Serum anti‐müllerian hormone levels and risk of premature ovarian insufficiency in female childhood cancer survivors: Systematic review and network meta‐analysis

Background: Female childhood cancer survivors (CCS) might have impaired ovarian reserves, especially after alkylating agents or radiotherapy. The purpose of this systematic review and network meta‐analysis is to evaluate the role of serum anti‐Müllerian hormone (AMH) for ovarian reserve screening and the risk of premature ovarian insufficiency (POI) according to the subtype of childhood cancer. (2) Methods: PRISMA‐NMA guidelines were followed. We carried out a network meta‐analysis based on a random effects model for mixed multiple treatment comparisons to rank childhood cancers effects on fertility by surface under the cumulative ranking curve (SUCRA). Studies were selected only if they had an age‐matched control group. Quality assessment was performed using Newcastle–Ottawa Scale. The co‐primary outcomes were mean AMH levels and the incidence of POI. (3) Results: A total of 8 studies (1303 participants) were included. Women treated for a neuroblastoma during infancy were more likely to be ranked first for impaired AMH levels (SUCRA = 65.4%), followed by mixed CCS (SUCRA = 29.6%). The greatest rates of POI were found in neuroblastoma survivors (SUCRA = 42.5%), followed by acute lymphoid leukemia (SUCRA = 26.3%) or any other neoplasia (SUCR A= 20.5%). (4) Conclusions: AMH represents a trustworthy approach for ovarian reserve screening. Direct and indirect comparisons found no differences in mean AMH levels and POI risk between subtypes of CCS and healthy controls. SUCRA analysis showed that female neuroblastoma survivors were more at risk for reduced serum AMH levels and increased risk of POI

Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer recurrence: systematic review and meta-analysis.

Background: Ovarian cancer is the first cause of death among gynecological malignancies with a high incidence of recurrence. Different treatment options are suitable to prolong the survival rate of these patients. Over the last years, one of the most intriguing methods, adopted in different oncologic centers worldwide, is the hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: A meta-analysis was performed to value the role of HIPEC for ovarian cancer recurrence. Search strategy was conducted with a combination of the following keywords: "ovarian recurrence, ovarian cancer recurrence, peritoneal cancer recurrence, ovarian recurrence AND HIPEC, secondary cytoreduction HIPEC". Seven studies were selected for analysis. Results: In women with recurrent ovarian cancer (ROC), the use of HIPEC in addition to cytoreductive surgery and chemotherapy significantly improved 1-year overall survival (OS) when compared to protocols without HIPEC (OR 2.42; 95% CI, 1.06-5.56; P=0.04; I2=4%). The improvement in OS was maintained significant also after 2, 3 and 5 years respectively (OR 3.33; 95% CI, 1.81-6.10; P<0.01; I2=0%), (OR 4.22; 95% CI, 2.07-8.60; P<0.01; I2=52%), (OR 5.17; 95% CI, 1.40-19.09; P=0.01; I2=82%). Conclusions: HIPEC seems to have an effective role to prolong survival in patients affected by ROC

The Parkes Galactic Meridian Survey (PGMS): observations and CMB polarization foreground analysis

We present observations and CMB foreground analysis of the Parkes Galactic Meridian Survey (PGMS), an investigation of the Galactic latitude behaviour of the polarized synchrotron emission at 2.3 GHz with the Parkes Radio Telescope. The survey consists of a 5-deg wide strip along the Galactic meridian l=254-deg extending from Galactic plane to South Galactic pole. We identify three zones distinguished by polarized emission properties: the disc, the halo, and a transition region connecting them. The halo section lies at latitudes |b| > 40-deg and has weak and smooth polarized emission mostly at large scale with steep angular power spectra of median slope $\beta_{\rm med} \sim -2.6$. The disc region covers the latitudes |b|<20-deg and has a brighter, more complex emission dominated by the small scales with flatter spectra of median slope $\beta_{\rm med} = -1.8$. The transition region has steep spectra as in the halo, but the emission increases toward the Galactic plane from halo to disc levels. The change of slope and emission structure at b \sim -20\degr is sudden, indicating a sharp disc-halo transition. The whole halo section is just one environment extended over 50-deg with very low emission which, once scaled to 70GHz, is equivalent to the CMB B-Mode emission for a tensor-to-scalar perturbation power ratio r_halo = 3.3 +/- 0.4 x 10^{-3}. Applying a conservative cleaning procedure, we estimate an r detection limit of $\delta r \sim 2\times 10^{-3}$ at 70~GHz (3-sigma C.L.) and, assuming a dust polariztion fraction <12%, $\delta r \sim 1\times 10^{-2}$ at 150~GHz. The 150-GHz limit matches the goals of planned sub-orbital experiments, which can therefore be conducted at this high frequency. The 70-GHz limit is close to the goal of proposed next generation space missions, which thus might not strictly require space-based platforms.Comment: 23 pages, 22 Figures. Accepted for publication on MNRAS. Some figures have been reduced in resolution. Replaced with the accepted version, 3 figures, more details on instrument performances, and map of polarization spectral index adde

