Prognostic significance of primary-tumor extension, stage and grade of nuclear differentiation in patients with renal cell carcinoma

Surgery remains the preferred therapy for renal cell carcinoma. The various adjunctive or complementary therapies currently yield disappointing results. Identifying reliable prognostic factors could help in selecting patients most likely to benefit from postoperative adjuvant therapies. We reviewed the surgical records of 78 patients who had undergone radical nephrectomy with lymphadenectomy for renal cell carcinoma, matched for type of operation and histology. According to staging (TNM), 5.1% of the patients were classified as stage I, 51.3% as stage II, 29.5% as stage III and 14.5% as stage IV. Of the 78 patients 40 were T2N0 and 21 T3aN0. Tumor grading showed that 39.7% of the patients had well-differentiated tumors(G1), 41.1% moderately-differentiated (G2), and 19.2% poorly-differentiated tumors (G3). Overall actuarial survival at 5 and 10 years was 100% for stage 1; 91.3% at 5 years and 83.1% at 10 years for stage II; 45.5% and 34.1% for stage III; and 29.1% and nil for stage IV (stage II vs stage III p = 0.0001). Patients with tumors confined to the kidney (pT2N0) had better 5- and 10-year survival rates than patients with tumors infiltrating the perirenal fat (pT3aN0) (p = 0.000006). Survival differed according to nuclear grading (G1 vs G3 ; p = 0.000005; G2 vs G3; p = 0.0009). In conclusion our review identified tumor stage, primary-tumor extension, and the grade of nuclear differentiation as reliable prognostic factors in patients with renal cell carcinomas

Bluetooth Mesh Technology for the Joint Monitoring of Indoor Environments and Mobile Device Localization: A Performance Study

Bluetooth Mesh is a recent SIG standard enabling the deployment of multi-hop Wireless Sensor Networks (WSNs) over Bluetooth Low Energy (BLE) communication links. The standard introduces many novel and interesting features in the Internet of Things (IoT) domain, such as the seamless integration among sensors and mobile and wearable devices, and the support for a wide range of different IoT application profiles. At the same time, fine-grained assessments of the performance are still needed to understand the potential of the technology. In this paper, we investigate the usage of Bluetooth Mesh solutions for the joint monitoring of indoor spaces and humans. Through the deployment of a test-bed, we evaluate the performance of Bluetooth Mesh WSNs under varying traffic loads and network sizes. In addition, by exploiting the short-range, multi-hop communications, we propose a procedure for the indoor localization of mobile devices and evaluate its accuracy. The results demonstrate that the technology supports reasonable delivery ratio under high traffic loads, however the network and localization performance sharply decreases when increasing the number of hops between the source and destination nodes

WoTwins: Automatic Digital Twin Generator for the Web of Things

Digital Twins are crucial in Industry 4.0 IoT scenarios, as they replicate physical assets and enable important tasks such as predictive analytics, what-if scenarios and real time monitoring. The heterogeneity of IoT use cases usually makes the development of digital twins extremely application-specific as well as prone to interoperability issues. To overcome these two challenges, we propose WoTwins, a framework that, on one side, leverages the W3C Web of Things (WoT) standard to model data and entities, and, on the other side, generates automatically Digital Twins of existing Web Things by modeling their state space through a Markov Decision Process (MDP) graph and by predicting its behavior though Machine Learning techniques. We conduct experiments on a simulated use cases related to IoT robotics to evaluate our proposa

Pulsed Current Effect on the Hard Anodizing of an AlSi10Mg Aluminum Alloy Obtained via Additive Manufacturing

The hard anodizing treatments of cast Al-Si alloys are notoriously difficult. Indeed, their microstructural features hinder the growth of a uniform, compact, and defect-free anodic oxide. In this paper, AlSi10Mg samples, produced via Gravity Casting (GC) and Additive Manufacturing, i.e., Laser Powder Bed Fusion (L-PBF), were hard anodized in a sulfuric acid bath, in order to verify how the particular microstructure obtained via L-PBF affects the thickness, hardness, compactness, and defectiveness of the anodic oxide. Moreover, for the first time, Pulsed Direct Current (PDC) procedures were used to perform the hard anodizing treatments on additively manufactured AlSi10Mg alloy. Several combinations of temperature and electrical parameters, i.e., current density, frequency, and Duty Cycle, were tested. The anodized samples were characterized through optical microscopy analysis, Scanning Electron Microscopy (SEM) analysis, and accelerated corrosion tests, i.e., Potentiodynamic Polarization (POL) and Electrochemical Impedance Spectroscopy (EIS) measurements. The PDC procedures allowed improvement of the compromise between evenness, compactness, and defectiveness. Among the attempted PDC procedures, a specific combination of electrical parameters and temperature allowed the best results to be obtained, i.e., the highest hardness and the lowest volumetric expansion values without compromising the oxide quality rating and the corrosion resistance behavior. However, none of the attempted PCD strategies allowed the hardness values obtained on samples produced via GC to be reached

Predictive value of hematological and phenotypical parameters on postchemotherapy leukocyte recovery

Background: Grade IV chemotherapy toxicity is defined as absolute neutrophil count <500/μL. The nadir is considered as the lowest neutrophil number following chemotherapy, and generally is not expected before the 7th day from the start of chemotherapy. The usual prophylactic dose of rHu-G-CSF (Filgrastim) is 300 μg/day, starting 24-48 h after chemotherapy until hematological recovery. However, individual patient response is largely variable, so that rHu-G-CSF doses can be different. The aim of this study was to verify if peripheral blood automated flow cytochemistry and flow cytometry analysis may be helpful in predicting the individual response and saving rHu-G-CSF. Methods: During Grade IV neutropenia, blood counts from 30 cancer patients were analyzed daily by ADVIA 120 automated flow cytochemistry analyzer and by Facscalibur flow cytometer till the nadir. "Large unstained cells" (LUCs), myeloperoxidase index (MPXI), blasts, and various cell subpopulations in the peripheral blood were studied. At nadir rHu-G-CSF was started and 81 chemotherapy cycles were analyzed. Cycles were stratified according to their number and to two dose-levels of rHuG-CSF needed to recovery (300-600 vs. 900-1200 μg) and analyzed in relation to mean values of MPXI and mean absolute number of LUCs in the nadir phase. The linear regressions of LUCs % over time in relation to two dose-levels of rHu-G-CSF and uni-multivariate analysis of lymphocyte subpopulations, CD34+ cells, MPXI, and blasts were also performed. Results: In the nadir phase, the increase of MPXI above the upper limit of normality (>10; median 27.7), characterized a slow hematological recovery. MPXI levels were directly related to the cycle number and inversely related to the absolute number of LUCs and CD34 +/CD45+ cells. A faster hematological recovery was associated with a higher LUC increase per day (0.56% vs. 0.25%), higher blast (median 36.7/μL vs. 19.5/μL) and CD34+/CD45+ cell (median 2.2/μL vs. 0.82/μL) counts. Conclusions: Our study showed that some biological indicators such as MPXI, LUCs, blasts, and CD34 +/CD45+ cells may be of clinical relevance in predicting individual hematological response to rHu-G-CSF. Special attention should be paid when nadir MPXI exceeds the upper limit of normality because the hematological recovery may be delayed. © 2009 Clinical Cytometry Society