Oita Sunrise City Resort Community Land Use Concept and Management Strategy

The client’s objective is to develop an urban resort concept containing residences, a spa, hotel, marina, and village components on the Oita Prefecture. This final report contains eight sections: 1) introduction, 2) market overview, 3) site analysis, 4) preliminary development program, 5) selected scenario for development, 6) concept plan showing interrelationship of all project elements and development phasing, 7) written documentation of the rationale behind the development concept and a related strategy for managing the properties, 8) final position on phasing and economic projections, including a cash flow model of the project over 10 years

Whole-Head Functional Near-Infrared Spectroscopy as an Ecological Monitoring Tool for Assessing Cortical Activity in Parkinson’s Disease Patients at Different Stages

Functional near-infrared spectroscopy (fNIRS) is increasingly employed as an ecological neuroimaging technique in assessing age-related chronic neurological disorders, such as Parkinson’s disease (PD), mainly providing a cross-sectional characterization of clinical phenotypes in ecological settings. Current fNIRS studies in PD have investigated the effects of motor and non-motor impairment on cortical activity during gait and postural stability tasks, but no study has employed fNIRS as an ecological neuroimaging tool to assess PD at different stages. Therefore, in this work, we sought to investigate the cortical activity of PD patients during a motor grasping task and its relationship with both the staging of the pathology and its clinical variables. This study considered 39 PD patients (age 69.0 ± 7.64, 38 right-handed), subdivided into two groups at different stages by the Hoehn and Yahr (HY) scale: early PD (ePD; N = 13, HY = [1; 1.5]) and moderate PD (mPD; N = 26, HY = [2; 2.5; 3]). We employed a whole-head fNIRS system with 102 measurement channels to monitor brain activity. Group-level activation maps and region of interest (ROI) analysis were computed for ePD, mPD, and ePD vs. mPD contrasts. A ROI-based correlation analysis was also performed with respect to contrasted subject-level fNIRS data, focusing on age, a Cognitive Reserve Index questionnaire (CRIQ), disease duration, the Unified Parkinson’s Disease Rating Scale (UPDRS), and performances in the Stroop Color and Word (SCW) test. We observed group differences in age, disease duration, and the UPDRS, while no significant differences were found for CRIQ or SCW scores. Group-level activation maps revealed that the ePD group presented higher activation in motor and occipital areas than the mPD group, while the inverse trend was found in frontal areas. Significant correlations with CRIQ, disease duration, the UPDRS, and the SCW were mostly found in non-motor areas. The results are in line with current fNIRS and functional and anatomical MRI scientific literature suggesting that non-motor areas—primarily the prefrontal cortex area—provide a compensation mechanism for PD motor impairment. fNIRS may serve as a viable support for the longitudinal assessment of therapeutic and rehabilitation procedures, and define new prodromal, low-cost, and ecological biomarkers of disease progression

A phase II study of primary dose-dense sequential doxorubicin plus cyclophosphamide and docetaxel in cT4 breast cancer

Background: Dose-dense chemotherapy with anthracyclines and taxanes has improved either disease free survival or overall survival in high risk patients with early breast cancer. Patients and Methods: The activity and safety of a dose-dense schedule (q14 days) of adriamycin 60 mg/sqm and cyclophosphamide 600 mg/sqm (AC) x 4 cycles followed by docetaxel 75 mg/sqm for 4 cycles with hematopoietic support in patients with stage IIIB breast cancer was explored. Patients with ER >= 10% tumors received concomitant endocrine therapy with 3-month triptorelin and letrozole. Results: Fifteen patients with histologically proven cT4b (three patients) and cT4d (twelve patients) MO breast cancer were enrolled. Median age was 48 years (range 25-66). Eight clinical responses including one pathological complete remission (pCR), three stable disease (including minor responses) and four progression of disease, one during AC and three during taxotere, were observed. Four patients had grade 3-4 non hematological toxicities and all except one discontinued treatment. Conclusion: Due to the high rate of progressive disease, this schedule should not represent a standard option in cT4 breast cancer

