Intraoperative ultrasound in conservative surgery for non-palpable breast cancer after neoadjuvant chemotherapy

AbstractAimsA complete clinical response after neoadjuvant chemotherapy (NACT) in breast cancer patients hinders the localization of the residual lesion and the removal of a minimum amount of breast tissue. The aim of the present work is to report our single-centre experience with intraoperative ultrasound-guided (IOUS) excision performed by surgeons in these patients.Patients and methodsFrom January 2008 to December 2012, IOUS excisions were performed on 58 patients with a previous intralesional ultrasound-detectable metallic marker and non-palpable breast cancer after NACT. The specimen margins were estimated by ultrasonography and macroscopic pathologic examination. Successful lesion removal, specimen weight, and analysis of the results as regards margins were evaluated, and the need for breast-conserving re-excision and mastectomy was considered.ResultsAfter NACT the average ultrasound/mammography and MRI diameters were 11.7 mm (0–30) and 9.1 mm (0–40) respectively. In all cases, the residual lesion or tissue around the marker was removed. The average weight of the specimens was 26.4 g (6–84), being lower in cases of complete response according to ultrasound (p < 0.05). In 4 patients (6.8%), breast-conserving re-excision was carried out, and in 3 patients (5.2%) a secondary mastectomy was performed, two of which had invasive lobular carcinoma.ConclusionsThe emplacement of a readily echodetectable metal marker before NACT makes IOUS excision feasible in an increasing number of complete clinical responses, with the excision of small amounts of breast tissue and a high percentage of conservative breast surgery. This technique requires surgeons to be trained, but has the advantage of a reduced use of other hospital services, better planning of operating theatres, and less discomfort for patients, which means that it is attractive and indeed recommendable

An embedded cohesive crack model for finite element analysis of quasi-brittle materials

This paper presents a numerical implementation of the cohesive crack model for the anal-ysis of quasibrittle materials based on the strong discontinuity approach in the framework of the finite element method. A simple central force model is used for the stress versus crack opening curve. The additional degrees of freedom defining the crack opening are determined at the crack level, thus avoiding the need for performing a static condensation at the element level. The need for a tracking algorithm is avoided by using a consistent pro-cedure for the selection of the separated nodes. Such a model is then implemented into a commercial program by means of a user subroutine, consequently being contrasted with the experimental results. The model takes into account the anisotropy of the material. Numerical simulations of well-known experiments are presented to show the ability of the proposed model to simulate the fracture of quasibrittle materials such as mortar, concrete and masonry

An embedded cohesive crack model for finite element analysis of brickwork masonry fracture

This paper presents a numerical procedure for fracture of brickwork masonry based on the strong discontinuity approach. The model is an extension of the cohesive model prepared by the authors for concrete, and takes into account the anisotropy of the material. A simple central-force model is used for the stress versus crack opening curve. The additional degrees of freedom defining the crack opening are determined at the crack level, thus avoiding the need of performing a static condensation at the element level. The need for a tracking algorithm is avoided by using a consistent procedure for the selection of the separated nodes. Such a model is then implemented into a commercial code by means of a user subroutine, consequently being contrasted with experimental results. Fracture properties of masonry are independently measured for two directions on the composed masonry, and then input in the numerical model. This numerical procedure accurately predicts the experimental mixed-mode fracture records for different orientations of the brick layers on masonry panels

ALS/FTD‐associated FUS activates GSK‐3β to disrupt the VAPB–PTPIP51 interaction and ER–mitochondria associations

Defective FUS metabolism is strongly associated with amyotrophic lateral sclerosis and frontotemporal dementia (ALS/FTD), but the mechanisms linking FUS to disease are not properly understood. However, many of the functions disrupted in ALS/FTD are regulated by signalling between the endoplasmic reticulum (ER) and mitochondria. This signalling is facilitated by close physical associations between the two organelles that are mediated by binding of the integral ER protein VAPB to the outer mitochondrial membrane protein PTPIP51, which act as molecular scaffolds to tether the two organelles. Here, we show that FUS disrupts the VAPB–PTPIP51 interaction and ER–mitochondria associations. These disruptions are accompanied by perturbation of Ca2+ uptake by mitochondria following its release from ER stores, which is a physiological read‐out of ER–mitochondria contacts. We also demonstrate that mitochondrial ATP production is impaired in FUS‐expressing cells; mitochondrial ATP production is linked to Ca2+ levels. Finally, we demonstrate that the FUS‐induced reductions to ER–mitochondria associations and are linked to activation of glycogen synthase kinase‐3β (GSK‐3β), a kinase already strongly associated with ALS/FTD

