117,361 research outputs found
ASO Author Reflections: Conization Before Radical Hysterectomy Improves Disease-Free Survival in Early Stage Cervical Cancer
No full textPast
A well-known randomized study demonstrated that minimally invasive radical hysterectomy was associated with poorer disease-free and overall survival in patients with early stage cervical cancer, when compared with an open approach.1 Despite not yet understanding the technical reasons for this result, different options have been proposed to explain the difference in oncological outcomes. One of these is potential peritoneal ‘contamination’ at time of colpotomy: this possibility is intuitively more likely in cases of bulky tumors.2,3 In this context, conization before radical hysterectomy may reduce the risk of peritoneal exposure to cancer tissue, maintaining the oncological safety of the surgical procedure.
Very few studies have investigated the impact of conization in cervical cancer survival, demonstrating an association between conization and reduced risk of recurrence.3
Present
In this multicenter, retrospective, observational cohort study, we analyzed the survival outcomes of a population of FIGO 2009 stage IB1 cervical cancer, by comparing the group that underwent conization with the group that did not undergo conization before radical hysterectomy. Three hundred and thirty-two patients (166, 50% in each group) were included after balance with a propensity match analysis. On the conization specimens, 14.4% and 85.6% of patients had negative and positive surgical margins, respectively. However, 41.6% of conization patients did not have residual tumor on the hysterectomy specimen, therefore significantly reducing the risk of peritoneal tumor ‘contamination’.
Patients undergoing conization before radical hysterectomy were less likely to receive adjuvant treatment (p < 0.001) and had a better 5-year disease-free survival than patients who did not receive conization (89.8% vs. 80.0%, respectively; p = 0.010). No difference in 5-year overall survival (97.1% vs. 91.4%, respectively; p = 0.114) and in recurrence pattern (p = 0.115) was reported between the two groups. Conization before radical hysterectomy and tumor diameter ≤ 20 mm were independently associated with reduced risk of recurrence.
Future
More and more evidence supports the role of protecting maneuvers performed at the time of radical hysterectomy to avoid peritoneal exposure to tumor cells. Amongst these, the avoidance of using a uterine manipulator, the closure of the vaginal cuff and, now, pre-operative conization, can be listed as actions aimed at reducing or eliminating the risk of peritoneal tumor contamination during minimally invasive surgery.4 Nevertheless, at the moment, most international guidelines and societies’ statements are cautious regarding the use of minimally invasive radical hysterectomy, particularly for tumors > 20 mm, unless within the setting of clinical trials. Prospective randomized trials are ongoing to further confirm or deny the detrimental effect of a minimally invasive approach to radical hysterectomy.5 Importantly, these trials promote or aim to assess the use of protective maneuvers to avoid peritoneal tumor exposure at the time of colpotomy, and conization could be proposed as one of these. Nevertheless, a randomized trial to specifically compare the survival of patients undergoing or not undergoing pre-operative conization, may be necessary in the future to better define and personalize the correct management of early stage cervical cancer.
References
1.
Ramirez PT, Frumovitz M, Pareja R, et al. Minimally Invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med. 2018;379(20):1895–904.
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2.
Pedone Anchora L, Bizzarri N, Kucukmetin A, et al. Investigating the possible impact of peritoneal tumor exposure amongst women with early stage cervical cancer treated with minimally invasive approach. Eur J Surg Oncol. 2020;7983(20):30829–5. https://doi.org/10.1016/j.ejso.2020.09.038.
3.
Casarin J, Buda A, Bogani G, et al. Predictors of recurrence following laparoscopic radical hysterectomy for early-stage cervical cancer: a multi-institutional study. Gynecol Oncol. 2020;159(1):164–70.
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4.
Bizzarri N, Pedone Anchora L, Kucukmetin A, et al. Protective role of conization before radical hysterectomy in early-stage cervical cancer: a propensity-score matching study. Ann Surg Oncol. 2021. https://doi.org/10.1245/s10434-021-09695-4.
5.
