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2. Recurrence and tumor-related death after resection of hepatocellular carcinoma in patients with metabolic syndrome.

Author

Berardi, Giammauro, Cucchetti, Alessandro, Sposito, Carlo, Ratti, Francesca, Nebbia, Martina, DSouza, Daniel, Pascual, Franco, Dogeas, Epameinondas, Tohme, Samer, Vitale, Alessandro, DAmico, Francesco, Alessandris, Remo, Panetta, Valentina, Simonelli, Ilaria, Colasanti, Marco, Russolillo, Nadia, Moro, Amika, Fiorentini, Guido, Serenari, Matteo, Rotellar, Fernando, Zimitti, Giuseppe, Famularo, Simone, Ivanics, Tommy, Donando, Felipe, Hoffman, Daniel, Onkendi, Edwin, Essaji, Yasmin, Giuliani, Tommaso, Lopez Ben, Santiago, Caula, Celia, Rompianesi, Gianluca, Chopra, Asmita, Abu Hilal, Mohammed, Sapisochin, Gonzalo, Torzilli, Guido, Corvera, Carlos, Alseidi, Adnan, Helton, Scott, Troisi, Roberto, Simo, Kerri, Conrad, Claudius, Cescon, Matteo, Cleary, Sean, Kwon, David, Ferrero, Alessandro, Ettorre, Giuseppe, Cillo, Umberto, Geller, David, Cherqui, Daniel, Serrano, Pablo, Ferrone, Cristina, Aldrighetti, Luca, Kingham, T, and Mazzaferro, Vincenzo

Subjects
Hepatocellular carcinoma, Metabolic syndrome, Metabolic-associated fatty liver disease, Nonalcoholic fatty liver disease, Obesity, Recurrence, Steatosis
Abstract

BACKGROUND & AIMS: Metabolic syndrome (MS) is a growing epidemic and a risk factor for the development of hepatocellular carcinoma (HCC). This study investigated the long-term outcomes of liver resection (LR) for HCC in patients with MS. Rates, timing, patterns, and treatment of recurrences were investigated, and cancer-specific survivals were assessed. METHODS: Between 2001 and 2021, data from 24 clinical centers were collected. Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival were analyzed as well as recurrence patterns and treatment. The analysis was conducted using a competing-risk framework. The trajectory of the risk of recurrence over time was applied to a competing risk analysis. For post-recurrence survival, death resulting from tumor progression was the primary endpoint, whereas deaths with recurrence relating to other causes were considered as competing events. RESULTS: In total, 813 patients were included in the study. Median OS was 81.4 months (range 28.1-157.0 months), and recurrence occurred in 48.3% of patients, with a median RFS of 39.8 months (range 15.7-174.7 months). Cause-specific hazard of recurrence showed a first peak 6 months (0.027), and a second peak 24 months (0.021) after surgery. The later the recurrence, the higher the chance of receiving curative intent approaches (p = 0.001). Size >5 cm, multiple tumors, microvascular invasion, and cirrhosis were independent predictors of recurrence showing a cause-specific hazard over time. RFS was associated with death for recurrence (hazard ratio: 0.985, 95% CI: 0.977-0.995; p = 0.002). CONCLUSIONS: Patients with MS undergoing LR for HCC have good long-term survival. Recurrence occurs in 48% of patients with a double-peak incidence and time-specific hazards depending on tumor-related factors and underlying disease. The timing of recurrence significantly impacts survival. Surveillance after resection should be adjusted over time depending on risk factors. IMPACT AND IMPLICATIONS: Metabolic syndrome (MS) is a growing epidemic and a significant risk factor for the development of hepatocellular carcinoma (HCC). The present study demonstrated that patients who undergo surgical resection for HCC on MS have a good long-term survival and that recurrence occurs in almost half of the cases with a double peak incidence and time-specific hazards depending on tumor-related factors and underlying liver disease. Also, the timing of recurrence significantly impacts survival. Clinicians should therefore adjust follow-up after surgery accordingly, considering timing of recurrence and specific risk factors. Also, the results of the present study might help design future trials on the use of adjuvant therapy following resection.

Published
2024

4. Cornerstones and divergencies in the implementation and use of liver hypertrophy techniques: results from a nationwide survey for the set-up of the prospective registry

Author

Ratti, Francesca, Serenari, Matteo, Avolio, Alfonso, Batignani, Giacomo, Boggi, Ugo, Brolese, Alberto, Caccamo, Lucio, Celotti, Andrea, Cillo, Umberto, Cinardi, Nicola, Cotsoglou, Christian, Dalla Valle, Raffaele, De Carlis, Luciano, De Simone, Paolo, Di Benedetto, Fabrizio, Ercolani, Giorgio, Ettorre, Giuseppe Maria, Fedi, Massimo, Ferrero, Alessandro, Giuliani, Antonio, Giuliante, Felice, Grazi, Gian Luca, Gruttadauria, Salvatore, Guglielmi, Alfredo, Izzo, Francesco, Lai, Quirino, Lorenzin, Dario, Maestri, Marcello, Massani, Marco, Mazzaferro, Vincenzo, Memeo, Riccardo, Nardo, Bruno, Portolani, Nazario, Ravaioli, Matteo, Rocca, Aldo, Romagnoli, Renato, Romano, Fabrizio, Saladino, Edoardo, Tisone, Giuseppe, Troisi, Roberto, Veneroni, Luigi, Vennarecci, Giovanni, Viganò, Luca, Viola, Giuseppe, Vivarelli, Marco, Zanus, Giacomo, Aldrighetti, Luca, and Jovine, Elio

Published
2024
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5. Factors Associated with and Impact of Open Conversion in Laparoscopic and Robotic Minor Liver Resections: An International Multicenter Study of 10,541 Patients

Author

Saleh, Mansour, Pascual, Franco, Ghallab, Mohammed, Wu, Andrew G. R., Chin, Ken-Min, Ratti, Francesca, Giglio, Mariano Cesare, Garatti, Marco, Nghia, Phan Phuoc, Kato, Yutaro, Lim, Chetana, Herman, Paulo, Coelho, Fabricio Ferreira, Schmelzle, Moritz, Pratschke, Johann, Aghayan, Davit L., Liu, Qiu, Marino, Marco V., Belli, Andrea, Chiow, Adrian K. H., Sucandy, Iswanto, Ivanecz, Arpad, Di Benedetto, Fabrizio, Choi, Sung Hoon, Lee, Jae Hoon, Park, James O., Prieto, Mikel, Guzman, Yoelimar, Fondevila, Constantino, Efanov, Mikhail, Rotellar, Fernando, Choi, Gi-Hong, Robles-Campos, Ricardo, Kadam, Prashant, Sutcliffe, Robert P., Troisi, Roberto I., Tang, Chung Ngai, Chong, Charing C., D’Hondt, Mathieu, Dalla Valle, Bernardo, Ruzzenente, Andrea, Kingham, T. Peter, Scatton, Olivier, Liu, Rong, Mejia, Alejandro, Mishima, Kohei, Wakabayashi, Go, Lopez-Ben, Santiago, Wang, Xiaoying, Ferrero, Alessandro, Ettorre, Giuseppe Maria, Vivarelli, Marco, Mazzaferro, Vincenzo, Giuliante, Felice, Yong, Chee Chien, Yin, Mengqiu, Monden, Kazuteru, Geller, David, Chen, Kuo-Hsin, Sugioka, Atsushi, Edwin, Bjørn, Cheung, Tan-To, Long, Tran Cong Duy, Abu Hilal, Mohammad, Aldrighetti, Luca, Soubrane, Olivier, Fuks, David, Han, Ho-Seong, Cherqui, Daniel, and Goh, Brian K. P.