InP monolithically integrated label swapper device for spectral amplitude coded optical packet networks

In this paper a label swapping device, for spectral amplitude coded optical packet networks, fully integrated using InP technology is presented. Compared to previous demonstrations using discrete component assembly, the device footprint is reduced by a factor of 105 and the operation speed is increased by a factor of 103. This is, to the best of our knowledge, the first demonstration of a totally integrated label swapping device

Detection of entanglement with few local measurements

We introduce a general method for the experimental detection of entanglement by performing only few local measurements, assuming some prior knowledge of the density matrix. The idea is based on the minimal decomposition of witness operators into a pseudo-mixture of local operators. We discuss an experimentally relevant case of two qubits, and show an example how bound entanglement can be detected with few local measurements.Comment: 5 pages + 1 figur

Impact of the COVID-19 pandemic on the care of cancer patients in Spain

Background: Studies evaluating the effects of the COVID-19 pandemic on public healthcare systems are limited, particularly in cancer management. As no such studies have been carried out in Spain, our objective is to describe and quantify the impact of the COVID-19 pandemic on cancer patients in Spanish hospitals during the first wave of the pandemic. Materials and methods: This retrospective, multicenter, nationwide study collected information from hospital departments treating oncology patients. An electronic questionnaire comparing outcomes and management of oncohematological patients for the March-June 2019 and March-June 2020 periods was used. Results: Information from 78 departments (36 tertiary hospitals) was analyzed. Forty-four departments implemented adapted protocols during March 2020. Most of these (n = 38/44; 86.4%) carried out COVID-19 triage, while 26 of 44 (59.1%) carried out onsite polymerase chain reaction tests for clinically suspected cases. A shift from in-person to telephone visits was observed in 43 of 44 (97.7%) departments. Comparing the March-June 2019 and March-June 2020 periods, the number of new patients decreased by 20.8% (from 160.2 to 126.4). Decreases were also seen in the mean number of total (2858.2 versus 1686.1) and cancer (465.5 versus 367.2) biopsies, as well as the mean number of bone marrow biopsies (30.5 versus 18.6). Concerning the number of patients visiting specific cancer care departments, a decrease from 2019 to 2020 was seen for mean number of chemotherapy treatments (712.7 versus 643.8) and radiation therapy (2169.9 versus 2139.9). Finally, a reduction from 2019 to 2020 of 12.9% (from 8.6 to 7.4) in the mean number of patients included in clinical trials was noted. Conclusions: This study provides the first comprehensive data concerning the impact of COVID-19 on cancer care in Spain. The pandemic caused a 20.8% decrease in newly diagnosed patients, which may impact future outcomes. Measures must be taken to ensure cancer management receives priority in times of healthcare emergencies

InP monolithically integrated label swapper device for spectral amplitude coded optical packet networks

In this paper a label swapping device, for spectral amplitude coded optical packet networks, fully integrated using InP technology is presented. Compared to previous demonstrations using discrete component assembly, the device footprint is reduced by a factor of 105 and the operation speed is increased by a factor of 103. This is, to the best of our knowledge, the first demonstration of a totally integrated label swapping device

A first-principles approach to electrical transport in atomic-scale nanostructures

We present a first-principles numerical implementation of Landauer formalism for electrical transport in nanostructures characterized down to the atomic level. The novelty and interest of our method lies essentially on two facts. First of all, it makes use of the versatile Gaussian98 code, which is widely used within the quantum chemistry community. Secondly, it incorporates the semi-infinite electrodes in a very generic and efficient way by means of Bethe lattices. We name this method the Gaussian Embedded Cluster Method (GECM). In order to make contact with other proposed implementations, we illustrate our technique by calculating the conductance in some well-studied systems such as metallic (Al and Au) nanocontacts and C-atom chains connected to metallic (Al and Au) electrodes. In the case of Al nanocontacts the conductance turns out to be quite dependent on the detailed atomic arrangement. On the contrary, the conductance in Au nanocontacts presents quite universal features. In the case of C chains, where the self-consistency guarantees the local charge transfer and the correct alignment of the molecular and electrode levels, we find that the conductance oscillates with the number of atoms in the chain regardless of the type of electrode. However, for short chains and Al electrodes the even-odd periodicity is reversed at equilibrium bond distances.Comment: 14 pages, two-column format, submitted to PR