Superparamagnetic iron oxide (SPIO) for sentinel lymph node detection in vulvar cancer.

OBJECTIVES: Sentinel lymph node (SLN) detection with superparamagnetic iron oxide (SPIO) nanoparticles has been widely studied and standardized for breast and prostate cancer, but there is scarce evidence concerning its use in vulvar cancer. The objective of this study was to compare SLN detection using a SPIO tracer injected at the time of the surgery detected by a magnetometer, with the standard procedure of using a technetium 99 radioisotope (Tc99) detected by a gamma probe, in patients with vulvar cancer. METHODS: The SPIO vulvar cancer study was a single-center prospective interventional non-inferiority study of SPIO compared to Tc99, conducted between 2016 and 2021 in patients who met the GROINSS-V study inclusion criteria for selective sentinel lymph node dissection in vulvar cancer. RESULTS: We included 18 patients and a total of 41 SLNs. The level of agreement between tracers was 92.7% (80.6%-97.4%), corresponding to 38 out of 41 SLNs, which confirms the non-inferiority of SPIO compared to Tc99. The SLN detection rate per groin was 96.3 (81.7%-99.3) using Tc99 and 100% (87.5%-100%) using SPIO. Both tracers had a detection rate of 100% for positive lymph nodes. CONCLUSIONS: The use of SPIO as a tracer for detecting SLNs in patients with vulvar cancer has shown to be non-inferior to that of the standard radiotracer, with the advantages of not requiring nuclear medicine and being able to inject it at the time of surgery after induction of anesthesia.

NFC-enabled photothermal-based microfluidic paper analytical device for glucose detection.

This study introduces the development of a photothermal-based microfluidic paper analytical device (PT-µPAD) integrated with near-field communication (NFC) technology and smartphone readout for enzyme-free glucose quantification in human samples. With the properties of gold nanoparticles (AuNPs) both as a nanozyme and as a photothermal substrate, there is no need for costly reagents like enzymes or a readout instrumentation for the selective and sensitive detection of glucose. In PT-µPADs, AuNPs are etched by hydrogen peroxide (H2O2) generated from glucose catalysis. Photothermal detection from the plasmonic heating of these AuNPs when illuminated by a 533nm LED light source is achieved by inserting the PT-µPAD sensor into a portable NFC platform suitable for smartphone readout. Temperature variation is directly proportional to the glucose concentration. After optimization, we acquired a linear range between 5.0 and 20.0 µmol L-1 (R2 = 0.9967) and a limit of detection (LOD) of 25.0 nmol L-1 for glucose. Additionally, while our sensor does not utilize any enzyme, it is remarkably selective to glucose with no effects from interferences. Recovery studies in various human control samples indicated a range of 99.73-102.66% with the highest RSD of 3.53%, making it highly accurate and precise. Moreover, our method is more sensitive than other methods relying on conventional µPADs for glucose sensing. By integrating the potential benefits of microfluidics, nanomaterials as nanozymes, and NFC technology for wireless readout, our sensor demonstrates great promise as an accessible, affordable, and shelf-stable device for glucose quantification. Moreover, this concept can be extended to detect other molecules of interest as a point-of-care (POC) diagnostics device.

Simple distance-based thread analytical device integrated with ion imprinted polymer for Zn2+ quantification in human urine samples.

This article presents the development of a distance-based thread analytical device (dTAD) integrated with an ion-imprinted polymer (IIP) for quantitative monitoring of zinc ions (Zn2+) in human urine samples. The IIP was easily chemically modified onto the thread channel using dithizone (DTZ) as a ligand to bind to Zn2+ with methacrylic acid (MAA) as a functional monomer and ethylene glycol dimethacrylate (EGDMA) as well as 2,2-azobisisobutyronitrile (AIBN) as cross-linking agents to enhance the selectivity for Zn2+ detection. The imprinted polymer was characterized using Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy and Scanning Electron Microscopy-Energy Dispersive X-ray Spectroscopy (SEM-EDS). Under optimization, the linear detection range was from 1.0 to 20.0 mg L-1 (R2 = 0.9992) with a limit of detection (LOD) of 1.0 mg L-1. Other potentially interfering metal ions and molecules did not interfere with this approach, leading to high selectivity. Furthermore, our technique exhibits a remarkable recovery ranging from 100.48% to 103.16%, with the highest relative standard deviation (% RSD) of 5.44% for monitoring Zn2+ in human control urine samples, indicating high accuracy and precision. Similarly, there is no significant statistical difference between the results obtained using our method and standards on zinc supplement sample labels. The proposed method offers several advantages in detecting trace Zn2+ for point-of-care (POC) medical diagnostics and environmental sample analysis, such as ease of use, instrument-free readout, and cost efficiency. Overall, our developed dTAD-based IIP method holds potential for simple, affordable, and rapid detection of Zn2+ levels and can be applied to other metal ions' analysis.