Development of sentinel node localization and ROLL in breast cancer in Europe

The concept of a precise region in which to find the lymph nodes that drain the lymph directly from the primary tumor site can be traced back to a century ago to the observations of Jamieson and Dobson who described how cancer cells spread from cancer of the stomach in a single lymph node, which they called the â\u80\u9cprimary glandâ\u80\u9d. However, Cabanas was the first in 1977 to realize the importance of this concept in clinical studies following lymphography performed in patients with penile cancer. Thanks to Mortonâ\u80\u99s studies on melanoma in 1992, we began to understand the potential impact of the sentinel lymph node (SN) on the surgical treatment of this type of cancer. The use of a vital dye (blue dye) administered subdermally in the region surrounding the melanoma lesion led to the identification of the sentinel node, and the vital dye technique was subsequently applied to other types of solid tumors, e.g. breast, vulva. However, difficulties in using this technique in anatomical regions with deep lymphatic vessels, e.g. axilla, led to the development of lymphoscintigraphy, started by Alex and Krag in 1993 on melanoma and breast cancer and optimized by our group at European Institute of Oncology (IEO) in Milan in 1996. Today, lymphoscintigraphy is still considered as the most reliable method for the detection of the SN. In 1996, a new method for the localization of non-palpable breast lesion called radioguided occult lesion localization (ROLL) was also developed at IEO. Retrospective and prospective studies have since shown that the ROLL procedure permits the easy and accurate surgical removal of non-palpable breast lesions, overcoming the limitations of previous techniques such as the wire-guided localization. The purpose of this paper is to describe the evolution of SN biopsy and radioguided surgery in the management of breast cancer. We also include a review of the literature on the clinical scenarios in which SN biopsy in breast cancer is currently used, with particular reference to controversies and future prospects

Axillary sentinel lymph node biopsy after mastectomy: a case report

<p>Abstract</p> <p>Background</p> <p>Sentinel lymph node biopsy has been established as the preferred method for staging early breast cancer. A prior history of mastectomy is felt to be a contraindication.</p> <p>Case presentation</p> <p>A patient with recurrent breast cancer in her skin flap was discovered to have positive axillary sentinel nodes by sentinel lymph node biopsy five years after mastectomy for ductal carcinoma in situ.</p> <p>Conclusion</p> <p>A prior history of mastectomy may not be an absolute contraindication to sentinel lymph node biopsy.</p

Very young women (<35 years) with operable breast cancer : Features of disease at presentation

Background: Breast cancer rarely occurs in young women. Our knowledge about disease presentation, prognosis and treatment effects are largely dependent upon older series. Materials and methods: We evaluated biological features and stage at presentation for 1427 consecutive premenopausal patients aged ≤50 years with first diagnosis of invasive breast cancer referred to surgery at the European Institute of Oncology from April 1997 to August 2000. A total of 185 patients (13%) were aged &lt;35 years ('very young') and 1242 (87%) were aged 35-50 years (‘less young’). The expression of estrogen receptors (ER), progesterone receptors (PgR), presence of vascular invasion (VI), grading (G), expression of Ki-67, HER2/neu overexpression, pathological stage according to TNM staging system (pTNM), pathological tumor size and number of axillary lymph node involvement were evaluated. Results: Compared with less young patients, the very young patient group had a higher percentage of tumors classified as ER negative (P &lt;0.001), PgR negative (P = 0.001), higher expression of Ki-67 ≥20% of cells stained; 62.2% versus 53%, (P &lt;0.001), vascular or lymphatic invasion (48.6% versus 37.3%, P = 0.006), and pathological grade 3 (P &lt; 0.0001). There was no difference between the two groups for pT, pathological tumor size (pN) and number of positive lymph nodes. Conclusions: We conclude that compared with less young premenopausal patients, very young women have a greater chance of having an endocrine-unresponsive tumor, and are more likely to present with a higher grade, more extensively proliferating and vessel invading disease. Pathological tumor size, nodal status and number of positive axillary lymph-nodes have a similar distribution among the younger and the older cohorts, thus not supporting previous data indicating more advanced disease in younger patients at diagnosis of operable disease

Enfermedades que afectan el cultivo de café: Elucidando el ciclo de vida de Roya, Mal de Hilachas y Cercosporiosis

Coffee (Coffea spp.) is the second most significant commodity worldwide, with C. arabica being its most representative species. The coffee crop is affected by different fungal diseases that reduce the photosynthetically active area of its leaves and the production of grains. In order of agronomic importance, the rust caused by the biotrophic pathogen Hemileia vastatrix is a disease difficult to manage due to its type of reproduction. Another no less important, Thread Blight, caused by the basidiomycetes Ceratobasidium noxium (Syn. Corticium koleroga) and C. chavesanum, affects all aerial tissues of plants. The third disease, Cercospora leaf spot caused by Cercospora coffeicola, affects both leaves and grains, making it difficult to manage. Although there is enough scientific information on Rust, very little is known about the etiology, symptomatology, life cycle, and management of Thread Blight and Cercospora leaf spot. High-resolution photographs and micrographs were used and related with available scientific information. In addition, current scientific information on each disease was compiled, and with that, the life cycles were developed. Likewise, this manuscript describes the management of the three diseases based mainly on the use of genetic, cultural, physical, biological, and chemical measures and their integration as a sustainable alternative in the coffee agroecosystem. Current and future challenges in coffee include the evaluation of cultivars, genetic diversity of Ceratobasidium spp. and C. coffeicola, plant-pathogen interactions, and agroecological management practices.El café (Coffea spp.) es el segundo producto básico de mayor importancia a nivel mundial, siendo C. arabica su especie más representativa. El cultivo de café es afectado por diferentes enfermedades fúngicas que reducen el área fotosintéticamente activa de sus hojas y la producción de granos. Por orden de importancia se destacan la Roya causada por el patógeno biótrofo Hemileia vastatrix que es de difícil manejo por su tipo de reproducción. Otra no menos importante, el Mal de hilachas ocasionada por los basidiomicetos Ceratobasidium noxium (Sin. Corticium koleroga) y C. chavesanum, que afectan todos los tejidos aéreos de las plantas. La tercera enfermedad, la Cercosporiosis causada por Cercospora coffeicola infecta tanto hojas como granos lo que dificulta su manejo. Aunque hay basta información científica sobre la Roya, muy poco se conoce sobre la etiología, sintomatología, ciclo de vida y manejo de Mal de hilachas y Cercosporiosis. Se utilizaron fotografías y micrografías de alta resolución y se las relacionó con la información científica disponible. Además, se recopiló información científica actualizada sobre cada enfermedad, y con eso se elaboraron los ciclos de vida. Así mismo, en este manuscrito se describe el manejo de las tres enfermedades basado principalmente en el uso de medidas genéticas, culturales, físicas, biológicas y químicas, y su integración como una alternativa sostenible en el agroecosistema de café. Entre los principales desafíos actuales y futuros en café están la evaluación de cultivares, diversidad genética de Ceratobasidium spp. y C. coffeicola, interacciones planta-patógenos, y prácticas de manejo agroecológicas

