Oncological safety of stromal vascular fraction enriched fat grafting in two-stage breast reconstruction after nipple sparing mastectomy: long-term results of a prospective study

OBJECTIVE: Autologous fat transfer (AFT) is commonly used to treat implant palpability and prevent fibrosis and thinning in mastectomy skin flaps. A major limit to this procedure is volume retention over time, leading to the introduction of fat enrichment with stromal vascular fraction (SVF+AFT). Oncological concerns have been raised over the injection of an increased concentration of progenitors cells (ASCs) in the SVF. The aim of the study is to evaluate the long-term cancer recurrence risk of SVF+AFT cases compared to AFT, in patients undergoing Nipple Sparing Mastectomy (NSM). PATIENTS AND METHODS: A prospective study was designed to compare three groups of patients undergoing NSM followed by SVF+AFT, AFT or none (control group), after a two-stage breast reconstruction. Patients were strictly followed-up for at least 5-years from the second stage reconstructive procedure. Loco-regional and systemic recurrence rate were evaluated over time as the primary outcome. Logistic regression was used to investigate which factors were associated with recurrence events and independent variables of interest were: surgical technique, age above 50 years old, lympho-vascular invasion, oncological stage, adjuvant or neoadjuvant chemotherapy, adjuvant radiotherapy and adjuvant hormone therapy. RESULTS: 41 women were included in G1 (SVF+AFT), 64 in G2 (AFT), and 64 in G3 (control group). Loco-regional recurrence rate was 2.4% for G1, 4.7% for G2, and 1.6% for G3. Systemic recurrence was 7.3%, 3.1%, and 3.1%, respectively. Among the variables included, there were no significant risk factors influencing a recurrence event, either loco-regional or systemic. In particular, SVF+AFT (G1) did not increase the oncological recurrence. CONCLUSIONS: Our data suggest that both centrifuged and SVF-enhanced fat transfer have a similar safety level in comparison to patients who did not undergo fat grafting in breast reconstruction after NSM

An accurate approach for computational pKa determination of phenolic compounds

Computational chemistry is a valuable tool, as it allows for in silico prediction of key parameters of novel compounds, such as pKa. In the framework of computational pKa determination, the literature offers several approaches based on different level of theories, functionals and continuum solvation models. However, correction factors are often used to provide reliable models that adequately predict pKa. In this work, an accurate protocol based on a direct approach is proposed for computing phenols pKa. Importantly, this methodology does not require the use of correction factors or mathematical fitting, making it highly practical, easy to use and fast. Above all, DFT calculations performed in the presence two explicit water molecules using CAM-B3LYP functional with 6-311G+dp basis set and a solvation model based on density (SMD) led to accurate pKa values. In particular, calculations performed on a series of 13 differently substituted phenols provided reliable results, with a mean absolute error of 0.3. Furthermore, the model achieves accurate results with -CN and -NO2 substituents, which are usually excluded from computational pKa studies, enabling easy and reliable pKa determination in a wide range of phenols

Oncoplastic conservative surgery for breast cancer: long-term outcomes of our first ten years experience

The main goal of oncoplastic breast surgery (OBS) is to optimize cosmetic outcomes and reduce patient morbidity, while still providing an oncologically-safe surgical outcome and extending the target population of conservative surgery. Although the growing number of reported experiences with oncoplastic surgery, few studies account for the long-term outcomes