Published
2024
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6. Assessing ChatGPT’s Potential in HIV Prevention Communication: A Comprehensive Evaluation of Accuracy, Completeness, and Inclusivity

Author

De Vito, Andrea, Colpani, Agnese, Moi, Giulia, Babudieri, Sergio, Calcagno, Andrea, Calvino, Valeria, Ceccarelli, Manuela, Colpani, Gianmaria, d’Ettorre, Gabriella, Di Biagio, Antonio, Farinella, Massimo, Falaguasta, Marco, Focà, Emanuele, Giupponi, Giusi, Habed, Adriano José, Isenia, Wigbertson Julian, Lo Caputo, Sergio, Marchetti, Giulia, Modesti, Luca, Mussini, Cristina, Nunnari, Giuseppe, Rusconi, Stefano, Russo, Daria, Saracino, Annalisa, Serra, Pier Andrea, and Madeddu, Giordano

Published
2024
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11. Echocardiographic evaluation in patient candidate for liver transplant: from pathophysiology to hemodynamic optimization

Author

Marta Iaconi, Micaela Maritti, Giuseppe Maria Ettorre, and Luigi Tritapepe

Subjects
Liver transplantation, Echocardiography, Coronary artery disease, Strain, Portopulmonary hypertension, Cirrhosis, Anesthesiology, RD78.3-87.3, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Cardiovascular complications are common in patients with severe liver disease and are an important cause of peri-operative and post-transplant morbidity and mortality. Cirrhotic cardiomyopathy (CCM), often found in advanced liver disease, is characterized by diastolic dysfunction, systolic dysfunction, and electrophysiological abnormalities. While CCM may not cause symptoms at rest, it can become evident during stressful activities, such as surgery. Liver transplantation, while being the definitive treatment for end-stage liver disease (ESLD), carries significant cardiovascular risks. Preoperative cardiac evaluation is essential for assessing these risks and planning appropriate management. Cardiac imaging, particularly echocardiography, plays a crucial role in evaluating liver transplant candidates, helping to identify conditions such as CCM, pulmonary hypertension, hepatopulmonary syndrome, and others. Currently, liver transplant anesthetists must acquire echocardiographic knowledge and skills to evaluate the cardiocirculatory conditions of the transplanted patient, especially in the pre-operative phase, but also intra-operatively and post-operatively.

Published
2024
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14. A step towards digital operations -- A novel grey-box approach for modelling the heat dynamics of Ultra-low temperature freezing chambers

Author

Huang, Tao, Bacher, Peder, Møller, Jan Kloppenborg, D'Ettorre, Francesco, and Markussen, Wiebke Brix

Subjects
Electrical Engineering and Systems Science - Systems and Control
Abstract

Ultra-low temperature (ULT) freezers store perishable bio-contents and have high energy consumption, which highlight a demand for reliable methods for intelligent surveillance and smart energy management. This study introduces a novel grey-box modelling approach based on stochastic differential equations to describe the heat dynamics of the ULT freezing chambers. The proposed modelling approach only requires temperature data measured by the embedded sensors and uses data from the regular operation periods for model identification. The model encompasses three states: chamber temperature, envelope temperature, and local evaporator temperature. Special attention is given to the local evaporator temperature state, which is modelled as a time-variant system, to characterize the time delay and dynamic variations in cooling intensity. Two ULT freezers with different operational patterns are modelled. The unknown model parameters are estimated using the maximum likelihood method. The results demonstrate that the models can accurately predict the chamber temperature measured by the control probe (RMSE < 0.19 {\deg}C) and are promising to be applied for forecasting future states. In addition, the model for local evaporator temperature can effectively adapt to different operational patterns and provide insight into the local cooling supply status. The proposed approach greatly promotes the practical feasibility of grey-box modelling of the heat dynamics for ULT freezers and can serve several potential digital applications. A major limitation of the modelling approach is the low identifiability, which can potentially be addressed by inferring model parameters based on relative parameter changes.

Published
2023

15. Switch to phagocytic microglia by CSFR1 inhibition drives amyloid-beta clearance from glutamatergic terminals rescuing LTP in acute hippocampal slices

Author

Gaia Piccioni, Nunzia Maisto, Asia d’Ettorre, Georgios Strimpakos, Robert Nisticò, Viviana Triaca, and Dalila Mango

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Microglia, traditionally regarded as innate immune cells in the brain, drive neuroinflammation and synaptic dysfunctions in the early phases of Alzheimer disease (AD), acting upstream to Aβ accumulation. Colony stimulating factor 1-receptor (CSF-1R) is predominantly expressed on microglia and its levels are significantly increased in neurodegenerative diseases, possibly contributing to the chronic inflammatory microglial response. On the other hand, CSF-1R inhibitors confer neuroprotection in preclinical models of neurodegenerative diseases. Here, we determined the effects of the CSF-1R inhibitor PLX3397 on the Aβ-mediated synaptic alterations in ex vivo hippocampal slices. Electrophysiological findings show that PLX3397 rescues LTP impairment and neurotransmission changes induced by Aβ. In addition, using confocal imaging experiments, we demonstrate that PLX3397 stimulates a microglial transition toward a phagocytic phenotype, which in turn promotes the clearance of Aβ from glutamatergic terminals. We believe that the selective pruning of Aβ-loaded synaptic terminals might contribute to the restoration of LTP and excitatory transmission alterations observed upon acute PLX3397 treatment. This result is in accordance with the mechanism proposed for CSF1R inhibitors, that is to eliminate responsive microglia and replace it with newly generated, homeostatic microglia, capable of promoting brain repair. Overall, our findings identify a connection between the rapid microglia adjustments and the early synaptic alterations observed in AD, possibly highlighting a novel disease-modifying target.

Published
2024
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16. Seasonal Patterns of Resource Use Within Natural Populations of Burying Beetles

Author

Swastika Issar, Chloé Leroy, Patrizia d'Ettorre, and Rebecca M. Kilner

Subjects
age structure, burying beetles, cuticular hydrocarbons, phenology, reproductive success, seasonality, Ecology, QH540-549.5
Abstract

ABSTRACT For organisms in temperate environments, seasonal variation in resource availability and weather conditions exert fluctuating selection pressures on survival and fitness, resulting in diverse adaptive responses. By manipulating resource availability on a local spatial scale, we studied seasonal patterns of resource use within natural populations of burying beetles Nicrophorus vespilloides in a Norfolk woodland. Burying beetles are necrophagous insects that breed on vertebrate carcasses. They are active in Europe between April and October, after which they burrow into the soil and overwinter. Using breeding and chemical analyses, we compared the fecundity and physiological state of beetles that differed in their seasonal resource use. We found seasonal variation in carrion use by wild burying beetles and correlated differences in their reproductive success and cuticular hydrocarbon profiles. Our results provide novel insight into the seasonal correlates of behaviour, physiology and life history in burying beetles.

Published
2024
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18. Impact of Liver Cirrhosis, Severity of Cirrhosis, and Portal Hypertension on the Difficulty and Outcomes of Laparoscopic and Robotic Major Liver Resections for Primary Liver Malignancies

Author

Cipriani, Federica, Aldrighetti, Luca, Ratti, Francesca, Wu, Andrew G. R., Kabir, Tousif, Scatton, Olivier, Lim, Chetana, Zhang, Wanguang, Sijberden, Jasper, Aghayan, Davit L., Siow, Tiing-Foong, Dokmak, Safi, Coelho, Fabricio Ferreira, Herman, Paulo, Marino, Marco V., Mazzaferro, Vincenzo, Chiow, Adrian K. H., Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung-Hoon, Lee, Jae Hoon, Gastaca, Mikel, Vivarelli, Marco, Giuliante, Felice, Ruzzenente, Andrea, Yong, Chee-Chien, Yin, Mengqiu, Fondevila, Constantino, Efanov, Mikhail, Morise, Zenichi, Di Benedetto, Fabrizio, Brustia, Raffaele, Dalla Valle, Raffaele, Boggi, Ugo, Geller, David, Belli, Andrea, Memeo, Riccardo, Gruttadauria, Salvatore, Mejia, Alejandro, Park, James O., Rotellar, Fernando, Choi, Gi-Hong, Robles-Campos, Ricardo, Wang, Xiaoying, Sutcliffe, Robert P., Pratschke, Johann, Lai, Eric C. H., Chong, Charing C. N., D’Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Kingham, T. Peter, Ferrero, Alessandro, Ettorre, Giuseppe Maria, Cherqui, Daniel, Liang, Xiao, Soubrane, Olivier, Wakabayashi, Go, Troisi, Roberto I., Cheung, Tan-To, Kato, Yutaro, Sugioka, Atsushi, Han, Ho-Seong, Long, Tran Cong duy, Liu, Qu, Liu, Rong, Edwin, Bjørn, Fuks, David, Chen, Kuo-Hsin, Abu Hilal, Mohammad, and Goh, Brian K. P.

