Carbonates and intermediate-depth seismicity: Stable and unstable shear in altered subducting plates and overlying mantle.

A model for intermediate-depth earthquakes of subduction zones is evaluated based on shear localization, shear heating, and runaway creep within thin carbonate layers in an altered downgoing oceanic plate and the overlying mantle wedge. Thermal shear instabilities in carbonate lenses add to potential mechanisms for intermediate-depth seismicity, which are based on serpentine dehydration and embrittlement of altered slabs or viscous shear instabilities in narrow fine-grained olivine shear zones. Peridotites in subducting plates and the overlying mantle wedge may be altered by reactions with CO2-bearing fluids sourced from seawater or the deep mantle, to form carbonate minerals, in addition to hydrous silicates. Effective viscosities of magnesian carbonates are higher than those for antigorite serpentine and they are markedly lower than those for H2O-saturated olivine. However, magnesian carbonates may extend to greater mantle depths than hydrous silicates at temperatures and pressures of subduction zones. Strain rates within altered downgoing mantle peridotites may be localized within carbonated layers following slab dehydration. A simple model of shear heating and temperature-sensitive creep of carbonate horizons, based on experimentally determined creep laws, predicts conditions of stable and unstable shear with strain rates up to 10/s, comparable to seismic velocities of frictional fault surfaces. Applied to intermediate-depth earthquakes of the Tonga subduction zone and the double Wadati-Benioff zone of NE Japan, this mechanism provides an alternative to the generation of earthquakes by dehydration embrittlement, beyond the stability of antigorite serpentine in subduction zones.

Aqueous alteration processes in Jezero crater, Mars-implications for organic geochemistry.

The Perseverance rover landed in Jezero crater, Mars, in February 2021. We used the Scanning Habitable Environments with Raman and Luminescence for Organics and Chemicals (SHERLOC) instrument to perform deep-ultraviolet Raman and fluorescence spectroscopy of three rocks within the crater. We identify evidence for two distinct ancient aqueous environments at different times. Reactions with liquid water formed carbonates in an olivine-rich igneous rock. A sulfate-perchlorate mixture is present in the rocks, which probably formed by later modifications of the rocks by brine. Fluorescence signatures consistent with aromatic organic compounds occur throughout these rocks and are preserved in minerals related to both aqueous environments.

Modern Breast Cancer Surgery 1st Central-Eastern European Professional Consensus Statement on Breast Cancer.

This text is based on the recommendations accepted by the 4th Hungarian Consensus Conference on Breast Cancer, modified on the basis of the international consultation and conference within the frames of the Central-Eastern European Academy of Oncology. The recommendations cover non-operative, intraoperative and postoperative diagnostics, determination of prognostic and predictive markers and the content of cytology and histology reports. Furthermore, they address some specific issues such as the current status of multigene molecular markers, the role of pathologists in clinical trials and prerequisites for their involvement, and some remarks about the future.

Ductile deformation during carbonation of serpentinized peridotite.

Carbonated serpentinites (listvenites) in the Samail Ophiolite, Oman, record mineralization of 1-2 Gt of CO2, but the mechanisms providing permeability for continued reactive fluid flow are unclear. Based on samples of the Oman Drilling Project, here we show that listvenites with a penetrative foliation have abundant microstructures indicating that the carbonation reaction occurred during deformation. Folded magnesite veins mark the onset of carbonation, followed by deformation during carbonate growth. Undeformed magnesite and quartz overgrowths indicate that deformation stopped before the reaction was completed. We propose deformation by dilatant granular flow and dissolution-precipitation assisted the reaction, while deformation in turn was localized in the weak reacting mass. Lithostatic pore pressures promoted this process, creating dilatant porosity for CO2 transport and solid volume increase. This feedback mechanism may be common in serpentinite-bearing fault zones and the mantle wedge overlying subduction zones, allowing massive carbonation of mantle rocks.

Gas Migration Episodes Observed During Peridotite Alteration in the Samail Ophiolite, Oman.

