Epitrochlear Lymph Node Dissection and Axillary Lymph Node Biopsy. An Unusual Clinical Presentation in a Patient with Forearm Melanoma

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FOOT: a new experiment to measure nuclear fragmentation at intermediate energies

Summary: Charged particle therapy exploits proton or 12C beams to treat deep-seated solid tumors. Due to the advantageous characteristics of charged particles energy deposition in matter, the maximum of the dose is released to the tumor at the end of the beam range, in the Bragg peak region. However, the beam nuclear interactions with the patient tissues induces fragmentation both of projectile and target nuclei and needs to be carefully taken into account. In proton treatments, target fragmentation produces low energy, short range fragments along all the beam range, which deposit a non negligible dose in the entry channel. In 12C treatments the main concern is represented by long range fragments due to beam fragmentation that release their dose in the healthy tissues beyond the tumor. The FOOT experiment (FragmentatiOn Of Target) of INFN is designed to study these processes, in order to improve the nuclear fragmentation description in next generation Treatment Planning Systems and the treatment plans quality. Target (16O and 12C nuclei) fragmentation induced by –proton beams at therapeutic energies will be studied via an inverse kinematic approach, where 16O and 12C therapeutic beams impinge on graphite and hydrocarbon targets to provide the nuclear fragmentation cross section on hydrogen. Projectile fragmentation of 16O and 12C beams will be explored as well. The FOOT detector includes a magnetic spectrometer for the fragments momentum measurement, a plastic scintillator for ΔE and time of flight measurements and a crystal calorimeter to measure the fragments kinetic energy. These measurements will be combined in order to make an accurate fragment charge and isotopic identification. Keywords: Hadrontherapy, Nuclear fragmentation cross sections, Tracking detectors, Scintillating detector

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Le neoplasie della giunzione sigma-retto: esperienze personali

Gli Autori riferiscono la propria esperienza con 25 pazienti ope - rati per una neoplasia della giunzione sigma-retto, nel periodo com - preso tra il 1° gennaio 1998 ed il 31 dicembre 2002, nella Sezione di Chirurgia Generale ed Oncologica dell’Università degli Studi di Perugia. In accordo con quanto riportato dalla letteratura, sostengono un’individualità anatomo-funzionale di questo tratto del colon. Sottolineano inoltre le modalità di manifestazione clinica e l’evolu - zione delle neoplasie che colpiscono la giunzione e che le diversificano da quelle degli altri segmenti del colon, condizionando la scelta chi - rurgica e la prognosi

Status and evolution of CRAB

Starting from 2007 the CMS experiment will produce several Pbytes of data each year, to be distributed over many computing centers located in many different countries. The CMS computing model defines how the data are to be distributed such that CMS physicists can access them in an efficient manner in order to perform their physics analysis. CRAB (CMS Remote Analysis Builder) is a specific tool, designed and developed by the CMS collaboration, that facilitates access to the distributed data in a very transparent way. The tool’s main feature is the possibility of distributing and parallelizing the local CMS batch data analysis processes over different Grid environments without any specific knowledge of the underlying computational infrastructures. More specifically CRAB allows the transparent usage of WLCG, gLite and OSG middleware. CRAB interacts with both the local user environment, with CMS Data Management services and with the Grid middleware. CRAB has been in production and in routine use by end-users since Spring 2004. It has been extensively used during studies to prepare the Physics Technical Design Report (PTDR) and in the analysis of reconstructed event samples generated during the Computing Software and Analysis Challenge (CSA06). This involved generating thousands of jobs per day at peak rates. In this contribution we discuss the current implementation of CRAB, experience with using it in production and plans for improvements in the immediate futur

Narrative Medicine: A Digital Diary in the Management of Bone and Soft Tissue Sarcoma Patients. Preliminary Results of a Multidisciplinary Pilot Study