Published
2024
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19. Lipid-based insulin-resistance markers predict cardiovascular events in metabolic dysfunction associated steatotic liver disease

Author

Alessandra Colantoni, Tommaso Bucci, Nicholas Cocomello, Francesco Angelico, Evaristo Ettorre, Daniele Pastori, Gregory Y.H. Lip, Maria Del Ben, and Francesco Baratta

Subjects
MASLD, Cardiovascular events, Insulin resistance, TyG index, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Insulin resistance (IR) is the cornerstone of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD), pathophysiologically being the key link between MASLD, metabolic disorders, and cardiovascular (CV) diseases. There are no prospective studies comparing the predictive values of different markers of insulin resistance (IR) in identifying the presence of MASLD and the associated risk of cardiovascular events (CVEs). Methods Post hoc analysis of the prospective Plinio Study, involving dysmetabolic patients evaluated for the presence of MASLD. The IR markers considered were Homeostatic Model Assessment for IR (HOMA-IR), Triglycerides-Glycemia (TyG) index, Triglycerides to High-Density Lipoprotein Cholesterol ratio (TG/HDL-C), Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI). Receiver operative characteristic (ROC) analyses were performed to find the optimal cut-offs of each IR marker for detecting MASLD and predicting CVEs in MASLD patients. Logistic and Cox multivariable regression analyses were performed, after dichotomizing the IR markers based on the optimal cut-offs, to assess the factors independently associated with MASLD and the risk of CVEs. Results The study included 772 patients (age 55.6 ± 12.1 years, 39.4% women), of whom 82.8% had MASLD. VAI (Area Under the Curve [AUC] 0.731), TyG Index (AUC 0.723), and TG/HDL-C ratio (AUC: 0.721) predicted MASLD but was greater with HOMA-IR (AUC: 0.792) and LAP (AUC: 0.787). After a median follow-up of 48.7 (25.4–75.8) months, 53 MASLD patients experienced CVEs (1.8%/year). TyG index (AUC: 0.630), LAP (AUC: 0.626), TG/HDL-C (AUC: 0.614), and VAI (AUC: 0.590) demonstrated comparable, modest predictive values in assessing the CVEs risk in MASLD patients. Conclusion In dysmetabolic patients HOMA-IR and LAP showed the best accuracy in detecting MASLD. The possible use of lipid-based IR markers in stratifying the CV risk in patients with MASLD needs further validation in larger cohorts.

Published
2024
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20. Clinical and laboratory predictors of mpox severity and duration: an Italian multicentre cohort study (mpox-Icona)Research in context

Author

Valentina Mazzotta, Silvia Nozza, Simone Lanini, Davide Moschese, Alessandro Tavelli, Roberto Rossotti, Francesco Maria Fusco, Lorenzo Biasioli, Giulia Matusali, Angelo Roberto Raccagni, Davide Mileto, Chiara Maci, Giuseppe Lapadula, Antonio Di Biagio, Luca Pipitò, Enrica Tamburrini, Antonella d’Arminio Monforte, Antonella Castagna, Andrea Antinori, Spinello Antinori, Chiara Baiguera, Gianmaria Baldin, Matteo Bassetti, Paolo Bonfanti, Giorgia Brucci, Elena Bruzzesi, Caterina Candela, Antonio Cascio, Antonella d'Arminio Monforte, Andrea Delama, Gabriella D'Ettorre, Damiano Farinacci, Maria Rita Gismondo, Andrea Gori, Massimiliano Lanzafame, Miriam Lichtner, Giulia Mancarella, Alessandro Mancon, Giulia Marchetti, Emanuele Nicastri, Alessandro Pandolfo, Francesca Panzo, Stefania Piconi, Carmela Pinnetti, Alessandro Raimondi, Marco Ridolfi, Giuliano Rizzardini, Alessandra Rodanò, Margherita Sambo, Vincenzo Sangiovanni, Nadia Sangiovanni, Daniele Tesoro, and Serena Vita

Subjects
mpox, Severity, MPOXV, Evolution, Recovery, Ct-value, Medicine, Medicine (General), R5-920
Abstract

Summary: Background: Severe and prolonged mpox courses have been described during the 2022–2023 outbreak. Identifying predictors of severe evolution is crucial for improving management and therapeutic strategies. We explored the predictors of mpox severity and tested the association between mpox severity and viral load in biological fluids. We also analysed the predictors of disease duration and kinetics of inflammatory markers and described the viral presence and duration of shedding in biological fluids. Methods: This multicentre historical cohort study included adults diagnosed with laboratory-confirmed mpox diagnosis between May 2022 and September 2023 at 15 Italian centres. Patients were followed up from the day of diagnosis until clinical recovery. Biological fluids (blood, urine, saliva, and oropharyngeal and rectal swabs) were collected from each subgroup during the course of the disease and after healing. The primary outcomes were disease severity (presence of mucosal involvement, extended rash, or need for hospitalisation) and its association with the cycle threshold value (Ct-value, surrogate of viral load) in biological fluids, using standard linear and linear mixed-effect logistic regression models. Among the secondary outcomes, predictors of disease duration were assessed using a linear regression model. Findings: A total of 541 patients were enrolled, including four (0.74%) women, with a median age of 38 years (IQR 33–44). Among the 235 people living with HIV (PLWH) (43.44%), 22 (4.07%) had a CD4 count lower than 350 cells/μL. Severe mpox was reported in 215 patients (39.74%). No patient died. Multivariable analysis showed that, severe mpox was more likely among Caucasians (OR 1.82; 95% CI 1.14–2.90, p = 0.012) and patients who had an onset of fever (1.95; 1.27–2.99, p = 0.002), lymphadenopathy (2.30; 1.52–3.48, p

Published
2024
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21. Recurrence and tumor-related death after resection of hepatocellular carcinoma in patients with metabolic syndrome

Author

Giammauro Berardi, Alessandro Cucchetti, Carlo Sposito, Francesca Ratti, Martina Nebbia, Daniel M. D’Souza, Franco Pascual, Epameinondas Dogeas, Samer Tohme, Alessandro Vitale, Francesco Enrico D’Amico, Remo Alessandris, Valentina Panetta, Ilaria Simonelli, Marco Colasanti, Nadia Russolillo, Amika Moro, Guido Fiorentini, Matteo Serenari, Fernando Rotellar, Giuseppe Zimitti, Simone Famularo, Tommy Ivanics, Felipe Gaviria Donando, Daniel Hoffman, Edwin Onkendi, Yasmin Essaji, Tommaso Giuliani, Santiago Lopez Ben, Celia Caula, Gianluca Rompianesi, Asmita Chopra, Mohammed Abu Hilal, Gonzalo Sapisochin, Guido Torzilli, Carlos Corvera, Adnan Alseidi, Scott Helton, Roberto I. Troisi, Kerri Simo, Claudius Conrad, Matteo Cescon, Sean Cleary, David Choon Hyuck Kwon, Alessandro Ferrero, Giuseppe Maria Ettorre, Umberto Cillo, David Geller, Daniel Cherqui, Pablo E. Serrano, Cristina Ferrone, Luca Aldrighetti, T. Peter Kingham, and Vincenzo Mazzaferro

Subjects
Hepatocellular carcinoma, Metabolic syndrome, Nonalcoholic fatty liver disease, Metabolic-associated fatty liver disease, Recurrence, Steatosis, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background & Aims: Metabolic syndrome (MS) is a growing epidemic and a risk factor for the development of hepatocellular carcinoma (HCC). This study investigated the long-term outcomes of liver resection (LR) for HCC in patients with MS. Rates, timing, patterns, and treatment of recurrences were investigated, and cancer-specific survivals were assessed. Methods: Between 2001 and 2021, data from 24 clinical centers were collected. Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival were analyzed as well as recurrence patterns and treatment. The analysis was conducted using a competing-risk framework. The trajectory of the risk of recurrence over time was applied to a competing risk analysis. For post-recurrence survival, death resulting from tumor progression was the primary endpoint, whereas deaths with recurrence relating to other causes were considered as competing events. Results: In total, 813 patients were included in the study. Median OS was 81.4 months (range 28.1–157.0 months), and recurrence occurred in 48.3% of patients, with a median RFS of 39.8 months (range 15.7–174.7 months). Cause-specific hazard of recurrence showed a first peak 6 months (0.027), and a second peak 24 months (0.021) after surgery. The later the recurrence, the higher the chance of receiving curative intent approaches (p = 0.001). Size >5 cm, multiple tumors, microvascular invasion, and cirrhosis were independent predictors of recurrence showing a cause-specific hazard over time. RFS was associated with death for recurrence (hazard ratio: 0.985, 95% CI: 0.977–0.995; p = 0.002). Conclusions: Patients with MS undergoing LR for HCC have good long-term survival. Recurrence occurs in 48% of patients with a double-peak incidence and time-specific hazards depending on tumor-related factors and underlying disease. The timing of recurrence significantly impacts survival. Surveillance after resection should be adjusted over time depending on risk factors. Impact and implications: Metabolic syndrome (MS) is a growing epidemic and a significant risk factor for the development of hepatocellular carcinoma (HCC). The present study demonstrated that patients who undergo surgical resection for HCC on MS have a good long-term survival and that recurrence occurs in almost half of the cases with a double peak incidence and time-specific hazards depending on tumor-related factors and underlying liver disease. Also, the timing of recurrence significantly impacts survival. Clinicians should therefore adjust follow-up after surgery accordingly, considering timing of recurrence and specific risk factors. Also, the results of the present study might help design future trials on the use of adjuvant therapy following resection.