Performance Evaluation of UOWC Systems from an Empirical Channel Model Approach for Air Bubble-Induced Scattering.

Underwater optical wireless communication (UOWC) systems provide the potential to establish secure high-data-rate communication links in underwater environments. The uniqueness of oceanic impairments, such as absorption, scattering, oceanic turbulence, and air bubbles demands accurate statistical channel models based on empirical measurements for the development of UOWC systems adapted to different types of water and link conditions. Recently, generalized Gamma and a mixture of two generalized Gamma probability density functions (PDF) were proposed to describe the statistical behavior of small and large air bubbles, respectively, when considering several levels of particle-induced scattering. In this paper, we derive novel closed-form analytic expressions to compute the bit error rate (BER) and outage performance using both proposed PDFs for various scattering conditions. Furthermore, simple asymptotic expressions are obtained to determine the diversity order of each scenario. Monte Carlo simulation results verify the obtained theoretical expressions. Our results also reveal that UOWC systems present lower BER and outage performance under more turbid water cases with respect to the tap water case due to the higher diversity order and despite the significant increases in pathloss at short link distances. Particle-induced scattering provides an inherent mechanism of turbid waters to mitigate air bubble-induced fluctuations and light blockages.

Highly Sensitive Photothermal Microfluidic Thread-Based Duplex Immunosensor for Point-of-Care Monitoring.

Herein, we successfully developed a thread-based analytical device (µTAD) for simultaneous immunosensing of two biomolecules with attomolar sensitivity by using a photothermal effect. A photothermal effect exploits a strong light-to-heat energy conversion of plasmonic metallic nanoparticles at localized surface plasmon resonance. The key innovation is to utilize the cotton thread to realize this sensor and the use of chitosan modification for enhancing the microfluidic properties, for improving the efficiency of photothermal conversion, and for sensor stability. The developed µTAD sensor consists of (i) a sample zone, (ii) a conjugation zone coated with gold nanoparticles bound with an antibody (AuNPs-Ab2), and (iii) a test zone immobilized with a capture antibody (anti-Ab1). The prepared µTAD is assembled in a custom three-dimensional (3D) printed device which holds the laser for illumination and the thermometer for readout. The 3D-printed supportive device enhances signal response by focusing light and localizing the heat generated. For proof of concept, simultaneous sensing of two key stress and inflammation biomarkers, namely, cortisol and interleukin-6 (IL-6), are monitored using this technique. Under optimization, this device exhibited a detection linear range of 2.0-14.0 ag/mL (R2 = 0.9988) and 30.0-360.0 fg/mL (R2 = 0.9942) with a detection limit (LOD) of 1.40 ag/mL (∼3.86 amol/L) and 20.0 fg/mL (∼950.0 amol/L) for cortisol and IL-6, respectively. Furthermore, the analysis of both biomolecules in human samples indicated recoveries in the range of 98.8%-102.88% with the highest relative standard deviation being 3.49%, offering great accuracy and precision. These results are the highest reported sensitivity for these analytes using an immunoassay method. Our PT-µTAD strategy is therefore a promising approach for detecting biomolecules in resource-limited point-of-care settings.

Ingestible pH sensing device for gastrointestinal health monitoring based on thread-based electrochemical sensors.

There exists a strong correlation between the pH levels of the gastrointestinal (GI) tract and GI diseases such as inflammatory bowel disease (IBS), ulcerative colitis, and pancreatis. Existing methods for diagnosing many GI diseases predominantly rely on invasive, expensive, and time-consuming techniques such as colonoscopy and endoscopy. In this study, an autonomous ingestible smart biosensing system in a pill format with integrated pH sensors is reported. The smart sensing pills will measure the pH profile as they transit through the GI tract. The data is then downloaded from the pills after they are collected from the feces. The sensor is based on electrodeposited PANI on carbon-coated conductive threads providing high pH sensitivity. Engineering innovations allowed integration of thread-based sensors on 3D-printed pill surfaces with front-end readout electronics, memory, and microcontroller assembled on mm-size circular printed circuit boards. The entire smart sensing pill possesses an overall length of 22.1 mm and an outer diameter of 9 mm. The modular biosensing system allows integration of thread-based biosensors to monitor other biomarkers in GI tract that mitigates the complex sensor fabrication process as well as overall pill assembly.

