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The binary neutron star merger event GW170817 was detected through both electromagnetic radiation and gravitational waves. Its afterglow emission may have been produced by either a narrow relativistic jet or an isotropic outflow. High-spatial-resolution measurements of the source size and displacement can discriminate between these scenarios. We present very-long-baseline interferometry observations, performed 207.4 days after the merger by using a global network of 32 radio telescopes. The apparent source size is constrained to be smaller than 2.5 milli–arc seconds at the 90% confidence level. This excludes the isotropic outflow scenario, which would have produced a larger apparent size, indicating that GW170817 produced a structured relativistic jet. Our rate calculations show that at least 10% of neutron star mergers produce such a jet.

Precision medicine has revolutionized the therapeutic management of cancer patients with a major impact on non-small cell lung cancer (NSCLC), particularly lung adenocarcinoma, where advances have been remarkable. Tissue biopsy, required for tumor molecular testing, has significant limitations due to the difficulty of the biopsy site or the inadequacy of the histological specimen. In this context, liquid biopsy, consisting of the analysis of tumor-released materials circulating in body fluids, such as blood, is increasingly emerging as a valuable and non-invasive biomarker for detecting circulating tumor DNA (ctDNA) carrying molecular tumor signatures. In advanced/metastatic NSCLC, liquid biopsy drives target therapy by monitoring response to treatment and identifying eventual genomic mechanisms of resistance. In addition, recent data have shown a significant ability to detect minimal residual disease in early-stage lung cancer, underlying the potential application of liquid biopsy in the adjuvant setting, in early detection of recurrence, and also in the screening field. In this article, we present a review of the currently available data about the utility and application of liquid biopsy in lung cancer, with a particular focus on the approach to different techniques of analysis for liquid biopsy and a comparison with tissue samples as well as the potential practical uses in early and advanced/metastatic NSCLC.

Background: Recent preclinical studies identified Axl, a tyrosine kinase receptor implicated in tumour progression and epithelial-to-mesenchymal transition, as a putative therapeutic target in malignant pleural mesothelioma (MPM), an invariably fatal malignancy with limited treatment options. Here, we studied the expression of Axl and its ligand Gas-6 (growth arrest signal-6) in primary specimens of MPM, correlating their expression levels with tumour phenotype and clinical outcomes. Methods: Two independent cohorts of consecutive patients diagnosed with MPM were studied: a derivation cohort composed of 63 cases and a validation set of 35 cases. Clinical variables including patients’ demographics, tumour stage, histotype, performance status (PS), Axl and Gas-6 staining were tested for predicting overall survival (OS) using univariate and multivariate analyses. Results: In the derivation cohort, Axl ( P =0.001) but not Gas-6 overexpression ( P =0.35) emerged as a univariate prognostic factor for OS, together with stage ( P =0.05), PS ( P <0.001) hypoalbuminaemia ( P <0.001) and anaemia ( P <0.001). Multivariate analyses confirmed Axl overexpression ( P =0.01), PS ( P =0.01), hypoalbuminaemia ( P <0.001) and anaemia ( P =0.04) as independent predictors of OS. The prognostic role of Axl overexpression was externally validated in an independent cohort ( P =0.03). Conclusion: Overexpression of Axl is found in the majority of MPM specimens and influences patient’s survival independently from other established prognostic factors. Such information may support patient selection for future trials.

Mental Time Travel (MTT) allows us to remember past events and imagine future ones. According to previous literature, the Temporal Distance of events affects MTT: our ability to order events worsens for close, compared to far, events. However, those studies established distances a-priori, albeit the way we perceive events’ temporal distance may subjectively differ from their objective distance. Thus, in the current study, we aimed to investigate the effects of Perceived Temporal Distance (PTD) on the MTT ability and the brain areas mediating this process. Thirty-three healthy volunteers took part in an fMRI MTT task. Participants were asked to project themselves into the past, present, or future, and to judge a series of events as relative-past or relative-future, in relation to the adopted time location. Outside the scanner, participants provided PTD estimates for each stimulus of the MTT task. Participants’ performance and functional activity were analyzed as a function of these estimations. At the behavioural level, PTD predicts the modulation of the performance for relative-past and relative-future. Bilateral angular gyrus, retrosplenial cortex, temporo-parietal region and medial, middle and superior frontal gyri mediate the PTD effect. In addition to these areas, the closer the relative-future events are perceived, the higher the involvement of left parahippocampal and lingual gyri and right cerebellum. Thus, perceived proximity of events activates frontal and posterior parietal areas, which therefore might mediate the processing of PTD in the cognitive spatial representation of time. Future proximity also activates cerebellum and medial temporal areas, known to be involved in imaginative and constructive cognitive functions.

