In this work, we experimentally analyze the periodic oscillations that take place in staircase APDs with separate absorption and multiplication regions when operating under continuous laser light. ...These oscillations increase in frequency when the APD gain increases. We have verified that they are not affected by the parameters (gain and bandwidth) of the transimpedance amplifier, and thus originate inside the APD. The phenomenon is analyzed systematically by considering devices with different thicknesses of the absorption region. Possible physical interpretations related to the flux of holes generated by impact ionization are provided.
•Satellite interferometric data as tools for landslide intensity estimation.•Intensity as input for landslide potential loss calculation.•Regional scale approach fully relying on interferometric ...data.•Combination of interferometric data and gravitational process models.
Multi-Temporal Interferometric Synthetic Aperture Radar (MTInSAR) data offer a valuable support to landslide mapping and to landslide activity estimation in mountain environments, where in situ measures are sometimes difficult to gather. Nowadays, the interferometric approach is more and more used for wide-areas analysis, providing useful information for risk management actors but at the same time requiring a lot of efforts to correctly interpret what satellite data are telling us. In this context, hot-spot-like analyses that select and highlight the fastest moving areas in a region of interest, are a good operative solution for reducing the time needed to inspect a whole interferometric dataset composed by thousands or millions of points. In this work, we go beyond the concept of MTInSAR data as simple mapping tools by proposing an approach whose final goal is the quantification of the potential loss experienced by an element at risk hit by a potential landslide. To do so, it is mandatory to evaluate landslide intensity. Here, we estimate intensity using Active Deformation Areas (ADA) extracted from Sentinel-1 MTInSAR data. Depending on the localization of each ADA with respect to the urban areas, intensity is derived in two different ways. Once exposure and vulnerability of the elements at risk are estimated, the potential loss due to a landslide of a given intensity is calculated. We tested our methodology in the Eastern Valle d’Aosta (north-western Italy), along four lateral valleys of the Dora Baltea Valley. This territory is characterized by steep slopes and by numerous active and dormant landslides. The goal of this work is to develop a regional scale methodology based on satellite radar interferometry to assess the potential impact of landslides on the urban fabric.
•A prebiotic soursop whey beverage was processed by high-intensity ultrasound (HIUS).•The in vitro bioactivities were tested to verify possible effects in vivo.•Wistar rats were used in a feed ...intervention with sonicated and thermally treated beverages.•The HIUS beverage decreased total triglycerides, vLDL-c and alanine aminotransferase (ALT).•In vivo benefits were related to bioactive peptides and antidiabetic activity of HIUS beverage.
New technologies for food processing have been used to enhance the beneficial effects of foods. This study aimed to evaluate the effects of a prebiotic soursop whey beverage processed by high-intensity ultrasound (HIUS) on healthy rats. Whey beverages were processed by HIUS (20KHz, 520 W of nominal power, <53 °C, 20.3 W of acoustic power, energy density of 2.9 kJ.cm−3 and 9.5 min to process 100 mL) and high-temperature short-time (HTST, 75 °C for 15 s) before being supplemented to Wistar rats by gavage for 15 days. Antioxidant, antidiabetic, anti-hypertensive, and anticancer activities, lipid peroxidation, bioactive peptides, and microstructure of the beverages were analyzed. In addition, the body mass, food, and water intake, systolic blood pressure, biochemical and oxidative stress parameters were measured. The sonicated beverage induced satiety, decreased glutathione peroxidase activity, total triglycerides, very-low-density lipoprotein cholesterol, and alanine aminotransferase. These findings suggest that ultrasound technology can provide in vivo health and functional benefits.
Objectives
Radiomics of soft tissue sarcomas (STS) is assumed to correlate with histologic and molecular tumor features, but radiogenomics analyses are lacking. Our aim was to identify if distinct ...patterns of natural evolution of STS obtained from consecutive pre-treatment MRIs are associated with differential gene expression (DGE) profiling in a pathway analysis.
Methods
All patients with newly diagnosed STS treated in a curative intent in our sarcoma reference center between 2008 and 2019 and with two available pre-treatment contrast-enhanced MRIs were included in this retrospective study. Radiomics features (RFs) were extracted from fat-sat contrast-enhanced T1-weighted imaging. Log ratio and relative change in RFs were calculated and used to determine grouping of samples based on a consensus hierarchical clustering. DGE and oncogenesis pathway analysis were performed in the delta-radiomics groups identified in order to detect associations between delta-radiomics patterns and transcriptomics features of STS. Secondarily, the prognostic value of the delta-radiomics groups was investigated.
