How Dual-Energy Contrast-Enhanced Spectral Mammography Can Provide Useful Clinical Information About Prognostic Factors in Breast Cancer Patients: A Systematic Review of Literature

Introduction: In the past decade, a new technique derived from full-field digital mammography has been developed, named contrast-enhanced spectral mammography (CESM). The aim of this study was to define the association between CESM findings and usual prognostic factors, such as estrogen receptors, progesterone receptors, HER2, and Ki67, in order to offer an updated overview of the state of the art for the early differential diagnosis of breast cancer and following personalized treatments. Materials and methods: According to the PRISMA guidelines, two electronic databases (PubMed and Scopus) were investigated, using the following keywords: breast cancer AND (CESM OR contrast enhanced spectral mammography OR contrast enhanced dual energy mammography) AND (receptors OR prognostic factors OR HER2 OR progesterone OR estrogen OR Ki67). The search was concluded in August 2021. No restriction was applied to publication dates. Results: We obtained 28 articles from the research in PubMed and 114 articles from Scopus. After the removal of six replicas that were counted only once, out of 136 articles, 37 articles were reviews. Eight articles alone have tackled the relation between CESM imaging and ER, PR, HER2, and Ki67. When comparing radiological characterization of the lesions obtained by either CESM or contrast-enhanced MRI, they have a similar association with the proliferation of tumoral cells, as expressed by Ki-67. In CESM-enhanced lesions, the expression was found to be 100% for ER and 77.4% for PR, while moderate or high HER2 positivity was found in lesions with non-mass enhancement and with mass closely associated with a non-mass enhancement component. Conversely, the non-enhancing breast cancer lesions were not associated with any prognostic factor, such as ER, PR, HER2, and Ki67, which may be associated with the probability of showing enhancement. Radiomics on CESM images has the potential for non-invasive characterization of potentially heterogeneous tumors with different hormone receptor status. Conclusions: CESM enhancement is associated with the proliferation of tumoral cells, as well as to the expression of estrogen and progesterone receptors. As CESM is a relatively young imaging technique, a few related works were found; this may be due to the "off-label" modality. In the next few years, the role of CESM in breast cancer diagnostics will be more thoroughly investigated

Distribution of the Mediterranean ribbed limpet Patella ferruginea Gmelin, 1791 along the Ligurian coast and implications for conservation actions

Patella ferruginea is a limpet endemic to the Western Mediterranean Sea. It is presently considered the most threatened marine macroinvertebrate in the region and has been included in several international conservation directives. Its populations were widespread throughout the Western Mediterranean in the late Pleistocene period, and remained broadly distributed until the 19th century. Presently this species is confined into small populations in a few restricted areas due to human harvesting for food and baits, construction of coastal infrastructures and the effects of seawater pollution. In particular, the species is reported as presently disappeared from the whole of the Italian continental coast and measures are in progress to reintroduce the species through translocation and reproduction in controlled conditions along the Ligurian coasts of the Northwestern Mediterranean.Recent surveys implemented in the framework of the present work along the Ligurian coasts, to assess the most suitable sites for reintroduction, resulted in the discovery of 32 specimens of this endemic limpet, which previously was thought to have vanished from the area. These findings shed new light on the ability of species to naturally disperse, the relevance of the measures set in place to restore presently rarefied populations and may provide information to aid in the selection and management of sites within the Natura 2000 Ecological network

Fasting glucose and body mass index as predictors of activity in breast cancer patients treated with everolimus-exemestane: the EverExt study

Evidence on everolimus in breast cancer has placed hyperglycemia among the most common high grade adverse events. Anthropometrics and biomarkers of glucose metabolism were investigated in a observational study of 102 postmenopausal, HR + HER2- metastatic breast cancer patients treated with everolimus-exemestane in first and subsequent lines. Best overall response (BR) and clinical benefit rate (CBR) were assessed across subgroups defined upon fasting glucose (FG) and body mass index (BMI). Survival was estimated by Kaplan-Meier method and log-rank test. Survival predictors were tested in Cox models. Median follow up was 12.4 months (1.0-41.0). The overall cohort showed increasing levels of FG and decreasing BMI (p < 0.001). Lower FG fasting glucose at BR was more commonly associated with C/PR or SD compared with PD (p < 0.001). We also observed a somewhat higher BMI associated with better response (p = 0.052). More patients in the lowest FG category achieved clinical benefit compared to the highest (p < 0.001), while no relevant differences emerged for BMI. Fasting glucose at re-assessment was also predictive of PFS (p = 0.037), as confirmed in models including BMI and line of therapy (p = 0.049). Treatment discontinuation was significantly associated with changes in FG (p = 0.014). Further research is warranted to corroborate these findings and clarify the underlying mechanisms