Published
2024
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22. Bowel preparation before elective right colectomy: Multitreatment machine-learning analysis on 2,617 patients

Author

Ciano, Paolo, Benedetti, Michele, Montemurro, Leonardo Antonio, Clementi, Marco, Bertocchi, Elisa, Masini, Gaia, Altamura, Amedeo, Rubichi, Francesco, Migliore, Marco, Parlanti, Daniele, Vago, Gabriele, Sciuto, Antonio, Pace, Ugo, Bucci, Andrea Fares, Simone, Michele, Cassini, Diletta, Pandolfini, Lorenzo, Falsetto, Alessandro, Ficari, Ferdinando, Giudici, Francesco, Cianchi, Fabio, Patriti, Alberto, Ricci, Marcella Lodovica, Siquini, Walter, Cardinali, Alessandro, D'Ugo, Stefano, Spampinato, Marcello, Scabini, Stefano, Aprile, Alessandra, Soriero, Domenico, Caricato, Marco, Capolupo, Gabriella Teresa, Pignata, Giusto, Andreuccetti, Jacopo, Canfora, Ilaria, Liverani, Andrea, Lamacchia, Giuseppe, Franceschilli, Claudia, Campagnacci, Roberto, Maurizi, Angela, Marini, Pierluigi, Attinà, Grazia Maria, Elmore, Ugo, Puccetti, Francesco, Corcione, Francesco, Bracale, Umberto, Peltrini, Roberto, Santoro, Roberto, Amodio, Pietro, Carlini, Massimo, Spoletini, Domenico, Marcellinaro, Rosa, Giuliani, Antonio, Del Vecchio, Giovanni, Sorrentino, Mario, Stefanoni, Massimo, Ferrari, Giovanni, Lombardi, Pietro Maria, Di Leo, Alberto, Crepaz, Lorenzo, Verzelli, Augusto, Budassi, Andrea, Sica, Giuseppe, Bagaglini, Giulia, Rausei, Stefano, Tenconi, Silvia, Cavaliere, Davide, Solaini, Leonardo, Ercolani, Giorgio, Baiocchi, Gian Luca, Molfino, Sarah, Milone, Marco, De Palma, Giovanni Domenico, Ciaccio, Giovanni, Locurto, Paolo, Tebala, Giovanni Domenico, Di Cintio, Antonio, Boni, Luigi, Cassinott, Elisa, Mancini, Stefano, Sagnotta, Andrea, Guerrieri, Mario, Ortenzi, Monica, Persiani, Roberto, Biondi, Alberto, Lucchi, Andrea, Vitali, Giulia, Parini, Dario, De Luca, Maurizio, Spinelli, Antonino, Carrano, Francesco, Genna, Michele, Fior, Francesca, Bottino, Vincenzo, Ferronetti, Antonio, Coratti, Andrea, Giuliani, Giuseppe, Benigni, Roberto, Scala, Dario, Puppio, Battistino, Vagliasindi, Alessio, Muratore, Andrea, Marsanic, Patrizia, Pipitone Federico, Nicoletta Sveva, Pavanello, Maurizio, Di Marco, Carlo, Rivolta, Umberto, Bertoglio, Camillo Leonardo, Piccoli, Micaela, Pecchini, Francesca, Talarico, Carlo, Greco, Vincenzo, Carrara, Alessandro, Motter, Michele, Tirone, Giuseppe, Totis, Mauro, Tamini, Nicolò, Roviello, Franco, Piagnerelli, Riccardo, Anastasi, Alessandro, Canonico, Giuseppe, Guercioni, Gianluca, Cicconi, Simone, Ettorre, Giuseppe Maria, Colasanti, Marco, Montuori, Mauro, Pinotti, Enrico, Mariani, Pierpaolo, Carminati, Roberta, de Manzini, Nicolò, Osenda, Edoardo, Donini, Annibale, Graziosi, Luigina, Armellino, Mariano Fortunato, De Martino, Ciro, Taglietti, Lucio, Birindelli, Arianna, Anania, Gabriele, Chiozza, Matteo, Di Cosmo, Mariantonietta, Zigiotto, Daniele, Feo, Carlo Vittorio, Pindozzi, Fioralba, Millo, Paolo, Grivon, Manuela, Pedrazzani, Corrado, Conti, Cristian, Guerriero, Silvio, Organetti, Lorenzo, Costanzi, Andrea, Monteleone, Michela, Vettoretto, Nereo, Botteri, Emanuele, Marchesi, Federico, Dalmonte, Giorgio, Basti, Massimo, Frazzini, Diletta, Longo, Graziano, Santoni, Simone, Cicetti, Moreno, La Gioia, Gabriele, Brisinda, Giuseppe, Berti, Stefano, Catarci, Marco, Guadagni, Stefano, Masedu, Francesco, Ruffo, Giacomo, Viola, Massimo Giuseppe, and Scatizzi, Marco

Published
2024
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23. Efficacy of antiseptic mouthrinses against SARS-CoV-2: A prospective randomized placebo-controlled pilot study

Author

Fantozzi, Paolo Junior, Pampena, Emanuele, Pierangeli, Alessandra, Oliveto, Giuseppe, Sorrentino, Leonardo, Di Vanna, Domenico, Pampena, Riccardo, Lazzaro, Alessandro, Gentilini, Elio, Mastroianni, Claudio Maria, D'Ettorre, Gabriella, Polimeni, Antonella, Romeo, Umberto, and Villa, Alessandro

Subjects
Biomedical and Clinical Sciences, Dentistry, Emerging Infectious Diseases, Dental/Oral and Craniofacial Disease, Clinical Research, Prevention, Infectious Diseases, Lung, Adult, Humans, SARS-CoV-2, COVID-19, Povidone-Iodine, Anti-Infective Agents, Local, Hydrogen Peroxide, Chlorhexidine, Pilot Projects, Prospective Studies, Sodium Chloride, Antiviral Agents, Public health, Oral medicine, Oral diseases, Mouth, Oral cavity, Saliva, Disinfection, Oral rinses, Povidone-iodine, Povidone‑iodine, Clinical Sciences, Otorhinolaryngology, Clinical sciences
Abstract

ObjectivesCoronavirus-disease-19 (COVID-19) continues to affect millions of individuals worldwide. Antiviral activity of mouthrinses remains an important research area as the oral cavity is a site of SARS-CoV-2 initial replication. The aim of this study was to assess the effectiveness of three different mouthrinses in reducing the oral/oropharyngeal SARS-CoV-2 viral load.MethodsAdult patients, hospitalized with confirmed COVID-19 were recruited for the study. Oral/oropharyngeal baseline SARS-CoV-2 samples were collected and analyzed by Real-Time-PCR. Subsequently, patients were instructed to rinse with 1 % hydrogen peroxide (H2O2), 0.12 % chlorhexidine (CHX), 1 % povidone‑iodine (PVP-I) or Sodium Chloride 0.9 % (placebo). Viral loads were measured right after (T1), and at 45 min (T2) from the rinse.ResultsIn the PVP-I 1 % group, 5/8 (62.5 %) patients at T1, and 3/8 (37.5 %) patients at T2, SARS-CoV-2 was not detectable in the swab specimens. In the H2O2 1 % group, 2/11 (18.2 %) patients at T1, and 2/11 (18.2 %) other patients at T2 showed no SARS-CoV-2 loads. One (12.5 %) patient in the CHX 0.12 % group showed SARS-CoV-2 negativity at T2. One (9.1 %) patient at T1, and another (9.1 %) patient at T2 showed no SARS-CoV-2 loads in the placebo group.ConclusionsOral SARS-CoV-2 loads were reduced at T1 in the PVP-I 1 % and H2O2 1 % groups.Clinical relevancePVP-I 1 % was the most effective rinse especially in patients with low viral copy numbers at baseline.

