| 1. |
- Karam, Elias, et al.
(author)
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Endoscopic and Surgical Management of Non-Metastatic Ampullary Neuroendocrine Neoplasia : A Multi-Institutional Pancreas2000/EPC Study
- 2023
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In: Neuroendocrinology. - 0028-3835. ; 113:10, s. 1024-1034
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Journal article (peer-reviewed)abstract
- Introduction: Ampullary neuroendocrine neoplasia (NEN) is rare and evidence regarding their management is scarce. This study aimed to describe clinicopathological features, management, and prognosis of ampullary NEN according to their endoscopic or surgical management. Methods: From a multi-institutional international database, patients treated with either endoscopic papillectomy (EP), transduodenal surgical ampullectomy (TSA), or pancreaticoduodenectomy (PD) for ampullary NEN were included. Clinical features, post-procedure complications, and recurrences were assessed. Results: 65 patients were included, 20 (30.8%) treated with EP, 19 (29.2%) with TSA, and 26 (40%) with PD. Patients were mostly asymptomatic (n = 46; 70.8%). Median tumor size was 17 mm (12-22), tumors were mostly grade 1 (70.8%) and pT2 (55.4%). Two (10%) EP resulted in severe American Society for Gastrointestinal Enterology (ASGE) adverse post-procedure complications and 10 (50%) were R0. Clavien 3-5 complications did not occur after TSA and in 4, including 1 postoperative death (15.4%) of patients after PD, with 17 (89.5%) and 26 R0 resection (100%), respectively. The pN1/2 rate was 51.9% (n = 14) after PD. Tumor size larger than 1 cm (i.e., pT stage >1) was a predictor for R1 resection (p < 0.001). Three-year overall survival and disease-free survival after EP, TSA, and PD were 92%, 68%, 92% and 92%, 85%, 73%, respectively. Conclusion: Management of ampullary NEN is challenging. EP should not be performed in lesions larger than 1 cm or with a endoscopic ultrasonography T stage beyond T1. Local resection by TSA seems safe and feasible for lesions without nodal involvement. PD should be preferred for larger ampullary NEN at risk of nodal metastasis.
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| 2. |
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| 3. |
- Hakanson, L, et al.
(author)
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Modelling of radiocesium in lakes - Lake sensitivity and remedial strategies
- 1996
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In: JOURNAL OF ENVIRONMENTAL RADIOACTIVITY. - : ELSEVIER SCI LTD. - 0265-931X. ; 33:1, s. 1-25
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Journal article (other academic/artistic)abstract
- A given fallout of radiocesium (e.g. after the Chernobyl accident) will be distributed and taken by biota very differently in various types of lakes. Thus, lakes have different ''sensitivities'' to radiocesium. Important environmental factors regulating t
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| 4. |
- Hakanson, L, et al.
(author)
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Modelling of radiocesium in lakes - The VAMP model
- 1996
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In: JOURNAL OF ENVIRONMENTAL RADIOACTIVITY. - : ELSEVIER SCI LTD. - 0265-931X. ; 33:3, s. 255-308
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Journal article (other academic/artistic)abstract
- The objective of this work is to present a new, state-of-the-art model for predicting radiocesium in lakes. The target variables to model and predict are Cs concentrations in lake water and in predatory fish. These results emanate from IAEA's VAMP project
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| 5. |
- Hofman, D., et al.
(author)
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Computerised Decision Support Systems for the management of freshwater radioecological emergencies : assessment of the state-of-the-art with respect to the experiences and needs of end-users
- 2011
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In: Journal of Environmental Radioactivity. - : Elsevier BV. - 0265-931X .- 1879-1700. ; 102:2, s. 119-127
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Journal article (peer-reviewed)abstract
- Assessment of the environmental and radiological consequences of a nuclear accident requires the management of a great deal of data and information as well as the use of predictive models. Computerised Decision Support Systems (CDSS) are essential tools for this kind of complex assessment and for assisting experts with a rational decision process. The present work focuses on the assessment of the main features of selected state-of-the-art CDSS for off-site management of freshwater ecosystems contaminated by radionuclides. This study involved both developers and end-users of the assessed CDSS and was based on practical customisation exercises, installation and application of the decision systems. Potential end-users can benefit from the availability of several ready-to-use CDSS that allow one to run different kinds of models aimed at predicting the behaviour of radionuclides in aquatic ecosystems, evaluating doses to humans, assessing the effectiveness of different kinds of environmental management interventions and ranking these interventions, accounting for their social, economic and environmental impacts. As a result of the present assessment, the importance of CDSS "integration" became apparent: in many circumstances, different CDSS can be used as complementary tools for the decision-making process. The results of this assessment can also be useful for the future development and improvement of the CDSS.
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| 6. |
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| 7. |
- Monte, L., Brittain, J.E., Håkanson, L., Heling, R., Smith, J.T. and Zheleznyak, M.
(author)
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Review and assessment of models used to predict the fate of radionuclides in lakes.
- 2003
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In: J. Env. Radioactivity. ; 69, s. 177-205
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Journal article (peer-reviewed)
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| 8. |
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| 9. |
- Monte, L., et al.
(author)
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The EVANET_HYDRA network: Introduction
- 2005
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In: Evaluation and nertwork of EC-decision support systems in the field of hydrological dispersion models and of aquatic radioecological research. - : ENEA, Rome. ; , s. 15-20
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Book chapter (peer-reviewed)
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| 10. |
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