Ovarian cancer metastasis to the pectoral muscle

peer reviewedWe report the case of a patient with a sero-papillary ovarian cancer and a pectoral muscle metastasis. Muscular metastases are more common than previously suspected; any physician could encounter this type of case in his daily practice. This paper summarizes the literature on the subject

Design of FDM 3D printed polymers: An experimental-modelling methodology for the prediction of mechanical properties

Additive manufacturing technologies provide new opportunities for the manufacturing of components with customisable geometries and mechanical properties. In particular, fused deposition modelling (FDM) allows for customisable mechanical properties by controlling the void density and filament orientation. In this work, a methodology is provided for the prediction of the mechanical properties and mesostructure of FDM polymers. To this end, we propose a computational framework for the simulation of the printing process taking as input data specific manufacturing parameters and filament properties. A new two-stage thermal and sintering model is developed to predict the bond formation process between filaments. The model predictions are validated against original experimental data for acrylonitrile butadiene styrene (ABS) components manufactured by FDM. A parametric study is finally presented to interpret the effects of different manufacturing parameters on the mechanical performance of ABS specimens. Overall, the proposed framework offers new avenues for the design of 3D printed polymeric components with custom properties, directly in terms of manufacturing settings.D. Garcia-Gonzalez acknowledges support from the Talent Attraction grant (CM 2018 - 2018-T2/IND-9992) from the Comunidad de Madrid. S. Garzon-Hernandez, D. Garcia-Gonzalez and A. Arias acknowledge support from Ministerio de Ciencia, Innovación y Universidades, Agencia Estatal de Investigación y Fondo Europeo de Desarrollo Regional,comoentidades financiadoras (RTI2018-094318- B-I00)

A continuum mechanics constitutive framework for transverse isotropic soft tissues

In this work, a continuum constitutive framework for the mechanical modelling of soft tissues that incorporates strain rate and temperature dependencies as well as the transverse isotropy arising from fibres embedded into a soft matrix is developed. The constitutive formulation is based on a Helmholtz free energy function decoupled into the contribution of a viscous-hyperelastic matrix and the contribution of fibres introducing dispersion dependent transverse isotropy. The proposed framework considers finite deformation kinematics, is thermodynamically consistent and allows for the particularisation of the energy potentials and flow equations of each constitutive branch. In this regard, the approach developed herein provides the basis on which specific constitutive models can be potentially formulated for a wide variety of soft tissues. To illustrate this versatility, the constitutive framework is particularised here for animal and human white matter and skin, for which constitutive models are provided. In both cases, different energy functions are considered: Neo-Hookean, Gent and Ogden. Finally, the ability of the approach at capturing the experimental behaviour of the two soft tissues is confirmed.The researchers are indebted to the Ministerio de Economía y Competitividad de España (Projects DPI2014-57989-P and DPI2017-85970-R) for the financial support which permitted to conduct part of this work. D.G.-G. and A.J. acknowledge funding from the European Union’s Seventh Framework Programme ( FP7 2007-2013 ) ERC Grant Agreement No. 306587

Radiotherapy in breast cancer: current standards of treatment, prediction of local recurrence and open questions

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A phase IIa, nonrandomized study of radium-223 dichloride in advanced breast cancer patients with bone-dominant disease

Radium-223 dichloride (radium-223) mimics calcium and emits high-energy, short-range alpha-particles resulting in an antitumor effect on bone metastases. This open-label, phase IIa nonrandomized study investigated safety and short-term efficacy of radium-223 in breast cancer patients with bone-dominant disease. Twenty-three advanced breast cancer patients with progressive bone-dominant disease, and no longer candidates for further endocrine therapy, were to receive radium-223 (50 kBq/kg IV) every 4 weeks for 4 cycles. The coprimary end points were change in urinary N-telopeptide of type 1 (uNTX-1) and serum bone alkaline phosphatase (bALP) after 16 weeks of treatment. Exploratory end points included sequential 18F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) to assess metabolic changes in osteoblastic bone metastases. Safety data were collected for all patients. Radium-223 significantly reduced uNTX-1 and bALP from baseline to end of treatment. Median uNTX-1 change was −10.1 nmol bone collagen equivalents/mmol creatinine (−32.8 %; P = 0.0124); median bALP change was −16.7 ng/mL (−42.0 %; P = 0.0045). Twenty of twenty-three patients had FDG PET/CT identifying 155 hypermetabolic osteoblastic bone lesions at baseline: 50 lesions showed metabolic decrease (≥25 % reduction of maximum standardized uptake value from baseline) after 2 radium-223 injections [32.3 % metabolic response rate (mRR) at week 9], persisting after the treatment period (41.5 % mRR at week 17). Radium-223 was safe and well tolerated. Radium-223 targets areas of increased bone metabolism and shows biological activity in advanced breast cancer patients with bone-dominant disease