Published
2022

24. Rate and predictors of thromboprophylaxis in internal medicine wards: Results from the AURELIO study

Author

Filoni, Dario, Totè, Chiara, Trivigno, Chiara, Ciacci, Paolo, Orlando, Federica, Paraninfi, Aurora, Casciaro, Marco Antonio, Accapezzato, Daniele, Rossi, Elisabetta, Gioia, Chiara, Izzo, Raffaella, Summa, Maria Luna, Polisena, Nausica, Iantorno, Laura, Capozza, Alessandro, Marti, Roberta, Meloni, Pier Luigi, Sauchella, Assunta, Melis, Sara, Berria, Maria, Solinas, Beatrice, Vilardi, Luca, Sarobba, Paola, Pisanu, Manuela, Mangatia, Paolo, Armentaro, Giuseppe, Volpentesta, Mara, Scarcelli, Mariarosangela, Cringoli, Maurizio, Blanca, Deborah, Casella, Francesco, Baldini, Lorenzo, Arienti, Vincenzo, Lazzerini, Pietro Enea, Capecchi, Leopoldo, ed Ambra Otranto, Barbara Castignani, Crociani, Andrea, Donnarumma, Emilia, Pacciani, Giulia, Rovereto, Rossella, Lunardi, Sarah, Bonito, Giacomo, Pietrangelo, Antonello, Vegetti, Alberto, Di Minno, Giovanni, Tufano, Antonella, Lodigiani, Corrado, Pacetti, Veronica, Domenicali, Marco, Magna, Arianna, Maggio, Enrico, Vidili, Gianpaolo, Sciacqua, Angela, Cogliati, Chiara, Di Giulio, Rosella, Bernardini, Sciaila, Fallarino, Alessia, Palumbo, Ilaria Maria, Pannunzio, Arianna, Bagnato, Chiara, Serra, Carla, Boddi, Maria, Falsetti, Lorenzo, Zaccone, Vincenzo, Ettorre, Evaristo, Desideri, Giovambattista, Santoro, Luca, Cantisani, Vito, Pignatelli, Pasquale, Santoliquido, Angelo, Violi, Francesco, and Loffredo, Lorenzo

Published
2024
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25. Right to Occupational Safety: Prevalence of Latent Tuberculosis Infection in Healthcare Workers. A 1-Year Retrospective Survey Carried out at Hospital of Lecce (Italy)

Author

Gabriele d’Ettorre, Stela Karaj, Prisco Piscitelli, Osvaldo Maiorano, Carmen Attanasi, Roberta Tornese, Eugenia Carluccio, Paolo Giannuzzi, Enrico Greco, Giancarlo Ceccarelli, Gabriella d’Ettorre, Giambattista Lobreglio, Pierpaolo Congedo, Francesco Broccolo, and Alessandro Miani

Subjects
tuberculosis, LTBI, healthcare workers, Mantoux tuberculin skin test (TST), interferon gamma release assay (IGRA), prevention, Internal medicine, RC31-1245
Abstract

Background: Prevention of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) to ensure the “Right to Occupational Safety” is a special challenge globally, as HCWs have a higher risk of acquiring the infection in hospital settings because of frequent close exposure to patients suffering from tuberculosis (TB). Methods: Aretrospective study was performed with the aim of assessing the prevalence of LTBI related to demographical and occupational risk factors among HCWs employed in a large hospital in Italy. The study involved 1461 HCWs screened for LTBI by Mantoux tuberculin skin test (TST) and then confirmed with Interferon Gamma Release Assay (IGRA) test in case of positivity. Immunosuppressed and BGC-vaccinated workers were tested directly with IGRA. Results: LTBI was diagnosed in 4.1% of the HCWs and the prevalence resulted lower than other studies conducted in low TB incidence countries. The variables significantly linked with higher frequency of the infection were: age ≥40 years (OR = 3.14; 95% CI: 1.13–8.74; p < 0.05), length of service ≥15 years (OR = 4.11; 95% CI: 1.48–11.43; p < 0.05) and not being trained on TB prevention (OR = 3.46; 95% CI: 1.85–6.46; p < 0.05). Not trained HCWs presented a higher risk of LTBI also after adjustment for age and length of service, compared to trained HCWs. Conclusions: screening of HCWs for LTBI should be always considered in routinely occupational surveillance in order to early diagnose the infection and prevent its progression. Safety policies in hospital settings centered on workers’ training on TB prevention is crucial to minimize LTBI occurrence in HCWs.

Published
2023
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28. Impact of Tumor Size on the Difficulty of Laparoscopic Major Hepatectomies: An International Multicenter Study

Author

Kato, Yutaro, Sugioka, Atsushi, Kojima, Masayuki, Syn, Nicholas L., Zhongkai, Wang, Liu, Rong, Cipriani, Federica, Armstrong, Thomas, Aghayan, Davit L., Siow, Tiing-Foong, Lim, Chetana, Scatton, Olivier, Herman, Paulo, Coelho, Fabricio Ferreira, Marino, Marco V., Mazzaferro, Vincenzo, Chiow, Adrian K. H., Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Gastaca, Mikel, Vivarelli, Marco, Giuliante, Felice, Dalla Valle, Bernardo, Ruzzenente, Andrea, Yong, Chee-Chien, Fondevila, Constantino, Efanov, Mikhail, Di Benedetto, Fabrizio, Belli, Andrea, Park, James O., Rotellar, Fernando, Choi, Gi-Hong, Robles-Campos, Ricardo, Wang, Xiaoying, Sutcliffe, Robert P., Schmelzle, Moritz, Pratschke, Johann, Lai, Eric C. H., Chong, Charing C. N., D’Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Kingham, T. Peter, Forchino, Fabio, Ferrero, Alessandro, Ettorre, Giuseppe Maria, Levi Sandri, Giovanni Battista, Pascual, Franco, Cherqui, Daniel, Soubrane, Olivier, Wakabayashi, Go, Troisi, Roberto I., Cheung, Tan-To, Chen, Zewei, Yin, Mengqiu, D’Silva, Mizelle, Han, Ho-Seong, Nghia, Phan Phuoc, Long, Tran Cong duy, Edwin, Bjørn, Fuks, David, Chen, Kuo-Hsin, Abu Hilal, Mohammad, Aldrighetti, Luca, and Goh, Brian K. P.

Published
2023
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29. REDISCOVER International Guidelines on the Perioperative Care of Surgical Patients With Borderline-resectable and Locally Advanced Pancreatic Cancer

Author

Boggi, Ugo, Kauffmann, Emanuele, Napoli, Niccolò, Barreto, S. George, Besselink, Marc G., Fusai, Giuseppe K., Hackert, Thilo, Abu Hilal, Mohammad, Marchegiani, Giovanni, Salvia, Roberto, Shrikhande, Shailesh V., Truty, Mark, Werner, Jens, Wolfgang, Christopher L., Bannone, Elisa, Capretti, Giovanni, Cattelani, Alice, Coppola, Alessandro, Cucchetti, Alessandro, De Sio, Davide, Di Dato, Armando, Di Meo, Giovanna, Fiorillo, Claudio, Gianfaldoni, Cesare, Ginesini, Michael, Hidalgo Salinas, Camila, Lai, Quirino, Miccoli, Mario, Montorsi, Roberto, Pagnanelli, Michele, Poli, Andrea, Ricci, Claudio, Sucameli, Francesco, Tamburrino, Domenico, Viti, Virginia, Addeo, Pietro F., Alfieri, Sergio, Bachellier, Philippe, Baiocchi, Gian Luca, Balzano, Gianpaolo, Barbarello, Linda, Brolese, Alberto, Busquets, Juli, Butturini, Giovanni, Caniglia, Fabio, Caputo, Damiano, Casadei, Riccardo, Chunhua, Xi, Colangelo, Ettore, Coratti, Andrea, Costa, Francesca, Crafa, Francesco, Dalla Valle, Raffaele, De Carlis, Luciano, de Wilde, Roeland F., Del Chiaro, Marco, Di Benedetto, Fabrizio, Di Sebastiano, Pierluigi, Dokmak, Safi, Hogg, Melissa, Egorov, Vyacheslav I., Ercolani, Giorgio, Ettorre, Giuseppe Maria, Falconi, Massimo, Ferrari, Giovanni, Ferrero, Alessandro, Filauro, Marco, Giardino, Alessandro, Grazi, Gian Luca, Gruttadauria, Salvatore, Izbicki, Jakob R, Jovine, Elio, Katz, Matthew, Keck, Tobias, Khatkov, Igor, Kiguchi, Gozo, Kooby, David, Lang, Hauke, Lombardo, Carlo, Malleo, Giuseppe, Massani, Marco, Mazzaferro, Vincenzo, Memeo, Riccardo, Miao, Yi, Mishima, Kohei, Molino, Carlo, Nagakawa, Yuichi, Nakamura, Masafumi, Nardo, Bruno, Panaro, Fabrizio, Pasquali, Claudio, Perrone, Vittorio, Rangelova, Elena, Liu, Rong, Romagnoli, Renato, Romito, Raffaele, Rosso, Edoardo, Schulick, Richard, Siriwardena, Ajith, Spampinato, Marcello Giuseppe, Strobel, Oliver, Testini, Mario, Troisi, Roberto Ivan, Uzunoglo, Faik G., Valente, Roberto, Veneroni, Luigi, Zerbi, Alessandro, Vicente, Emilio, Vistoli, Fabio, Vivarelli, Marco, Wakabayashi, Go, Zanus, Giacomo, Zureikat, Amer, Zyromski, Nicholas J., Coppola, Roberto, D’Andrea, Vito, Davide, José, Dervenis, Christos, Frigerio, Isabella, Konlon, Kevin C., Michelassi, Fabrizio, Montorsi, Marco, Nealon, William, Portolani, Nazario, Sousa Silva, Donzília, Bozzi, Giuseppe, Ferrari, Viviana, Trivella, Maria G., Cameron, John, Clavien, Pierre-Alain, Asbun, Horacio J., Boraschi, Piero, Campani, Daniela, Cappelli, Carla, Cioni, Roberto, Dominici, Massimo, Esposito, Irene, Gambacorta, Maria A, Marciano, Emanuele, Masi, Gianluca, Morganti, Alessio, Mutignani, Massimiliano, Neri, Emanuele, Paiar, Fabiola, Reni, Michele, Rotondo, Maria Isabella, Silvestris, Nicola, Tortora, Giampaolo, Vasile, Enrico, and Volterrani, Duccio

