Management of triple negative breast cancer

Triple negative breast cancer (TNBC) accounts for approximately 15% of breast cancer cases. TNBC is an immunohistochemically defined subtype, with significant diversity within the subtype. Generally TNBC occurs in younger women and is marked by high rates of relapse, visceral and CNS metastases, and early death. Current therapy fails to curtail the innate aggressive behaviour of TNBC in the majority of patients. The poor prognosis coupled with a lack of targeted use of therapies is reflected in the high mortality. In a minority of patients with highly chemosensitive disease, no robust clinical evidence exists to guide use of current cytotoxics. Critical to optimal future management are accurate identification of truly triple negative disease and adequately powered prospective TNBC trials to establish treatment efficacy and define predictive biomarkers

A study of working fluids for heat driven ejector refrigeration using lumped parameter models

This paper studies the influence of working fluids over the performance of heat driven ejector refrigeration systems performance by using a lumped parameter model. The model used has been selected after a comparison of different models with a set of experimental data available in the literature. The effect of generator, evaporator and condenser temperature over the entrainment ratio and the COP has been investigated for different working fluids in the typical operating conditions of low grade energy sources. The results show a growth in performance (the entrainment ratio and the COP) with a rise in the generator and evaporator temperature and a decrease in the condenser temperature. The working fluids have a great impact on the ejector performance and each refrigerant has its own range of operating conditions. R134a is found to be suitable for low generator temperature (70-100 degrees C), whereas the hydrocarbons R600 is suitable for medium generator temperatures (100-130 degrees C) and R601 for high generator temperatures (130-180 degrees C). (C) 2015 Elsevier Ltd and IIR. All rights reserved

Autonomic function in elderly uremics studied by spectral analysis of heart rate

Autonomic function in elderly uremics studied by spectral analysis of heart rate.BackgroundAging determines an altered response of the autonomic nervous system (ANS) to physiologic stresses. A widespread autonomic damage is well recognized in chronic renal failure (CRF).MethodsWe studied 30 CRF patients, aged 19 to 85 years, who were on bicarbonate hemodialysis. Surface electrocardiogram was recorded on lying and 65° head-up tilt standing positions. A dedicated software, using an autoregressive modeling technique, allowed to calculate power spectral analysis (PSA) of heart rate variability, assessing a low-frequency band in the range 0.03 to 0.15 Hz, and a high-frequency band in the range 0.15 to 0.33 Hz. Low-frequency and high-frequency components are regarded, but not invariably, as specific markers of sympathetic and parasympathetic activities, respectively, and the low-frequency/high frequency ratio as an index of sympathovagal balance.ResultsIn normal controls, low-frequency band value and low-frequency/high-frequency ratio on standing resulted significantly reduced in the group older than 65 years when compared with those younger than 65 years; an opposite finding was seen in high-frequency band value on standing. In uremic patients, low-frequency band on lying resulted significantly lower only in elderly uremics when compared with elderly controls, whereas low-frequency band on standing was significantly lower in elderly than in younger uremics. Regression analysis showed a significant inverse relationship between aging and most low-frequency band values, especially in uremics. The comparison of linear regression models confirmed that a sympathetic autonomic derangement is greatly present in older uremics, in particular after 50 years of age.ConclusionOur data support assertion that combination of aging and CRF increases the chance of autonomic derangement being present

Metrological Characterization of a Vision-Based Measurement System for the Online Inspection of Automotive Rubber Profile

This paper deals with the metrological characterization of a stereovision-based measurement system for the inspection of automotive rubber profiles in an industrial plant. The characterization of this class of measurement systems introduces new challenges due to both the unavailability of reference measurement instruments and the complexity of the measurement system itself, which does not allow a straightforward application of the standard procedures for uncertainty evaluation. To assign optimum values to a number of design parameters, the followed approach focuses not only on evaluating the total uncertainty but also on analyzing systematic effects and influence quantities

A New Calibration Procedure for 3-D Shape Measurement System Based on Phase-Shifting Projected Fringe Profilometry

An original procedure is presented for the calibration of fringe-projection-based 3-D vision systems. The proposed approach estimates both the phase-to-depth and transverse relationships by directly measuring the phase maps for only three planes placed within the calibration volume and then estimating the phase maps for a number of other ldquovirtual planes.rdquo Experimental tests conducted on a fringe projection system show the effectiveness of the proposed procedure