Introduction to the special issue on the role of operational research in future epidemics/ pandemics.

In this special issue, 23 research papers are published focusing on COVID-19 and operational research solution techniques. First, we detail the process from advertising the call for papers to the point where the best papers are accepted. Then, we provide a summary of each paper focusing on applications, solution techniques and insights for practitioners and policy makers. To provide a holistic view for readers, we have clustered the papers into different groups: transmission, propagation and forecasting, non-pharmaceutical intervention, healthcare network configuration, healthcare resource allocation, hospital operations, vaccine and testing kits, and production and manufacturing. Then, we introduce other possible subjects that can be considered for future research.

On the scattering-induced fading for optical wireless links through seawater: statistical characterization and its applications.

Recent research has shown that an accurate underwater channel characterization is necessary for underwater optical wireless communication (UOWC) in order to improve its current limitations related to the achievable data rate and the link distance, as required in undersea optical networks. This paper presents a new statistical model to characterize the scattering effect in terms of a fading never considered before. In this way, the probability density function of the scattering-induced fading channel is derived by means of a Gamma distribution by using only one degree of freedom in clear ocean and coastal waters. The developed fading model is employed to compute the performance of UOWC systems in terms of bit error rate and outage probability along with turbulence-induced fading modeled by a Weibull distribution. The results prove that smaller diversity order values are achieved when scattering-induced fading is the dominant effect, i.e., when the condition σ s2>1ß 1 is satisfied, where σ s2 and ß1 are parameters related to the Gamma and Weibull distributions, respectively. Moreover, the optical power penalty due to scattering-induced fading is analytically evaluated in several turbulence conditions to provide a deeper insight. Optical power penalty values of up to 6 dB and 9 dB are achieved when compared with no scattering scenarios at moderate distances for clear ocean and coastal waters. As a key feature, scattering should be always considered in terms of fading for future designs of advanced UOWC systems. The analytical results are verified by Monte Carlo simulations.

Capacity of underwater optical wireless communication systems over salinity-induced oceanic turbulence channels with ISI.

Point-to-point underwater optical wireless communication (UOWC) links are mainly impaired by scattering due to impurities and turbidity in the open water, resulting in a significant inter-symbol interference (ISI) that limits seriously both channel capacity and the maximum practical information rate. This paper conducts, for the first time, the channel capacity analysis of UOWC systems in the presence of ISI and salinity-induced oceanic turbulence when the undersea optical channel is accurately modeled by linear discrete-time filtering of the input symbols. In this way, novel upper and lower bounds on channel capacity and mutual information are developed for non-uniform on-off keying (OOK) modulation when different constraints are imposed on the channel input. The results show that the capacity-achieving distribution, which is computed through numerical optimization, is discrete and depends on the optical signal-to-noise-ratio (SNR). Moreover, a non-uniform input distribution significantly improves the channel capacity of such systems affected by ISI and oceanic turbulence, especially at low optical SNR. Monte Carlo techniques are employed to test the developed bounds for different undersea optical channels with one, two and three casual ISI coefficients.

In Silico and in Vitro Study of Trace Amines (TA) and Dopamine (DOP) Interaction with Human Alpha 1-Adrenergic Receptor and the Bacterial Adrenergic Receptor QseC.