Observational study of coagulation activation in early breast cancer: Development of a prognostic model based on data from the real world setting

Background: Cancer and coagulation activation are tightly related. The extent to which factors related to both these pathologic conditions concur to patient prognosis intensely animates the inherent research areas. The study herein presented aimed to the development of a tool for the assessment and stratification of risk of death and disease recurrence in early breast cancer. Methods: Between 2008 and 2010, two hundreds thirty-five (N: 235) patients diagnosed with stage I-IIA breast cancer were included. Data on patient demographics and clinic-pathologic features were collected in course of face-to-face interviews or actively retrieved from clinical charts. Plasma levels of plasminogen activator inhibitor type 1 (PAI-1), fragment 1 + 2 (F1 + 2), thrombin antithrombin complex (TAT), factor VIII (FVIII), and D-dimer (DD) were measured at breast cancer diagnosis and prior to any therapeutic procedure, including breast surgery. The risk of death was computed in terms of overall survival (OS), which was the primary outcome. For a subset of patients (N = 62), disease free survival (DFS) was also assessed as a measure of risk of disease recurrence. Results: Median follow up was 95 months (range 6-112 months). Mean age at diagnosis was 60.3 ± 13.4 years. Cancer cases were more commonly intraductal carcinomas (N: 204; 86.8%), pT1 (131; 55.7%), pN0 (141; 60%) and G2 (126; 53.6%). Elevated levels of PAI-1 (113; 48.1%) represented the most frequent coagulation abnormality, followed by higher levels of F1 + 2 (97; 41.3%), DD (63; 27.0%), TAT (34; 40%), and FVIII (29; 12.3%). In univariate models of OS, age, pT, DD, FVIII were prognostically relevant. In multivariate models of OS, age (p = 0.043), pT (p = 0.001), levels of DD (p = 0.029) and FVIII (p = 0.087) were confirmed. In the smaller subgroup of 62 patients, lymph node involvement, percent expression of estrogen receptors and levels of FVIII impacted DFS significantly. Conclusions: We developed a risk assessment tool for OS including patient- and cancer-related features along with biomarkers of coagulation activation in a cohort of early BC patients. Further studies are warranted to validate our prognostic model in the early setting and eventually extend its application to risk evaluation in the advanced setting for breast and other cancers

Contrasting styles of (U)HP rock exhumation along the Cenozoic Adria-Europe plate boundary (Western Alps, Calabria, Corsica)

Since the first discovery of ultrahigh pressure (UHP) rocks 30 years ago in the Western Alps, the mechanisms for exhumation of (U)HP terranes worldwide are still debated. In the western Mediterranean, the presently accepted model of synconvergent exhumation (e.g., the channel-flow model) is in conflict with parts of the geologic record. We synthesize regional geologic data and present alternative exhumation mechanisms that consider the role of divergence within subduction zones. These mechanisms, i.e., (i) the motion of the upper plate away from the trench and (ii) the rollback of the lower plate, are discussed in detail with particular reference to the Cenozoic Adria-Europe plate boundary, and along three different transects (Western Alps, Calabria-Sardinia, and Corsica-Northern Apennines). In the Western Alps, (U)HP rocks were exhumed from the greatest depth at the rear of the accretionary wedge during motion of the upper plate away from the trench. Exhumation was extremely fast, and associated with very low geothermal gradients. In Calabria, HP rocks were exhumed from shallower depths and at lower rates during rollback of the Adriatic plate, with repeated exhumation pulses progressively younging toward the foreland. Both mechanisms were active to create boundary divergence along the Corsica-Northern Apennines transect, where European southeastward subduction was progressively replaced along strike by Adriatic northwestward subduction. The tectonic scenario depicted for the Western Alps trench during Eocene exhumation of (U)HP rocks correlates well with present-day eastern Papua New Guinea, which is presented as a modern analog of the Paleogene Adria-Europe plate boundary

Has color Doppler a role in the evaluation of mammary lesions?

Has color Doppler a role in the evaluation of mammary lesions? A schematic review of color Doppler diagnostic criteria, indicating a benign or malignant lesion, are described.Malignant tumors have a tendency to show increased vascularization, but avascular tumors may be found as well as hypervascular benign tumors.Number of vessels, blood-flow velocity, and intra-tumoral vessel resistance assessed by color Doppler ultrasonography don't permit clear differentiation between malignant and benign tumors, but intra-tumoral blood-flow analysis well correlates with aggressiveness and histological grade of the mass, so a preoperative assessment using Color Doppler may give preliminary prognostic informations useful for therapeutic planning.Color Doppler ultrasound may be valuable also in assessing the efficacy of neoadjuvant chemotherapy and in particular of antiangiogenesis treatments.Color Doppler ultrasound has many other useful applications in the evaluation of diseases of the female and male breast, that are reviewed in the paper.Color Doppler however is not conceived as a stand-alone examination, but associated with B-mode ultrasound that is quite effective as a diagnostic tool, often not requiring Doppler informations

