Clinical recommendations for diagnosis and treatment according to current updated knowledge on BIA-ALCL

Shared strategies and correct information are essential to guide physicians in the management of such an uncommon disease as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). A systematic review of the literature was performed to collect the most relevant evidence on BIA-ALCL reported cases. A panel of multidisciplinary experts discussed the scientific evidence on BIA-ALCL, and updated consensus recommendations were developed through the Delphi process. The lastest reported Italian incidence of BIA-ALCL is 3.5 per 100.000 implanted patients (95% CI, 1.36 to 5.78), and the disease counts over 1216 cases worldwide as of June 2022. The most common presentation symptom is a late onset seroma followed by a palpable breast mass. In the event of a suspicious case, ultrasound-guided fine-needle aspiration should be the first step in evaluation, followed by cytologic and immunohistochemical examination. In patients with confirmed diagnosis of BIA-ALCL confined to the capsule, the en-bloc capsulectomy should be performed, followed by immediate autologous reconstruction, while delayed reconstruction applies for disseminate disease or radically unresectable tumor. Nevertheless, a multidisciplinary team approach is essential for the correct management of this pathology

Precision measurements of g1g_1 of the proton and the deuteron with 6 GeV electrons

The inclusive polarized structure functions of the proton and deuteron, g1p and g1d, were measured with high statistical precision using polarized 6 GeV electrons incident on a polarized ammonia target in Hall B at Jefferson Laboratory. Electrons scattered at lab angles between 18 and 45 degrees were detected using the CEBAF Large Acceptance Spectrometer (CLAS). For the usual DIS kinematics, Q^2>1 GeV^2 and the final-state invariant mass W>2 GeV, the ratio of polarized to unpolarized structure functions g1/F1 is found to be nearly independent of Q^2 at fixed x. Significant resonant structure is apparent at values of W up to 2.3 GeV. In the framework of perturbative QCD, the high-W results can be used to better constrain the polarization of quarks and gluons in the nucleon, as well as high-twist contributions

Dark sectors 2016 Workshop: community report

This report, based on the Dark Sectors workshop at SLAC in April 2016, summarizes the scientific importance of searches for dark sector dark matter and forces at masses beneath the weak-scale, the status of this broad international field, the important milestones motivating future exploration, and promising experimental opportunities to reach these milestones over the next 5-10 years

Offshoring innovation: an empirical investigation of dyadic complementarity within SMEs

Despite scholarly agreement that complementary capabilities are essential to successful collaborations, little is known about how small and medium-sized enterprises (SMEs) manage collaborative innovation through offshoring. Besides, the innovation management literature remains generally silent about when supplier joint actions could work in enhancing offshoring innovation (OI) performance. The purpose of this study is twofold. First, we aim to delineate why supplier's asset specificity and goal compatibility predict supplier's complimentary capabilities in OI. Second, we empirically explore the role of supplier joint actions in enhancing OI performance. Based on data collected from 200 SMEs having active OI relationships spanning four developed European countries, our results propose that supplier's complementary capabilities mediate the relationship between critical relational antecedents (supplier's asset specificity and goal compatibility) and OI performance. It should be noted, however, that despite their incentivising power, supplier joint actions can be a “double-edged sword” in SMEs’ OI relationships

Profile of down syndrome–associated malignancies: Epidemiology, clinical features and therapeutic aspects

Down syndrome (DS) is a congenital chromosomal abnormality caused by the presence of all or part of a third copy of chromosome 21 (+21). DS is frequently complicated by congenital heart or digestive tract diseases at birth. DS patients are prone to infections and have mental retardation, with dementia such as Alzheimer's disease showing in later life. Furthermore, malignancies with specific characteristics are also highly reported in DS patients compared with non-DS patients. Therefore, DS is believed to be a cancer predisposition syndrome due to the chromosomal instability. Acute myeloid leukemia (AML) and especially acute megakaryoblastic leukemia (AMKL) by French-American-British (FAB) classification are the most frequent hematological malignancies in DS patients, occurring at a rate that is 500 times higher than that in non-DS patients. Interestingly, transient abnormal myelopoiesis (TAM) is observed in approximately 10% of DS neonates with GATA1 mutations, and most TAM patients are asymptomatic and show spontaneous regression; however, about 10%–20% of TAM cases are fatal because of complications such as fetal effusion, liver fibrosis, and other complications.Acute lymphoblastic leukemia (ALL) is also associated with DS, occurring at a rate that is 20 times higher than that in non-DS patients. Furthermore, the prognosis of DS-ALL patients is poorer than that of non-DS-ALL patients. A recent genetic analysis revealed that more than half of DS-ALL cases have a mutation in the CRLF2–JAK pathway, indicating that JAK inhibitors might have a limited effect for DS-ALL patients.Notably, solid tumors such as neuroblastoma, Wilms tumor, and brain tumor, which are frequently observed in non-DS children, are rarely reported in DS children. The reason remains unknown, but it may be because of the triplication of the Down syndrome critical region 1 (DSCR1) gene on chromosome 21. In adult patients with DS, the expected age-adjusted incidence rates of solid tumors are low compared with age-matched euploid cohorts for most cancers except for testicular cancer. Although the average life expectancy of patients with DS will increase with advances in healthcare, the detailed health problems including cancer rates in older DS patients remain unknown. Therefore, these issues will be needed to be addressed in future studies

Sign Singularity of the Local Energy Transfer in Space Plasma Turbulence

In weakly collisional space plasmas, the turbulent cascade provides most of the energy that is dissipated at small scales by various kinetic processes. Understanding the characteristics of such dissipative mechanisms requires the accurate knowledge of the fluctuations that make energy available for conversion at small scales, as different dissipation processes are triggered by fluctuations of a different nature. The scaling properties of different energy channels are estimated here using a proxy of the local energy transfer, based on the third-order moment scaling law for magnetohydrodynamic turbulence. In particular, the sign-singularity analysis was used to explore the scaling properties of the alternating positive-negative energy fluxes, thus providing information on the structure and topology of such fluxes for each of the different type of fluctuations. The results show the highly complex geometrical nature of the flux, and that the local contributions associated with energy and cross-helicity non-linear transfer have similar scaling properties. Consequently, the fractal properties of current and vorticity structures are similar to those of the Alfvenic fluctuations