Results
Sixty-three patients were included (median age: 63 years, interquartile range: 52.5–70). The consensus clustering identified 3 reliable delta-radiomics patient groups (A, B, and C). On imaging, group B patients were characterized by increase in tumor heterogeneity, necrotic signal, infiltrative margins, peritumoral edema, and peritumoral enhancement before the treatment start (
p
value range: 0.0019–0.0244), and, molecularly, by downregulation of natural killer cell–mediated cytotoxicity genes and upregulation of Hedgehog and Hippo signaling pathways. Group A patients were characterized by morphological stability of pre-treatment MRI traits and no local relapse (log-rank
p
= 0.0277).
Conclusions
This study highlights radiomics and transcriptomics convergence in STS. Proliferation and immune response inhibition were hyper-activated in the STS that were the most evolving on consecutive imaging.
Key Points
•
Three consensual and stable delta-radiomics clusters were identified and captured the natural patterns of morphological evolution of STS on pre-treatment MRIs
.
•
These 3 patterns were explainable and correlated with different well-known semantic radiological features with an ascending gradient of pejorative characteristics from the A group to C group to B group
.
•
Gene expression profiling stressed distinct patterns of up/downregulated oncogenetic pathways in STS from B group in keeping with its most aggressive radiological evolution
.
To compare the perioperative outcomes of robot-assisted radical prostatectomy (RARP) with pelvic lymph-nodes dissection (PLND) when the same surgeon performs RARP and PLND versus one surgeon performs ...RARP and another surgeon performs PLND.
From January 2022 to March 2023, data of consecutive patients who underwent RARP with PLND were prospectively collected. The surgeries were performed by two "young" surgeons with detailed profile. Specifically for the study purpose, one surgeon performed RARP, and the other surgeon performed PLND. A set of surgeries performed according to the standard setup (i.e., the same surgeon performing both RARP and PLND) was retrieved from the institutional database and used as comparator arm. To test the study hypothesis, patients were divided into two groups: "dual-surgeon" versus "single-surgeon".
Fifty patients underwent RARP and PLND performed according to dual-surgeon setup and were compared to the last 50 procedures performed according to the standard single-surgeon setup. Patients in the groups had comparable baseline characteristics. Dual-surgeon interventions had significantly shorter median total operative (194 IQR 178-215 versus 174 IQR 146-195 minutes, p<0.001) and console time (173 IQR 158-194 versus 154 IQR 129-170 minutes, p<0.001). No significant differences were found in terms of blood loss, intraoperative complications, postoperative outcomes, and final pathology results.
The present analysis found that when RARP and PLND are split onto two surgeons, the operative time is shorter by 20 minutes compared to when a single surgeon performs RARP and PLND. This is an interesting finding that could sponsor further studies.
The study aimed to evaluate the impact of abdominal drain placement (vs. omission) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN), focusing on complications, time to ...canalization, deambulation, and pain management. A prospectively-maintained institutional database was queried to get data of patients who underwent RAPN for renal masses between January 2018 and May 2023 at our Institution. Baseline, surgical, and postoperative data were collected. Retrieved patients were stratified based upon placement of abdominal drain (Y/N). Descriptive analyses comparing the two groups were conducted as appropriate.77 After adjusting for potential confounders, a logistic regression analysis was conducted to evaluate significant predictors of any grade and "major" complications. 342 patients were included: 192 patients in the "drain group" versus 150 patients in the "no-drain" group. Renal masses were larger (p < 0.001) and at higher complexity (RENAL score, p = 0.01), in the drain group. Procedures in the drain group had statistically significantly longer operative time, ischemia time, and higher blood loss (all p-values < 0.001). The urinary collecting system was more likely involved compared to the no-drain group (p = 0.01). At multivariate analysis, abdominal drainage was not a significant predictor of any grade (OR 0.79, 95%CI 0.33-1.87) and major postoperative complications (OR 3.62, 95%CI 0.53-9.68). Patients in the drain group experienced a statistically significantly higher hemoglobin drop (p < 0.01). Moreover, they exhibited statistically significant higher paracetamol consumption (p < 0.001) and need for additional opioids (p = 0.02). In summary, the study results suggest the safety of omitting drain placement and remark on the need for personalized decision-making, which considers patient and procedural factors.
