exchangers thermal performance cooling artificially wetted soil poultry barn heat stress

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Spontaneous porto-systemic shunts in liver cirrhosis:Clinical and therapeutical aspects

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World Journal of Gastroenterology 2020年第15期26卷 1726-1732页

作者： Silvia Nardelli Oliviero Riggio Stefania Gioia Marta Puzzono giuseppe Pelle lorenzo Ridola Department of Translational and Precision Medicine “Sapienza”University of RomeRome 00185Italy Department of Interventional Radiology Santa Maria Goretti HospitalLatina 04100Italy

Spontaneous porto-systemic shunts(SPSS)are frequent in liver cirrhosis and their prevalence increases as liver function deteriorates,probably as a consequence of worsening portal hypertension,but without achieving an effective protection against cirrhosis'*** types of SPSS have been described in the literature,each one associated with different clinical *** particular,recurrent or persistent hepatic encephalopathy is more frequent in patients with splenorenal shunt,while the presence of gastric varices and consequently the incidence of variceal bleeding is more common in gastrorenal *** the advanced stage,the presence of large SPSS can lead to the so called“portosystemic shunt syndrome”,characterized by a progressive deterioration of hepatic function,hepatic encephalopathy and,sometimes,portal vein *** detection of SPSS in patients with liver cirrhosis is recommended in order to prevent or treat recurrent hepatic encephalopathy or variceal bleeding.

关键词： Porto-systemic shunts Liver cirrhosis Variceal bleeding Hepatic encephalopathy Portal vein thrombosis Porto-systemic shunt syndrome

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Nonalcoholic fatty liver disease (NAFLD) prevention: role of Mediterranean diet and physical activity

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Hepatobiliary Surgery and Nutrition 2019年第2期8卷 167-169页

作者： Francesca Maria Trovato Paola Castrogiovanni lorenzo Malatino giuseppe Musumeci Department of Clinical and Experimental Medicine Human Anatomy and Histology SectionSchool of MedicineUniversity of CataniaCataniaItaly Department of Biomedical and Biotechnological Sciences Human Anatomy and Histology SectionSchool of MedicineUniversity of CataniaCataniaItaly

Nonalcoholic fatty liver disease(NAFLD)is one of the most common causes of chronic liver disease in Western countries leading to high morbidity and mortality and is strongly related to obesity(1).Indeed,metabolic syndrome and insulin resistance play a role in the pathogenesis of NAFLD,which involves intrahepatic triglyceride accumulation and inflammation(2).NAFLD is a consequence of genetic predisposition interacting with environmental and behavioral *** within the literature strongly support the idea that it represents the hepatic feature of a multisystem disease together with type 2 diabetes,cardiovascular disease(CVD),chronic kidney disease and osteoporosis(3).Nevertheless,the exact mechanism of hepatic fat accumulation and the progression to nonalcoholic steatohepatitis(NASH)is not completely *** fat is closely related to cardiometabolic risk(4)and,in order to decrease intrahepatic lipid(IHL)content and improve NAFLD,lifestyle interventions involving both diet and physical activity are recommended(2).In particular,great attention is focused on Mediterranean diet,which seems to help in gradually improving the severity of NAFLD(5).A randomized,cross-over intervention study demonstrated that in just 6 weeks,an olive-oil rich Mediterranean diet can result in a 40%relative reduction in liver fat measured by magnetic resonance in the form of IHL%(6).NAFLD improvement was associated with increased insulin sensitivity and reduced circulating insulin concentrations,even without a change in body weight(6).

关键词： NAFLD prevention hepatic

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Squamous cell carcinoma of the scrotum: A look beyond the chimneystacks

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World Journal of Clinical Cases 2014年第11期2卷 654-660页

作者： Ritva Vyas Homayoun Zargar Rossella Di Trolio giuseppe Di lorenzo Riccardo Autorino Department of Dermatology University Hospitals Case Medical Center Cleveland OH 44106 United States Glickman Urological and Kidney Institute Cleveland Clinic Cleveland OU 44195 United States Unit of Medical Oncology and Innovative Therapy National Cancer Institute "Fondazione Giovanni Pascale" 80100 Napoli Italy Genitourinary Cancer Section and Rare-Cancer Center Medical Oncology Division University Federico II 80100 Napoli Italy Urology Institute University Hospitals Case Medical Center Cleveland OH 44106 United States Urology Unit Second University of Naples80100 Naples Italy

Despite the low incidence, squamous cell carcinoma(SCC) remains the most common scrotal malignancy featuring a propensity for recurrence and metastasis. In recent years there has been a significant change in the epidemiology of scrotal SCC. Surgery is the mainstay of treatment for resectable disease. Sentinel lymph node dissection similar to algorithm for patients with penile SCC can reduce the morbidity of routine lymph node dissection. Emerging treatments for advanced and metastatic SCC are at the cusp of significantly changing management of this disease. We have performed a comprehensive review of scrotal SCC with a focus on these topics.

