Magnetic resonance tumor regression grade (MR-TRG) to assess pathological complete response following neoadjuvant radiochemotherapy in locally advanced rectal cancer

This study aims to evaluate the feasibility of a magnetic resonance (MR) automatic method for quantitative assessment of the percentage of fibrosis developed within locally advanced rectal cancers (LARC) after neoadjuvant radiochemotherapy (RCT). A total of 65 patients were enrolled in the study and MR studies were performed on 3.0 Tesla scanner; patients were followed-up for 30 months. The percentage of fibrosis was quantified on T2-weighted images, using automatic K-Means clustering algorithm. According to the percentage of fibrosis, an optimal cut-off point for separating patients into favorable and unfavorable pathologic response groups was identified by ROC analysis and tumor regression grade (MR-TRG) classes were determined and compared to histopathologic TRG. An optimal cut-off point of 81% of fibrosis was identified to differentiate between favorable and unfavorable pathologic response groups resulting in a sensitivity of 78.26% and a specificity of 97.62% for the identification of complete responders (CRs). Interobserver agreement was good (0.85). The agreement between P-TRG and MR-TRG was excellent (0.923). Significant differences in terms of overall survival (OS) and disease free survival (DFS) were found between favorable and unfavorable pathologic response groups. The automatic quantification of fibrosis determined by MR is feasible and reproducible

CT diagnosis of small bowel obstruction caused by internal hernia from persistent attachment of a Meckel's diverticulum to the umbilicus by the obliterated omphalomesenteric duct

We report a case of small bowel obstruction (SBO) caused by internal hernia from persistent attachment of a Meckel's diverticulum (MD) to the umbilicus by the obliterated omphalomesenteric duct that was diagnosed by multidetector CT and confirmed during laparoscopic surgery. Although clinical, pathological and radiological features of MD and its complications are well known, the diagnosis of MD is difficult to establish preoperatively. CT findings that allow the diagnosis of this very unusual cause of SBO are presented here with laparoscopic surgery correlation

Equivalence of switching linear systems by bisimulation

A general notion of hybrid bisimulation is proposed for the class of switching linear systems. Connections between the notions of bisimulation-based equivalence, state-space equivalence, algebraic and input–output equivalence are investigated. An algebraic characterization of hybrid bisimulation and an algorithmic procedure converging in a finite number of steps to the maximal hybrid bisimulation are derived. Hybrid state space reduction is performed by hybrid bisimulation between the hybrid system and itself. By specializing the results obtained on bisimulation, also characterizations of simulation and abstraction are derived. Connections between observability, bisimulation-based reduction and simulation-based abstraction are studied.\ud \u

Splitting neutrino masses and showering into Sky

Neutrino masses might be as light as a few time the atmospheric neutrino mass splitting. High Energy ZeV cosmic neutrinos (in Z-Showering model) might hit relic ones at each mass in different resonance energies in our nearby Universe. This non-degenerated density and energy must split UHE Z-boson secondaries (in Z-Burst model) leading to multi injection of UHECR nucleons within future extreme AUGER energy. Secondaries of Z-Burst as neutral gamma, below a few tens EeV are better surviving local GZK cut-off and they might explain recent Hires BL-Lac UHECR correlations at small angles. A different high energy resonance must lead to Glashow's anti-neutrino showers while hitting electrons in matter. In air, Glashow's anti-neutrino showers lead to collimated and directional air-showers offering a new Neutrino Astronomy. At greater energy around PeV, Tau escaping mountains and Earth and decaying in flight are effectively showering in air sky. These Horizontal showering is splitting by geomagnetic field in forked shapes. Such air-showers secondaries release amplified and beamed gamma bursts (like observed TGF), made also by muon and electron pair bundles, with their accompanying rich Cherenkov flashes. Also planet' s largest (Saturn, Jupiter) atmosphere limbs offer an ideal screen for UHE GZK and Z-burst tau neutrino, because their largest sizes. Titan thick atmosphere and small radius are optimal for discovering up-going resonant Glashow resonant showers. Earth detection of Neutrino showering by twin Magic Telescopes on top mountains, or by balloons and satellites arrays facing the limbs are the simplest and cheapest way toward UHE Neutrino Astronomy .Comment: 4 pages, 7 figures; an author's name correction and Journal Referenc

Some non perturbative calculations on spin glasses

Models of spin glasses are studied with a phase transition discontinuous in the Parisi order parameter. It is assumed that the leading order corrections to the thermodynamic limit of the high temperature free energy are due to the existence of a metastable saddle point in the replica formalism. An ansatz is made on the form of the metastable point and its contribution to the free energy is calculated. The Random Energy Model is considered along with the p-spin and the p-state Potts Models in their p < infinity expansion.Comment: 12 pages, LaTe

Neoadjuvant eribulin mesylate following anthracycline and taxane in triple negative breast cancer: Results from the HOPE study

Background Eribulin mesylate (E) is indicated for metastatic breast cancer patients previously treated with anthracycline and taxane. We argued that E could also benefit patients eligible for neoadjuvant chemotherapy. Methods Patients with primary triple negative breast cancer 2 cm received doxorubicin 60 mg/m2 and paclitaxel 200 mg/m2 x 4 cycles (AT) followed by E 1.4 mg/m2 x 4 cycles. Primary endpoint was pathological complete response (pCR) rate; secondary and explorative endpoints included clinical/metabolic response rates and safety, and biomarker analysis, respectively. Using a two-stage Simon design, 43 patients were to be included provided that 4 of 13 patients had achieved pCR in the first stage of the study. Results In stage I of the study 13 women were enrolled, median age 43 years, tumor size 2–5 cm in 9/13 (69%), positive nodal status in 8/13 (61%). Main grade 3 adverse event was neutropenia (related to AT and E in 4 and 2 cases, respectively). AT followed by E induced clinical complete + partial responses in 11/13 patients (85%), pCR in 3/13 (23%). Median measurements of maximum standardized uptake value (SUVmax) resulted 13, 3, and 1.9 at baseline, after AT and E, respectively. Complete metabolic response (CMR) occurred after AT and after E in 2 and 3 cases, respectively. Notably, 2 of the 5 (40%) patients with CMR achieved pCR at surgery. Immunostaining of paired pre-/post-treatment tumor specimens showed a reduction of β-catenin, CyclinD1, Zeb-1, and c-myc expression, in the absence of N-cadherin modulation. The study was interrupted at stage I due to the lack of the required patients with pCR. Conclusions Despite the early study closure, preoperative E following AT showed clinical and biological activity in triple negative breast cancer patients. Furthermore, the modulation of β-catenin pathway core proteins, supposedly outside the domain of epithelial–mesenchymal transition, claims for further investigation. Trial registration EU Clinical Trial Register, EudraCT number 2012-004956-12

Plasma antioxidants from chocolate

There is some speculation that dietary flavonoids from chocolate, in particular (-)epicatechin, may promote cardiovascular health as a result of direct antioxidant effects or through antithrombotic mechanisms. Here we show that consumption of plain, dark chocolate results in an increase in both the total antioxidant capacity and the (-)epicatechin content of blood plasma, but that these effects are markedly reduced when the chocolate is consumed with milk or if milk is incorporated as milk chocolate. Our findings indicate that milk may interfere with the absorption of antioxidants from chocolate in vivo and may therefore negate the potential health benefits that can be derived from eating moderate amounts of dark chocolate