Benign biliary strictures comprise a heterogeneous group of diseases. The most common strictures amenable to endoscopic treatment are post-cholecystectomy, post-liver transplantation, related to primary sclerosing cho...Benign biliary strictures comprise a heterogeneous group of diseases. The most common strictures amenable to endoscopic treatment are post-cholecystectomy, post-liver transplantation, related to primary sclerosing cholangitis and to chronic pancreatitis. Endoscopic treatment of benign biliary strictures is widely used as first line therapy, since it is effective, safe, noninvasive and repeatable. Endoscopic techniques currently used are dilation, multiple plastic stents insertion and fully covered self-expandable metal stents. The main indication for dilation alone is primary sclerosing cholangitis related strictures. In the vast majority of the remaining cases, temporary placement of multiple plastic stents with/without dilation is considered the treatment of choice. Although this approach is effective, it requires multiple endoscopic sessions due to the short duration of stent patency. Fully covered self-expandable metal stents appear as a good alternative to plastic stents, since they have an increased radial diameter, longer stent patency, easier insertion technique and similar efficacy. Recent advances in endoscopic technique and various devices have allowed successful treatment in most cases. The development of novel endoscopic techniques and devices is still ongoing.展开更多
Although recent diagnostic and therapeutic advances have substantially improved the survival of patients with gastric cancer(GC), the overall prognosis is still poor. Surgery is the only curative treatment and should ...Although recent diagnostic and therapeutic advances have substantially improved the survival of patients with gastric cancer(GC), the overall prognosis is still poor. Surgery is the only curative treatment and should be performed in experienced centers. Due to high relapse following surgery, complementary and systemic treatment aimed at eradicating micrometastasis should be performed in most cases. Cytotoxic treatments are effective in downstaging locally advanced cancer, but different sensitivities and toxicities probably exist in different GC subtypes. Current treatment protocols are based primarily on clinical data and histological features, but molecular biomarkers that would allow for the prediction of treatment responses are urgently needed. Understanding how host factors are responsible for inter-individual variability of drug response or toxicity will also contribute to the development of more effective and less toxic treatments.展开更多
The buildings＇ capacity to maintain minimum structural safety levels during natural disasters, such as earthquakes, is recognisably one of the aspects that most influence urban resilience. Moreover, the public invest...The buildings＇ capacity to maintain minimum structural safety levels during natural disasters, such as earthquakes, is recognisably one of the aspects that most influence urban resilience. Moreover, the public investment in risk mitigation strategies is fimdamental, not only to promote social and urban and resilience, but also to limit consequent material, human and environmental losses. Despite the growing awareness of this issue, there is still a vast number of traditional masonry buildings spread throughout many European old city centres that lacks of adequate seismic resistance, requiring therefore urgent retrofitting interventions in order to both reduce their seismic vulnerability and to cope with the increased seismic requirements of recent code standards. Thus, this paper aims at contributing to mitigate the social and economic impacts of earthquake damage scenarios through the development of vulnerability-based comparative analysis of some of the most popularretrofitting techniques applied after the 1998 Azores earthquake. The influence of each technique individually and globally studied resorting to a seismic vulnerability index methodology integrated into a GIS tool and damage and loss scenarios are constructed and critically discussed. Finally, the economic balance resulting from the implementation of that techniques are also examined.展开更多
ABSTRACT This paper discusses the adoption of Artificial Intelligence-based techniques to estimate seismic damage,not with the goal of replacing existing approaches,but as a mean to improve the precision of empirical ...ABSTRACT This paper discusses the adoption of Artificial Intelligence-based techniques to estimate seismic damage,not with the goal of replacing existing approaches,but as a mean to improve the precision of empirical methods.For such,damage data collected in the aftermath of the 1998 Azores earthquake(Portugal)is used to develop a comparative analysis between damage grades obtained resorting to a classic damage formulation and an innovative approach based on Artificial Neural Networks(ANNs).The analysis is carried out on the basis of a vulnerability index computed with a hybrid seismic vulnerability asssment methodology,which is subsequently used as input to both approaches.The results obtained are then compared with real post-earthquake damage observation and critically discussed taking into account the level of adjustment achieved by each approach.Finally,a computer routine that uses the ANN as an approximation function is developed and applied to derive a new vulnerability curve expression.In general terms,the ANN developed in this study allowed to obtain much better approximations than those achieved with the original vulnerability approach,which has revealed to be quite non-conservative.Similarly,the proposed vulnerability curve expression was found to provide a more accurate damage prediction than the traditional analytical expressions.展开更多
文摘Benign biliary strictures comprise a heterogeneous group of diseases. The most common strictures amenable to endoscopic treatment are post-cholecystectomy, post-liver transplantation, related to primary sclerosing cholangitis and to chronic pancreatitis. Endoscopic treatment of benign biliary strictures is widely used as first line therapy, since it is effective, safe, noninvasive and repeatable. Endoscopic techniques currently used are dilation, multiple plastic stents insertion and fully covered self-expandable metal stents. The main indication for dilation alone is primary sclerosing cholangitis related strictures. In the vast majority of the remaining cases, temporary placement of multiple plastic stents with/without dilation is considered the treatment of choice. Although this approach is effective, it requires multiple endoscopic sessions due to the short duration of stent patency. Fully covered self-expandable metal stents appear as a good alternative to plastic stents, since they have an increased radial diameter, longer stent patency, easier insertion technique and similar efficacy. Recent advances in endoscopic technique and various devices have allowed successful treatment in most cases. The development of novel endoscopic techniques and devices is still ongoing.