关键词： Squamous cell carcinoma Genital cancer Scrotal cancer

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Evolution of incidental branch-duct intraductal papillary mucinous neoplasms of the pancreas: A study with magnetic resonance imaging cholangiopancreatography

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World Journal of Gastroenterology 2016年第43期22卷 9562-9570页

作者： Rossano Girometti Riccardo Pravisani Sergio giuseppe Intini Miriam Isola lorenzo Cereser Andrea Risaliti Chiara Zuiani Institute of Diagnostic Radiology Department of Medical and Biological Sciences University of Udine University Hospital "S. Maria della Misericordia" Clinical Surgery Department of Medical and Biological Sciences University of Udine University Hospital "S. Maria della Misericordia" Department of Medical and Biological Sciences University of Udine

AIM To investigate the type and timing of evolution of incidentally found branch-duct intraductal papillary mucinous neoplasms(bd-IPMN) of the pancreas addressed to magnetic resonance imaging cholangiopancreatography(MRCP) *** We retrospectively evaluated 72 patients who underwent, over the period 2006-2016, a total of 318 MRCPs(mean 4.4) to follow-up incidental, presumed bdIPMN without signs of malignancy, found or confirmedat a baseline MRCP examination. Median follow-up time was 48.5 mo(range 13-95 mo). MRCPs were acquired on 1.5T and/or 3.0T systems using 2D and/or 3D technique. Image analysis assessed the rates of occurrence over the follow-up of the following outcomes:(1) imaging evolution, defined as any change in cysts number and/or size and/or appearance; and(2) alert findings, defined as worrisome features and/or high risk stigmata(e.g., thick septa, parietal thickening, mural nodules and involvement of the main pancreatic duct). Time to outcomes was described with the Kaplan-Meir approach. Cox regression model was used to investigate clinical or initial MRCP findings predicting cysts *** We found a total of 343 cysts(per-patient mean 5.1) with average size of 8.5 mm(range 5-25 mm). Imaging evolution was observed in 32/72 patients(44.4%; 95%CI: 32-9-56.6), involving 47/343 cysts(13.7%). There was a main trend towards small( 0.01).CONCLUSION Changes in MRCP appearance of incidental bd-IPNM were frequent over the follow-up(44.4%), with relatively rare(8.3%) occurrence of non-malignant alert findings that prompted further diagnostic steps. Cha

关键词： Pancreas Cysts Branch-duct intraductal papillary mucinous neoplasm Magnetic resonance cholangiopancreatography Follow-up

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Anterior vertebral body tethering for idiopathic scoliosis in growing children:A systematic review

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World Journal of Orthopedics 2022年第5期13卷 481-493页

作者： Davide Bizzoca Andrea Piazzolla lorenzo Moretti Giovanni Vicenti Biagio Moretti giuseppe Solarino UOSD Spinal Deformity Centre AOU Consorziale Policlinico di BariBari 70124Italy Department of Biomedical Sciences and Human Oncology University of Bari“Aldo Moro”Bari 70124Italy Orthopaedic and Trauma Unit AUO Consorziale Policlinico di BariBari 70124Italy Department of Basic Medical Sciences Neuroscience and Sense OrgansOrthopaedic and Trauma UnitUniversity of Bari“Aldo Moro”Bari 70124PugliaItaly

BACKGROUND The management of idiopathic scoliosis(IS)in skeletally immature patients should aim at three-dimensional deformity correction,without compromising spinal and chest *** 2019,the US Food and Drug Administration approved the first instrumentation system for anterior vertebral body tethering(AVBT),under a Humanitarian Device Exception,for skeletally immature patients with curves having a Cobb angle between 35°and 65°.AIM To summarize current evidence about the efficacy and safety of AVBT in the management of IS in skeletally immature *** From January 2014 to January 2021,Ovid Medline,Embase,Cochrane Library,Scopus,Web of Science,Google Scholar and PubMed were searched to identify relevant *** methodological quality of the studies was evaluated and relevant data were *** Seven clinical trials recruiting 163 patients were included in the present *** studies out of seven were classified as high quality,whereas the remaining two studies were classified as moderate quality.A total of 151 of 163 AVBT procedures were performed in the thoracic spine,and the remaining 12 tethering in the lumbar *** 117 of 163(71.8%)patients had a nonprogressive curve at skeletal ***-three of 163(14.11%)patients required unplanned revision surgery within the follow-up *** to posterior spinal fusion(PSF)was performed in 18 of 163(11%)*** AVBT is a promising growth-friendly technique for treatment of IS in growing ***,it has moderate success and perioperative complications,revision and conversion to PSF.

关键词： Idiopathic scoliosis Spinal growth modulation Anterior spinal instrumentation Curve correction Anterior vertebral body tethering Paediatric spine Growing spine Skeletally immature patients Growth-friendly spinal implants

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