BACKGROUND/AIMS: Trace amines (TA) are small organic compounds that have neuromodulator activity due to their interaction with some neuron-related receptors, such as trace amine associated receptors (TAARs), α2-adrenergic receptor (α2-AR) and ß-adrenergic receptor (ß-AR). However, there is little information on whether TA and dopamine (DOP) can interact with other adrenergic receptors (ARs) such as the mammalian α1-AR and the bacterial counterpart QseC, which is involved in quorum sensing of some Gram-negative pathogens. The aim of this study was to investigate the interaction of TA and DOP with α1-AR and QseC. METHODS: We performed an in silico study using 3D structure from SWISS MODEL and analyzed the protein interaction via molecular docking using PyMol, PoseView and PyRX 8.0. For the in vitro study, we investigated the QseC kinase activity by measuring the remaining ATP in a reaction containing QseC-enriched membrane incubated together with purified QseB and EPI, TA, DOP, or PTL respectively. We also measured the intracellular Ca++ levels, which represents the α1-AR activation, in LNCAP (pancreatic cell line) cells treated with EPI, TA, DOP and PTL respectively using a fluorescence-based assay. The LNCAP cell proliferation was measured using an MTT-based assay. RESULTS: Our in silico analysis revealed that TAs and DOP have high binding affinity to the human α1-AR and the bacterial adrenergic receptor (QseC), comparable to epinephrine (EPI). Both are membrane-bound kinases. Experimental studies with pancreatic cell line (LNCAP) showed that the TAs and DOP act as α1-AR antagonist by counteracting the effect of EPI. In the presence of EPI, TA and DOP trigger an increase of the intracellular Ca++ levels in the LNCAP cells leading to an inhibition of cell proliferation. Although in silico data suggest an interaction of TA and DOP with QseC, they do not inhibit the kinase activity of QseC, a histidine kinase receptor involved in quorum sensing which is also sensitive to EPI. CONCLUSION: Our study showed that the TAs and DOP act as α1-AR antagonist but no effect was observed for QseC.

Prognostic Value and Therapeutic Implication of Laparoscopic Extraperitoneal Paraaortic Staging in Locally Advanced Cervical Cancer: A Spanish Multicenter Study.

PURPOSE: To assess the impact of laparoscopic extraperitoneal paraaortic staging in therapeutic planning and prognosis of patients with locally advanced cervical cancer (LACC) as compared with imaging staging. METHODS: Retrospective multicenter study of stage IB2 and IIA2 to IVA (FIGO 2009) LACC patients who were candidates for primary chemoradiotherapy. The study (surgical) group included 634 patients undergoing laparoscopic/robotic extraperitoneal paraaortic staging treated with extended-field radiotherapy (EFRT) if lymph node involvement was confirmed. The control (imaging) group included 288 patients treated with EFRT when lymph node involvement was suspected on positron emission tomography-computed tomography scans and/or magnetic resonance imaging. RESULTS: In the study group, a median of 13 (range 9-17) lymph nodes were removed, with a rate of positive paraaortic nodes of 18%, with metastatic size ≤ 5 mm in 20.4% of cases. Paraaortic EFRT was administered to 18% of patients in the study group and in 58% of controls. In 34% of patients from the surgical group, EFRT was modified according to surgical findings with respect to imaging staging. The median follow-up in the study and control groups was 3.7 and 4.8 years, respectively. In both groups, the overall survival and cancer-specific disease-free survival were similar. The time interval between diagnosis and starting EFRT was 18 days longer in the study group, without differences in overall survival as compared with controls (hazard ratio 1.00, 95% confidence interval 0.998-1.005; p = 0.307). CONCLUSIONS: Laparoscopic extraperitoneal paraaortic staging in LACC patients is safe and modified therapeutic planning, allowing better selection of candidates for EFRT.

Impact of angular pointing error on BER performance of underwater optical wireless links.

Even in clear ocean water, underwater optical wireless communication (UOWC) is impaired not only by absorption and scattering, but also by oceanic turbulence and dynamic pointing errors which result in a fading channel, degrading the bit error rate (BER) performance. In this paper, for the first time, we quantify analytically the trade-off between geometric loss and misalignment in underwater scattering channels. A novel geometric loss model is developed which is used to compute the average BER in the presence of absorption and scattering over salinity-induced oceanic turbulence channels. Our findings suggest that UOWC systems are less sensitive to angular pointing errors due to jitter since scattering is able to alleviate such a fading effect at the expense of a higher attenuation due to geometric spread. Monte Carlo simulation results are further included to verify the developed BER expression which is valid over a wide range of signal-to-noise-ratio (SNR). Finally, the impact of inter-symbol interference (ISI) is also quantified by measuring the optical power penalty.

Secure communication for FSO links in the presence of eavesdropper with generic location and orientation.

