Autologous fat grafting after sarcoma surgery : evaluation of oncological safety

Background: The regenerative effectiveness of lipoaspirate procedures relies on the presence of mesenchymal stem cells, but the stromal microenvironment and hormonal secretions of the adipose tissue may be involved in cancer growth. Only few oncological outcome studies of fat grafting at the surgical site of malignant neoplasms of mesenchymal origin are available; none of these studies examined a series of sarcoma cases. Objectives: We analyzed outcome in terms of local or distant spread and overall survival to investigate the oncological safety of fat grafting in patients with sarcoma. Patients and methods: Sixty consecutive patients who had undergone 143 fat grafting procedures after surgical resection of bone and soft tissue sarcomas of the head, trunk, and limbs with clear resection margins were enrolled from 2004 to 2015 in our tertiary care center. A multidisciplinary sarcoma team administered adjuvant therapies. Patients were recurrence free at fat grafting. Results: The overall median follow-up was 7.5 years. At follow-up after fat grafting (2.4 years), one patient had distant metastasis and two had local relapse. Kaplan\u2013Meier analysis showed disease-free survival rate of 95.4% (CI: 89.1\u2013100.0) at 24 months. The risk of local recurrence (LR) within 24 months was 4.6% (CI: 0.0\u201320.9). The probability of not having LR after fat grafting was 65 89.1%. Conclusion: We found no evidence of an increased cancer risk after fat grafting procedures in patients with sarcoma, but a stimulatory role of fat cannot be excluded for bone sarcomas based on the cases reported here, and further studies are therefore needed

Autologous fat grafting after sarcoma surgery : evaluation of oncological safety

Background: The regenerative effectiveness of lipoaspirate procedures relies on the presence of mesenchymal stem cells, but the stromal microenvironment and hormonal secretions of the adipose tissue may be involved in cancer growth. Only few oncological outcome studies of fat grafting at the surgical site of malignant neoplasms of mesenchymal origin are available; none of these studies examined a series of sarcoma cases. Objectives: We analyzed outcome in terms of local or distant spread and overall survival to investigate the oncological safety of fat grafting in patients with sarcoma. Patients and methods: Sixty consecutive patients who had undergone 143 fat grafting procedures after surgical resection of bone and soft tissue sarcomas of the head, trunk, and limbs with clear resection margins were enrolled from 2004 to 2015 in our tertiary care center. A multidisciplinary sarcoma team administered adjuvant therapies. Patients were recurrence free at fat grafting. Results: The overall median follow-up was 7.5 years. At follow-up after fat grafting (2.4 years), one patient had distant metastasis and two had local relapse. Kaplan–Meier analysis showed disease-free survival rate of 95.4% (CI: 89.1–100.0) at 24 months. The risk of local recurrence (LR) within 24 months was 4.6% (CI: 0.0–20.9). The probability of not having LR after fat grafting was ≥ 89.1%. Conclusion: We found no evidence of an increased cancer risk after fat grafting procedures in patients with sarcoma, but a stimulatory role of fat cannot be excluded for bone sarcomas based on the cases reported here, and further studies are therefore needed

Design and Experimental Validation of a Software-Defined Radio Access Network Testbed with Slicing Support

Network slicing is a fundamental feature of 5G systems to partition a single network into a number of segregated logical networks, each optimized for a particular type of service, or dedicated to a particular customer or application. The realization of network slicing is particularly challenging in the Radio Access Network (RAN) part, where multiple slices can be multiplexed over the same radio channel and Radio Resource Management (RRM) functions shall be used to split the cell radio resources and achieve the expected behaviour per slice. In this context, this paper describes the key design and implementation aspects of a Software-Defined RAN (SD-RAN) experimental testbed with slicing support. The testbed has been designed consistently with the slicing capabilities and related management framework established by 3GPP in Release 15. The testbed is used to demonstrate the provisioning of RAN slices (e.g. preparation, commissioning and activation phases) and the operation of the implemented RRM functionality for slice-aware admission control and scheduling

Local safety of immediate reconstruction during primary treatment of breast cancer : direct-to-implant versus expander-based surgery

Introduction: After mastectomy, immediate breast reconstruction is paramount. With the growing number of nipple-sparing mastectomies, the chances of successful one-stage reconstruction with implants are also increasing. Local safety is one of the main issues. This study investigated the factors that could lead to major or minor complications after expander-based versus direct-to-implant (DTI) reconstruction. Methods: The studied factors were age, body mass index (BMI), hypertension, smoking, diabetes, type of mastectomy (nipple-sparing/total), implant size, neoadjuvant/adjuvant chemotherapy, and radiotherapy. The study sample included 294 immediate reconstructions over 3 years. The primary outcome was the incidence of complications, major or minor depending on the necessity of revision surgery. For the DTI pocket, we applied a variant of the conventional submuscular technique. Results: In DTI reconstructions (median follow-up 26 months), the complication rate was 17.2% (4.3% major and 12.8% minor) with no significant association with clinical variables. In expander-based reconstructions (median follow-up 19 months), the complication rate was 18.3% (12.5% major and 5.8% minor). Univariate analysis showed a significant association between overall complications and radiotherapy (P = 0.01) as well as between major complications and expander size (P < 0.005), BMI (P < 0.005), and radiotherapy (P < 0.01); radiotherapy and BMI retained significance in multivariate analysis. Neoadjuvant/adjuvant chemotherapy did not affect the complication rate. Conclusions: There was evidence of an association between major complications and clinical variables in the expander-based cohort. Larger expander size was a predictor of failure, especially combined with radiation. Direct-to-implant reconstruction proved to be safe. We describe a reliable method of reconstruction and a safe range of implant sizes even beyond 500 g

The space of words: on the sensorimotor processing of variable affordances in noun-adjective combinations.