Published
2024
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30. Influence of Uric Acid on Vascular and Cognitive Functions: Evidence for an Ambivalent Relationship

Author

Francesco Baratta, Federica Moscucci, Evaristo Ettorre, Raffaella Bocale, Arrigo F. G. Cicero, Pietro Cirillo, Federica Fogacci, Ilaria Lospinuso, Carmine Savoia, Alessandro Mengozzi, Agostino Virdis, Claudio Borghi, and Giovambattista Desideri

Subjects
uric acid, cardiovascular disease, cerebrovascular disease, cognitive function, Microbiology, QR1-502
Abstract

The growing recognition of the public health impact of cognitive impairment and dementia has sparked a global initiative to identify risk factors and develop strategies to prevent or slow the progression of these cognitive disorders. Uric acid, the end product of the metabolism of purine nucleotides, has been reported as a key factor of many conditions potentially involved in cognitive dysfunction/dementia. In addition, some studies support the hypothesis that elevated uric acid levels could reduce the risk of Alzheimer’s disease, slow down the decline of cognition, and delay the progression of Alzheimer’s disease, while other evidence achieves opposite positions. These discrepancies might reflect a biological ambivalence for uric acid depending on a very complex interplay of factors that include its concentrations achieved in biological fluids, the nature, and concentration of free radicals, the presence and concentration of other antioxidant molecules, potentially responsible for bi-directional effects of uric acid on brain health/functioning. In this narrative review, we attempt to elucidate the influential role of uric acid metabolism in cognitive functioning by discussing pathophysiological mechanisms putatively involved, being well aware that none of them can be considered one-sided due to the complexity of the human organism.

Published
2024
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31. Probability of lymph node metastases in patients undergoing adequate lymphadenectomy during surgery for intrahepatic cholangiocarcinoma: a retrospective multicenter study

Author

Carlo Sposito, Alessandro Cucchetti, Francesca Ratti, Laura Alaimo, Francesco Ardito, Stefano Di Sandro, Matteo Serenari, Giammauro Berardi, Marianna Maspero, Giuseppe Maria Ettorre, Matteo Cescon, Fabrizio Di Benedetto, Felice Giuliante, Andrea Ruzzenente, Giorgio Ercolani, Luca Aldrighetti, and Vincenzo Mazzaferro

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Introduction Nodal metastases (LNM) are one of the major determinants of prognosis following surgery for intrahepatic cholangiocarcinoma (ICC). Previous studies investigating the correlation between clinical-radiological features and the probability of LNM include patients undergoing inadequate nodal sampling. Aim of this study was to develop a model to predict the risk of LNM in patients undergoing adequate lymphadenectomy using preoperative clinical and radiological features. Methods Patients undergoing radical surgery for ICC with adequate lymphadenectomy at seven Italian Centers between 2000 and 2023 were collected and divided in a derivation and a validation cohort. Logistic regression and dominance analysis were applied in the derivation cohort to identify variables associated with LNM at pathology. The final coefficients were derived from the model having the highest c-statistic in the derivation cohort with the lowest number of variables included (parsimony). The model was then tested in the external validation cohort and the linear predictor was divided into quartiles to generate four risk categories. Results A total of 693 patients were identified. Preoperative Ca19-9, clinically suspicious lymph nodes at radiology, patients’ age and tumour burden score were significantly associated with LNM. These factors were included in a model (https://aicep.website/?cff-form=20) showing a c-statistic of 0.723 (95%CI: 0.680, 0.766) and 0.771 (95%CI: 0.699, 0.842) in the derivation and validation cohort respectively. A progressive increase of pathological lymph node positivity across risk groups was observed (29.9% in low-risk, 45.1% in intermediate-low risk, 51.5% in intermediate-high risk and 87.3% in high-risk patients; p=0.001). Conclusions A novel model that combines preoperative Ca19-9, clinically suspicious lymph nodes at radiology, patients’ age and tumour burden score was developed to predict the risk of lymph node metastasis (LNM) before surgery. The model exhibited high accuracy, and has the potential to assist clinicians in the management of patients who are candidate to surgery.

Published
2024
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38. Defining Global Benchmarks for Laparoscopic Right Posterior Sectionectomy/H67: An International Multicenter Study

Author

Zhao, Jianping, Lu, Yuanxiang, Zhang, Wanguang, Chua, Darren W., Liu, Qu, Liu, Rong, Pratschke, Johann, Ratti, Francesca, Zimmitti, Giuseppe, Aghayan, Davit L., Edwin, Bjørn, Siow, Tiing-Foong, Scatton, Olivier, Herman, Paulo, Marino, Marco V., Mazzaferro, Vincenzo, Chiow, Adrian K. H., Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Gastaca, Mikel, Vivarelli, Marco, Giuliante, Felice, Ruzzenente, Andrea, Yong, Chee-Chien, Yin, Mengqiu, Fondevila, Constantino, Efanov, Mikhail, Morise, Zenichi, Di Benedetto, Fabrizio, Brustia, Raffaele, Dalla Valle, Raffaele, Boggi, Ugo, Geller, David, Belli, Andrea, Memeo, Riccardo, Mejia, Alejandro, Park, James O., Rotellar, Fernando, Choi, Gi-Hong, Robles-Campos, Ricardo, Wang, Xiaoying, Sutcliffe, Robert P., Lai, Eric C. H., Chong, Charing C. N., D’Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Kingham, T. Peter, Ferrero, Alessandro, Ettorre, Giuseppe Maria, Cherqui, Daniel, Liang, Xiao, Soubrane, Olivier, Fuks, David, Wakabayashi, Go, Troisi, Roberto I., Cheung, Tan-To, Sugioka, Atsushi, Long, Tran Cong duy, Abu Hilal, Mohammad, Aldrighetti, Luca, Chen, Kuo-Hsin, Han, Ho-Seong, Goh, Brian K. P., Prieto, Mikel, De Meyere, Celine, Meurs, Juul, Ng, Kelvin K., Lee, Kit-Fai, Tarakanov, Pavel, Alikhanov, Ruslan, Thiruchelvam, Nita, Jang, Jae Young, Kojima, Masayuki, Kato, Yutaro, Kruger, Jaime Arthur Pirola, Coelho, Fabricio Ferreira, Lopez-Lopez, Victor, Casellas I Robert, Margarida, Montalti, Roberto, Giglio, Mariano, Lee, Boram, Wang, Hao-Ping, Salleh, Mansour, Pascual, Franco, Yu, Shian, Chen, Zewei, Vani, Simone, Ardito, Francesco, Giustizieri, Ugo, Citterio, Davide, Mocchegiani, Federico, Colasanti, Marco, Berardi, Giammauro, Guzmán, Yoelimar, Labadie, Kevin P., Conticchio, Maria, Dogeas, Epameinondas, Kauffmann, Emanuele F., Giuffrida, Mario, Sommacale, Daniele, Amory, Boris, Magistri, Paolo, Mishima, Kohei, Kadam, Prashant, Tang, Chung-Ngai, Ghotbi, Jacob, Fretland, Åsmund Avdem, Forchino, Fabio, Mazzotta, Alessandro, Barbara, Marco, Pagano, Duilio, Gruttadauria, Salvatore, Krenzien, Felix, Schmelzle, Moritz, Cipriani, Federica, Lim, Chetana, Zheng, Junhao, Nghia, Phan Phuoc, Valle, Bernardo Dalla, and Cipriani, Federica

