FEM analysis of RF breast ablation: Multiprobe versus cool-tip electrode

Background: Radio-frequency ablation (RFA) has recently received much attention as an effective minimally invasive strategy for the local treatment of tumors. The purpose of this study was to evaluate the efficacy of single-needle cool-tip RF breast ablation in terms of temperature distribution and duration of the procedure as compared to multiprobe RF breast ablation. Materials and Methods: Two different commercially available radiofrequency ablation needle electrodes were compared. Finite-element method (FEM) models were developed to simulate the thermoablation procedures. A series of ex vivo radiofrequency thermal lesions were induced to check the response of the FEM calculations. Results: Data obtained from FEM models and from ex vivo procedures showed that cool-tip RF breast ablation assures better performances than multiprobe RF breast ablation in terms of temperature distribution and duration of the procedure. Histopathological analysis of the cool-tip RF thermoablated specimens showed successful induction of coagulation necrosis in the thermoablated specimens. Conclusion: Data obtained from FEM models and from ex vivo procedures suggest that the proposed cool-tip RF breast ablation may kill more tumor cells in vivo with a single application than the multiprobe RF breast ablation

Telehealth in oncofertility and breast cancer patients during COVID-19: preliminary results of insenoallasalute.it project

Abstract. – OBJECTIVE: Breast cancer (BC) is the leading diagnosis in premenopausal patients. Lockdown measures during COVID-19 pandemic reduced facilities for premenopausal patients, impairing oncological and reproductive health. To reduce its effect, a telehealth program called insenoallasalute.it was designed in Italy. PATIENTS AND METHODS: A national-based multicentric observational study was undertaken by insenoallasalute.it study group (Italian Ministry of Health, Modena Hospital and Tor Vergata University Hospital) to raise awareness among women on a) BC and its negative role on reproductive health; b) increase adherence to screening programs and self-examination; c) present oncofertility strategies. A webbased platform with two sections was designed: an informative section and a telehealth application activated with a mobile one-time password. After a self-evaluation test to select premenopausal women with maternal desire and family or personal history for BC or ovarian cancer, and premenopausal women with maternity desires with prior medically assisted procreation, a dedicated agenda for telehealth evaluation was displayed and planned. In case the patients fulfilled the criteria for further evaluation, they were invited to perform an outpatient evaluation in one of the pilot centers. RESULTS: From July 2021 to December 2021, 2,830 single accounts were activated, and 2,450 (86.57%) completed the tests. 53 patients were selected to undergo telehealth consultation and 40 (80.0%) scheduled the telehealth visit. 6 patients underwent surgery in the study centers. CONCLUSIONS: In our experience insenoallasalute.it embodied an innovative solution to spread BC awareness, BC screening program, and oncofertility opportunities in the oncological population

Ultrasound-guided laser ablation after excisional vacuum-assisted breast biopsy for small malignant breast lesions: Preliminary results

Background: The purpose of this preliminary study is to evaluate the feasibility of the excisional ultrasound (US) guided vacuum-assisted breast biopsy (VAE), followed by US-guided Laser Interstitial Thermal Therapy (LITT) in the treatment of unifocal ductal breast carcinomas ≤ 1 cm and estimate the ablation rate analyzing the final histopathological results after subsequent surgical excision. Methods: In a single session 11 female patients with unifocal less than a centimeter breast cancer underwent 2 different minimally invasive percutaneous US-guided techniques: a VAE breast biopsy with an 8 G needle to remove the lesion and, immediately after, a LITT ablation in the biopsy site. Four weeks later, all patients underwent radiological follow-up. Afterward, a systematic surgery was performed, the ablation rate was calculated, and iconographic and histological features were correlated. Results: Average maximum diameter of the lesions was 7.6 mm (5-10 mm). No patient reported pain or discomfort during procedure. 1/11 patient (9.1%) reported an early minor complication (a small superficial skin burn). After surgical excision, the histopathological evaluation reported in 10/11 cases (90.9%) complete ablation of the target lesion. In only one case (9.1%) residual cancer was detected. The necrotic-hemorrhagic cavities showed a mean maximum diameter of 27.3 mm (20-35 mm). Conclusions: Laser ablation performed after excisional biopsy could be considered a valid alternative to surgical excision for the treatment of lesions ≤ 1 cm, if carried out by expert radiologists. The association of these minimally invasive percutaneous methods has proven to be reliable, fast, and safe with an ablation rate of 90.9% and excellent aesthetic results. RM and CESM are potentially able to quantifying treatment results and to follow-up the ablation effects