Evidence suggests that the processing of graspable object nouns elicits specific motor programs related to potential hand-object interactions. Notably, adjectives specifying manipulative features of these objects are integrated into this sensorimotor representation. The present experiment investigated the effect of adjectives denoting the position of the object in space on the sensorimotor representation of graspable object nouns. We used a reach-to-grasp compatibility task, in which participants had to categorize object nouns as artifact or natural, by performing either a power or precision grip matching or not the typical grip associated with the object. On each trial, the object noun was presented with a near or far adjective. While reliable grasp-compatibility effects emerged for object nouns on RTs, this was not modulated by the spatial position denoted by the adjective. Spatial adjectives appear not to be integrated into the noun sensorimotor representation, supporting the distinction between stable and variable affordances

Spectral and timing properties of IGR J00291+5934 during its 2015 outburst

We report on the spectral and timing properties of the accreting millisecond X-ray pulsar IGR J00291+5934 observed by XMM-Newton and NuSTAR during its 2015 outburst. The source is in a hard state dominated at high energies by a comptonization of soft photons ($\sim0.9$ keV) by an electron population with kT$_e\sim30$ keV, and at lower energies by a blackbody component with kT$\sim0.5$ keV. A moderately broad, neutral Fe emission line and four narrow absorption lines are also found. By investigating the pulse phase evolution, we derived the best-fitting orbital solution for the 2015 outburst. Comparing the updated ephemeris with those of the previous outbursts, we set a $3\sigma$ confidence level interval $-6.6\times 10^{-13}$ s/s $< \dot{P}_{orb} < 6.5 \times 10^{-13}$ s/s on the orbital period derivative. Moreover, we investigated the pulse profile dependence on energy finding a peculiar behaviour of the pulse fractional amplitude and lags as a function of energy. We performed a phase-resolved spectroscopy showing that the blackbody component tracks remarkably well the pulse-profile, indicating that this component resides at the neutron star surface (hot-spot).Comment: 9 pages, 7 figures. Accepted for publication in MNRA

Cross-Border Investment, Conflict of Laws, and the Privatization of Securities Law

The rapid acceleration of transnational investing is occurring in an environment in which emerging markets, and foreign interest in these markets, are exploding. The issues involved with cross-border investment, conflict of laws and the privatization of securities law are examined

Discovery of a new accreting millisecond X-ray pulsar in the globular cluster NGC 2808

We report on the discovery of coherent pulsations at a period of 2.9 ms from the X-ray transient MAXI J0911-655 in the globular cluster NGC 2808. We observed X-ray pulsations at a frequency of $\sim339.97$ Hz in three different observations of the source performed with XMM-Newton and NuSTAR during the source outburst. This newly discovered accreting millisecond pulsar is part of an ultra-compact binary system characterised by an orbital period of $44.3$ minutes and a projected semi-major axis of $\sim17.6$ lt-ms. Based on the mass function we estimate a minimum companion mass of 0.024 M$_{\odot}$, which assumes a neutron star mass of 1.4 M$_{\odot}$ and a maximum inclination angle of $75^{\circ}$ (derived from the lack of eclipses and dips in the light-curve of the source). We find that the companion star's Roche-Lobe could either be filled by a hot ($5\times 10^{6}$ K) pure helium white dwarf with a 0.028 M$_{\odot}$ mass (implying $i\simeq58^{\circ}$) or an old (>5 Gyr) brown dwarf with metallicity abundances between solar/sub-solar and mass ranging in the interval 0.065$-$0.085 M$_{\odot}$ (16 < $i$ < 21). During the outburst the broad-band energy spectra are well described by a superposition of a weak black-body component (kT$\sim$ 0.5 keV) and a hard cutoff power-law with photon index $\Gamma \sim$ 1.7 and cut-off at a temperature kT$_e\sim$ 130 keV. Up to the latest Swift-XRT observation performed on 2016 July 19 the source has been observed in outburst for almost 150 days, which makes MAXI J0911-655 the second accreting millisecond X-ray pulsar with outburst duration longer than 100 days.Comment: 7 pages, 5 figures, accepted for publication in A&

Leadership and the Liberal Arts: Achieving the Promise of a Liberal Education

A collection of essays by presidents of prominent liberal arts colleges and leading intellectuals who reflect on the meaning of educating individuals for leadership and how it can be accomplished in ways consistent with the missions of liberal arts institutions. Edited by faculty from the Jepson School for Leadership Studies at the University of Richmond, the Jepson Studies in Leadership series will reflect the school\u27s broad-based, liberal arts approach to the study of leadership. The Jepson School has faculty representatives from the disciplines of English literature, history, philosophy, political science, psychology, public administration, religious studies, and organizational leadership. No other school or program is better situated to provide a multidisciplinary perspective on this important topic.https://scholarship.richmond.edu/bookshelf/1020/thumbnail.jp