Instrumental Monitoring of a Slow-Moving Landslide in Piedmont (Northwest Italy) for the Definition of Rainfall Thresholds.

The prediction and prevention of landslide hazard is a challenging topic involving the assessment and quantitative evaluation of several elements: geological and geomorphological setting, rainfalls, and ground motion. This paper presents the multi-approach investigation of the Nevissano landslide (Asti Province, Piedmont, NW Italy). It shows a continuous and slow movement, alongside few paroxysmal events, the last recorded in 2016. The geological and geomorphological models were defined through a field survey. An inventory of the landslide's movements and rainfall records in the period 2000-2016 was performed, respectively, through archive investigations and the application of "Moving Sum of Daily Rainfall" method, allowing for the definition of rain thresholds for the landslide activation (105 mm and 193 mm, respectively, in 3 and 30 days prior to the event). The displacements over the last 8 years (2016-2023) were monitored through an innovative in-continuum monitoring inclinometric system and Earth Observation (EO) data (i.e., relying on Interferometric Synthetic Aperture Radar, or InSAR data): it gave the opportunity to validate the rainfall thresholds previously defined. This study aims to provide information to public authorities for the appropriate management of the site. Moreover, the proposed workflow could be adopted as a guideline for investigating similar situations.

The cellular apoptosis susceptibility CAS/CSE1L gene protects ovarian cancer cells from death by suppressing RASSF1C.

The cellular apoptosis susceptibility gene CAS/CSE1L is overexpressed in cancer, although it was originally identified as a gene that renders cells vulnerable to apoptotic stimuli. CAS/CSE1L has roles in the nucleocytoplasmic recycling of importin-α and in the regulation of gene expression, cell migration, and secretion. We identified CAS/CSE1L as a survival factor for ovarian cancer cells in vitro and in vivo. In 3/3 ovarian cancer cell lines, CAS/CSE1L was down-modulated by the unorthodox proapoptotic signaling of the MET receptor. CAS/CSE1L knockdown with RNA interference committed the ovarian cancer cells to death, but not immortalized normal cells and breast and colon cancer cells. In 70 and 95% of these latter cells, respectively, CAS/CSE1L was localized in the cytoplasm, while it accumulated in the nucleus in >90% of ovarian cancer cells. Nuclear localization depended on AKT, which was constitutively active in ovarian cancer cells. In the nucleus, CAS/CSE1L regulated the expression of the proapoptotic Ras-association domain family 1 gene products RASSF1C and RASSF1A, which mediated death signals evoked by depletion of CAS/CSE1L. Our data show that CAS/CSE1L protects ovarian cancer cells from death through transcriptional suppression of a proapoptotic gene and suggest that the localization of CAS/CSE1L dictates its function.

Assessing energy balance via seismic and mechanical observations in high temperature induced crack damage in marbles.

Assessing the rock physical and mechanical behavior under different temperatures has become of utmost importance. It is well known that thermal stresses induce significant crack damage in rocks due to thermal expansion or phase transformation and volume changes. Quantifying and forecasting the evolution of rock physical and mechanical parameters with temperature is thus crucial for evaluating rock integrity in many applications such as geothermal fields, nuclear waste storage, wildfire or volcanic processes. In marbles the degree of previous exposure to temperature and the chemical composition (i.e. calcite vs dolomite) plays a key role for controlling the mechanical evolution under temperature. Moreover separating out the energy contribution provided by anelastic processes driving crack damage and elastic reversible deformation under increasing temperature remains an open challenge. With these aims, three sample sets of marbles with different contents of calcite and dolomite from two Brazilian quarries were tested under different temperature conditions (from room temperature up to 600 °C). A marked increase of thermal cracking was observed after 400 °C, accompanying mass loss up to 1% and porosity increase. Moreover, a significant drop in seismic wave velocities, uniaxial compressive strength and electrical resistivity, in wet conditions, was also detected. Spectral behavior from seismic traces and energy dissipation from stress-strain curves were analyzed. A dominance of the dissipated energy compared to the elastic one was observed and related to the generation of new fracturing surfaces. This hypothesis was supported by the spectral behavior showing multiple scattering effects in the high frequency components, with an increase in attenuation. The results suggested that the percentage of dolomite has a high influence on the mechanical behavior even at low temperature, mirroring the prevalence of brittle processes in dolomitic marbles. This study represents a comprehensive benchmark for the study of effect of temperature on rocks because of its multidisciplinary and multimethod approach and the demonstrated sensitivity to subtle textural changes. Moreover, it provides a reliable tool for crack damage analysis at each thermal stress.

The clinical outcome of epithelial ovarian cancer patients with apparently isolated lymph node recurrence: a multicenter retrospective Italian study.