To assess the prognostic value of presurgical CA15.3 in a large cohort of patients with early breast cancer. A total of 7.942 consecutive patients with breast cancer operated at the European Institute of Oncology between 1998 and 2005 and with presurgical values of CA 15.3 available were included. We explored patterns of recurrence by baseline CA 15.3 values. Mean CA15.3 was 17.0 U/ml. CA15.3 was associated with age, tumor size, nodal involvement, Ki-67 labeling index, grade, HER2 expression, molecular subtype, and perivascular invasion. CA15.3 was independently associated with distant metastases [HR > 20 U/ml vs. ≤ 20 U/ml: 1.34 (95% CI 1.15–1.56)] and death [HR > 20 U/ml vs. ≤ 20 U/ml: 1.30 (95% CI 1.11–1.53)]. When considering CA15.3 as continuous variable, we observed a constant risk of metastasis and death from the lowest values to about 15–20 U/ml, and then a significantly increasing risk with increasing values of CA15.3. Finally, CA15.3 provided significant additional information to the common prognostic factors to predict the occurrence of metastases (C-index P value 0.04). In patients with operable breast cancer, presurgical CA15.3 value is an independent prognostic factor for metastases and deaths. CA15.3 provides additional information to the common prognostic factors and should be considered in the adjuvant therapeutic algorithm.

The nearby radio galaxy M87 offers a unique opportunity for exploring the connection between γ-ray production and jet formation at an unprecedented linear resolution. However, the origin and location of the γ-rays in this source is still elusive. Based on previous radio/TeV correlation events, the unresolved jet base (radio core) and the peculiar knot HST-1 at >120 pc from the nucleus are proposed as candidate site(s) of γ-ray production. Here we report our intensive, high-resolution radio monitoring observations of the M87 jet with the VLBI Exploration of Radio Astrometry (VERA) and the European VLBI Network (EVN) from February 2011 to October 2012. During this period, an elevated level of the M87 flux is reported at TeV with VERITAS. We detected a remarkable flux increase in the radio core with VERA at 22/43 GHz coincident with the VHE activity. Meanwhile, HST-1 remained quiescent in terms of its flux density and structure at radio. These results strongly suggest that the TeV γ-ray activity in 2012 originates in the jet base within 0.03 pc (projected) from the central supermassive black hole.

One of the most intriguing open questions of today's astrophysics is the jet physical properties and the location and the mechanisms for the production of MeV, GeV, and TeV gamma-rays in AGN jets. M87 is a privileged laboratory for a detailed study of the properties of jets, owing to its proximity, its massive black hole, and its conspicuous emission at radio wavelengths and above. We started on November 2009 a monitoring program with the e-EVN at 5 GHz. We present here results of these multi-epoch observations and discuss the two episodes of activity at energy E>100 GeV that occured in this period. One of these observations was obtained at the same day of the first high energy flare. We added to our results literature data obtained with the VLBI and VLA. A clear change in the proper motion velocity of HST-1 is present at the epoch ~2005.5. In the time range 1998 – 2005.5 the apparent velocity is subluminal, and superluminal (~2.7c) after 2005.5.