Geophysical prospecting for the pre- and early-historical reconstruction of the subsurface underneath the Paleochristian Basilica of Santa Maria di Compulteria (northern Campania, Italy)

The medieval Basilica of Santa Maria in Compulteria was built at an important road junction in the Alife Plain (Campania region), a wide basin within the Apennine mountains of southern Italy. Archaeological excavations carried out during the 1990s at shallow depths under the floor of the Basilica discovered the remains of Roman Age buildings, but little is known about their extent and the older phases of occupation of this key site. We present here the results of two high-resolution 3D geophysical surveys – ground penetrating radar and electrical resistivity tomography – carried out to understand the nature and the extent of the structures buried down to about 10 m depth under the modern floor of the Basilica. The geophysical investigations allowed us to find evidence for older anthropogenic traces at a greater depth, which have never been hypothesized. An integrated interpretation of the geophysical measurements with previous archaeological data for the shallow part, and with admissible human traces at depth, has provided an exhaustive reconstruction of the subsurface remains from the upper to the deeper portion of the investigated volume. In particular, our findings highlight anomalous features of likely anthropogenic origin, which are ascribed to historical and pre-historical phases preceding the construction of the middle age Basilica

CONCENTRAZIONI DI CARNOSINA ED L-ISTIDINA NEL LATTE E SANGUE DI CAPRE

The aim of this research was the detection of Carnosine (Carn) and l-Histidine (l- Hist) in goat milk and blood plasma of two different farms. The Farm T raised racially mixed goats instead the Farm S the pure race Chamoised of the Alps. The mean value ± S.E. (nmol/ml) in milk of Farm T: Carn (19,74±7,48) ed l-Hist (33,44±7,94) and in Farm S: Carn (15,45±4,01) and l-Hist (59,87±2,19); significant higher levels of l-Hist was found in Farm S (p<0,05).The mean value ± S.E. (nmol/ml) in plasma of Farm T: Carn (65,14±7,52) and l-Hist (177,70±14,34) and in Farm S: Carn (40,57±5,46) and l-Hist (187,59±18,12); significant higher levels of Carn was found in Farm T (p<0,01). In both the Farm there were significant differences (p<0,001) for Carn and l-Hist between milk and plasma. In Farm S there was a constant distribution of Carn and l-Hist in both compartment: l-Hist 82%- Carn 18% in plasma and l-Hist 81%-Carn 19% in milk, instead in Farm T l-Hist 73%-Carn 27% in plasma and l-Hist 63%-Carn 37% in milk. These data shows a different distribution in Farm T between milk and plasma of these two molecules instead there were constant in Chamoised Farm; this could be due to homogeneity of goat. The higher concentration of l-Hist in milk of Chamoised Farm could be index of a best quality of product, because this molecule is considered limiting the production of milk proteins

Casein Proteolysis in Human Milk : Tracing the Pattern of Casein Breakdown and the Formation of Potential Bioactive Peptides

The protein and peptide fraction of human milk samples collected from mothers of pre- and full-term infants in the first week after parturition was analysed by use of liquid chromatography-mass spectrometry and tandem mass spectrometry. By characterising the peptide sequence, we defined the pathway of casein hydrolysis which leads to the formation of small peptides through intermediate oligopeptides. It was found that the action of a plasmin-like enzyme acting on specific lysine residues is the primary step in casein degradation. This is followed by endopeptidases and/or exopeptidases mediated cleavage of the oligopeptides which, in turn, produces a multiplicity of short peptides differing by one or more amino acid residues. In this process, a series of potentially bioactive peptides (opioid, phosphopeptides) and their precursors are produced

Innovare la didattica universitaria attraverso l\u2019integrazione delle ICT: l\u2019esperienza del Progetto PRODID (Innovating Accademic Didactic Through ICT: the Experience of the PRODID Project)

This article deals with the theme of innovation in academic didactic through the use of technologies and is one of the outputs of a larger project, "Preparazione alla professionalit\ue0 docente e innovazione didattica" (PRODID), which aims to establish and develop strategies to support teaching profession at the University of Padua. The authors introduce the theoretical framework and the projects carried out in the University of Padua to take advantage of the potential of technology, then present the results obteined during the first year of the project. Data were collected using a structured questionnaire which involved professors of the University and semi-structured interviews conducted with 16 privileged witnesses forming part of the teaching staff. The questionnaire collects the level of diffusion of didactic solutions that rely on online resources and the quality of teaching experiences conducted by the teachers. The interviews relate to multiple aspects of teaching by highlighting best and innovative practices, resistances due to established practices, and teaching models adopted