OBJECTIVES: To assess the clinical outcome of epithelial ovarian cancer patients who developed an apparently isolated lymph node recurrence after primary therapy. METHODS: The authors retrospectively assessed 69 patients with epithelial ovarian cancer who were clinically or pathologically free of disease after primary therapy and who subsequently developed an apparently isolated lymph node recurrence. The median follow-up of survivors was 74.5 months. RESULTS: Median age was 58 years, FIGO stage was III-IV in 52 (75%) patients, residual disease after primary surgery was >1 cm in 36 (52%), first-line chemotherapy consisted of paclitaxel-/platinum-based chemotherapy in 44 (64%), time to recurrence was >12 months in 43 (62%), recurrence was pelvic and/or para-aortic in 41 (59%), and treatment at recurrence consisted of chemotherapy alone in 44 (64%), surgery plus chemotherapy in 22 (32%), surgery alone in one patient, surgery plus irradiation in one, and irradiation alone in one patient. Survival after recurrence was significantly related to the type of treatment (chemotherapy alone versus surgery plus chemotherapy, median: 20.8 months versus not reached, p=0.0002), and patient age (>58 versus <58 years, median: 26.8 versus 44.0 months, p=0.02). Overall survival was significantly related to the type of treatment (chemotherapy alone versus surgery plus chemotherapy, median: 45.4 months versus not reached, p=0.0001), patient age (>58 versus <58 years, median: 45.4 versus 62.9 months, p=0.03) and time to recurrence (<12 months versus >12 months, median: 45.4 versus 66.9 months, p=0.01). Cox model showed that treatment at recurrence was the strongest independent prognostic variable for both survival after recurrence (hazard ratio [HR]=0.277, p=0.0003) and overall survival (HR=0.249, p=0.0002). CONCLUSION: Patients who underwent surgery plus chemotherapy had a 72% reduction in the risk of death after recurrence and a 75% reduction in the risk of death after initial diagnosis when compared with those treated with chemotherapy alone. Secondary cytoreductive surgery appears to be able to prolong survival in epithelial ovarian cancer patients with apparently isolated lymph node recurrence.

Numerical Analysis of Bowing Phenomenon Due to Thermal Stresses in Marble Slabs.

Bowing is a pathology known by the deformation experienced in some external covering systems in ornamental stones, especially in marble, and thermal action is one of the key factors that lead to this degradation. Previous studies presented remarkable contributions about the mechanical behavior of bowing but they were based on classical beam's theory and improper assumptions might mislead the evaluation of internal stresses. This study proposes to evaluate internal stresses in bowing due to thermal loading considering the true deformed shape in continuum media. Finite displacement concepts are proposed to calculate stress-strain relationship and comparison with linear elastic theory is also addressed. Internal stresses not predictable in the Euler-Bernoulli beam were found in parametric analyses. Moreover, the numerical analysis accomplished in this paper indicates that transient heat flux should induce higher stresses than just considering higher gradients of temperature in steady flux which could explain the larger decohesion through width in bowing tests.

Impact of Bevacizumab-containing Primary Treatment on Outcome of Recurrent Ovarian Cancer: An Italian Study.

BACKGROUND/AIM: The aim of the study was to assess the outcome of advanced ovarian cancer patients who i) underwent primary surgery followed by carboplatin/paclitaxel-based chemotherapy with or without bevacizumab, ii) were in complete response after chemotherapy, iii) and subsequently recurred. PATIENTS AND METHODS: The hospital records of 138 complete responders after chemotherapy with (n=58) or without (n=80) bevacizumab were reviewed. RESULTS: Both survival after recurrence and overall survival were related to age (≤61 vs. >61 years, p=0.002 and p=0.0001), performance status (0 vs. ≥1, p=0.002 and p=0.001), histotype (serous vs. non serous, p=0.005 and p=0.01), time to recurrence (≥12 vs. <12 months, p<0.0001 and p<0.0001) and treatment at recurrence (surgery plus chemotherapy vs. chemotherapy, p=0.01 and p=0.004), but not to first-line treatment. CONCLUSION: This investigation failed to detect a more aggressive behavior of recurrent ovarian cancer after bevacizumab-containing primary treatment.

Clinical Outcome of Patients With Malignant Tumors Associated With Mature Cystic Teratomas of the Ovary: A Retrospective Multicenter Italian Study.

BACKGROUND/AIM: The aim of the study was to assess the clinical outcome of patients with malignant transformation of an ovarian mature teratoma. PATIENTS AND METHODS: This study was conducted on 23 patients who underwent primary surgery at three Italian Gynecological Centers. Histologically, nine (39.1%) patients had squamous cell carcinoma, five (21.7%) had a thyroid carcinoma, six (26.1%) had a carcinoid, one (4.3%) patient had papillary renal carcinoma, one (4.3%) had medulloblastoma and one (4.3%) had intestinal-type mucinous adenocarcinoma. RESULTS: All six patients with stage I squamous cell carcinoma had no evidence of disease (NED) after a median time of 141 months. Of the three patients with stage IIb-IIIc squamous cell carcinoma, two had NED after 119 and 154 months, and one died of the disease 9 months after diagnosis. All five women with stage I thyroid carcinoma had NED after a median of 60 months. Of the six patients with stage I carcinoid, five had NED after a median of 168 months, whereas one died due to carcinoid heart disease. The three patients with stage I renal carcinoma, medulloblastoma and mucinous adenocarcinoma had NED after 24, 141 and 149 months, respectively. CONCLUSION: The clinical outcome of early-stage malignancies associated with mature ovarian teratomas is excellent following treatment.