Serpentinization and carbonation of mantle rocks (peridotite alteration) are fundamentally important processes for a spectrum of geoscience topics, including arc volcanism, earthquake processes, chemosynthetic biological communities, and carbon sequestration. Data from a hydrophone array deployed in the Multi-Borehole Observatory (MBO) of the Oman Drilling Project demonstrates that free gas generated by peridotite alteration and/or microbial activity migrates through the formation in discrete bursts of activity. We detected several, minutes-long, swarms of gas discharge into Hole BA1B of the MBO over the course of a 9 month observation interval. The episodic nature of the migration events indicates that free gas accumulates in the permeable flow network, is pressurized, and discharges rapidly into the borehole when a critical pressure, likely associated with a capillary barrier at a flow constriction, is reached. Our observations reveal a dynamic mode of fluid migration during serpentinization, and highlight the important role that free gas can play in modulating pore pressure, fluid flow, and alteration kinetics during peridotite weathering.

Tracing Carbonate Formation, Serpentinization, and Biological Materials With Micro-/Meso-Scale Infrared Imaging Spectroscopy in a Mars Analog System, Samail Ophiolite, Oman.

Visible-shortwave infrared (VSWIR) imaging spectrometers map composition remotely with spatial context, typically at many meters-scale from orbital and airborne data. Here, we evaluate VSWIR imaging spectroscopy capabilities at centimeters to sub-millimeter scale at the Samail Ophiolite, Oman, where mafic and ultramafic lithologies and their alteration products, including serpentine and carbonates, are exposed in a semi-arid environment, analogous to similar mineral associations observed from Mars orbit that will be explored by the Mars-2020 rover. At outcrop and hand specimen scales, VSWIR spectroscopy (a) identifies cross-cutting veins of calcite, dolomite, magnesite, serpentine, and chlorite that record pathways and time-order of multiple alteration events of changing fluid composition; (b) detects small-scale, partially altered remnant pyroxenes and localized epidote and prehnite that indicate protolith composition and temperatures and pressures of multiple generations of faulting and alteration, respectively; and (c) discriminates between spectrally similar carbonate and serpentine phases and carbonate solid solutions. In natural magnesite veins, minor amounts of ferrous iron can appear similar to olivine's strong 1-µm absorption, though no olivine is present. We also find that mineral identification for carbonate and serpentine in mixtures with each other is strongly scale- and texture-dependent; ∼40 area% dolomite in mm-scale veins at one serpentinite outcrop and ∼18 area% serpentine in a calcite-rich travertine outcrop are not discriminated until spatial scales of <∼1-2 cm/pixel. We found biological materials, for example bacterial mats versus vascular plants, are differentiated using wavelengths <1 µm while shortwave infrared wavelengths >1 µm are required to identify most organic materials and distinguish most mineral phases.

Hydrothermal Alteration of the Ocean Crust and Patterns in Mineralization With Depth as Measured by Micro-Imaging Infrared Spectroscopy.

Processes for formation, cooling, and altering Earth's ocean crust are not yet completely understood due to challenges in access and sampling. Here, we use contiguous micro-imaging infrared spectroscopy to develop complete-core maps of mineral occurrence and investigate spatial patterns in the hydrothermal alteration of 1.2 km of oceanic crust recovered from Oman Drilling Project Holes GT1A, GT2A, and GT3A drilled in the Samail Ophiolite, Oman. The imaging spectrometer shortwave infrared sensor measured reflectance of light at wavelengths 1.0-2.6 µm at 250-260 µm/pixel, resulting in >1 billion independent measurements. We map distributions of nine key primary and secondary minerals/mineral groups-clinopyroxene, amphibole, calcite, chlorite, epidote, gypsum, kaolinite/montmorillonite, prehnite, and zeolite-and find differences in their spatial occurrences and pervasiveness. Accuracy of spectral mapping of occurrence is 68%-100%, established using X-ray diffraction measurements from the core description. The sheeted dikes and gabbros of upper oceanic crust Hole GT3A show more pervasive alteration and alteration dominated by chlorite, amphibole, and epidote. The foliated/layered gabbros of GT2A from intermediate crustal depths have similarly widespread chlorite but more zeolite and little amphibole and epidote. The layered gabbros of the lower oceanic crust (GT1A) have remnant pyroxene and 2X less chlorite, but alteration is extensive within and surrounding major fault zones with widespread occurrences of amphibole. The results indicate greater distribution of higher temperature alteration minerals in the upper oceanic crust relative to deeper gabbros and highlight the importance of fault zones in hydrothermal convection in the lower ocean crust.