When the beam waist at the receiver is significantly larger than the receiver size, free-space optical (FSO) links may be vulnerable to some optical tapping risks at the physical layer. In this paper, we conduct a new framework for the analysis of the secrecy performance in terms of the secrecy outage probability (SOP) of FSO systems affected by gamma-gamma (GG) turbulence-induced fading channels with pointing errors. As a key feature, we evaluate the SOP in the presence of an external eavesdropper with generic location and orientation. For that reason, a new misalignment error model is proposed to consider a non-orthogonal optical beam with respect to the photodetector plane at the eavesdropper's receiver, where the effective area is determined by a rotated ellipse. New approximate and asymptotic solutions at high signal-to-noise-ratio (SNR) for the secrecy performance are obtained in closed-form, which are verified by exact Monte Carlo simulations. By using the developed expressions, we analyze in greater detail some effects such as the SNR of the eavesdropper's channel, the normalized beamwidth at the receiver-side, and the location and orientation of the eavesdropper on the secrecy performance for different turbulence conditions.

Accessory polar renal artery not pre-operatively visualized at extra-peritoneal para-aortic lymphadenectomy.

The objective of this video is to describe the technique of extra-peritoneal para-aortic laparoscopic lymphadenectomy and emphasize potential vascular risks that should be taken into account during the procedure.The procedure was performed at Donostia University Hospital, a tertiary referral and educational center in San Sebastián, Spain.A 58-year-old woman, body mass index 25.4 kg/m2, G2P2, with a diagnosis of intermediate-risk endometrial adenocarcinoma, International Federation of Gynecology and Obstetrics (FIGO) IBG2 based on pre-operative endometrial histology and pre-operative magnetic resonance imaging (MRI), but upstaged to high-risk endometrial adenocarcinoma on final report (IBG3). In our hospital, risk stratification is based on pelvic MRI (myometrial invasion, cervical invasion) and biopsy (histology and grade) to tailor surgery. Computed tomography (CT) scan pre-operatively is only performed for type 2 endometrial carcinoma and grade 3 histologies.The local institutional review board was consulted, which confirmed that the study was exempt from requiring approval.The patient underwent an extra-peritoneal para-aortic laparoscopic lymphadenectomy, trans-peritoneal bilateral pelvic lymphadenectomy, and a total hysterectomy and bilateral salpingo-oophorectomy.It is mandatory to check pre-operative imaging studies in order to identify vascular anomalies that are not uncommon and may increase the risk of vascular complications.1 Frequently these vascular anomalies, such as a retro-aortic left renal vein, or a double vena cava or left vena cava, may be a casual finding in the pre-operative study, and often such findings are not reported by the radiologist. It is vitally important that the surgeon checks for and identifies any such anomolies, as the risk of complications may be decreased if anomalies of this type are detected pre-operatively.In addition, in the case of existing polar renal arteries, these are frequently not identified in the pre-operative study,2 leading to a risk of injury and partial renal necrosis. There are several anatomical variations of the renal arteries, with an aortic lower polar artery found in 3% of cadavers and 1% of patients on CT, more frequently on the right side.3 Renovascular hypertension4 secondary to an injury of an accessory polar renal artery (APRA) has also been described.Although vascular anomalies, especially venous ones, are more frequently found at the infra-renal left level, in this video we show access to the right side of the dissection and the care that needs to be taken in order not to damage a vascular structure at this level. Special caution is required with the right side of the dissection so as not to injure any perforating veins, including Fellow's vein, when pushing all the nodes to the roof of the dissection.The dissection maneuvers are fine and blunt, establishing bridges of tissue to be sectioned, and thus identifying vascular structures, such as a right APRA that is to be identified and preserved.The surgeon must have a good knowledge of retro-peritoneal vascular anatomy, they should examine pre-operative imaging studies to check for vascular anomalies, and they need to possess an accurate surgical technique to avoid potential vascular injury during laparoscopic para-aortic lymphadenectomy.

Prevention of lymphorrhea in aortic lymphadenectomy.

The objective of this video 1 is to describe the technique to avoid postoperative lymphorrhea after a lumboaortic lymphadenectomy. All procedures were performed at Donostia University Hospital, a tertiary referral and educational center in San Sebastián, Spain. Lumboaortic extra-peritoneal lymphadenectomy was performed for several gynecological malignancies (endometrial and cervical cancer). During the procedure, afferent lymphatic capillaries were identified at the infra-renal aortic level and clipped to avoid retrograde lymphorrhea at this level. Numerous strategies have been described to reduce the likelihood of lymphorea and lymphocele formation.1 Harmonic scalpel and other sealing advanced devices are not useful to secure lymphatic leakage at this level, although some authors have published a clinical benefit in their use,2 while clips have been found useful to prevent leakage in other lymphatic locations.3 The use of harmonic scalpel, biological agents or surgical patch has been ineffective in our experience, but sealing clips and peritonization (marsupialization),4 once the procedure is concluded, could be an effective approach. Performing simple gestures during lumboaortic lymphadenectomy can help to reduce the appearance of posterior lymphorrhea.

