3 research outputs found

    Selective modification of nanoparticle arrays by laser-induced self assembly (MONA-LISA): putting control into bottom-up plasmonic nanostructuring

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    Nano-structuring of metals is one of the greatest challenges for the future of plasmonic and photonic devices. Such a technological challenge calls for the development of ultra-fast, high-throughput and low-cost fabrication techniques. Laser processing, accounts for the aforementioned properties, representing an unrivalled tool towards the anticipated arrival of modules based in metallic nanostructures, with an extra advantage: the ease of scalability. In the present work we take advantage of the ability to tune the laser wavelength to either match the absorption spectral profile of the metal or to be resonant with the plasma oscillation frequency, and demonstrate the utilization of different optical absorption mechanisms that are size-selective and enable the fabrication of pre-determined patterns of metal nanostructures. Thus, we overcome the greatest challenge of Laser Induced Self Assembly by combining simultaneously large-scale character with atomic-scale precision. The proposed process can serve as a platform that will stimulate further progress towards the engineering of plasmonic devices

    Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study

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    Background: Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours. Methods: In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186. Findings: Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78路6%] female patients and 4922 [21路4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1路4 [IQR 0路6-3路4]) compared with the prepandemic phase (2路0 [0路9-3路7]; p<0路0001) and pandemic decrease phase (2路3 [1路0-5路0]; p<0路0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69路0%] of 3704 vs 1515 [71路5%] of 2119; OR 1路1 [95% CI 1路0-1路3]; p=0路042), lymph node metastases (343 [9路3%] vs 264 [12路5%]; OR 1路4 [1路2-1路7]; p=0路0001), and tumours at high risk of structural disease recurrence (203 [5路7%] of 3584 vs 155 [7路7%] of 2006; OR 1路4 [1路1-1路7]; p=0路0039). Interpretation: Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation. Funding: None
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