Tafasitamab combined with idelalisib or venetoclax in patients with CLL previously treated with a BTK inhibitor.

Patients with relapsed/refractory chronic lymphocytic leukemia (R/R CLL) whose treatment failed with a Bruton's tyrosine kinase inhibitor have poor outcomes. We investigated tafasitamab plus idelalisib (cohort A) or venetoclax (cohort B) in this patient population in a phase II study (NCT02639910). In total, 24 patients were enrolled (cohort A: n = 11, median time on study, 7.4 months; cohort B: n = 13, median time on study, 15.6 months). The most common treatment-emergent adverse event (TEAE) in cohort A was anemia (63.6%) and in cohort B was infusion-related reaction (53.8%). The most common severe TEAE was neutropenia (cohort A: 45.5%; cohort B: 46.2%). The best overall response rate was 90.9% (cohort A) and 76.9% (cohort B). Undetectable minimal residual disease in peripheral blood was achieved in 2/8 patients (cohort A) and 6/7 patients (cohort B). Overall, these results suggest that anti-CD19 antibody-based combinations may be important in the treatment of patients with CLL.

Deep continental roots and cratons.

The formation and preservation of cratons-the oldest parts of the continents, comprising over 60 per cent of the continental landmass-remains an enduring problem. Key to craton development is how and when the thick strong mantle roots that underlie these regions formed and evolved. Peridotite melting residues forming cratonic lithospheric roots mostly originated via relatively low-pressure melting and were subsequently transported to greater depth by thickening produced by lateral accretion and compression. The longest-lived cratons were assembled during Mesoarchean and Palaeoproterozoic times, creating the stable mantle roots 150 to 250 kilometres thick that are critical to preserving Earth's early continents and central to defining the cratons, although we extend the definition of cratons to include extensive regions of long-stable Mesoproterozoic crust also underpinned by thick lithospheric roots. The production of widespread thick and strong lithosphere via the process of orogenic thickening, possibly in several cycles, was fundamental to the eventual emergence of extensive continental landmasses-the cratons.

[Modern surgical treatment of breast cancer. 4th Breast Cancer Consensus Conference]. / IV. Emlorák Konszenzus Konferencia ­ Az emlorák korszeru sebészi kezelése.

The surgical treatment is still the most effective method in curing of early breast cancer. Breast preservation and the application of oncoplastic principles became generally accepted, the sentinel lymph node biopsy in the surgical treatment of the axilla is primary, and the indication for axillary block dissection (ABD) is narrowing further. The neoadjuvant oncological treatment that is applied more and more widely presented surgery with new challenges. Hereunder we summarise our recommendations on the surgical treatment of breast cancer based on the content of the 3rd Breast Cancer Consensus Conference and considering the latest international studies and professional recommendations.

Lipid Biomarker Record of the Serpentinite-Hosted Ecosystem of the Samail Ophiolite, Oman and Implications for the Search for Biosignatures on Mars.

Serpentinization is a weathering process in which ultramafic rocks react with water, generating a range of products, including serpentine and other minerals, in addition to H2 and low-molecular-weight hydrocarbons that are capable of sustaining microbial life. Lipid biomarker analyses of serpentinite-hosted ecosystems hold promise as tools for investigating microbial activity in ancient Earth environments and other terrestrial planets such as Mars because lipids have the potential for longer term preservation relative to DNA, proteins, and other more labile organic molecules. Here, we report the first lipid biomarker record of microbial activity in the mantle section of the Samail Ophiolite, in the Sultanate of Oman, a site undergoing active serpentinization. We detected isoprenoidal (archaeal) and branched (bacterial) glycerol dialkyl glycerol tetraether (GDGT) lipids, including those with 0-3 cyclopentane moieties, and crenarchaeol, an isoprenoidal GDGT containing four cyclopentane and one cyclohexane moieties, as well as monoether lipids and fatty acids indicative of sulfate-reducing bacteria. Comparison of our geochemical data and 16S rRNA data from the Samail Ophiolite with those from other serpentinite-hosted sites identifies the existence of a common core serpentinization microbiome. In light of these findings, we also discuss the preservation potential of serpentinite lipid biomarker assemblages on Earth and Mars. Continuing investigations of the Samail Ophiolite and other terrestrial analogues will enhance our understanding of microbial habitability and diversity in serpentinite-hosted environments on Earth and elsewhere in the Solar System.