文摘Although recent diagnostic and therapeutic advances have substantially improved the survival of patients with gastric cancer(GC), the overall prognosis is still poor. Surgery is the only curative treatment and should be performed in experienced centers. Due to high relapse following surgery, complementary and systemic treatment aimed at eradicating micrometastasis should be performed in most cases. Cytotoxic treatments are effective in downstaging locally advanced cancer, but different sensitivities and toxicities probably exist in different GC subtypes. Current treatment protocols are based primarily on clinical data and histological features, but molecular biomarkers that would allow for the prediction of treatment responses are urgently needed. Understanding how host factors are responsible for inter-individual variability of drug response or toxicity will also contribute to the development of more effective and less toxic treatments.
基金URBSIS:Assessing Vulnerability and Managing Earthquake Risk at Urban Scale(PTDC/ECM-URB/2564/2012)
文摘The buildings＇ capacity to maintain minimum structural safety levels during natural disasters, such as earthquakes, is recognisably one of the aspects that most influence urban resilience. Moreover, the public investment in risk mitigation strategies is fimdamental, not only to promote social and urban and resilience, but also to limit consequent material, human and environmental losses. Despite the growing awareness of this issue, there is still a vast number of traditional masonry buildings spread throughout many European old city centres that lacks of adequate seismic resistance, requiring therefore urgent retrofitting interventions in order to both reduce their seismic vulnerability and to cope with the increased seismic requirements of recent code standards. Thus, this paper aims at contributing to mitigate the social and economic impacts of earthquake damage scenarios through the development of vulnerability-based comparative analysis of some of the most popularretrofitting techniques applied after the 1998 Azores earthquake. The influence of each technique individually and globally studied resorting to a seismic vulnerability index methodology integrated into a GIS tool and damage and loss scenarios are constructed and critically discussed. Finally, the economic balance resulting from the implementation of that techniques are also examined.
基金This work was funded by the Portuguese Foundation for Science and Technology(FCT)through the postdoctoral Grant SFRH/BPD/122598/2016The authors acknowledge to the Society of Promotion for Housing and Infrastructures Rehabilitation(SPRHI)the Regional Secretariat for Housing and Equipment(SRHE)of Faial for their support and contribution to the development of this work
文摘ABSTRACT This paper discusses the adoption of Artificial Intelligence-based techniques to estimate seismic damage,not with the goal of replacing existing approaches,but as a mean to improve the precision of empirical methods.For such,damage data collected in the aftermath of the 1998 Azores earthquake(Portugal)is used to develop a comparative analysis between damage grades obtained resorting to a classic damage formulation and an innovative approach based on Artificial Neural Networks(ANNs).The analysis is carried out on the basis of a vulnerability index computed with a hybrid seismic vulnerability asssment methodology,which is subsequently used as input to both approaches.The results obtained are then compared with real post-earthquake damage observation and critically discussed taking into account the level of adjustment achieved by each approach.Finally,a computer routine that uses the ANN as an approximation function is developed and applied to derive a new vulnerability curve expression.In general terms,the ANN developed in this study allowed to obtain much better approximations than those achieved with the original vulnerability approach,which has revealed to be quite non-conservative.Similarly,the proposed vulnerability curve expression was found to provide a more accurate damage prediction than the traditional analytical expressions.
