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BackgroundThe aim of this study is to report the experience with conversion surgery from six Gruppo Italiano Ricerca Cancro Gastrico (GIRCG) centers, focusing our analysis on factors affecting survival and the risk of recurrence.MethodsA retrospective, multicenter cohort study was performed in patients who had undergone conversion gastrectomy between 2005 and 2017. Data were extracted from a GIRCG database including all metastatic gastric cancer patients submitted to surgery. Only stage IV unresectable tumors/metastases which became resectable after chemotherapy were included in this analysis.ResultsForty-five resected M1 patients were included in the analysis. Reasons for being deemed unresectable at diagnosis were peritoneal involvement (PCI > 6) (n = 38, 84.4%), distant metastatic nodes (n = 3, 6.6%) and extensive liver involvement (n = 4, 8.8%). Median follow-up was 25 months (IQR 9-50). Median overall survival from surgery was 15 months and 1-, 3- and 5-year survivals were 57.2, 36.1 and 24%, respectively. Median progression-free survival was 12 months with 1- and 3-year survival of 46.4 and 33.9%, respectively. At cox regression analysis the only independent prognostic factor for OS was the presence of more than one type of metastasis (HR 4.41, 95% CI 1.72–11.3, p = 0.002). A positive microscopic resection margin was the only risk factor for recurrence (HR 5.72, 95% CI 1.04–31.4, p = 0.045).ConclusionsUnresectable stage IV GC patients could benefit from radical surgery after chemotherapy and achieve long survivals. The main prognostic factor for these patients was the presence of more than one type of extra-gastric metastatic involvement.

This is the first broadband dielectric spectroscopy study on the temperature- and frequency-dependent electrical conductivity of polyamide 6 (PA6) composites containing both metal microparticles (Al, Fe, or Cu) and carbon nanotubes (CNT). The dually reinforced PA6 hybrids are prepared through compression molding of metal- and CNT-loaded microparticles (MP). These MP are synthesized by activated anionic ring-opening polymerization (AAROP) of ε-caprolactam in suspension, carried out in the presence of the micron-sized metal powders and the nanosized CNT fillers, with a combined load of up to 10 wt%. The good dispersion of the two loads by the AAROP strategy results in a notable increase in the electrical conductivity by up to 11 orders of magnitude. Moreover, the frequency-dependent behavior of the measured conductivity obeys the so-called universal dynamic response. This response involves a direct current (d.c.) electrical conductivity ( σ dc ) observed beyond a critical frequency, F c , followed by a power-law response characterized by an exponent s , which fluctuates between 0.11 and 0.43. The σ dc of the binary composites spans from 1.42 × 10 −5 to 1.63 × 10 −2  S/cm, this increase being attributed to the synergetic effect between CNT and the metal particles that contribute to the carrier mobility within the conductive network. Graphical Abstract

It has been previously demonstrated that T lymphocytes may be involved in the development of hypertension and microvascular remodeling, and that circulating T effector lymphocytes may be increased in hypertension. In particular, Th1 and Th 17 lymphocytes may contribute to the progression of hypertension and microvascular damage while T-regulatory (Treg) lymphocytes seem to be protective in this regard. However, no data is available about patients with severe obesity, in which pronounced microvascular alterations were observed. We have investigated 32 severely obese patients undergoing bariatric surgery, as well as 24 normotensive lean subjects and 12 hypertensive lean subjects undergoing an elective surgical intervention. A peripheral blood sample was obtained before surgery for assessment of CD4+ T lymphocyte subpopulations. Lymphocyte phenotype was evaluated by flow cytometry in order to assess T-effector and Treg lymphocytes. A marked reduction of several Treg subpopulations was observed in obese patients compared with controls, together with an increased in CD4+ effector memory T-effector cells. In severely obese patients, Treg lymphocytes are clearly reduced and CD4+ effector memory cells are increased. It may be hypothesized that they might contribute to the development of marked microvascular alterations previously observed in these patients.