Assessing the needs of Hungarian breast cancer patients for modern oncoplastic breast surgical treatment. Questionnaire study of 500 patients / A magyar emlorákos betegek igényei a korszeru onkoplasztikus emlosebészeti ellátásra. 500 beteg kérdoíves vizsgálata

INTRODUCTION: The significant need for breast reconstruction resulting from the spread of oncoplastic breast surgery raises a number of systemic issues. Clarification and regulation of the indications are needed for aesthetic changes of the reconstructed breast due to oncotherapy treatments, ageing and technical problems of implants; a number of operations, targeted aesthetic goals as well as surgical capacities and financial background should also be determined. AIM: Our aim was to conduct a survey on the opinions and needs of the Hungarian breast cancer population about a modern breast reconstruction system. PATIENT AND METHOD: A study was conducted enrolling 500 patients who underwent mastectomy with immediate or delayed reconstruction. A structured questionnaire containing eleven questions was used to measure the attitude for loss and reconstruction of breast, the expectation of cosmetic outcome and qualification of the operating surgeon and the needs relating to the health system and funding. RESULTS: The median age was 47 years (min.-max.: 26-73), 59% (n = 294) was married and 52% (n = 260) had graduated in university. The majority of women (70%; n = 348) would like to have nakedly also similar breasts after the reconstruction process. To achieve this, 43% (n = 217) and 37% (n = 184) would undergo maximum two or four procedures, respectively, supported by the national health insurance company. 86% (n = 430) would like to choose qualified breast surgeon for her treatment. CONCLUSION: The modern oncoplastic treatment raises complex, systemic issues. Women with breast cancer would like to have qualified breast surgeons restoring their breasts by two operations, all funded by the national health insurance company. Orv Hetil. 2020; 161(29): 1221-1228.

Ambient weathering of magnesium oxide for CO2 removal from air.

To avoid dangerous climate change, new technologies must remove billions of tonnes of CO2 from the atmosphere every year by mid-century. Here we detail a land-based enhanced weathering cycle utilizing magnesite (MgCO3) feedstock to repeatedly capture CO2 from the atmosphere. In this process, MgCO3 is calcined, producing caustic magnesia (MgO) and high-purity CO2. This MgO is spread over land to carbonate for a year by reacting with atmospheric CO2. The carbonate minerals are then recollected and re-calcined. The reproduced MgO is spread over land to carbonate again. We show this process could cost approximately $46-159 tCO2-1 net removed from the atmosphere, considering grid and solar electricity without post-processing costs. This technology may achieve lower costs than projections for more extensively engineered Direct Air Capture methods. It has the scalable potential to remove at least 2-3 GtCO2 year-1, and may make a meaningful contribution to mitigating climate change.

Evaluation of the modified Regnault "B" technique as a standard level II oncoplastic breast-conserving surgery / A módosított Regnault "B" emlomegtartó mutét mint II. szintu standard onkoplasztikus emlosebészeti technika