Basaran D, Leitao MM Jr. The landmark series: minimally invasive surgery for cervical cancer. Ann SurgOncol. 2021;28(1):204–11
A performance evaluation tool for spectrum sharing in multi-operator LTE networks
No full textRecent advances in wireless networking introduce the concept of resource sharing as one promising way to enhance the performance of radio communications. As the wireless spectrum is a scarce resource, and its usage is often found to be inefficient, it may be meaningful to design solutions where multiple operators join their efforts, so that wireless access of their terminals takes place on shared, rather than proprietary to a single operator, frequency bands. In spite of the conceptual simplicity of this idea, the resulting mathematical analysis may be very complex, since it involves analytical representation of multiple wireless channels. Simulation studies may be extremely useful to obtain a correct performance characterization of wireless networks with shared resources. In this spirit, the present paper introduces and evaluates an original extension of the well known ns-3 network simulator, which focuses on multiple operators of the most up-to-date cellular scenarios, i.e., the Long Term Evolution of UMTS employing OFDMA multiplexing. Spectrum sharing is represented through a proper software architecture, where several sharing policies can be framed. A detailed simulation campaign is run to assess the computational performance of the proposed architecture, and to show its effectiveness in analyzing realistic scenarios. © 2012 Elsevier B.V. All rights reserved
An asynchronous scheduler to minimize energy consumption in wireless sensor networks
No full textEnergy efficiency is one of the main issues in the design and optimization of Wireless Sensor Networks (WSN) since each node is typically subject to a hard battery limitation.
Taking into account that the most energy-consuming component of a WSN node is the radio, the design of energyefficient routing and MAC protocols is certainly a valid approach to face the problem. Minimizing the energy consumption allows to increase the lifetime of nodes and so of the overall network. This paper deals with a novel low power Medium Access Control (MAC) protocol compliant with the ZigBee standard. In particular, a new algorithm to tune the duty cycle of a node, i.e., the cycling between an awake and a
sleep state of the radio transceiver, is proposed. The basic idea of this solution is that neighboring nodes exchange information about their transmission time, so that each one knows in advance when it is supposed to be awake to receive a message and when it can switch off its radio. Low requirements in terms of processing and storage capacity characterize this solution. Furthermore, it is able to react effectively both to network topology changes and to clock desynchronization. The effectiveness of the defined schema has been evaluated, in terms of delay and power consumption, by means of simulations. The simulation results have highlighted
substantial improvements of the proposed solution
Simulation models for the performance evaluation of spectrum sharing techniques in OFDMA networks
No full textCooperation in wireless networks is an important means to improve the resource utilization efficiency. It finds an interesting application in the context of spectrum sharing, where multiple wireless users put their licensed frequency bands in common in order to achieve a better resource usage. Due to the complexity of the problem, mathematical analysis is typically focused on simple scenarios. However, we believe that, in order to obtain a concrete proof of concept of the sharing paradigm, it is mandatory to assess its performance in realistic situations, i.e., with a larger number of nodes and a wider range of applications. Therefore, the support of a proper simulation environment is fundamental