Breast cancer rehabilitation and reconditioning

Breast Cancer (BC), a prominent oncological disease, has become an increasing concern for countless women across the globe. The rising incidences underscore the urgent need for a comprehensive post-treatment rehabilitation strategy to address the challenges posed by intensive treatments. This rehabilitation is not merely about physical recovery but requires a holistic lens, considering disability as an overarching loss of functional integrity. Embracing this perspective enables healthcare professionals to devise strategies that focus on the entirety of a patient's well-being. Central to this approach is the Individual Rehabilitation Project (IRP), a tailored program designed to elevate the post-treatment quality of life. It stresses the importance of early interventions, particularly after surgery, to mitigate potential complications and functional deficits. Physical activities, curated and executed under professional guidance, form a cornerstone of the rehabilitation process. Depending on each patient's specific condition and stage of recovery, a range of exercises is recommended. Beyond the immediate post-surgical phase, patients are introduced to adaptive physical endeavors like fencing and dragon boating. Such activities are not merely for physical recovery but also play a significant role in enhancing self-esteem, self-perception, and overall mental resilience. Once acute and post-acute care has been completed, and a clinical functional stability is reached, BC patients, now better defined as person with BC disability (PwBC). As the narrative unfolds, it becomes clear that BC rehabilitation is an intricate dance between physical recovery and psychological well-being, necessitating an individualized, patient-centric approach. Furthermore, this opinion paper highlights the urgency for rigorous research, especially randomized trials, to refine and validate the efficacy of these rehabilitation procedures, ensuring that patients not only survive but thrive post-treatment

Pediatric nurses in pediatricians' offices: a survey for primary care pediatricians

Background: The role played by nurses in caring for children in pediatricians' officies in the community is crucial to ensure integrated care. In Italy, pediatricians are responsible for the health of children aged 0-14 years living in the community. This study aimed to describe Italian primary care pediatricians' opinions about the usefulness of several nursing activities that pediatric nurses could perform in pediatricians' offices. Methods: An online survey with pediatricians working in primary care in Italy was conducted between April-December 2018. A 40-item questionnaire was used to assess four types of nursing activities: clinical care, healthcare education, disease prevention, and organizational activities. The answers ranged from 1 (not useful at all) to 6 (very useful). Moreover, three open-ended questions completed the questionnaire. Results: Overall, 707 pediatricians completed the online survey. Participants were mainly female (63%), with a mean age of 57.74 (SD = 6.42). The presence of a pediatric nurse within the pediatrician's office was considered very useful, especially for healthcare education (Mean 4.90; SD 1.12) and disease prevention (Mean 4.82; SD 1.11). Multivariate analysis confirmed that pediatricians 'with less working experience', 'having their office in a small town', and 'collaborating with a secretary and other workers in the office' rated the nurse's activities significantly more useful. Conclusions: A pediatric nurse in the pediatrician's office can significantly contribute to many activities for children and their families in the community. These activities include clinical care, healthcare education, disease prevention, and the organizational processes of the office. Synergic professional activity between pediatricians and pediatric nurses could ensure higher health care standards in the primary care setting