Aim of the study was to compare perioperative, functional and oncological outcomes after off-clamp vs on-clamp robotic partial nephrectomy (RPN).
Patients who underwent off-clamp or on-clamp (warm ...ischemia) RPN were extracted from 2 institutional prospectively-maintained databases. 123 patients who underwent off-clamp RPN at one institution were excluded, so that each institution contributed with unselected patients (institution 1:on-clamp RPN vs institution 2:off-clamp). 2:1 propensity-score matching (age, sex, smoking, diabetes, hypertension, ASA score, solitary kidney, preoperative eGFR, tumor size and R.E.N.A.L.score). Perioperative outcomes were compared. A linear mixed model was fitted to eGFR as the outcome regressed on fixed effects for 1) management of clamping (on-clamp/off-clamp), 2) time (at baseline, at discharge, at 12 and 24 months postoperatively), and 3) clamp/time interaction. Survival events were compared between groups.
1983 patients were pooled. After matching, 400 on-clamp vs 200 off-clamp patients were analyzed. No significant differences were found in key perioperative outcomes. The effect of on-clamp on eGFR changed over time. At discharge, groups had similar drop in eGFR. The difference between groups was greatest at 12-months postoperatively, with on-clamp patients showing a deficit of 5 ml/min. At 24-months follow-up, this gap shrunk to 2 ml/min. There were no significant differences in overall survival (p = 0.1), recurrence (χ2 = 0.008, p = 0.9), or metastasis free survival (χ2 = 0.962 p = 0.3). Only one cancer-specific death occurred in off-clamp group.
We confirm no significant differences in the perioperative and oncological outcomes between off-clamp and on-clamp RPN. Avoided ischemia benefits renal function within 1-year follow-up after surgery. At longer follow-up, difference with on-clamp is softened.
Objectives
To evaluate the reliability of transperineal interstitial laser ablation of the prostate (TPLA) in preserving antegrade ejaculation compared to transurethral resection of the prostate ...(TURP).
Patients and Methods
In this single‐centre, prospective, randomized, open‐label study, consecutive patients with indication for surgical treatment for benign prostatic obstruction (BPO) were enrolled between January 2020 and September 2021 (NCT04781049). Patients were randomized to one of two treatment arms: Group A: TPLA (experimental group) and Group B: TURP (reference standard group). The primary endpoint was change in ejaculatory function (assessed by the Male Sexual Health Questionnaire – Ejaculatory function domain EJ‐MSHQ) at 1 month after surgery. Secondary endpoints included comparison of visual analogue scale (VAS) scores, changes in sexual function (assessed using the five‐item International Index of Erectile Function IIEF‐5), change in International Prostate Symptom Score IPSS, change in quality of life score, and maximum urinary flow rate Qmax improvement at 1–6 months, as appropriate.
Results
Fifty‐one patients (26 TPLA vs 25 TURP) were analysed. No differences in the perception of pain assessed by VAS and no differences in IIEF‐5 score were found between the groups. The distribution of ejaculatory function assessed by the EJ‐MSHQ remained unmodified after TPLA (P = 0.2), while a median 30% decrease in EJ‐MSHQ score was observed after TURP (P = 0.01). Absence of antegrade ejaculation was reported in one patient in the TPLA group (vs 18 patients in the TURP group). A statistically significant difference between the treatment groups was found in terms of postoperative Qmax (TPLA vs TURP: 15.2 interquartile range 13.5–18.3 mL/s vs 26.0 interquartile range 22.0–48.0 mL/s; P < 0.001). Both treatments significantly improved Qmax, with a mean 23.9 mL/s improvement after TURP (95% confidence interval CI 17.1–30.7) vs 6.0 mL/s after TPLA (95% CI 5.0–7.0), and IPSS, with a mean decrease of 11.6 (95% CI 9.7–13.5) vs 5.8 after TPLA (95% CI.2–9.6) with respect to baseline.
Conclusion
In our study, TPLA preserved ejaculatory function in 96% of cases in addition to providing significant relief from BPO.
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