Smart Devices and Services for Smart City

Citizen quality of life can be improved through facilities and services that have been thought to ease citizen interaction with municipal authorities, offices and structures. All technologies and devices, used for developing these facilities, are the pillars of the Smart City idea: a City that adapts itself, at least in part, to citizens’ needs. Advanced Metering Infrastructure (AMI) could become the backbone of all the smart city projects. Other public services can be loaded on AMI’s to be smart and thus helping to find the affordability of investments. The paper deals with this topic by describing devices and results of a pilot project, which has been carried out in an Italian middle city (Salerno), to experience the use of RF 169MHz wM-bus based AMI. Experimental results regarding a set of about 2500 installed devices for gas and water metering, car parking management and elder tele-assistance, will be reported in detail to show convenience and problems of this approach

The wandering spleen: case report of laparoscopic splenectomy in a pregnant woman

Abstract Background Wandering spleen is a rare condition, which is characterized by augmented mobility of the spleen, due to congenital or acquired causes. It is more frequent in multiparous women, but only a few cases are reported during pregnancy. Wandering spleen is usually asymptomatic until the onset of its possible complications, and this can mislead clinicians in reaching the correct diagnosis. Case presentation We report the case of a wandering spleen with acute splenic infarction in a pregnant woman and its minimally invasive surgical treatment, focusing on the clinical and radiological findings that could mislead or drive clinicians to the right diagnosis, or a potential disaster. Conclusions Splenic preservation in the wandering spleen where it is safe and possible is the main goal of the treatment. Clinical and radiological findings are the most relevant elements to drive surgical treatment. To reach the best and opportune treatment for the patient, the wandering spleen is an insidious condition and must be included in the differential diagnosis in the acute abdomen diagnostic process

Escherichia coli Nissle 1917 in ulcerative colitis treatment: Systematic review and meta-analysis

Background & Aims: Escherichia coli Nissle 1917 (EcN) has been recommended as a therapeutic tool for ulcerative colitis (UC) treatment. However, to date, no meta-analysis has been performed on this topic. Methods. We performed a literature search on PubMed, MEDLINE, Science Direct and EMBASE. We evaluated success rates for induction of remission, relapse rates and side effects, expressed as Intention-To-Treat. Odd ratios (OR), pooled OR and 95% confidence intervals (CI) were calculated, based on the Mantel-Haenszel method. Heterogeneity was assessed by using the χ2 and I2 statistics and, if present, a random-effects model was adopted. Results. We selected six eligible trials, with 719 patients, 390 assigned to the study group and 329 to the control group. EcN induced remission in 61.6% of cases, while in the control group (mesalazine) the remission was achieved in 69.5% of cases, with a mean difference of 7.9%. The pooled OR was 0.92 (95% CI 0.15-9.66, p=0.93). A single study showed a better performance of EcN than the placebo. A relapse of the disease occurred in 36.8% in the EcN group and in 36.1% in the control group (mesalazine), with a mean difference of 0.8%, OR=1.07, with a 95% CI of 0.70-1.64 (p=0.74). Side effects were comparable (OR=1.44, 95% CI 0.80-2.59, p=0.22). Conclusions. EcN is equivalent to mesalazine in preventing disease relapse, thus confirming current guideline recommendations. EcN seems to be as effective as controls in inducing remission and therefore, its use cannot be recommended as in one study the comparison was performed against placebo. Further studies may be helpful for this subject

Statistical techniques applied to the automatic diagnosis of dermoscopic images

An image based system implementing a well‐known diagnostic method is disclosed for the automatic detection of melanomas as support to clinicians. The software procedure is able to recognize automatically the skin lesion within the digital image, measure morphological and chromatic parameters, carry out a suitable classification for the detection of structural dermoscopic criteria provided by the 7‐Point Check. Original contribution is referred to advanced statistical techniques, which are introduced at different stages of the image processing, including the border detection, the extraction of low‐level features and scoring of high order features (namely dermoscopic criteria). The proposed approach is experimentally tested with reference to a large image set of pigmented lesions