Maximizing Sentinel Lymph Node Detection: Aortic Sentinel Lymph Node Detection in Endometrial Cancer.

STUDY OBJECTIVE: To determine the importance of a dual (cervical and fundal) indocyanine green (ICG) injection and thorough dissection for the detection of sentinel lymph nodes (SLNs). DESIGN: Description and step-by-step demonstration of the surgical procedure using video (Canadian Task Force classification III). SETTING: Hospital Universitario Donostia, San Sebastián, Spain. PATIENTS: A 60-year-old woman with a diagnosis of IAG1 endometrial adenocarcinoma (EC). INTERVENTIONS: The patient received a cervical and transcervical fundal ICG injection for para-aortic and pelvic SLN detection in the setting of a research protocol, followed by a total hysterectomy and bilateral salpingo-oophorectomy with a frozen section of the uterus as a standard approach [1]. Institutional Review Board approval was obtained for the research protocol of this study. MEASUREMENTS AND MAIN RESULTS: Dual ICG injection [2] adds the benefit of a cervical injection (that best evaluates the pelvic region [3]) to the fundal injection, with better spread to the lumboaortic pathway [4] so as not to lose the aortic drainage and aortic SLN, whose relevance is still discussed due to its low incidence of metastasis [5]. This search does not add to the associated morbidity but is associated with increased operative time. For pelvic SLN dissection, patience and good training are key; the surgeon must always be on the lookout for uncommon pathways if no SLN is detected in the classical areas. The final histological classification was upgraded to a grade IIIC2 (ie, micrometastasis in the aortic and pelvic-right pararectal space) EC, 3 cm G1 with no lymphovascular invasion. CONCLUSION: Dual ICG injection allows comprehensive mapping not only of pelvic SLNs, but also of para-aortic SLNs, in EC, maximizing the identification of all possible affected areas. Nonetheless, the relevance of its added benefit requires further evaluation.

Efficacy of a Fibrin Sealant (Tissucol Duo) for the Preventionof Lymphocele after Laparoscopic Pelvic Lymphadenectomy:A Randomized Controlled Trial.

STUDY OBJECTIVE: To assess the efficacy of Tissucol Duo (Baxter AG, Vienna, Austria) fibrin sealant in decreasing the incidence of lymphocele (LC) after pelvic laparoscopic lymph node dissection using harmonic shears. DESIGN: Randomized controlled trial (Canadian Task Force classification level I). SETTING: Tertiary referral and educational center. PATIENTS: Seventy-four patients randomized to the use of sealant per hemipelvis. INTERVENTION: Fibrin sealant. MEASUREMENTS AND MAIN RESULTS: After bilateral pelvic lymphadenectomy a fibrin sealant was used in 1 hemipelvis but not the other, applied in 41 patients (55.4%) to the left and 33 patients (44.6%) to the right hemipelvis. The primary outcome was the incidence of LC after surgery in symptomatic and asymptomatic patients. Imaging (ultrasound, computed tomography, and magnetic resonance) was performed to detect LC at 3, 6, and 12 months after surgery. Overall, 26 patients (35.1%) developed LC, and 4 were symptomatic (5.4%). Allowing patients to serve as their own treatment group and control, the hemipelvis treated with Tissucol Duo corresponding to the treatment group and that not treated to the control group, LCs were found in 17 (23%) and 14 (19%) cases, respectively, but the difference was not significant. The mean initial LC maximum diameter was 27.1 mm (standard deviaiotn, 35.2), and LCs tended to decrease in size during the first year to a mean of 8.7 mm. CONCLUSION: Application of Tissucol Duo fibrin sealant after laparoscopic pelvic lymphadenectomy using ultrasonic shears does not decrease the occurrence of symptomatic or asymptomatic LC.

A Microwave Polarimeter Demonstrator for Astronomy with Near-Infra-Red Up-Conversion for Optical Correlation and Detection.