Background. Guidelines for the implementation of narrative medicine in clinical practice exist; however, in Italy, no standard methodology is currently available for the management of oncological patients. Since 2017, at the “Regina Elena” National Cancer Institute, studies using “digital narrative diaries” (DNMLAB platform) have been carried out; this article focuses on a pilot, uncontrolled, real-life study aiming to evaluate the utility of DNM integrated with the care pathway of patients with bone and limb soft tissue sarcomas. Methods. Adult patients completed the diary during treatment or follow-up by writing their narrative guided by a set of narrative prompts. The endpoints were: (a) patients’ opinions about therapeutic alliance, awareness, and coping ability; (b) healthcare professionals’ (HCPs’) opinions about communication, therapeutic alliance, and information collection. Open- and closed-ended questions (Likert score: 1–5) were used to assess the items. Results. At the interim analysis of data from seven patients and five HCPs, DNM was shown to improve: (a) the expression of patients’ point of view, the perception of effective taking charge, disease awareness, and self-empowerment (score: 4.8/5); (b) patients’ communication, relationships, and illness knowledge (score: 4.6–4.8/5). Conclusions. The preliminary results supported the need to integrate patients’ narratives with clinical data and encourage further research

The FOOT (Fragmentation Of Target) Experiment

International audienceParticle therapy uses protons or 12C beams for the treatment of deep-seated solid tumors. Due to the features of the energy deposition of charged particles in matter, a limited amount of dose is released to the healthy tissue in the beam entrance region, while the maximum of the dose is released to the tumor at the end of the beam range, in the Bragg peak region. However nuclear interactions between beam and patient tissues induce fragmentation both of projectile and target. This has to be carefully taken into account since different ions have different effectiveness in producing a biological damage. In 12C treatments the main concern are long range forward emitted secondary ions produced in projectile fragmentation that release dose in the healthy tissue after the tumor. Instead, in a proton treatment, the target fragmentation produces low energy, short range fragments along all the beam range. The FOOT experiment (FragmentatiOn Of Target) is designed to study these processes. Target nuclei (16O,12C) fragmentation induced by 150-250 MeV proton beam will be studied by means of the inverse kinematic approach. 16O,12C therapeutic beams, at the quoted kinetic energy per nucleon, collide on graphite and hydrocarbons target. The cross section on Hydrogen can be then extracted by subtraction. This configuration explores also the projectile fragmentation of these 16O,12C beams, or other ions of therapeutic interest, such as 4He for instance. The detector includes a magnetic spectrometer based on silicon pixel and strip detectors, a scintillating crystal calorimeter able to stop the heavier produced fragments, and a ∆E detector, with TOF capability, to achieve the needed energy resolution and particle identification. In addition to the electronic apparatus, an alternative setup based on the concept of the “Emulsion Cloud Chamber”, coupled with the interaction region of the electronic FOOT setup, will provide the measurement of lighter charged fragments: protons, deuterons, tritons and Helium nuclei. The FOOT data taking is foreseen in the available experimental rooms existing in the presently operational charged particle therapy facilities in Europe, and possibly at GSI. An initial phase with the emulsion setup will start in early 2018, while the complete electronic detector will take data starting in 2019. In this work a general description of the FOOT experiment and of its expected performances is presented

The FOOT FragmentatiOn Of Target Experiment

International audienceIn proton-therapy clinical practice a constant RBE equal to 1.1 is adopted, regardless of the demonstrated RBE variations, which depends on physical and biological parameters. Among other mechanisms, nuclear interactions might influence the proton-RBE due to secondary heavier particles produced by target fragmentation that can significantly contribute to the total dose: an un-wanted and undetermined increase of normal tissues complications probability may occur. The FOOT experiment is designed to study these processes. Target ($^{16}$O,$^{12}$C) fragmentation induced by 150 − 250 M eV proton beam will be studied via inverse kinematic approach, where $^{16}$O and $^{12}$C therapeutic beams, with the same kinetic energy per nucleon of the proton, collide on graphite and hydrocarbons target to provide the cross section on Hydrogen (to explore also the projectile fragmentation). The detector design, the performances and expected resolution results obtained form Monte Carlo study, based on the FLUKA code will be presented