Surgical Prevention of Arm Lymphedema in Breast Cancer Treatment

Disruption of the axillary nodes and closure of arm lymphatics can explain the significantly high risk of early and late lymphatic complications after axillary dissection, especially the most serious complication that is arm lymphedema which occurs in about 25% (ranging from 13 to 52%) of patients. Sentinel lymph node (SLN) biopsy has reduced the severity of swelling to nearly 6% (from 2 to 7%) and, in case of positive SLN, complete axillary dissection (AD) is still required. That is why ARM method was developed aiming at identifying and preserve lymphatics draining the arm. It consists in injecting intradermally and subcutaneously a small quantity (1-2 ml) of blue dye at the medial surface of the arm which helps in locating the draining arm lymphatic pathways. ARM technique allowed to find variable clinical anatomical conditions from what was already generally known, that is the most common location of arm lymphatics below and around the axillary vein. In about one-third of the cases, blue lymphatics can be found till 3-4 cm below the vein, site where SLN can easily be located, justifying the occurrence of lymphedema after only SLN biopsy. ARM procedure showed that blue nodes were almost always placed at the lateral part of the axilla, under the vein and above the second intercostals brachial nerve. Leaving in place lymph nodes related to arm lymphatic drainage would decrease the risk of arm lymphedema, but not retrieving all nodes, the main risk is to leave metastatic disease in the axilla. Conversely, arm lymphatic pathways when they enter the axilla, cannot be site of breast tumoral disease and their preservation would certainly bring about a significant decrease of lymphedema occurrence rate

The Neapolitan Yellow Tuff caldera offshore the Campi Flegrei: Stratal architecture and kinematic reconstruction during the last 15 ky

In this study we integrate high-resolution swath bathymetry, single channel reflection seismic data and gravity core data, to provide new insights into the shallow structure and latest Quaternary to Holocene evolution of the submerged sector of the Neapolitan Yellow Tuff (NYT) caldera (Campi Flegrei) in the Pozzuoli Bay. The new data allow for a reconstruction of the offshore geometry of the NYT caldera collapse\u2013ring fault system, along with the style and timing of deformation of the inner caldera resurgence. Our interpretation shows that the NYT eruption (~15 ka BP) was associated with a caldera collapse bounded by an inward-dipping ring fault system. The ring fault system consists in a 1\u20132 km wide fault zone that encircles an inner caldera region ~5 km in diameter and is often marked by the occurrence of pore fluids ascending through the fault zone, up to the seafloor, particularly in the western sector of the bay. A shallow magmatic intrusion along the ring fault zone was also detected offshore Bagnoli in the eastern part of the Pozzuoli Bay. Following the NYT eruption, the inner caldera region underwent significant deformation and resurgence with a maximum cumulative uplift of the offshore structure in the order of 180 m. The net uplift rate of the caldera resurgent dome was ~9\u201312 mm/year during the period 15.0\u20136.6 ka BP. The style of deformation of the resurgent structure can be described in terms of a broad doming, accompanied by subordinate brittle deformation, mostly concentrated in a small apical graben at the summit of the resurgent dome. Chronostratigraphic calibration of seismic profiles obtained by three tephra layers cored in the Pozzuoli Bay indicates 5 to 25 m of post-Roman differential subsidence and tilting towards ESE of the inner caldera resurgence, as recorded by the drowning of the infralittoral prograding wedge below the present-day storm wave base

Tallimustine in advanced previously untreated colorectal cancer, a phase II study.

Tallimustine is a novel benzoyl mustard derivative from distamycin A with a unique mode of action. It is a DNA minor groove binder and produces highly sequence-specific alkylations. Previous studies have shown significant anti-tumour effects in animal models. We performed a phase II study in previously untreated patients with advanced colorectal cancer, using a schedule of i.v. bolus infusions of 900 microgram m-2 once every 4 weeks. Seventeen patients were enrolled, and no responses were documented in 14 evaluable patients. Toxicity mainly consisted a highly selective neutropenia, which warrants further investigation of this agent in combination with myeloid growth factors

Spectral analysis of lava flows: Temporal and physicochemical effects

In a volcanic context, the spectral response of lava flows depends on several endogenous and exogenous factors, like chemical composition, passing of years and weathering. A deeper knowledge about lava properties can be inferred by investigating their spectral response in satellite images. Here, we compare the spectral response of lava in time, physical, and chemical characteristics, inspecting visible to infrared high spatial resolution ESA Sentinel-2 satellite images of different volcanoes. Our results show increasing and decreasing patterns of the lava spectral response as a function of time and physicochemical composition

Basin-scale interaction between post-LGM faulting and morpho-sedimentary processes in the S. Eufemia Gulf (Southern Tyrrhenian Sea)