for high-quality applied research. In this paper we present and evaluate an original extension of the well known ns-3 network simulator which focuses on multiple operators of the most up-to-date cellular scenarios, i.e., the Long Term Evolution of UMTS employing OFDMA multiplexing. We describe the software architecture that enables the spectrum sharing and, in particular, allows operators to interact in order to agree on a spectrum division. A sample sharing policy is given as well, and a detailed simulation campaign is run to validate the proposed architecture, assess its efficiency, and evaluate the simulation time related to scenarios with an increasing number of nodes
Oxychalepus anchora
No full textOxychalepus anchora (Chapuis 1877) (Figure 2) Odontota anchora Chapuis 1877: 18 [Syntypes: Colombia, La Bas (INSB)]. Uhmann 1965: 257 (types). Chalepus anchora (Chapuis). Baly 1885: 79 (redescription); Donckier 1899: 585 (catalog); Blackwelder 1946: 726 (faunal list); Callan 1954: 945 (faunal list); Silva et al. 1985: 36 (museum list). Chalepus ancora (Chapuis). Fiusa 1941: 24 (host plant); Guérin 1953: 101 (faunal list). Chalepus (Xenochalepus) ancora (Chapuis). Weise 1911a: 48 (note), 1911b: 26 (catalog), 1911c: 39 (catalog); Bruch, 1915: 377 (faunal list), 1928: 203 (faunal list); Lima 1936: 327 (faunal list); Silva 1938: 62 (host plant); Blunck 1954: 365 (host plant). Chalepus ancora (Chapuis). Guérin 1953: 101 (faunal list). Xenochalepus ancora (Chapuis). Bondar 1929: 180 (biology), 1930a: 47 (biology), 1930b: 171 (biology); Uhmann 1930a: 33 (distribution), 1930b: 249 (distribution), 1930c: 163 (distribution); Carvalho & Carvalho 1939: 55 (faunal list); Silva 1939: 95 (host plant); Schlottfeldt 1944a: 62 (host plant), 1944b: 113 (host plants); Fiusa 1946: 337 (host plant). Xenochalepus anchora (Chapuis). Maulik 1937: 137 (host plants); Lima 1955: 211 (faunal list). Oxychalepus ancora (Chapuis). Uhmann 1938b: 438 (transfer, redescription); Papp 1953: 84 (catalog). Oxychalepus anchora (Chapuis). Uhmann 1953: 169 (pupa), 1957a: 107 (catalog); Monrós & Viana 1947: 248 (Argentina species); Callan 1954: 945 (faunal list); Maes & Staines 1991: 38 (faunal list); Staines 1996 (1997): 42 (Nicaragua species); Maes 1998: 1020 (faunal list); Santiago-Blay 2004: 71 (host plants). Description. Head, antennae, and scutellum black; pronotum yellow, with a medial black band attenuate anteriorly and two narrow black lateral bands; elytra orangish-yellow with black anchor-like marking along suture on basal ½, apical ¼ black; legs black, base of the femora yellow (there are forms with the femora entirely yellow and others with the femora entirely black); venter black, with yellow maculae. Head: with faint medial sulcus; slightly depressed between eyes; vertex alutaceous; frons punctate, not projecting. Antenna: antennomeres 1 and 2 subglobose; 3–4 cylindrical; 5–10 transverse; 11 pointed at apex; 1–4 slightly compressed laterally. Pronotum: trapezoidal, surface covered with sparse, irregularly distributed large punctures, with a shallow longitudinal medial sulcus; lateral margin sinuate, constricted behind head; anterior angle with small tooth; posterior angle rounded; basal impression present; pronotal length 0.9–1.3 mm (n=20); pronotal width 1.3–1.8 mm. Scutellum: subcordate; alutaceous. Elytron: subparallel; lateral margin dentate; apices strongly dentate, individually rounded; with 10 puncture rows; scutellar row absent; intervals 2, 4, and 8 costate for entire length, interval 6 costate at base and apex; elytral length 5.8–6.4 mm; elytral width 2.4–2.9 mm. Venter: pro-, meso-, metasterna, abdominal sterna 1 and 2 orange in center, black laterally; remainder of abdomen entirely black; abdominal sterna with row of punctures at apex. Leg: femur and tibia punctate. Length: 7.4–9.2 mm. Pupa. (from Uhmann 1953). Color bright brown, darkens with age; length less than