INTRODUCTION AND AIM: This study aimed to describe the modified Regnault "B" oncoplastic technique as a standard volume-displacement level II oncoplastic breast-conserving surgery and the related clinicopathological study. METHOD: A retrospective, single-centre study was performed between April 2012 and October 2018 involving 215 breast-cancer patients. Patient characteristics and postoperative complications were recorded, and the quality of life was rated by questionnaires. Aesthetic outcomes were evaluated with BCCT.core software and a five-point Likert scale. RESULTS: The mean patient age was 53 years (range: 29-81 years), with a median follow-up of 47 months (range: 7-85 months). The average surgery time was 47 min (range: 35-85 min) and the pathological average size of the tumours was 33 mm (range: 18-58 mm). Due to positive surgical margins, 13 (6%) completion re-excisions and 3 (1.4%) mastectomies were performed. In total, 16 complications (7.4%) were recorded. The median Likert scale score was 4.2, and the median overall aesthetic outcome assessed by BCCT.core was 1.3 points. According to the quality of life questionnaire, average points of the results demonstrated a high level of patient satisfaction. CONCLUSION: In medium- to large-breasted patients, the modified Regnault "B" technique is a safe and repeatable level II volume-displacement oncoplastic breast-conservation technique. This technique allows extended removal (20-50% of breast tissue) of T1-T3 tumours from the upper outer quadrant and the border of outer quadrants of the breast with improved aesthetic results. The advantage of this technique is that contralateral symmetrisation is not required, while disadvantage of this technique is the skin incision on the breast skin envelope that can make some difficulties when completion mastectomy is required with immediate reconstruction. Orv Hetil. 2020; 161(24): 1002-1011.

Major element mobility during serpentinization, oxidation and weathering of mantle peridotite at low temperatures.

Mantle peridotite in Wadi Fins in eastern Oman exhibits three concentric alteration zones with oxide and sulfide mineralogy recording gradients in fO2 and fS2 (fugacity) of more than 20 orders of magnitude over 15-20 cm. The black cores of samples (approx. 5 cm in diameter) exhibit incomplete, nearly isochemical serpentinization, with relict primary mantle minerals (olivine, orthopyroxene and clinopyroxene) along with sulfide assemblages (pentlandite/heazlewoodite/bornite) recording low fO2 and moderate fS2. In addition to the black cores, two alteration zones are evident from their colouration in outcrop and hand samples: green and red. These zones exhibit non-isochemical alteration characterized by intergrowths of stevensite/lizardite. All three reaction zones are cut by calcite ± serpentine veins, which are most abundant in the outer, red zones, sometimes are flanked by narrow red and/or green zones where they cut the black zones, and thus may be approximately coeval with all three alteration zones. The alteration zones record progressively higher fO2 recorded by Ni-rich sulfides and iron oxides/hydroxides. These alteration zones lost 20-30% of their initial magnesium content, together with mobilization of iron over short distances from inner green zones into outer red zones, where iron is reprecipitated in goethite intermixed with silicates due to higher fO2. Thermodynamic modelling at 60°C and 50 MPa (estimated alteration conditions) reproduces sulfide assemblages, fO2 changes and Mg and Fe mobility. This article is part of a discussion meeting issue 'Serpentinite in the Earth system'.

Evaluation of the central pedicled, modified Wise-pattern technique as a standard level II oncoplastic breast-conserving surgery: A retrospective clinicopathological study of 190 breast cancer patients.

Involving 207 breast cancer patients a retrospective study was performed to facilitate the acceptance of the central pedicled, modified Wise-pattern therapeutic mammoplasty technique as a standard volume-displacement level II oncoplastic breast-conserving surgery (OBCS). The overall local recurrence rate was 5.8% with an average follow-up of 43.9 months. The median time to the initiation of the adjuvant treatment was 4.9 weeks. Due to positive surgical margins, 13 (6.84%) completional surgeries were performed. In total, 45 complications (12.9%) were recorded. The median values of the esthetic outcomes represented improved cosmetic results. The modified Wise-pattern technique could be a standard, safe and repeatable level II volume-displacement OBCS.

Evaluation of a Retroglandular Oncoplastic Technique as a Standard Level I Oncoplastic Breast-Conserving Surgery: A Retrospective Clinicopathologic Study of 102 Patients With Breast Cancer.