Published
2024
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39. Peta-electron volt gamma-ray emission from the Crab Nebula

Author

The LHAASO Collaboration, Cao, Zhen, Aharonian, F., An, Q., Axikegu, Bai, L. X., Bai, Y. X., Bao, Y. W., Bastieri, D., Bi, X. J., Bi, Y. J., Cai, H., Cai, J. T., Cao, Zhe, Chang, J., Chang, J. F., Chen, B. M., Chen, E. S., Chen, J., Chen, Liang, Chen, Long, Chen, M. J., Chen, M. L., Chen, Q. H., Chen, S. H., Chen, S. Z., Chen, T. L., Chen, X. L., Chen, Y., Cheng, N., Cheng, Y. D., Cui, S. W., Cui, X. H., Cui, Y. D., Piazzoli, B. D'Ettorre, Dai, B. Z., Dai, H. L., Dai, Z. G., Danzengluobu, della Volpe, D., Dong, X. J., Duan, K. K., Fan, J. H., Fan, Y. Z., Fan, Z. X., Fang, J., Fang, K., Feng, C. F., Feng, L., Feng, S. H., Feng, Y. L., Gao, B., Gao, C. D., Gao, L. Q., Gao, Q., Gao, W., Ge, M. M., Geng, L. S., Gong, G. H., Gou, Q. B., Gu, M. H., Guo, F. L., Guo, J. G., Guo, X. L., Guo, Y. Q., Guo, Y. Y., Han, Y. A., He, H. H., He, H. N., He, J. C., He, S. L., He, X. B., He, Y., Heller, M., Hor, Y. K., Hou, C., Hou, X., Hu, H. B., Hu, S., Hu, S. C., Hu, X. J., Huang, D. H., Huang, Q. L., Huang, W. H., Huang, X. T., Huang, X. Y., Huang, Z. C., Ji, F., Ji, X. L., Jia, H. Y., Jiang, K., Jiang, Z. J., Jin, C., Ke, T., Kuleshov, D., Levochkin, K., Li, B. B., Li, Cheng, Li, Cong, Li, F., Li, H. B., Li, H. C., Li, H. Y., Li, Jie, Li, Jian, Li, K., Li, W. L., Li, X. R., Li, Xin, Li, Y., Li, Y. Z., Li, Zhe, Li, Zhuo, Liang, E. W., Liang, Y. F., Lin, S. J., Liu, B., Liu, C., Liu, D., Liu, H., Liu, H. D., Liu, J., Liu, J. L., Liu, J. S., Liu, J. Y., Liu, M. Y., Liu, R. Y., Liu, S. M., Liu, W., Liu, Y., Liu, Y. N., Liu, Z. X., Long, W. J., Lu, R., Lv, H. K., Ma, B. Q., Ma, L. L., Ma, X. H., Mao, J. R., Masood, A., Min, Z., Mitthumsiri, W., Montaruli, T., Nan, Y. C., Pang, B. Y., Pattarakijwanich, P., Pei, Z. Y., Qi, M. Y., Qi, Y. Q., Qiao, B. Q., Qin, J. J., Ruffolo, D., Rulev, V., Sáiz, A., Shao, L., Shchegolev, O., Sheng, X. D., Shi, J. Y., Song, H. C., Stenkin, Yu. V., Stepanov, V., Su, Y., Sun, Q. N., Sun, X. N., Sun, Z. B., Tam, P. H. T., Tang, Z. B., Tian, W. W., Wang, B. D., Wang, C., Wang, H., Wang, H. G., Wang, J. C., Wang, J. S., Wang, L. P., Wang, L. Y., Wang, R. N., Wang, Wei, Wang, X. G., Wang, X. J., Wang, X. Y., Wang, Y., Wang, Y. D., Wang, Y. J., Wang, Y. P., Wang, Z. H., Wang, Z. X., Wang, Zhen, Wang, Zheng, Wei, D. M., Wei, J. J., Wei, Y. J., Wen, T., Wu, C. Y., Wu, H. R., Wu, S., Wu, W. X., Wu, X. F., Xi, S. Q., Xia, J., Xia, J. J., Xiang, G. M., Xiao, D. X., Xiao, G., Xiao, H. B., Xin, G. G., Xin, Y. L., Xing, Y., Xu, D. L., Xu, R. X., Xue, L., Yan, D. H., Yan, J. Z., Yang, C. W., Yang, F. F., Yang, J. Y., Yang, L. L., Yang, M. J., Yang, R. Z., Yang, S. B., Yao, Y. H., Yao, Z. G., Ye, Y. M., Yin, L. Q., Yin, N., You, X. H., You, Z. Y., Yu, Y. H., Yuan, Q., Zeng, H. D., Zeng, T. X., Zeng, W., Zeng, Z. K., Zha, M., Zhai, X. X., Zhang, B. B., Zhang, H. M., Zhang, H. Y., Zhang, J. L., Zhang, J. W., Zhang, L. X., Zhang, Li, Zhang, Lu, Zhang, P. F., Zhang, P. P., Zhang, R., Zhang, S. R., Zhang, S. S., Zhang, X., Zhang, X. P., Zhang, Y. F., Zhang, Y. L., Zhang, Yi, Zhang, Yong, Zhao, B., Zhao, J., Zhao, L., Zhao, L. Z., Zhao, S. P., Zheng, F., Zheng, Y., Zhou, B., Zhou, H., Zhou, J. N., Zhou, P., Zhou, R., Zhou, X. X., Zhu, C. G., Zhu, F. R., Zhu, H., Zhu, K. J., and Zuo, X.

Subjects
Astrophysics - High Energy Astrophysical Phenomena
Abstract

The Crab pulsar and the surrounding nebula powered by the pulsar's rotational energy through the formation and termination of a relativistic electron-positron wind is a bright source of gamma-rays carrying crucial information about this complex conglomerate. We report the detection of $\gamma$-rays with a spectrum showing gradual steepening over three energy decades, from $5\times 10^{-4}$ to $1.1$ petaelectronvolt (PeV). The ultra-high-energy photons exhibit the presence of a PeV electron accelerator (a pevatron) with an acceleration rate exceeding 15% of the absolute theoretical limit. Assuming that unpulsed $\gamma$-rays are produced at the termination of the pulsar's wind, we constrain the pevatron's size, between $0.025$ and $0.1$ pc, and the magnetic field $\approx 110 \mu$G. The production rate of PeV electrons, $2.5 \times 10^{36}$ erg $\rm s^{-1}$, constitutes 0.5% of the pulsar's spin-down luminosity, although we do not exclude a non-negligible contribution of PeV protons to the production of the highest energy $\gamma$-rays., Comment: 43 pages, 13 figures, 2 tables; Published in Science

Published
2021
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40. Waiting list mortality and 5-year transplant survival benefit of patients with MASLD: An Italian liver transplant registry study

Author

Vitale, Alessandro, Trapani, Silvia, Russo, Francesco Paolo, Miele, Luca, Svegliati Baroni, Gianluca, Marchesini, Giulio, Burra, Patrizia, Ottoveggio, Marco Salvatore, Romagnoli, Renato, Martini, Silvia, De Simone, Paolo, Carrai, Paola, Cescon, Matteo, Morelli, Maria Cristina, De Carlis, Luciano, Belli, Luca, Gruttadauria, Salvatore, Volpes, Riccardo, Colledan, Michele, Fagiuoli, Stefano, Di Benedetto, Fabrizio, De Maria, Nicola, Rossi, Giorgio, Caccamo, Lucio, Donato, Francesca, Vennarecci, Giovanni, Di Costanzo, Giovan Giuseppe, Vivarelli, Marco, Carraro, Amedeo, Sacerdoti, David, Ettorre, Giuseppe Maria, Giannelli, Valerio, Agnes, Salvatore, Gasbarrini, Antonio, Rossi, Massimo, Ginanni Corradini, Stefano, Mazzaferro, Vincenzo, Bhoori, Sherrie, Manzia, Tommaso Maria, Lenci, Ilaria, Zamboni, Fausto, Mameli, Laura, Baccarani, Umberto, Toniutto, Pierluigi, Lupo, Luigi Giovanni, Tandoi, Francesco, Rendina, Maria, Andorno, Enzo, Giannini, Edoardo Giovanni, Spada, Marco, Billato, Ilaria, Marchini, Andrea, Romano, Pierluigi, Brancaccio, Giuseppina, D’Amico, Francesco, Ricci, Andrea, Cardillo, Massimo, and Cillo, Umberto

Published
2024
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41. Clinical and laboratory predictors of mpox severity and duration: an Italian multicentre cohort study (mpox-Icona)