Crystallization is a fundamental process in materials science, providing the primary route for the realization of a wide range of new materials. Crystallization rates are also considered to be useful probes of glass-forming ability 1 – 3 . At the microscopic level, crystallization is described by the classical crystal nucleation and growth theories 4 , 5 , yet in general solid formation is a far more complex process. In particular, the observation of apparently different crystal growth regimes in many binary liquid mixtures greatly challenges our understanding of crystallization 1 , 6 – 12 . Here, we study by experiments, theory and computer simulations the crystallization of supercooled mixtures of argon and krypton, showing that crystal growth rates in these systems can be reconciled with existing crystal growth models only by explicitly accounting for the non-ideality of the mixtures. Our results highlight the importance of thermodynamic aspects in describing the crystal growth kinetics, providing a substantial step towards a more sophisticated theory of crystal growth. The contribution of non-ideal mixing for the crystallization of supercooled mixtures of argon and krypton is reported, showing that this process is well described by classical crystal growth theories when such thermodynamics is considered.

The High Energy cosmic-Radiation Detection (HERD) facility is a China-led international space mission that will start its operation around 2027 aboard the future China’s Space Station. The mission is expected to extend the direct measurements on cosmic rays and gamma rays by at least one order of magnitude in energy respect to the limits of the experiments currently operating in space. This is possible thanks to its novel design, based on a 3D, homogeneous, isotropic and finely-segmented calorimeter, with good energy resolution (< 1% for electromagnetic showers, < 30% for hadronic showers) and a good effective geometric factor (> 3 m 2 sr for electromagnetic showers, > 2 m 2 sr for hadronic showers). The main challenge of the hardware design is the implementation of the read-out system for each of the almost 8000 LYSO crystals of the calorimeter, since a large dynamic range of 10 7 is needed and absolute energy scale calibration is crucial for space instruments. In this contribution, we describe the double read-out scheme chosen for the final configuration, made of wave-length shifting fibers coupled with an intensified scientific CMOS and photodiodes connected to a specifically designed front-end electronics. In particular, we will discuss the advantages of both read-out systems and the benefits offered to the apparatus by this double read-out scheme.

We reported on the interaction between poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) and high-boiling-point additives in PEDOT:PSS aqueous dispersions and in the final polymer films with the aim of stablishing correlations between the structure of both inks and solid thin films. By Small-Angle X-ray Scattering (SAXS) using synchrotron radiation, it was found that the structural changes of dispersions of PEDOT:PSS with high-boiling-point additives can be explained as a two-step mechanism depending on the additive concentration. A compaction of PEDOT:PSS grains was observed at low concentrations while a swelling of the grains together with a phase segregation between PEDOT and PSS segments was evidenced at larger concentrations. Thin films’ morphology and structure were investigated by atomic force microscopy (AFM) and synchrotron Grazing Incidence Wide-Angle X-ray Scattering (GIWAXS) respectively. Our two-step model provides an explanation for the small and sharp domains of PEDOT:PSS thin films observed for low-additive concentrations (first step) and larger domains and roughness found for higher-additive concentrations (second step). A reduction of the ratio of PSS in PEDOT:PSS thin films upon the presence of additives was also observed. This can be related to a thinning of the PSS shells of PEDOT:PSS grains in the dispersion. The results discussed in this work provide the basis for a controlled tuning of PEDOT:PSS thin films structure and the subsequent electrical properties.

Adrenocortical carcinoma is a heterogeneous and aggressive cancer that originates from steroidogenic cells within the adrenal cortex. In this study, we have assessed for the preclinical gold standard NCI-H295 in direct comparison with the more recently established MUC-1 and a here newly reported ACC cell line (TVBF-7) the mutational status of important driver genes (TP53, MEN1, PRKAR1A, CTNNB1, APC, ZNRF-3, IGF-2, EGFR, RB1, BRCA1, BRCA2, RET, GNAS and PTEN), Wnt-signaling specificities (CTNNB1 mutation vs. APC mutation vs. wildtype), steroidogenic-(CYP11A1, CYP17A1, HSD3B2, HSD17B4, CYP21A2, CYP11B1, CYP11B2, MC2R, AT1R) and nuclear-receptor-signaling (AR, ER, GCR), varying electrophysiological potentials as well as highly individual hormone secretion profiles (Cortisol, Aldosterone, DHEA, DHEAS, Testosterone, 17-OH Progesterone, among others) which were investigated under basal and stimulated conditions (ACTH, AngII, FSK). Our findings reveal important genetic and pathophysiological characteristics for these three cell lines and reveal the importance of such cell-line panels reflecting differential endocrine functionalities to thereby better reflect clinically well-known ACC patient heterogeneities in preclinical studies.

