The III–V semiconductor GaN is a promising material for photoelectrochemical (PEC) cells, however the large bandgap of 3.45 eV is a considerable hindrance for the absorption of visible light. ...Therefore, the substitution of small amounts of N anions by isovalent Sb is a promising route to lower the bandgap and thus increase the PEC activity under visible light. Herein we report a new chemical vapor deposition (CVD) process utilizing the precursors bis(N,N′-diisopropyl-2-methyl-amidinato)-methyl gallium (III) and triphenyl antimony (TPSb) for the growth of GaSbxN1−x alloys. X-ray diffraction (XRD) and scanning electron microscopy (SEM) measurements show crystalline and homogeneous thin films at deposition temperatures in the range of 500–800 °C. Rutherford backscattering spectrometry (RBS) combined with nuclear reaction analysis (NRA) shows an incorporation of 0.2–0.7 at% antimony into the alloy, which results in a slight bandgap decrease (up to 0.2 eV) accompanied by enhanced sub-bandgap optical response. While the resulting photoanodes are active under visible light, the external quantum efficiencies remained low. Intriguingly, the best performing films exhibits the lowest charge carrier mobility according to time resolved THz spectroscopy (TRTS) and microwave conductivity (TRMC) measurements, which showed mobilities of up to 1.75 cm2 V−1 s−1 and 1.2 × 10–2 cm2 V−1 s−1, for each timescale, respectively.
For the growth of 2D transition metal dichalcogenides, such as molybdenum (MoS2) and tungsten disulfides (WS2), metalorganic chemical vapor deposition (MOCVD) routes are favorable due to their ...superior scalability, the possibility to tune the processing temperatures by a proper choice of reactants thus avoiding the need for a postdeposition treatment. Herein, the first example of a promising MOCVD route for the direct fabrication of MoS2 and WS2 layers under moderate process conditions is reported. This straightforward route is successfully realized by the combination of metalorganic precursors of Mo or W bearing the amidinato ligand with just elemental sulfur. The formation of stoichiometric hexagonal 2H‐MoS2 and 2H‐WS2 is demonstrated which is confirmed by Raman, X‐ray diffraction, and X‐ray photoelectron spectroscopy studies. The deposited layers are evaluated for their electrocatalytic activity in hydrogen evolution reaction as a proof of principle for application in water splitting devices.
Homogenous molybdenum disulfide (MoS2) and tungsten disulfide (WS2) layers are fabricated via metalorganic chemical vapor deposition. Direct transition metal disulfide growth in the presence of elemental sulfur vapor is enabled by the reactivity of the imido‐amidinato precursors at 600–800 °C. Stoichiometric MoS2 thin films are formed in the complete temperature range and preliminary investigations indicate potential for the application in photoelectrochemical water splitting.
There are limited data available to indicate whether oncological outcomes might be influenced by the uterine manipulator, which is used at the time of hysterectomy for minimally invasive surgery in ...patients with endometrial cancer. The current evidence derives from retrospective studies with limited sample sizes. Without substantial evidence to support its use, surgeons are required to make decisions about its use based only on their personal choice and surgical experience.
To evaluate the use of the uterine manipulator on oncological outcomes after minimally invasive surgery, for apparent early-stage endometrial cancer.
We performed a retrospective multicentric study to assess the oncological safety of uterine manipulator use in patients with apparent early-stage endometrial cancer, treated with minimally invasive surgery. The type of manipulator, surgical staging, histology, lymphovascular space invasion, International Federation of Gynecology and Obstetrics stage, adjuvant treatment, recurrence, and pattern of recurrence were evaluated. The primary objective was to determine the relapse rate. The secondary objective was to determine recurrence-free survival, overall survival, and the pattern of recurrence.
A total of 2661 women from 15 centers were included; 1756 patients underwent hysterectomy with a uterine manipulator and 905 without it. Both groups were balanced with respect to histology, tumor grade, myometrial invasion, International Federation of Gynecology and Obstetrics stage, and adjuvant therapy. The rate of recurrence was 11.69% in the uterine manipulator group and 7.4% in the no-manipulator group (P<.001). The use of the uterine manipulator was associated with a higher risk of recurrence (hazard ratio, 2.31; 95% confidence interval, 1.27–4.20; P=.006). The use of uterine manipulator in uterus-confined endometrial cancer (International Federation of Gynecology and Obstetrics FIGO I–II) was associated with lower disease-free survival (hazard ratio, 1.74; 95% confidence interval, 0.57–0.97; P=.027) and higher risk of death (hazard ratio, 1.74; 95% confidence interval, 1.07–2.83; P=.026). No differences were found regarding the pattern of recurrence between both groups (chi-square statistic, 1.74; P=.63).