On the usability of augmented reality devices for interactive risk assessment

The use of Augmented Reality (AR) technologies is the new challenge of management models born under the “Industry 4.0” paradigm. The aim of the work is to evaluate the usability of two types of AR devices (tablet and see-through) employed in the training and information activities of workers according to the ISO/IEC 9126 and ISO 9241 standards. Starting from the state of the art, evaluating market and competitors and developing different concepts of interfaces, a dedicated application was programmed and, then, the usability of such devices for the professional figures involved was evaluated through experimental tests. Two reference scenarios were defined, the Department of Industrial Engineering of University of Naples Federico II and INAIL (National Institute for Insurance against Accidents at Work) laboratories, an user interface was designed and developed, as an aid in the drafting of the document for risk evaluation and subsequent training of workers. The activity is part of the IDEE Project (Interactive Design for Ergonomics), born by the collaboration between Joint Lab IDEAS and Contarp-INAIL-Regional Management for Campania. The data analysis allowed to evaluate the goodness of the devices and the degree of satisfaction in their use on the basis of the sample of users who conducted the tests. The use of AR devices produces better results than paperwork in terms of efficiency and effectiveness, but not all devices produce appreciable results in terms of user satisfaction. Although AR technologies are mature, the tasks need to be carefully defined to avoid rejection phenomena. The strong expectation, that they generate in potential users, risks to remain disappointed today for some usability limits found in currently available devices. It is necessary to start testing in pilot applications in various industrial fields in order to capture in time and adequately support this opportunity of innovation in Italy

The non-coding rna journal club: Highlights on recent papers-8

We are glad to share with you our eighth Journal Club and to highlight some of the most interesting papers published recently [...

Prolyl 3‐hydroxylase 2 is a molecular player of angiogenesis

Prolyl 3‐hydroxylase 2 (P3H2) catalyzes the post‐translational formation of 3‐ hydroxyproline on collagens, mainly on type IV. Its activity has never been directly associated to angiogenesis. Here, we identified P3H2 gene through a deep‐sequencing transcriptome analysis of human umbilical vein endothelial cells (HUVECs) stimulated with vascular endothelial growth factor A (VEGF‐A). Differently from many previous studies we carried out the stimulation not on starved HUVECs, but on cells grown to maintain the best condition for their in vitro survival and propagation. We showed that P3H2 is induced by VEGF‐A in two primary human endothelial cell lines and that its transcription is modulated by VEGF‐A/VEGF receptor 2 (VEGFR‐2) signaling pathway through p38 mitogen‐activated protein kinase (MAPK). Then, we demonstrated that P3H2, through its activity on type IV Collagen, is essential for angiogenesis properties of endothelial cells in vitro by performing experiments of gain‐ and loss‐of‐function. Immunofluorescence studies showed that the overexpression of P3H2 induced a more condensed status of Collagen IV, accompanied by an alignment of the cells along the Collagen IV bundles, so towards an evident pro‐angiogenic status. Finally, we found that P3h2 knockdown prevents pathological angiogenesis in vivo, in the model of laser‐induced choroid neovascularization. Together these findings reveal that P3H2 is a new molecular player involved in new vessels formation and could be considered as a potential target for anti‐angiogenesis therapy

The dependence of test-mass thermal noises on beam shape in gravitational-wave interferometers

In second-generation, ground-based interferometric gravitational-wave detectors such as Advanced LIGO, the dominant noise at frequencies $f \sim 40$ Hz to $\sim 200$ Hz is expected to be due to thermal fluctuations in the mirrors' substrates and coatings which induce random fluctuations in the shape of the mirror face. The laser-light beam averages over these fluctuations; the larger the beam and the flatter its light-power distribution, the better the averaging and the lower the resulting thermal noise. In semi-infinite mirrors, scaling laws for the influence of beam shape on the four dominant types of thermal noise (coating Brownian, coating thermoelastic, substrate Brownian, and substrate thermoelastic) have been suggested by various researchers and derived with varying degrees of rigour. Because these scaling laws are important tools for current research on optimizing the beam shape, it is important to firm up our understanding of them. This paper (1) gives a summary of the prior work and of gaps in the prior analyses, (2) gives a unified and rigorous derivation of all four scaling laws, and (3) explores, relying on work by J. Agresti, deviations from the scaling laws due to finite mirror size.Comment: 25 pages, 10 figures, submitted to Class. Quantum Gra