This paper presents a 10 to 20 GHz bandwidth microwave polarimeter demonstrator, based on the implementation of a near-infra-red frequency up-conversion stage that allows both the optical correlation, when operating as a synthesized-image interferometer, and signal detection, when operating as a direct-image instrument. The proposed idea is oriented towards the implementation of ultra-sensitive instruments presenting several dozens or even thousands of microwave receivers operating in the lowest bands of the cosmic microwave background. In this work, an electro-optical back-end module replaces the usual microwave detection stage with Mach-Zehnder modulators for the frequency up-conversion, and an optical stage for the signals correlation and detection at near-infra-red wavelengths (1550 nm). As interferometer, the instrument is able to correlate the signals of large-format instruments, while operating as a direct imaging instrument also presents advantages in terms of the possibility of implementing the optical back end by means of photonic integrated circuits to achieve reductions in cost, weight, size, and power consumption. A linearly polarized input wave, with a variable polar angle, is used as a signal source for laboratory tests. The receiver demonstrator has proved its capabilities of being used as a new microwave-photonic polarimeter for the study of the lowest bands of cosmic microwave background.

Sentinel Node Biopsy in Endometrial Cancer With Dual Cervical and Fundal Indocyanine Green Injection.

PURPOSE: The aim of this study was describe a novel sentinel lymph node (SLN) tracer injection procedure featuring dual cervical and fundal indocyanine green (ICG) injection for endometrial cancer and results of SLN biopsy. METHODS: Between June 26, 2014 and October 31, 2016, 111 patients underwent laparoscopic surgery for endometrial cancer at our institution. In all cases, we performed SLN biopsy with dual cervical and fundal ICG injection. All SLNs were processed with an ultrastaging technique. A total of 69 patients also underwent total pelvic and paraaortic lymphadenectomy. RESULTS: The detection rates were as follows: 92.79% (103/111) overall for SLNs; 89.19% (99/111) overall for pelvic SLNs; 61.26% (68/111) for bilateral SLNs; 59.46% (66/111) for paraaortic SLNs, and 4% (4/111) for isolated paraaortic SLNs. We found macroscopic lymph node metastasis in 11 patients (9.9%) and microdisease in lymph nodes in another 10 patients, raising the overall rate of lymph node involvement to 18.92%. There was 1 false-negative (negative SLN biopsy but positive aortic lymphadenectomy) and another positive case in 1 undetected SLN. The sensitivity of detection was 94.44%, specificity 100%, negative predictive value 97.83%, and negative likelihood ratio 0.06 for intermediate and high-risk endometrial cancer groups. CONCLUSIONS: The SLN biopsy with both cervical and fundal ICG injection offers good overall detection rates and improved mapping of the aortic area. The SLN ultrastaging increases the number of nodes considered positive.

Neuromuscular and Cardiovascular Adaptations in Response to High-Intensity Interval Power Training.

Romero-Arenas, S, Ruiz, R, Vera-Ibáñez, A, Colomer-Poveda, D, Guadalupe-Grau, A, and Márquez, G. Neuromuscular and cardiovascular adaptations in response to high-intensity interval power training. J Strength Cond Res 32(1): 130-138, 2018-The aim of this study was to determine the efficacy of a high-intensity power training (HIPT) program, and to compare the effects of HIPT to traditional power training (TPT) on the aerobic and power performance. For this purpose, 29 healthy men (23.1 ± 2.7 years) were recruited and randomly distributed into 3 different groups. One group performed TPT (n = 10), the second group performed power training organized as a circuit (HIPT; n = 10), and the third group served as control group (CG; n = 9). Training consisted of weightlifting thrice per week for 6 weeks. The TPT subjects performed 3 to 5 sets of each exercises with interset rest of 90 seconds, and HIPT subjects executed the training in a short circuit (15 seconds of rest between exercises). To know the effects in aerobic performance, maximal aerobic speed (MAS) was measured. To identify the effects on power performance, subjects performed a Wingate test, a countermovement jump (CMJ) test, and a power-load curve in bench press. The main results showed that after both power training protocols, subjects increased significantly (p ≤ 0.05) the power production during the Wingate Test, the height and power reached during the CMJ test, and the peak power produced during the power-load curve. However, only the HIPT group improved significantly MAS (p ≤ 0.05). There were no changes in any variables in CG. Hence, our results suggest that HIPT may be as effective as TPT for improving power performance in young adults. In addition, only HIPT elicited improvements in MAS.