Local safety of immediate reconstruction during primary treatment of breast cancer : direct-to-implant versus expander-based surgery

Introduction: After mastectomy, immediate breast reconstruction is paramount. With the growing number of nipple-sparing mastectomies, the chances of successful one-stage reconstruction with implants are also increasing. Local safety is one of the main issues. This study investigated the factors that could lead to major or minor complications after expander-based versus direct-to-implant (DTI) reconstruction. Methods: The studied factors were age, body mass index (BMI), hypertension, smoking, diabetes, type of mastectomy (nipple-sparing/total), implant size, neoadjuvant/adjuvant chemotherapy, and radiotherapy. The study sample included 294 immediate reconstructions over 3 years. The primary outcome was the incidence of complications, major or minor depending on the necessity of revision surgery. For the DTI pocket, we applied a variant of the conventional submuscular technique. Results: In DTI reconstructions (median follow-up 26 months), the complication rate was 17.2% (4.3% major and 12.8% minor) with no significant association with clinical variables. In expander-based reconstructions (median follow-up 19 months), the complication rate was 18.3% (12.5% major and 5.8% minor). Univariate analysis showed a significant association between overall complications and radiotherapy (P = 0.01) as well as between major complications and expander size (P < 0.005), BMI (P < 0.005), and radiotherapy (P < 0.01); radiotherapy and BMI retained significance in multivariate analysis. Neoadjuvant/adjuvant chemotherapy did not affect the complication rate. Conclusions: There was evidence of an association between major complications and clinical variables in the expander-based cohort. Larger expander size was a predictor of failure, especially combined with radiation. Direct-to-implant reconstruction proved to be safe. We describe a reliable method of reconstruction and a safe range of implant sizes even beyond 500 g

Triggering rogue waves in opposing currents

We show that rogue waves can be triggered naturally when a stable wave train enters a region of an opposing current flow. We demonstrate that the maximum amplitude of the rogue wave depends on the ratio between the current velocity, $U_0$, and the wave group velocity, $c_g$. We also reveal that an opposing current can force the development of rogue waves in random wave fields, resulting in a substantial change of the statistical properties of the surface elevation. The present results can be directly adopted in any field of physics in which the focusing Nonlinear Schrodinger equation with non constant coefficient is applicable. In particular, nonlinear optics laboratory experiments are natural candidates for verifying experimentally our results.Comment: 5 pages, 5 figure

A Two-Player Game of Life

We present a new extension of Conway's game of life for two players, which we call p2life. P2life allows one of two types of token, black or white, to inhabit a cell, and adds competitive elements into the birth and survival rules of the original game. We solve the mean-field equation for p2life and determine by simulation that the asymptotic density of p2life approaches 0.0362.Comment: 7 pages, 3 figure

On the origin of ambiguity in efficient communication

This article studies the emergence of ambiguity in communication through the concept of logical irreversibility and within the framework of Shannon's information theory. This leads us to a precise and general expression of the intuition behind Zipf's vocabulary balance in terms of a symmetry equation between the complexities of the coding and the decoding processes that imposes an unavoidable amount of logical uncertainty in natural communication. Accordingly, the emergence of irreversible computations is required if the complexities of the coding and the decoding processes are balanced in a symmetric scenario, which means that the emergence of ambiguous codes is a necessary condition for natural communication to succeed.Comment: 28 pages, 2 figure

Probing Intermolecular H-Bonding Interactions in Cyanuric Acid Networks: Quenching of the N K-Edge Sigma Resonances

The electronic characterization of the cyanuric acid both in gas phase and when embedded within an H-bonded scheme forming a monolayer on the Au(111) surface has been performed by means of X-ray Photoelectron Spectroscopy (XPS) and Near Edge X-ray Absorption Fine Structure (NEXAFS) spectroscopy. The experimental spectra at the N, O, and C K-edges have been assigned with the support of DFT calculations, and the combination between theory and experiment has allowed to us investigate the effect of the H-bonding intermolecular interaction on the spectra. In particular, the H-bond formation in the monolayer leads to a quenching of the N 1s NEXAFS resonances associated with transitions to the sigma empty orbitals localized on the N-H portion of the imide group. On the other hand, the pi* empty states remain substantially unperturbed. From a computational point of view, it has been shown that the DFT-TP scheme is not able to describe the N 1s NEXAFS spectra of these systems, and the configuration mixing has to be included, through the TDDFT approach in conjunction with the range-separated XC CAM-B3LYP functional, to obtain a correct reproduction of the N 1s core spectra