High-dose-rate Brachytherapy as Adjuvant Local rEirradiation for Salvage Treatment of Recurrent breAst cancer (BALESTRA): a retrospective mono-institutional study

Purpose: To evaluate clinical results of catheter-based interstitial high-dose-rate (HDR) brachytherapy (BT) as adjuvant treatment in previously irradiated recurrent breast cancer. Material and methods: Between January 2011 and September 2015, 31 consecutive patients with histologically confirmed recurrent breast cancer after conservative surgery and conventional whole breast radiotherapy, were retreated with a second conservative surgical resection and reirradiated with adjuvant interstitial HDR-BT. None of the brachytherapy implant was performed during the quadrantectomy procedure. A dose of 34 Gy in 10 fractions, 2 fractions per day, with a minimal interval of 6 hours was delivered. Results: At the time of the implant, the median age of patients was 59.7 years (range, 39.3-74.9 years). The median time from first treatment until BT for local recurrence was 11.9 years (range, 2.5-27.8 years). The median interval between salvage surgery and BT was 3.6 months (range, 1-8.2 months). No acute epidermitis or soft tissue side effects higher than grade 2 were recorded, with good cosmetic results in all patients. Most of the patients presented grade 1-2 late side effects. Only one patient developed grade 3 liponecrosis. After a median follow-up of 73.7 months (range, 28.8-102.4 months), the overall survival and cancer specific survival were 87.1% and 90.3%, respectively; 5-year local control and 5-year progression-free survival rate were 90.3% and 83.9%, respectively. Conclusions: Our preliminary analysis showed that HDR-BT is a feasible treatment for partial breast reirradiation offering very low complications rate and fast procedure. Higher patients' cohort is warranted in order to define the role of this treatment modality in the breast conservative management of local recurrence

Enfermedades que afectan el cultivo de café: Elucidando el ciclo de vida de Roya, Mal de Hilachas y Cercosporiosis

El café (Coffea spp.) es el segundo producto básico de mayor importancia a nivel mundial, siendo C. arabica su especie más representativa. El cultivo de café es afectado por diferentes enfermedades fúngicas que reducen el área fotosintéticamente activa de sus hojas y la producción de granos. Por orden de importancia se destacan la Roya causada por el patógeno biótrofo Hemileia vastatrix que es de difícil manejo por su tipo de reproducción. Otra no menos importante, el Mal de hilachas ocasionada por los basidiomicetos Ceratobasidium noxium (Sin. Corticium koleroga) y C. chavesanum, que afectan todos los tejidos aéreos de las plantas. La tercera enfermedad, la Cercosporiosis causada por Cercospora coffeicola infecta tanto hojas como granos lo que dificulta su manejo. Aunque hay basta información científica sobre la Roya, muy poco se conoce sobre la etiología, sintomatología, ciclo de vida y manejo de Mal de hilachas y Cercosporiosis. Se utilizaron fotografías y micrografías de alta resolución y se las relacionó con la información científica disponible. Además, se recopiló información científica actualizada sobre cada enfermedad, y con eso se elaboraron los ciclos de vida. Así mismo, en este manuscrito se describe el manejo de las tres enfermedades basado principalmente en el uso de medidas genéticas, culturales, físicas, biológicas y químicas, y su integración como una alternativa sostenible en el agroecosistema de café. Entre los principales desafíos actuales y futuros en café están la evaluación de cultivares, diversidad genética de Ceratobasidium spp. y C. coffeicola, interacciones planta-patógenos, y prácticas de manejo agroecológicas