In this study, the use of a uterine manipulator was associated with a worse oncological outcome in patients with uterus-confined endometrial cancer (International Federation of Gynecology and Obstetrics I–II) who underwent minimally invasive surgery. Prospective trials are essential to confirm these results.
Background
Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to ...evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setting and oncologic outcomes according to the volume of nodal disease.
Patients and Methods
A total of 29 Spanish centers participated in this retrospective, multicenter registry including patients with endometrial adenocarcinoma at preoperative early stage who had undergone SLN biopsy between 2015 and 2021. Each center collected data regarding demographic, clinical, histologic, therapeutic, and survival characteristics.
Results
A total of 892 patients were enrolled. After the surgery, 12.9% were suprastaged to FIGO 2009 stages III–IV and 108 patients (12.1%) had nodal involvement: 54.6% macrometastasis, 22.2% micrometastases, and 23.1% isolated tumor cells (ITC). Sensitivity of SLN biopsy was 93.7% and false negative rate was 6.2%. After a median follow up of 1.81 years, overall surivial and disease-free survival were significantly lower in patients who had macrometastases when compared with patients with negative nodes, micrometastases or ITC.
Conclusions
In our nationwide cohort we obtained high sensitivity of SLN biopsy to detect nodal disease. The oncologic outcomes of patients with negative nodes and low-volume disease were similar after tailoring adjuvant treatments. In total, 22% of patients with macrometastasis and 50% of patients with micrometastasis were at low risk of nodal metastasis according to their preoperative risk factors, revealing the importance of SLN biopsy in the surgical management of patients with early stage EC.
Understanding the photocatalytic–activity–defects relationship of titanium oxynitride nanotubes (TiON-NTs) is important for tailoring their photocatalytic performance. Herein, we fabricated highly ...ordered and vertically aligned nanotube arrays of TiON-NT-functionalized with iridium nanoparticles denoted as (Ir/TiON-NTs) for solar-driven water splitting. Positron annihilation lifetime spectroscopy (PALS) and variable-energy positron annihilation spectroscopy (VEPAS) were performed to quantify the vacancy-type defects of Ir/TiON-NTs relative to TiON-NTs and TiO 2 -NTs. The results display that the Ir/TiON-NTs exhibit abundant defects such as small nitrogen vacancies, larger size vacancy clusters, and small voids. The obtained photocurrent density of the Ir/TiON-NTs (11.3 mA cm −2 ) is about 3.97, 5, and 11.89 times higher than that of Ir/TiO 2 -NTs, TiON-NTs, and TiO 2 -NTs, respectively. The Mott–Schottky analysis revealed the highest significant negative shift in the band potential and the lowest donor density of Ir/TiON-NTs compared to its counterparts. This result is attributed to the unique structural and compositional merits of Ir/TiON-NTs despite the abundant defects, which delay the charge recombination and improve the photocatalytic activity. The presented study may open new frontiers on engineering the defects of metal oxynitrides with metal-based catalysts for photocatalytic applications.
Uterine leiomyosarcomas are very rare and highly aggressive tumors that have a high rate of recurrence and poor prognosis, even when early diagnosed. Due to their relative rarity, there is limited ...research on optimal management strategies.
A 60-year-old woman with a history of an asymptomatic uterine leiomyoma presented in October 2015 with postmenopausal bleeding and a friable vaginal cyst that bled when palpated. A partial cystectomy was performed, and malignant-like cystic and solid components were identified. Histopathology diagnosed an unclassifiable malignant epithelioid tumor. Subsequent imaging studies identified a malignant uterine tumor, a metabolically active vaginal lesion, and two benign leiomyomas. An anterior pelvic exenteration (colpectomy, hysterectomy, bilateral adnexectomy, total cystectomy, and cutaneous ureteroileostomy ad modum Bricker) were performed by laparotomy in March 2016. Examination of the surgical specimens identified a 75 × 75-mm leiomyoma, an 80 × 30-mm infiltrating mesenchymal uterine lesion with vascular invasion and tumor emboli, and a 60 × 30-mm perivascular vaginal tumor. Immunohistochemistry indicated a phenotypic transition from a uterine leiomyosarcoma to a vaginal epithelioid lesion; marker expression changed from the uterine tumor actin+/desmin+/caldesmon+/CD10- phenotype, through the tumor emboli, to an actin-/desmin-/caldesmon-/CD10+ phenotype in the vaginal lesion. A high-grade uterine mesenchymal tumor and vaginal metastasis were diagnosed. Adjuvant chemotherapy with docetaxel, gemcitabine, and doxorubicin commenced in May 2016 and treatment has been well tolerated.