that of adult. Head: not tuberculate; vertex with fine setae, 1 near antennal base and 2 nd near anterior margin of pronotum; labrum broadly triangular. Antenna: antennomeres distinct until apex, thickened after antennomere 5. Pronotum: with 3 setae on anterior ½; middle ⅓ with fine setae; basal ⅓ with a pair of strong setae in posterior angles; lateral margin on left with 3 setae, on right with 2 setae. Elytron: with ten rows of distinct punctures; costae distinct; apical margin dentate, with minute punctures each with seta. Venter: abdominal sterna 2–7 with broken transverse ridge and transverse impression in middle; sterna 4–6 with transverse row of six large cone-like setae in middle, setae curved; sternum 7 with transverse row of 8 cone-like setae; sternum 8 with four slender cones, 2 in middle and one in each side angle; sternum 9 with 2 slender cones in each side angle. Leg: with two large setae before apex and short seta on outer margin; ring of 4 setae on apex. Remarks. This species can be distinguished by the elytra without a scutellar row; by the vertex of the head having a faint medial sulcus; by antennomeres 1 and 2 being subglobose; and by the irregularly punctate disc of the pronotum. Host plant. Canavalia ensiformis DC, C. spontanea (sic), Dioclea sp., Cymbosema sp., Phaseolus sp. (Fabaceae) (Bondar 1929); Solanum auriculatum Rojas (Solanaceae) (Maulik 1937); Calopogonium mucunoides (Silva 1938); Glycine max (Schlottfeldt 1944b); Mucuna mutisiana DC (Fabaceae) (Uhmann 1953). Distribution. Argentina, Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, México, Nicaragua, Panamá, Paraguay, Peru, Trinidad (BWI), and Venezuela. Specimens examined. ?: New Amsterdam (BPBM). Argentina. No further data (DEI). Belize. Cayo: El Cayo, 1959 (USNM). Bolivia. Cochabinba: Chapas Villa Gral Roman, i.1952 (USNM). La Paz: Coroica, Nuasinillo, 12.ii.1949 (USNM); Coroica nr. Yungas, 27.xii.1948 (USNM); Puerto Villa, 4300’, 26.v.1989 (FSCA); Sud Yungas, Ocobaya, Finca Colaya, 1.i.1949 (USNM). Santa Cruz: Buena Vista, iii.1954 (USNM); Potrerillos del Guenda res., elev. 1322 ft., 6–12.i.2005 (UGAC). Nor. Yungas: La Paz, Pankarani, 17.iv.2007 (BYUC). Brazil. No further data (DEI).?: Chapada (USNM). Bahia: no further data (BPBM). Distrito Federal: 8 km W Planaltina, 7.x.1993 (BPBM). Mato Grosso: 8 km W Chapada dos Guimarãesi, 27.x.1993 (BPBM); Pq. Mae Bonifica, Cuiba, 1.i.2004 (BYUC). Rondonia: 62 km SW Ariquemes, nr. Fzda. Rancho Grande, 30.iii–10.iv.1992 (FSCA), 6–15.xii.1990 (EGRC); Rancho Grande, 15.x.1993 (BPBM). São Paulo: Jabaquara, 4.ii.1934 (USNM); 10 mi W Sorocaba, 21.ii.1980 (EGRC). Colombia. ?: La Basa (INSB). Cundinamarca: Anapoima, 9.x.1965 (USNM); Fusagasuga, 12.vii.1965 (USNM); Melgar, 11.xi.1965, 12.vii.1965, 8.viii.1965 (USNM); Sassaima, 19.iii.1965 (USNM); Villeta, 19.iii.1965 (USNM). Tolima: no further data (DEI); Ibagué (DEI); 10 mi E. Ibaguo, 9.iii.1955 (CASC). Honda: Tolima, 18.vi.1965 (USNM). Meta: Restrepo, 2.x.1965 (USNM); Villavicencio, ix.85, 18.ix.1965 (USNM). Costa Rica. no further data (DEI). Cartago: Turrialba (DEI). Guanacaste: Lomas Barbudal Res., 16.vii.1969 (PMNH). Limón: Hamburg Farm, 5.ix.1922 (DEI). Puntarenas: 4 km N Tarcoles, 21–28.xii.1979 (LACM); San José: San José (DEI); 5 km SW San Isidro, 7.viii.1990 (TAMU). Ecuador. Dos Rios: Quevedo, 31.viii.2002 (USNM). Napo: vic. Puerto Misshuai, 1650–1900 ft., 6–19.ix.1998 (FSCA). El Salvador. La Libertad: La Libertad, 10 m, 15.xii.1972 (FSCA). San Salvador: Santa Tecla, 9.iv.1957 (USNM). Guatemala. Huehuetenango: Concepcion, 1400 ft. (USNM). Izabal: Quebradas, v.1919 (USNM). Honduras. ?: Tegucigalpa, 3.ix.1917 (USNM). Morzan: Esc. Agr. Pan., Zamorpano, 2600 ft., 1.vii.1948 (USNM). Santa Barbara: vic. Agua Azul, 30.v.1993 (FSCA). México. Colima: Colima (USNM); Colima Vulcano (USNM). Guerrero: Acapulco, 30.vii, vii.1955 (USNM); 7 mi. W El Ocotito, 16.ix.1989 (UGAC). Morelos: Cuernavaca (USNM). Tabasco: La Chontalpa, 29.iv.1973 (USNM). San Luis Potosi: 37 mi S San Luis Potosi, 23.viii.1981 (CASC). Veracruz: Catemaco, 15.viii.1979 (USNM); Cordoba, 12.vi, 3.v.1900, 18.iv.1900 (USNM); Lake Catemaco, 10– 18.vii.1963 (USNM). Nicaragua. No further data (SEAN). Panamá. ?: Los Santos Laboratorio, Los Achetines, 3 km E Verado, 23.vi.1996 (TAMU). Bocas del Toro: 1 km S of oil storage facility, SE of Chiriquí Grande, i.15.2000 (USNM). Chiriquí: 7 km SE Fortuna Dam, 12.v.1991, 1100 m (HPSC); 25 mi NW David, 13.v.1960 (USUC); Lino (DEI); Plan de Chorcha, 29.v.1993 (EGRC). Panamá: Fort Kobbe, 20.vi.1976 (USNM), 28.vi.1974 (FSCA), 1.xi.1983, 3.xii.1995 (HPSC); Far Fan Spillway, 15.iii.1991 (HPSC). Paraguay. Caazapa: Sierra de Amambay, xi.1929 (USNM). Cordillera: Inst. Agro. Nac. Caocape, 17– 20.i.1983 (EGRC). Peru. No further data (DEI). Loreto: 100 mi NE Iquitos, 20.iii.1969 (FSCA); Jungle Amazon Inn, 30 mi E. Iquitos on Amazon River, 30.xii.1984 – 5.i.1985 (FSCA). Trinidad: no further data (NHRS). Talparo, 5–24.vii.1989, 7–25.vi.1991 (FSCA); 3.3 mi SSW Talparo, 21.vi.1991 (FSCA). Venezuela. Aragua: Rancho Grande, Estacion Aragua, vii.1941 (USNM). Bolívar: Cuidad Bolívar, 28.viii.1898 (USNM). Mérida: Mérida, 1700–2300 m, xi.1960 (DEI). Monagas: 60 km SE Matuin, 1.vii.1958 (LACM). Total: 150.Published as part of Staines, C. L., 2010, A review of the genus Oxychalepus Uhmann, 1937 (Coleoptera: Chrysomelidae: Cassidinae), pp. 35-56 in Zootaxa 2573 (1) on pages 38-40, DOI: 10.11646/zootaxa.2573.1.2, http://zenodo.org/record/530372
A novel MAC scheduler to minimize the energy consumption in a Wireless Sensor Network
Full text linkThe rising success of the Internet of Things has led the Wireless Sensor Networks to play an important role in many fields, ranging from military to civilian applications. However, since sensor nodes are battery powered, communication protocols and applications for these networks must be carefully designed in order to limit the power consumption. In this work, a new MAC protocol able to significantly reduce the power consumption and compatible with the IEEE 802.15.4 standard, is designed and validated. The defined protocol is based on an efficient setting of the node's duty cycle as a function of the transmission times of the neighbor nodes. In a duty cycle period, each node wakes up once to transmit and N times to receive, where N is the number of neighbors, while it remains in sleep mode for the rest of the time. The defined protocol has been validated through both an analytical and a simulative approach. By using the first approach, the proposed solution is compared with another energy-efficient protocol, namely AS-MAC; then, the differences between the simulated scenario and the analytical one are analyzed. By using the second approach (through Omnet++ simulator), we carried out a performance comparison between our protocol and the current MAC protocol compliant with the ZigBee standard. All the results have shown the effectiveness of the proposed solution, which has proved to be flexible and efficient, since it is able to provide high energy savings at different date rate, without a negative impact on the packets delivery
Cytoreductive surgery plus platinum-based hyperthermic intraperitoneal chemotherapy in epithelial ovarian cancer: A promising integrated approach to improve locoregional control
No full textAn adaptive FEC scheme to reduce bursty losses in a 802.11 network