Neoadjuvant Platinum-based Chemotherapy Followed by Radical Hysterectomy for Stage Ib2-IIb Adenocarcinoma of the Uterine Cervix - An Italian Multicenter Retrospective Study.

AIM: To assess the patterns of recurrence and clinical outcomes of patients with cervical adenocarcinoma who underwent neoadjuvant platinum-based chemotherapy (NACT) followed by radical hysterectomy. PATIENTS AND METHODS: Data were retrospectively analyzed for 82 patients with International Federation of Gynecology and Obstetrics stage Ib2-IIb cervical adenocarcinoma who underwent this chemo-surgical treatment. The median follow-up of survivors was 89 months (range=5-208 months). RESULTS: Pathological complete response, optimal response and suboptimal response with intra-cervical residual disease were obtained in five (6%), 10 (12%) and 36 (44%) patients, respectively. Adjuvant external-beam radiotherapy with or without concurrent chemotherapy was administered to 47 patients. Nineteen (23%) out of the 82 patients experienced recurrence after a median of 12 months (range=5.3-86.8 months). Recurrent disease was pelvic in 12 (63%) patients, extra-pelvic in five (26%), and both pelvic and extra-pelvic in two (10%). According to pathological response, tumor relapsed in 10% of optimal responders, 14% of sub-optimal responders with intra-cervical residual disease, and 36% of sub-optimal responders with extra-cervical residual disease or non-responders. Five-year recurrence-free and overall survival were 77% and 84%, respectively. Patients who achieved an optimal response or sub-optimal response with intra-cervical residual disease had better 5-year recurrence-free (87% vs. 64%, p=0.017) and overall (92% vs. 74%, p=0.012) survival than those who had sub-optimal response with extra-cervical residual disease or no response. The latter had a 1.441-fold higher risk of recurrence and a 1.652-fold higher risk of death than those who obtained an optimal response or a sub-optimal response with intra-cervical residual disease. CONCLUSION: NACT followed by radical hysterectomy may be an option for patients with stage Ib2-IIb adenocarcinoma of the uterine cervix.

Pegylated liposomal doxorubicin and vinorelbine in recurrent ovarian carcinoma: a pharmacokinetic study on alternate administration sequences.

BACKGROUND: This multicenter pharmacokinetic study evaluated the pharmacokinetics and toxicity of the combination of pegylated liposomal doxorubicin (PLD) and vinorelbine (VNR) in patients with recurrent ovarian cancer, when administered in opposing sequences. PATIENTS AND METHODS: Eighteen heavily pre-treated ovarian cancer patients received treatment with PLD 30 mg/m2 and VNR 30 mg/m2 every 3 weeks for 6 cycles, 9 being given the PLD-VNR sequence vs. 9 the VNR-PLD sequence. RESULTS: The VNR AUCtot and plasma levels were considerably higher with the PLD-VNR sequence and VNR clearance, clearly related to Kel, was about half that occurring with VNR-PLD. Toxicity was generally mild and reversible. In both arms, a sound correlation was found between VNR AUCtot and absolute neutrophil count decrease. A possible correlation between hematological toxicity and the 2 opposing administration sequences was also shown. CONCLUSION: The higher VNR AUCtot and plasma levels during the elimination phase with the PLD-VNR sequence may be related to a P-gp membrane glycoprotein inhibition by PLD vescicles which, in turn, may influence the plasma level of the associated VNR. PLD-VNR, producing a higher plasma level and very mild toxicity, may be considered the preferred sequence.

The retrograde and retroperitoneal totally laparoscopic hysterectomy for endometrial cancer.

Introduction. We retrospectively report our experience with the utilization of an original procedure for total laparoscopic hysterectomy based on completely retrograde and retroperitoneal technique for surgical staging and treatment of the endometrial cancer. The surgical, financial, and oncological advantages are here discussed. Methods. The technique used here has been based on a combination of a retroperitoneal approach with a retrograde and lateral dissection of the bladder and retrograde culdotomy with variable resection of parametrium. No disposable instruments and no uterine manipulator were utilized. Results. Intraoperative and postoperative complications were observed in 10% of the cases overall. Operative time length and mean haemoglobin drop value results were 129 min and 125 mL, respectively. Most patients were dismissed on days 3-5 from the hospital. Seventy-eight percent of the patients were alive with no evidence of disease at mean followup of 49 months. Conclusions. Our original laparoscopic technique is based on a retroperitoneal approach in order to rapidly control main uterine vessels coagulation, constantly check the ureter, and eventually decide type and site of lymph nodes removal. This procedure has important cost saving implications and the avoidance of uterine manipulator is of matter in case such as these of uterine malignancy.