Evidence for a Novel Reaction Mechanism of a Prompt Shock-Induced Fission Following the Fusion of 78Kr and 40Ca Nuclei at E/A =10 MeV

An analysis of experimental data from the inverse-kinematics ISODEC experiment on 78Kr+40Ca reaction at a bombarding energy of 10 AMeV has revealed signatures of a hitherto unknown reaction mechanism, intermediate between the classical damped binary collisions and fusion-fission, but also substantially different from what is being termed in the literature as fast fission or quasi fission. These signatures point to a scenario where the system fuses transiently while virtually equilibrating mass asymmetry and energy and, yet, keeping part of the energy stored in a collective shock-imparted and, possibly, angular momentum bearing form of excitation. Subsequently the system fissions dynamically along the collision or shock axis with the emerging fragments featuring a broad mass spectrum centered around symmetric fission, relative velocities somewhat higher along the fission axis than in transverse direction, and virtually no intrinsic spin. The class of massasymmetric fission events shows a distinct preference for the more massive fragments to proceed along the beam direction, a characteristic reminiscent of that reported earlier for dynamic fragmentation of projectile-like fragments alone and pointing to the memory of the initial mass and velocity distribution.Comment: 5 PAGES, 6 FIGURE

Oncological outcomes in fertility-sparing treatment in stage IA-G2 endometrial cancer

Background: The gold standard treatment for early-stage endometrial cancer (EC) is hysterectomy with bilateral salpingo-oophorectomy (BSO) with lymphadenectomy. In selected patients desiring pregnancy, fertility-sparing treatment (FST) can be adopted. Our review aims to collect the most incisive studies about the possibility of conservative management for patients with grade 2, stage IA EC. Different approaches can be considered beyond demolition surgery, such as local treatment with levonorgestrel-releasing intra-uterine device (LNG-IUD) plus systemic therapy with progestins. Study design: Our systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, EMBASE, and Scopus databases were consulted, and five studies were chosen based on the following criteria: patients with a histological diagnosis of EC stage IA G2 in reproductive age desiring pregnancy and at least one oncological outcome evaluated. Search imputes were “endometrial cancer” AND “fertility sparing” AND “oncologic outcomes” AND “G2 or stage IA”. Results: A total of 103 patients were included and treated with a combination of LNG-IUD plus megestrol acetate (MA) or medroxyprogesterone acetate (MPA), gonadotrophin-releasing hormone (GnRH) plus MPA/MA, hysteroscopic resectoscope (HR), and dilation and curettage (D&C). There is evidence of 70% to 85% complete response after second-round therapy prolongation to 12 months. Conclusions: Conservative measures must be considered temporary to allow pregnancy and subsequently perform specific counseling to adopt surgery. Fertility-sparing management is not the current standard of care for young women with EC. It can be employed for patients with early-stage diseases motivated to maintain reproductive function. Indeed, the results are encouraging, but the sample size must be increased

BRCA1/2 Molecular Assay for Ovarian Cancer Patients: A Survey through Italian Departments of Oncology and Molecular and Genomic Diagnostic Laboratories

In Italy, 5200 new ovarian cancers were diagnosed in 2018, highlighting an increasing need to test women for BRCA1/2. The number of labs offering this test is continuously increasing. The aim of this study was to show the results coming from the intersociety survey coordinated by four different Clinical and Laboratory Italian Scientific Societies (AIOM, SIAPEC-IAP, SIBIOC, and SIGU). A multidisciplinary team belonging to the four scientific societies drew up two different questionnaires: One was targeted toward all Italian Departments of Medical Oncology, and the second toward laboratories of clinical molecular biology. This survey was implemented from September 2017 to March 2018. Seventy-seven out of 305 (25%) Departments of Medical Oncology filled our survey form. Indeed, 59 molecular laboratories were invited. A total of 41 laboratories (70%) filled in the questionnaire. From 2014 to 2017, 16 new molecular laboratories were activated. A total of 12,559 tests were performed in the year 2016, with a mean of 339 tests and a median of 254 tests per laboratory, showing a glimpse of an extreme low number of tests performed per year by some laboratories. In terms of the type and number of professionals involved in the pre- and post-test counseling, results among the onco-genetic team were heterogeneous. Our data show that the number of laboratories providing BRCA1/2 germline assays is significantly increased with further implementation of the somatic test coming soon. The harmonization of the complete laboratory diagnostic path should be encouraged, particularly in order to reduce the gap between laboratories with high and low throughput

Projected Quasi-particle Perturbation theory

The BCS and/or HFB theories are extended by treating the effect of four quasi-particle states perturbatively. The approach is tested on the pairing hamiltonian, showing that it combines the advantage of standard perturbation theory valid at low pairing strength and of non-perturbative approaches breaking particle number valid at higher pairing strength. Including the restoration of particle number, further improves the description of pairing correlation. In the presented test, the agreement between the exact solution and the combined perturbative + projection is almost perfect. The proposed method scales friendly when the number of particles increases and provides a simple alternative to other more complicated approaches