Heat Transfer and Thermal Energy Storage Enhancement by Foams and Nanoparticles

The use of innovative methods for the design of heating, cooling, and heat storage devices has been mainly oriented in the last decade toward the use of nanofluids, metal foams coupled with working fluids, or phase change materials (PCMs). A network of nine Italian universities achieved significant results and innovative ideas on these topics by developing a collaborative project in the last four years, where different approaches and investigation techniques were synergically employed. They evaluated the quantitative extent of the enhancement in the heat transfer and thermal performance of a heat exchanger or thermal energy storage system with the combined use of nanofluids, metal foams, and PCMs. The different facets of this broad research program are surveyed in this article. Special focus is given to the comparison between the mesoscopic to macroscopic modeling of heat transfer in metal foams and nanofluids, as well as to the experimental data collected and processed in the development of the research

Instrumentation for Longitudinal Beam Gymnastics in FEL's and at the CLIC Test Facility 3

Built at CERN by an international collaboration, the CLIC Test Facility 3 (CTF3) aims at demonstrating the feasibility of a high luminosity 3 TeV e+-e- collider by the year 2010. One of the main issues to be demonstrated is the generation of a high average current (30 A) high frequency (12 GHz) bunched beam by means of RF manipulation. At the same time, Free Electron Lasers (FEL) are developed in several places all over the world with the aim of providing high brilliance photon sources. These machines rely on the production of high peak current electron bunches. The required performances put high demands on the diagnostic equipment and innovative longitudinal monitors have been developed during the past years. This paper gives an overview of the longitudinal instrumentation developed at ELETTRA and CTF3, where a special effort was made in order to implement at the same time non-intercepting devices for online monitoring, and destructive diagnostics which have the advantage of providing more detailed information

Global mapping of cancers: The Cancer Genome Atlas and beyond

Cancer genomes have been explored from the early 2000s through massive exome sequencing efforts, leading to the publication of The Cancer Genome Atlas in 2013. Sequencing techniques have been developed alongside this project and have allowed scientists to bypass the limitation of costs for whole-genome sequencing (WGS) of single specimens by developing more accurate and extensive cancer sequencing projects, such as deep sequencing of whole genomes and transcriptomic analysis. The Pan-Cancer Analysis of Whole Genomes recently published WGS data from more than 2600 human cancers together with almost 1200 related transcriptomes. The application of WGS on a large database allowed, for the first time in history, a global analysis of features such as molecular signatures, large structural variations and noncoding regions of the genome, as well as the evaluation of RNA alterations in the absence of underlying DNA mutations. The vast amount of data generated still needs to be thoroughly deciphered, and the advent of machine-learning approaches will be the next step towards the generation of personalized approaches for cancer medicine. The present manuscript wants to give a broad perspective on some of the biological evidence derived from the largest sequencing attempts on human cancers so far, discussing advantages and limitations of this approach and its power in the era of machine learning

Proposal for taking data with the KLOE-2 detector at the DAΦ\PhiNE collider upgraded in energy

This document reviews the physics program of the KLOE-2 detector at DA$\Phi$NE upgraded in energy and provides a simple solution to run the collider above the $\phi$-peak (up to 2, possibly 2.5 GeV). It is shown how a precise measurement of the multihadronic cross section in the energy region up to 2 (possibly 2.5) GeV would have a major impact on the tests of the Standard Model through a precise determination of the anomalous magnetic moment of the muon and the effective fine-structure constant at the $M_Z$ scale. With a luminosity of about $10^{32}$cm$^{-2}$s$^{-1}$, DA$\Phi$NE upgraded in energy can perform a scan in the region from 1 to 2.5 GeV in one year by collecting an integrated luminosity of 20 pb$^{-1}$ (corresponding to a few days of data taking) for single point, assuming an energy step of 25 MeV. A few years of data taking in this region would provide important tests of QCD and effective theories by $\gamma\gamma$ physics with open thresholds for pseudo-scalar (like the $\eta'$), scalar ($f_0,f'_0$, etc...) and axial-vector ($a_1$, etc...) mesons; vector-mesons spectroscopy and baryon form factors; tests of CVC and searches for exotics. In the final part of the document a technical solution for the energy upgrade of DA$\Phi$NE is proposed.Comment: 19 pages, 8 figure