BACKGROUND: This study presents a novel Level I oncoplastic breast-conserving surgery technique for performing tumorectomy by retroglandular exploration through a skin incision made in the inferior mammary fold. PATIENTS AND METHODS: A retrospective single-center cohort study involving patients with early-stage breast cancer (n = 102) was performed. The patient characteristics were recorded, as well as the quality of life rated by BREAST-Q. Postoperative complications were assessed using the Clavien-Dindo classification system. Esthetic outcomes were evaluated with Breast Cancer Conservative Treatment-cosmetic results (BCCT.core) software and a 5-point Likert scale. RESULTS: The median follow-up time was 11 months (range, 7-25 months). The median specimen weight and operative time were 49.8 g (range, 13.4-117.9 g) and 40 minutes (range, 20-80 minutes), respectively. The mean pathologic tumor size was 15 mm (SD, ±7). Owing to positive surgical margins, re-excisions and mastectomies were performed in 13.7% and 2.9% of patients, respectively. The overall complication rate was 24.5% (n = 25), with the most common being seroma formation (13.7%; n = 14). The median Likert scale score was 4.3 (range, 2.1-5), and the median overall esthetic outcome assessed by BCCT.core was 2.1 points (range, 1-4 points). In BREAST-Q domains, the median scores of the "adverse effects of radiation," "physical well-being," the "satisfaction with breasts," and the "psychosocial well-being" were 27, 35, 90, and 93, respectively. CONCLUSION: Retroglandular oncoplastic breast-conserving surgery is a novel, effective Level I oncoplastic technique for radical resection of breast tumors ≤ 3 cm in size. Additional advantages include the preservation of natural breast shape, the safety of the technique, and the lack of a need for contralateral symmetrization.

Progressive breast fibrosis caused by extreme radiosensitivity: Oncocytogenetic diagnosis and treatment by reconstructive flap surgery.

BACKGROUND: Fibrosis, a proliferative response of fibrocytes after tissue injury, is a common sequela of external radiotherapy and can vary greatly among patients even in the absence of DNA repair syndromes, due to their different intrinsic radiosensitivity. Fibrosis is also a serious cosmetic problem for patients, and in some cases it can also imply pain. CASE: Here, we report a case of a severe fibrosis 2 years after breast conserving surgery and postoperative 3D conformal breast irradiation. Furthermore, our patient had the suspicion of tumour recurrence. Our examinations were aimed at diagnosing recurrence or the lack of recurrence and investigating whether the symptoms occurred due to overdosing or extreme intrinsic radiosensitivity. Therefore, examining the patients' radiosensitivity, a cytogenetic test was performed, which revealed the patient's increased susceptibility to ionizing radiation, and therefore we rejected the prospect of overdosage. As a solution for the fibrosis, mastectomy was effectuated, and a latissimus dorsi musculocutaneous flap was used for reconstruction. CONCLUSIONS: We suggest a multi-disciplinary approach to manage fibrosis and propose cytogenetic markers to be used as predictors to identify patients who most likely benefit from a certain therapeutic regimen in terms of reduction of therapy-related side effects.

Mapping of the functional anatomy of lymphatic drainage to the axilla in early breast cancer: A cohort study of 933 cases.

INTRODUCTION: The aims of this study were to investigate the correlation between lymphatic drainage and the sentinel lymph node (SLN) status of the subregions in the context of the clinic-pathological parameters of the tumour and the coverage of the axillary volumes by standard and high tangential fields (STgF and HTgF) for whole breast radiotherapy and axillary reverse mapping (ARM). PATIENTS AND METHODS: 933 women with early breast cancer and clinically negative axillary status underwent breast surgery and SLN biopsy followed by axillary lymph node dissection in SLN-positive cases. The subregional localisation of the SLN(s) was registered and statistically analysed with the clinic-pathological characteristics of the breast tumour. In node-positive patients treated with breast-conserving therapy in whom the SLNs were found in the anterior or posterior axillary subregions, the axillary volumes were contoured using the Radiation Therapy Oncology Group contouring atlas (n = 61). RESULTS: In 91.1% (n = 797) of the cases, the SLN appeared in the anterior, posterior or central subregions. Using HTgF, Level I or II were completely covered in 65.6% (40/61) and 6.6% (4/61) of the cases, respectively. With STgF, the complete coverage was 0% for both levels. 6.8% (n = 63) of all cases had one positive lymph node in the expected ARM lymph node regions. DISCUSSION: A SLN is more than likely to be present in the anterior, posterior and central axillary subregions. Tangential fields allow only limited coverage of the axillary volumes. Preserving the lateral subregion during ARM may increase the possibility of understaging.