Correlation between density and resorption of fresh-frozen and autogenous bone grafts

Trial Design. This analysis compared the outcome of fresh-frozen versus autologous bone block grafts for horizontal ridge augmentation in patients with Cawood and Howell class IV atrophies. Methods. Seventeen patients received autologous grafts and 21 patients received fresh-frozen bone grafts. Patients underwent CT scans 1 week and 6 months after surgery for graft volume and density analysis. Results. Two autologous and 3 fresh-frozen grafts failed. Autologous and fresh-frozen grafts lost, respectively, 28% and 46% of their initial volume (P = 0.028). It is noteworthy that less dense fresh-frozen blocks lost more volume than denser grafts (61% versus 16%). Conclusions. According to these 6-month results, only denser fresh-frozen bone graft may be an acceptable alternative to autologous bone for horizontal ridge augmentation. Further studies are needed to investigate its behaviour at longer time points

Sensory and chemical profile of a phenolic extract from olive mill waste waters in plant-base food with varied macro-composition

Phenols from olive mill waste water (OMWW) represent valuable functional ingredients. The negative impact on sensory quality limits their use in functional food formulations. Chemical interactions phenols/biopolymers and their consequences on bioactivity in plant-base foods have been widely investigated, but no studies to date have explored the variation of bitterness, astringency and pungency induced by OMWW phenols as a function of the food composition. The aim of the paper was to profile the sensory and chemical properties of phenols from OMWW in plant-base foods varied in their macro-composition. Four phenol concentrations were selected (0.44, 1.00, 2.25, 5.06 g/kg) to induce significant variations of bitterness, sourness, astringency and pungency in three plant-base food: proteins/neutral pH \u2013 bean pur\ue9e (BP), starch/neutral pH \u2013 potato pur\ue9e (PP), fiber/low pH \u2013 tomato juice (TJ). The macro-composition affected the amount of the phenols recovered from functionalized food. The highest recovery was from TJ and the lowest from BP. Two groups of 29 and 27 subjects, trained to general Labelled Magnitude Scale and target sensations, participated in the evaluation of psychophysical curves of OMWW phenols and of functionalized plant-base foods, respectively. Target sensations were affected by the food macro-composition. Bitterness increased with phenol concentration in all foods. Astringency and sourness slightly increased with concentration, reaching the weak-moderate intensity at the highest phenol concentration in PP and TJ only. Pungency was suppressed in BP and perceived at weak-moderate intensity in PP and TJ sample at the highest phenol concentration. Proteins/neutral pH plant-food (BP) resulted more appropriate to counteract the impact of added phenol on negative sensory properties thus allowing to optimize the balance between health and sensory properties

ELISA assay employing epitope-specific monoclonal antibodies to quantify circulating HER2 with potential application in monitoring cancer patients undergoing therapy with trastuzumab

Circulating HER2 extracellular domain (HER2 ECD) levels were proposed as a surrogate for HER2 tissue expression to monitor breast cancer&nbsp;patients for early relapse or responses to standard or HER2-targeted therapies, such as the monoclonal antibody (mAb) trastuzumab. Currently, available commercial ELISA assays for HER2 ECD rely on antibodies recognizing undisclosed or unknown epitopes. In this work, two ELISA assays employing MGR2 and MGR3 epitope-specific mAbs for HER2 ECD were developed and validated, showing good assay precision and linearity of the dose-response signal within the dynamic range of 0.19–12.50 ng mL−1 and detection limits of 0.76 and 0.75 ng mL−1 for the MGR2 and MGR3 assays, respectively. The developed assay showed a good agreement with two widely used commercial kits for HER2 ECD quantification in serum samples&nbsp;from breast cancer patients. A complete characterization of mAb-HER2 ECD interaction was performed by means of surface plasmon resonance using trastuzumab as control for both epitope mapping and kinetics analysis. The epitopes recognized by the two mAbs showed no overlap with trastuzumab, which was confirmed by trastuzumab interference analysis in serum samples. The method showed to be a practical approach to determine HER2 ECD with a high degree of sensitivity, reliability and recovery in samples containing mAbs-based therapies

Correlation between Density and Resorption of Fresh-Frozen and Autogenous Bone Grafts

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