Background The Italian Research Group for Gastric Cancer supports the practice of follow-up after radical surgery for gastric cancer. Methods This multicenter, retrospective study (1998–2009) included patients with T1-4N0-3M0 gastric cancer who had undergone D2 gastrectomy and lymphadenectomy, with at least 15 lymph nodes examined, and who had developed recurrent disease. Timing and site of recurrence were correlated to the actual scheduled follow-up timing and modalities. Results From eight centers, 814 patients with recurrent cancer and over 1,754 (46.4 %) patients undergoing gastrectomy were investigated (median follow-up 31 months). The most frequent sites of recurrence were local/regional lymph nodes (35.4 %), liver (24.3 %), peritoneum (30.3 %), lung (10.4 %) and intraluminal (7.5 %). Ninety-four percent of the recurrences were diagnosed within 2 years and 98 % within 3 years. Thoracoabdominal computed tomography (CT) scan and (18)F-fluoro-2-deoxy- d -glucose positron emission tomography (18-FDG-PET) detected more than 90 % of recurrences, abdominal ultrasound detected 70 % and tumor markers detected 40 %, while <10 % were identified by physical examination, chest X-ray, and upper gastrointestinal endoscopy. Twenty-six percent of patients with recurrence were treated, but only 3.2 % were treated with potentially radical intent. Conclusion Oncological follow-up after radical surgery for gastric cancer should be focused in the first 3 years, and based mainly on thoracoabdominal CT scan and 18-FDG-PET.

A bstract In this paper, we report the measurement of the energy flow, the cross section and the average inelasticity of forward neutrons (+ antineutrons) produced in s = 13 TeV proton-proton collisions. These quantities are obtained from the inclusive differential production cross section, measured using the LHCf Arm2 detector at the CERN Large Hadron Collider. The measurements are performed in six pseudorapidity regions: three of them ( η > 10 . 75, 8 . 99 < η < 9 . 21 and 8 . 80 < η < 8 . 99), albeit with smaller acceptance and larger uncertainties, were already published in a previous work, whereas the remaining three (10 . 06 < η < 10 . 75, 9 . 65 < η < 10 . 06 and 8 . 65 < η < 8 . 80) are presented here for the first time. The analysis was carried out using a data set acquired in June 2015 with a corresponding integrated luminosity of 0 . 194 nb − 1 . Comparing the experimental measurements with the expectations of several hadronic interaction models used to simulate cosmic ray air showers, none of these generators resulted to have a satisfactory agreement in all the phase space selected for the analysis. The inclusive differential production cross section for η > 10 . 75 is not reproduced by any model, whereas the results still indicate a significant but less serious deviation at lower pseudorapidities. Depending on the pseudorapidity region, the generators showing the best overall agreement with data are either SIBYLL 2.3 or EPOS-LHC. Furthermore, apart from the most forward region, the derived energy flow and cross section distributions are best reproduced by EPOS-LHC. Finally, even if none of the models describe the elasticity distribution in a satisfactory way, the extracted average inelasticity is consistent with the QGSJET II-04 value, while most of the other generators give values that lie just outside the experimental uncertainties.

A bstract The forward η mesons production has been observed by the Large Hadron Collider forward (LHCf) experiment in proton-proton collision at s = 13 TeV. This paper presents the measurement of the inclusive production rate of η in p T < 1 . 1 GeV/c, expressed as a function of the Feynman- x variable. These results are compared with the predictions of several hadronic interaction models commonly used for the modelling of the air showers produced by ultra-high energy cosmic rays. This is both the first measurement of η mesons from LHCf and the first time a particle containing strange quarks has been observed in the forward region for high-energy collisions. These results will provide a powerful constraint on hadronic interaction models for the purpose of improving the understanding of the processes underlying the air showers produced in the Earth’s atmosphere by ultra-energetic cosmic rays.