Breast-conserving surgery has become the standard approach for about 80% of patients treated for primary breast cancer in most centres. However, mastectomy is still required in case of multicentric and/or large tumours or where recurrences occur after conservative treatment. When a total mastectomy is performed, the removal of the nipple areola complex (NAC) is a strongly debated issue. In fact, although removal of the NAC greatly increases the patient's sensation of mutilation, and the risk of tumor involvement of the areola is reported as a very variable percentage, NAC excision still remains the standard treatment. From March 2002 to September 2003, 106 nipple sparing mastectomies (NSM) were peformed in 102 patients, 63% of whom had invasive carcinoma and 37% of whom had in situ carcinoma. Four patients underwent bilateral surgery. In all cases, a large or multicentric tumour and/or diffuse microcalcifications, clinically distant from the NAC, were present. During surgery, the tissue under the areola was routinely sampled to exclude the presence of tumor. If disease-free at the frozen sections, the NAC was spared and a NSM was performed. Additionally, a total dose of 16 Gy of radiotherapy (ELIOT) was delivered intraoperatively in the region of the NAC. All the patients underwent an immediate plastic breast reconstruction. In eleven patients (10.4%), the breast tissue under the areola resulted infiltrated at the definitive histological examination: in 10 cases a single or multiple foci of in situ carcinoma and in one case an invasive component were present. Eleven patients (10.4%) developed a superficial skin areolar slough followed by spontaneous healing, and 5 patients (4.7%) lost their NAC due to total necrosis. Among these, one patient had a poor cosmetic result on the NAC with asymmetrical location and required further surgical removal and reconstruction with tattoo and local flap in a better position. When rating the results from 0 (bad) to 10 (excellent), on average, the colour of the areola was rated 9/10, the sensitivity of nipple 3/10, the overall aesthetic result was rated 8/10 by both the surgeon and the patients. Early radiodystrophy (pigmentation) was observed in eight cases (7.5%). After an average follow up of 13 months, one local recurrence, located under the clavicula, far from the NAC, was observed. The preliminary results of the psychological study show a very high satisfaction with the preservation of the nipple (97.6 %), with younger women expressing a higher satisfaction than older counterparts. In selected cases, NSM with ELIOT of NAC has so far permitted good local control of the disease and satisfactory cosmetic results. Wider surgical experience is required to minimise the risk of leaving tumor cells in the region of the spared NAC and a longer follow up is necessary to evaluate the long term tumor recurrence rate at the NAC.

Summary PURPOSE: In the last decade, several investigators have reported that autografts can be used to restore alveolar volume prior to implant insertion successfully. However, no report is available comparing implant inserted into calvarial, mandibular and iliac crest bone autografts. MATERIALS AND METHODS: A retrospective study on 261 implants inserted in 42 patients was performed. Several variables related to patients, anatomic sites, implants and grafts were investigated. Implant's failure and peri-implant bone resorption were considered as predictor of clinical outcome. The Kaplan–Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the clinical outcome. RESULTS: A total of 261 implants were inserted: 89 (34.1%) into the mandible and 172 (65.9%) into the maxilla. Nine different implant types were used. Implant length and diameter ranged from 8 to 15 mm and from 3.5 to 6.0 mm, respectively. Implants were inserted to replace 42 incisors, 32 cuspids, 77 premolars and 110 molars. The mean post-loading follow-up was 32 months. No implant was lost (i.e. survival rate SVR = 100%) and no differences were detected amongst the studied variables. On the contrary, crestal bone resorption correlates with jaws site and implant type. CONCLUSION: Implants can be inserted in autografted jaws successfully although a higher resorption could be expected in the molar region. In addition the type of implant can have an impact on clinical outcome.

This study aims to evaluate the efficacy of video-assisted thoracoscopic surgery (VATS) pleurodesis in the treatment of spontaneous pneumothorax with particular reference to the postoperative period and the rate of recurrence after pleural abrasion. One hundred and thirty-three patients who underwent VATS management of primary spontaneous pneumothorax were retrospectively reviewed. They were 113 males and 20 females with median age of 26 (range 12-37). Among these patients, 114 underwent VATS for recurrent pneumothorax and 19 for persistent air-leakage at the first episode. During surgical procedure, in 78% of cases, parenchymal blebs were identified and resected by stapler resection. All patients were submitted to pleural abrasion. No intra- or postoperative deaths occurred. Postoperative complications were persistent air-leak for more than 7 days in 6 patients (4.3%) bleeding in 3 patients (2.2%). The median chest-tube duration and hospital stay were 2 (range 2-11) and 3 (range 3-12) days, respectively. Median follow-up period of 53 (range 6-96) months was complete for all patients. Five episodes of recurrent pneumothorax were encountered and 4 of them, because of major entity, required re-do VATS with stapler resection and pleural abrasion: their postoperative period and residual follow-up was uneventful. The goal in the surgical management of spontaneous pneumothorax, which often affects \"apparently healthy\" young patients, is to secure the less recurrence rate with no mortality and quite null morbidity and functional impairment. VATS stapler resection and pleural abrasion is a safe procedure allowing a good management of the disease with low complication rate, short chest-drain duration, hospital stay and recurrence rate quite similar to those referred for other procedures such as pleural poudrage or limited pleurectomy.