Author

Antinori, Andrea, Antinori, Spinello, Baiguera, Chiara, Baldin, Gianmaria, Bassetti, Matteo, Biasioli, Lorenzo, Bonfanti, Paolo, Brucci, Giorgia, Bruzzesi, Elena, Candela, Caterina, Cascio, Antonio, Castagna, Antonella, Monforte, Antonella d'Arminio, Delama, Andrea, D'Ettorre, Gabriella, Farinacci, Damiano, Fusco, Francesco Maria, Gismondo, Maria Rita, Gori, Andrea, Lanini, Simone, Lanzafame, Massimiliano, Lapadula, Giuseppe, Lichtner, Miriam, Maci, Chiara, Mancarella, Giulia, Mancon, Alessandro, Marchetti, Giulia, Matusali, Giulia, Mazzotta, Valentina, Nicastri, Emanuele, Nozza, Silvia, Pandolfo, Alessandro, Panzo, Francesca, Piconi, Stefania, Pinnetti, Carmela, Pipitò, Luca, Raccagni, Angelo Roberto, Raimondi, Alessandro, Ridolfi, Marco, Rizzardini, Giuliano, Rodanò, Alessandra, Rossotti, Roberto, Sambo, Margherita, Sangiovanni, Vincenzo, Sangiovanni, Nadia, Tamburrini, Enrica, Tavelli, Alessandro, Tesoro, Daniele, Vita, Serena, Moschese, Davide, Mileto, Davide, Di Biagio, Antonio, and Monforte, Antonella d’Arminio

Published
2024
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43. Robot assisted object manipulation for minimally invasive surgery

Author

D'Ettorre, Claudia

Abstract

Robotic systems have an increasingly important role in facilitating minimally invasive surgical treatments. In robot-assisted minimally invasive surgery, surgeons remotely control instruments from a console to perform operations inside the patient. However, despite the advanced technological status of surgical robots, fully autonomous systems, with decision-making capabilities, are not yet available. In 2017, a structure to classify the research efforts toward autonomy achievable with surgical robots was proposed by Yang et al. Six different levels were identified: no autonomy, robot assistance, task autonomy, conditional autonomy, high autonomy, and full autonomy. All the commercially available platforms in robot-assisted surgery is still in level 0 (no autonomy). Despite increasing the level of autonomy remains an open challenge, its adoption could potentially introduce multiple benefits, such as decreasing surgeons' workload and fatigue and pursuing a consistent quality of procedures. Ultimately, allowing the surgeons to interpret the ample and intelligent information from the system will enhance the surgical outcome and positively reflect both on patients and society. Three main aspects are required to introduce automation into surgery: the surgical robot must move with high precision, have motion planning capabilities and understand the surgical scene. Besides these main factors, depending on the type of surgery, there could be other aspects that might play a fundamental role, to name some compliance, stiffness, etc. This thesis addresses three technological challenges encountered when trying to achieve the aforementioned goals, in the specific case of robot-object interaction. First, how to overcome the inaccuracy of cable-driven systems when executing fine and precise movements. Second, planning different tasks in dynamically changing environments. Lastly, how the understanding of a surgical scene can be used to solve more than one manipulation task. To address the first challenge, a control scheme relying on accurate calibration is implemented to execute the pick-up of a surgical needle. Regarding the planning of surgical tasks, two approaches are explored: one is learning from demonstration to pick and place a surgical object, and the second is using a gradient-based approach to trigger a smoother object repositioning phase during intraoperative procedures. Finally, to improve scene understanding, this thesis focuses on developing a simulation environment where multiple tasks can be learned based on the surgical scene and then transferred to the real robot. Experiments proved that automation of the pick and place task of different surgical objects is possible. The robot was successfully able to autonomously pick up a suturing needle, position a surgical device for intraoperative ultrasound scanning and manipulate soft tissue for intraoperative organ retraction. Despite automation of surgical subtasks has been demonstrated in this work, several challenges remain open, such as the capabilities of the generated algorithm to generalise over different environment conditions and different patients.

Published
2022

45. Development and validation of an artificial intelligence model for predicting post‐transplant hepatocellular cancer recurrence

Author

Quirino Lai, Carmine De Stefano, Jean Emond, Prashant Bhangui, Toru Ikegami, Benedikt Schaefer, Maria Hoppe‐Lotichius, Anna Mrzljak, Takashi Ito, Marco Vivarelli, Giuseppe Tisone, Salvatore Agnes, Giuseppe Maria Ettorre, Massimo Rossi, Emmanuel Tsochatzis, Chung Mau Lo, Chao‐Long Chen, Umberto Cillo, Matteo Ravaioli, Jan Paul Lerut, and the EurHeCaLT and the West‐East LT Study Group

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Published
2023
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46. Human frataxin, the Friedreich ataxia deficient protein, interacts with mitochondrial respiratory chain

Author

Davide Doni, Federica Cavion, Marco Bortolus, Elisa Baschiera, Silvia Muccioli, Giulia Tombesi, Federica d’Ettorre, Daniele Ottaviani, Elena Marchesan, Luigi Leanza, Elisa Greggio, Elena Ziviani, Antonella Russo, Milena Bellin, Geppo Sartori, Donatella Carbonera, Leonardo Salviati, and Paola Costantini

Subjects
Cytology, QH573-671
Abstract

Abstract Friedreich ataxia (FRDA) is a rare, inherited neurodegenerative disease caused by an expanded GAA repeat in the first intron of the FXN gene, leading to transcriptional silencing and reduced expression of frataxin. Frataxin participates in the mitochondrial assembly of FeS clusters, redox cofactors of the respiratory complexes I, II and III. To date it is still unclear how frataxin deficiency culminates in the decrease of bioenergetics efficiency in FRDA patients’ cells. We previously demonstrated that in healthy cells frataxin is closely attached to the mitochondrial cristae, which contain both the FeS cluster assembly machinery and the respiratory chain complexes, whereas in FRDA patients’ cells with impaired respiration the residual frataxin is largely displaced in the matrix. To gain novel insights into the function of frataxin in the mitochondrial pathophysiology, and in the upstream metabolic defects leading to FRDA disease onset and progression, here we explored the potential interaction of frataxin with the FeS cluster-containing respiratory complexes I, II and III. Using healthy cells and different FRDA cellular models we found that frataxin interacts with these three respiratory complexes. Furthermore, by EPR spectroscopy, we observed that in mitochondria from FRDA patients’ cells the decreased level of frataxin specifically affects the FeS cluster content of complex I. Remarkably, we also found that the frataxin-like protein Nqo15 from T. thermophilus complex I ameliorates the mitochondrial respiratory phenotype when expressed in FRDA patient’s cells. Our data point to a structural and functional interaction of frataxin with complex I and open a perspective to explore therapeutic rationales for FRDA targeted to this respiratory complex.

Published
2023
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47. Prospective minimally invasive pancreatic resections from the IGOMIPS registry: a snapshot of daily practice in Italy on 1191 between 2019 and 2022

Author

Boggi, Ugo, Donisi, Greta, Napoli, Niccolò, Partelli, Stefano, Esposito, Alessandro, Ferrari, Giovanni, Butturini, Giovanni, Morelli, Luca, Abu Hilal, Mohammad, Viola, Massimo, Di Benedetto, Fabrizio, Troisi, Roberto, Vivarelli, Marco, Jovine, Elio, Ferrero, Alessandro, Bracale, Umberto, Alfieri, Sergio, Casadei, Riccardo, Ercolani, Giorgio, Moraldi, Luca, Molino, Carlo, Dalla Valle, Raffaele, Ettorre, Giuseppe, Memeo, Riccardo, Zanus, Giacomo, Belli, Andrea, Gruttadauria, Salvatore, Brolese, Alberto, Coratti, Andrea, Garulli, Gianluca, Romagnoli, Renato, Massani, Marco, Borghi, Felice, Belli, Giulio, Coppola, Roberto, Falconi, Massimo, Salvia, Roberto, and Zerbi, Alessandro

Published
2023
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49. Evolution of minimally invasive techniques and surgical outcomes of ALPPS in Italy: a comprehensive trend analysis over 10 years from a national prospective registry

Author

Serenari, Matteo, Ratti, Francesca, Guglielmo, Nicola, Zanello, Matteo, Mocchegiani, Federico, Lenzi, Jacopo, Colledan, Michele, Mazzaferro, Vincenzo, Cillo, Umberto, Ferrero, Alessandro, Cescon, Matteo, Di Benedetto, Fabrizio, Massani, Marco, Grazi, Gianluca, Valle, Raffaele Dalla, Vivarelli, Marco, Ettorre, Giuseppe Maria, Aldrighetti, Luca, and Jovine, Elio

Published
2023
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