Differentiating leiomyosarcoma from leiomyoma is challenging and few tools other than microscopic evaluation are available. Vaginal compromise in leiomyosarcoma usually results from tumor extension, not hematogenous metastasis. A vaginal metastasis is a very rare initial presentation. We have found only two cases like this described on published literature. The atypical clinical and histological presentation in our case complicated diagnosis and delayed treatment. An early diagnosis and complete surgical clearance gives the best chance of survival, and imaging tools should be applied early in instances of new suspicious malignant lesions.
BackgroundTargeted axillary dissection, which combines sentinel lymph node biopsy with removal of the proven involved node noted during the staging process, has been shown to improve axillary staging ...and decrease false negative rates after neoadjuvant chemotherapy in patients with breast cancer.Objective(s)The main goal of this study was to assess the ability to identify and remove the clipped node and the false negative rate of targeted axillary dissection.MethodsWe performed a prospective study among patients with biopsy-confirmed nodal metastases who received neoadjuvant chemotherapy. A clip was placed on the sample node prior systemic therapy. After neoadjuvant chemotherapy, all patients underwent sentinel lymph node biopsy (dual tracer), localization and excision of the clipped node and axillary lymph node dissection. The clipped node was preoperatively localized in all cases placing an iodine-125 seed guided by ultrasound. The pathology of the sentinel nodes and clipped node was compared with other nodes.ResultsA total of 455 patients with invasive breast cancer were studied. Of the 148 patients with NAC, 32 met the eligibility criteria and were enrolled in the study. Mean age at diagnosis was 52.3 years. Systematic lymphadenectomy was performed in all patients, with an average of 14.3 lymph nodes removed. Detection rate of the clipped node alone was 96.9%, and 100% for targeted axillary dissection. Ability of clipped node alone to predict nodal status showed a FNR of 10,5% while SLNB alone performed by dual tracer and targeted axillary dissection, showed FNRs of 5.3% and 5.0%, respectively. Sentinel lymph nodes matched clipped node in 23 patients (74.2%).Conclusion (s)In node positive breast cancer patients, targeted axillary dissection is a reliably approach for axillary staging after neoadjuvant chemotherapy. The preoperative location of the clipped node is mandatory to increase the detection rate and optimize the results of the technique.
Background. Axillary surgical management in patients with node-positive breast cancer at the time of diagnosis converted to negative nodes through neoadjuvant chemotherapy (NAC) remains unclear. ...Removal of more than two sentinel nodes (SLNs) in these patients may decrease the false negative rate (FNR) of sentinel lymph node biopsies (SLNBs). We aim to analyse the detection rate (DR) and the FNR of SLNB assessment according to the number of SLNs removed. Methods. A retrospective study was performed from October 2012 to December 2018. Patients with invasive breast cancer who had a clinically node-positive disease at diagnosis and with a complete axillary response after neoadjuvant chemotherapy were selected. Patients included underwent SLNB and axillary lymph node dissection (ALND) after NAC. The SLN was considered positive if any residual disease was detected. Descriptive statistics were used to describe the clinicopathologic features and the results of SLNB and ALND. The DR of SLNB was defined as the number of patients with successful identification of SLN. Presence of residual disease in ALND and negative SLN was considered false negative. Results. A total of 368 patients with invasive breast cancer who underwent surgery after complete NAC were studied. Of them, 85 patients met the eligibility criteria and were enrolled in the study. The mean age at diagnosis was 50.8 years. Systematic lymphadenectomy was performed in all patients, with an average of 10 lymph nodes removed. The DR of SLNB was 92.9%, and the FNR was 19.1. The median number of SLNs removed was 3, and at least, three SLNs were obtained in 42 patients (53.2%). When at least three sentinel nodes were removed, the FNR decreased to 8.7%. Conclusions. In this cohort, the SLN assessment was associated with an adequate DR and a high FNR. Removing three or more SLNs decreased the FNR from 19.1% to 8.7%. Complementary approaches may be considered for axillary lymph node staging after neoadjuvant chemotherapy. The study was approved by our institution’s ethics committee (Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), Universidad Complutense de Madrid, Madrid, Spain) (https://clinicaltrials.gov/ct2/show/NCEI:20/0048).
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