An Equation of State of a Carbon-Fibre Epoxy Composite under Shock Loading

An anisotropic equation of state (EOS) is proposed for the accurate extrapolation of high-pressure shock Hugoniot (anisotropic and isotropic) states to other thermodynamic (anisotropic and isotropic) states for a shocked carbon-fibre epoxy composite (CFC) of any symmetry. The proposed EOS, using a generalised decomposition of a stress tensor [Int. J. Plasticity \textbf{24}, 140 (2008)], represents a mathematical and physical generalisation of the Mie-Gr\"{u}neisen EOS for isotropic material and reduces to this equation in the limit of isotropy. Although a linear relation between the generalised anisotropic bulk shock velocity $U^{A}_{s}$ and particle velocity $u_{p}$ was adequate in the through-thickness orientation, damage softening process produces discontinuities both in value and slope in the $U^{A}_{s}$-$u_{p}$ relation. Therefore, the two-wave structure (non-linear anisotropic and isotropic elastic waves) that accompanies damage softening process was proposed for describing CFC behaviour under shock loading. The linear relationship $U^{A}_{s}$-$u_{p}$ over the range of measurements corresponding to non-linear anisotropic elastic wave shows a value of $c^{A}_{0}$ (the intercept of the $U^{A}_{s}$-$u_{p}$ curve) that is in the range between first and second generalised anisotropic bulk speed of sound [Eur. Phys. J. B \textbf{64}, 159 (2008)]. An analytical calculation showed that Hugoniot Stress Levels (HELs) in different directions for a CFC composite subject to the two-wave structure (non-linear anisotropic elastic and isotropic elastic waves) agree with experimental measurements at low and at high shock intensities. The results are presented, discussed and future studies are outlined.Comment: 12 pages, 9 figure

On the mechanical behaviour of PEEK and HA cranial implants under impact loading

The human head can be subjected to numerous impact loadings such as those produced by a fall or during sport activities. These accidents can result in skull fracture and in some complex cases, part of the skull may need to be replaced by a biomedical implant. Even when the skull is not damaged, such accidents can result in brain swelling treated by decompressive craniectomy. Usually, after recovery, the part of the skull that has been removed is replaced by a prosthesis. In such situations, a computational tool able to analyse the choice of prosthesis material depending on the patient's specific activity has the potential to be extremely useful for clinicians. The work proposed here focusses on the development and use of a numerical model for the analysis of cranial implants under impact conditions. In particular, two main biomaterials commonly employed for this kind of prosthesis are polyether-ether-ketone (PEEK) and macroporous hydroxyapatite (HA). In order to study the suitability of these implants, a finite element head model comprising scalp, skull, cerebral falx, cerebrospinal fluid and brain tissues, with a cranial implant replacing part of the skull has been developed from magnetic resonance imaging data. The human tissues and these two biocompatible materials have been independently studied and their constitutive models are provided here. A computational model of the human head under impact loading is then implemented and validated, and a numerical comparison of the mechanical impact response of PEEK and HA implants is presented. This comparison was carried out in terms of the effectiveness of both implants in ensuring structural integrity and preventing traumatic brain injury.The researchers of the University Carlos III are indebted to the Ministerio de Economía y Competitividad de España (Project DPI2014-57989-P) and Vicerrectorado de Política Científica UC3M (Project 2013-00219-002) for the financial support. A.J. acknowledges funding from the European Union's Seventh Framework Programme (FP7 2007–2013) ERC Grant Agreement No. 306587. MRI data were provided by the Human Connectome Project, WUMinn Consortium (Principal Investigators: David Van Essen and Kamil Ugurbil; 1U54MH091657) funded by the 16 NIH Institutes and Centers that support the NIH Blueprint for Neuroscience Research; and by the McDonnell Center for Systems Neuroscience at Washington University. Finally, we would like to thank Dr. S Barhli and Prof. J Marrow for valuable assistance with the X-ray tomography; the machine used was bought from EPSRC Grant EP/M02833X/1 “University of Oxford: experimental equipment upgrade”. Open Access funded by European Research Counci