No full textOne of the challenges that video transmission over wireless networks (such as IEEE 802.11) must face is the packet loss that can heavily decrease the received video quality. What makes the challenge more difficult is the bursty nature of wireless losses. Many video decoders can mask the effects of small amounts of random packet loss, however, most are unable to successfully hide the effects of burst losses (periods with high loss data rate). Forward error correction (FEC) is a technique extensively adopted to increase error resilience. In unicast transmission, the FEC redundancy is usually added adaptively on the basis of a loss pattern feedback. In many cases the loss pattern is represented through a very simple statistics: the average packer error rate (PER). This paper proposes a technique to adaptively introduce FEC redundancy that exploits a feedback scheme based on a 4-state Markov model to describe the loss pattern. The model allows us to obtain a description of the loss pattern in terms of burst and gap length and density. The feedback is based on the RTCP extended Report - IP Video Metrics Report Blocks that includes statistics on error patterns, such as the average PER, burst length and density. Our simulation results show that the proposed method smoothes out the burst losses and outperforms solutions based on the average PER. © 2006 IEEE
Nemotelus anchora Loew 1846
No full text<i>Nemotelus anchora</i> Loew, 1846 <p> <b>Published records.</b> Sardinia (Rozkošný 1983). Oristano prov.: Oristano (Lindner 1938; Mason 2005); Sinis, Capo Mannu (Troiano & Toscano 1997). Sassari prov.: Asinara Island (Troiano & Toscano 1997; Nuvoli <i>et al.</i> 2007).</p> <p> <b>Material examined.</b> Sardinia, Cagliari prov.: [Cagliari], Stagno di Santa Gilla, 7.V.2001, L. Fancello leg., 1 ♂, 14 ♀♀, net (FMV).</p> <p> <b>Distribution.</b> Known in Italy from Emilia-Romagna (<i>cf</i>. Mason 2005), Sicily (Loew 1846; Jaennike 1866; Lindner 1938; Rozkošný 1977) and Sardinia (see above). It has been recorded also from Malta, Israel, Algeria, Tunisia and from several localities in the former USSR (northern Caucasus, Transcaucasus, Central Asia) (Rozkošný 1977, 1983, 2004).</p>Published as part of <i>Mason, Franco, Rozkošný, Rudolf & Hauser, Martin, 2009, A review of the soldier flies (Diptera: Stratiomyidae) of Sardinia *, pp. 507-530 in Zootaxa 2318</i> on page 51
Risk factors of the antenatal depression in a sample of Italian pregnant women: A preliminary study
Full text linkBackground: Antenatal depression is characterized by low mood, insomnia, disorganised behaviour, irritability, and agitation during the pregnancy. If underestimated, antenatal depression is untreated during the pregnancy. It is associated to higher levels of suicide, higher risk of depression after childbirth, preeclampsia, preterm birth, low birth weight, poor interactions between child and mother and severe obstetric outcomes. New data underlined the importance to prevent the risk of depression during the pregnancy. This study examines the predictive validity of potential risk factors, such as socio-demographic and psychological factors, in developing the antenatal depression.
Methods: The sample was composed by Italian pregnant women (N=247, mean age of 33.77, SD=4.78 years). This sample completed the Edinburg Postnatal Depression Scale (EPDS), the Teate Depression Inventory (TDI) and questionnaires about demographic variables. To study associations among variables examined bivariate correlations were computed. To analyse the role of socio-demographic factors and the psychological dimension to predict the severity of the antenatal depression a logistic regression was performed.
Results: Results showed significantly positive correlations between the EPDS and the TDI, and no associations among the EPDS and all socio-demographic factors. Therefore, only the psychological factors were significant predictive risk factors of antenatal period. Finally, higher score of the depression measured via TDI predicted higher score of the EPDS.
Conclusions: Our results had implications in clinical field. Indeed, the early diagnosis of depression during the pregnancy can help operators in the gynaecological field to prevent the depression in the post-partum period
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