The integrated interpretation of high-resolution multibeam bathymetry, seismic profiles and backscatter data in the S. Eufemia Gulf (SEG; Calabro-Tyrrhenian continental margin, south-eastern Tyrrhenian Sea) documents the relationship between postglacial fault activity and morpho-sedimentary processes. Three systems of active normal faults that affect the seafloor or the shallow subsurface, have been identified: 1) the S. Eufemia fault system located on the continental shelf with fault planes mainly oriented N26E-N40E; 2) the offshore fault system that lies on the continental slope off Capo Suvero with fault planes mainly oriented N28E-N60E; 3) the Angitola Canyon fault system located on the seafloor adjacent to the canyon having fault planes oriented N60EN85E. The faults produce a belt of linear escarpments with vertical displacement varying from a few decimeters to about 12 m. One of the most prominent active structures is the fault F1 with the highest fault length (about 9.5 km). Two main segments of this fault are identified: a segment characterised by seafloor deformation with metric slip affecting Holocene deposits; a segment characterised by folding of the seafloor. A combined tectonostratigraphic model of an extensional fault propagation fold is proposed here to explain such different deformation.In addition to the seabed escarpments produced by fault deformation, in the SEG, a strong control of fault activity on recent sedimentary processes is clearly observed. For example, canyons and channels frequently change their course in response to their interaction with main tectonic structures. Moreover, the upper branch of the Angitola Canyon shows straight flanks determined by fault scarps. Tectonics also determined different sediment accumulation rates and types of sedimentation (e.g., the accumulation of hanging wall turbidite deposits and the development of contourite deposits around the Maida Ridge). Furthermore, the distribution of landslides is often connected to main fault scarps and fluids are locally confined in the hanging wall side of faults and can escape at the seabed, generating pockmarks aligned along their footwall

Charge Collection Dynamics of the ARCADIA Passive Pixel Arrays: Laser Characterization and TCAD Modeling

Monolithic Active Pixel Sensors (MAPS) represent one of the most promising technologies for the next generation of radiation detectors. The ARCADIA project aims at the development of Fully Depleted (FD) MAPS employing a production process compatible with a 110 nm commercial CMOS technology. The first engineering run of the project included matrices of active pixels with embedded analog and digital frontend electronics and passive test structures such as passive pixel arrays, MOS capacitors and backside diodes. Although the produced samples were already characterized from the electrical point of view, a thorough study of the charge collection dynamics of the passive pixel arrays was still missing. In this paper we show the results of the dynamic characterization of a group of passive pixel arrays with different pixel pitches (50, 25 and 10 μm) and different pixel layouts. The tested samples have been illuminated from the backside with an infrared and a red laser with wavelengths equal to 1,060 nm and 660 nm, respectively. The pixel arrays have been mounted on a custom readout PCB connected to an external amplifier with 1 GHz bandwidth and the signals have been acquired through a fast digital oscilloscope. We employed both focused and unfocused laser spots to evaluate the change in the measured signal as a function of the laser spot position and the average response of the pixel arrays. An excellent agreement has been demonstrated by comparing the measured signals with the results of transient TCAD simulations and a time for 50% charge collection of 7.8, 4.2 and 2.6 ns has been predicted and experimentally validated in pixels with 50, 25 and 10 μm pitch, respectively

An Integrated Multiscale Method for the Characterisation of Active Faults in Offshore Areas. The Case of Sant\u2019Eufemia Gulf (Offshore Calabria, Italy)

Diagnostic morphological features (e.g., rectilinear seafloor scarps) and lateral offsets of the Upper Quaternary deposits are used to infer active faults in offshore areas. Although they deform a significant seafloor region, the active faults are not necessarily capable of producing large earthquakes as they correspond to shallow structures formed in response to local stresses. We present a multiscale approach to reconstruct the structural pattern in offshore areas and distinguish between shallow, non-seismogenic, active faults, and deep blind faults, potentially associated with large seismic moment release. The approach is based on the interpretation of marine seismic reflection data and quantitative morphometric analysis of multibeam bathymetry, and tested on the Sant\u2019Eufemia Gulf (southeastern Tyrrhenian Sea). Data highlights the occurrence of three major tectonic events since the Late Miocene. The first extensional or transtensional phase occurred during the Late Miocene. Since the Early Pliocene, a right-lateral transpressional tectonic event caused the positive inversion of deep (>3 km) tectonic features, and the formation of NE-SW faults in the central sector of the gulf. Also, NNE-SSW to NE-SW trending anticlines (e.g., Maida Ridge) developed in the eastern part of the area. Since the Early Pleistocene (Calabrian), shallow (<1.5 km) NNE-SSW oriented structures formed in a left-lateral transtensional regime. The new results integrated with previous literature indicates that the Late Miocene to Recent transpressional/transtensional structures developed in an 3cE-W oriented main displacement zone that extends from the Sant\u2019Eufemia Gulf to the Squillace Basin (Ionian offshore), and likely represents the upper plate response to a tear fault of the lower plate. The quantitative morphometric analysis of the study area and the bathymetric analysis of the Angitola Canyon indicate that NNE-SSW to NE-SW trending anticlines were negatively reactivated during the last tectonic phase. We also suggest that the deep structure below the Maida Ridge may correspond to the seismogenic source of the large magnitude earthquake that struck the western Calabrian region in 1905. The multiscale approach contributes to understanding the tectonic imprint of active faults from different hierarchical orders and the geometry of seismogenic faults developed in a lithospheric strike-slip zone orthogonal to the Calabrian Arc