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Temporally fluctuating environmental conditions are a ubiquitous feature of natural habitats. Yet, how finely natural populations adaptively track fluctuating selection pressures via shifts in standing genetic variation is unknown1,2. Here we generated genome-wide allele frequency data every 1–2 generations from a genetically diverse population of Drosophila melanogasterin extensively replicated field mesocosms from late June to mid-December (a period of approximately 12 total generations). Adaptation throughout the fundamental ecological phases of population expansion, peak density and collapse was underpinned by extremely rapid, parallel changes in genomic variation across replicates. Yet, the dominant direction of selection fluctuated repeatedly, even within each of these ecological phases. Comparing patterns of change in allele frequency to an independent dataset procured from the same experimental system demonstrated that the targets of selection are predictable across years. In concert, our results reveal a fitness relevance of standing variation that is likely to be masked by inference approaches based on static population sampling or insufficiently resolved time-series data. We propose that such fine-scaled, temporally fluctuating selection may be an important force contributing to the maintenance of functional genetic variation in natural populations and an important stochastic force impacting genome-wide patterns of diversity at linked neutral sites, akin to genetic draft.

Le développement en 1religne de l’immunothérapie avec les anti-PD-1 et anti-PD-L1 a transformé l’algorithme de traitement des cancers bronchiques non à petites cellules (CBNPC) avancés. Les associations chimiothérapie et anti-PD (L)-1 s’avèrent supérieures à la chimiothérapie indépendamment du niveau d’expression de PD-L1, constituant le standard thérapeutique lorsque PD-L1 est exprimé dans moins de 50 % des cellules tumorales dans les tumeurs épidermoïdes et non épidermoïdes. Comparativement à la chimiothérapie de 1religne, le pembrolizumab, le cemiplimab et l’atézolizumab améliorent la survie dans les CBNPC exprimant PD-L1 dans plus de 50 % des cellules tumorales. L’apport de la chimio-immunothérapie en cas d’expression de PD-L1 ≥ 50 % reste débattu. La place des combinaisons anti-CTLA-4 + anti-PD(L)-1, ou l’association avec une chimiothérapie de courte durée reste à préciser et ne peuvent être prescrit en France. Le traitement de seconde ligne est actuellement représenté soit par un doublet à base de sels de platine chez les patients traités en monothérapie de première ligne par anti-PD1, soit chez les patients traités par association chimiothérapie-immunothérapie par les chimiothérapies standards de seconde ligne, le docétaxel, quelle que soit l’histologie, ou le pémétrexed pour les carcinomes non épidermoïdes si non utilisé en première ligne. L’addition d’un traitement antiangiogénique aux taxanes améliore modestement la survie des patients. Le bévacizumab a montré son intérêt en association avec le paclitaxel. L’introduction de nouvelles modalités d’immunothérapie, la recherche de nouveaux biomarqueurs d’efficacité et la compréhension des mécanismes de résistance devraient permettre d’améliorer les résultats de ces traitements.

Depuis plusieurs années, les thérapies ciblées et l’immunothérapie ont considérablement amélioré le pronostic des patients avec un cancer bronchique non à petites cellules. De nouvelles questions se posent donc concernant l’admission de ces patients en réanimation, notamment dans le contexte d’une insuffisance respiratoire aiguë.

Lutetium-177 prostate-specific membrane antigen (PSMA) after cabazitaxel provides only short-lived activity despite substantial rates of prostate-specific antigen (PSA) decline in an all-comer population. Baseline disease characteristics, positron-emission tomography parameters, and quality of PSA decline can help identify patients likely to benefit from lutetium-177 PSMA.

DNA oligomers in solution have been found to develop liquid crystal phases via a hierarchical process that involves Watson–Crick base pairing, supramolecular assembly into columns of duplexes, and long-range ordering. The multiscale nature of this phenomenon makes it difficult to quantitatively describe and assess the importance of the various contributions, particularly for very short strands. We performed molecular dynamics simulations based on the coarse-grained oxDNA model, aiming to depict all of the assembly processes involved and the phase behavior of solutions of the DNA GCCG tetramers. We find good quantitative matching to experimental data at both levels of molecular association (thermal melting) and collective ordering (phase diagram). We characterize the isotropic state and the low-density nematic and high-density columnar liquid crystal phases in terms of molecular order, size of aggregates, and structure, together with their effects on diffusivity processes. We observe a cooperative aggregation mechanism in which the formation of dimers is less thermodynamically favored than the formation of longer aggregates.

Abstract:The article deals with a seventeenth-century manuscript copy of the Qur’an from Malta held at the University of Pennsylvania (Ms. Codex 1904). The manuscript’s copyist can be identified with Muḥammad al-Tāzī, also known as Baldassare Loyola Mandes (1631–1667), an alleged Moroccan prince who converted to Christianity and gained considerable fame in Catholic countries for his missionary activity and anti-Islamic polemics. In spite of the large number of contemporary sources and modern studies on him, some aspects of his life still remain elusive. Several passages of the accounts of his Islamic past appear nebulous, and, in particular, his royal descent continues to raise doubts. On the one hand, the University of Pennsylvania Qur’an represents a unique document of his pre-conversion life. On the other hand, it bears witness to a peculiar but little-studied form of manuscript production in early modern Europe, represented by books copied by Muslim scribes under conditions of captivity.

The energy transition is driving the adoption of local renewable energy production. Decentralised renewable plants enable citizens to play an active role in generating and managing energy supplies. In Europe, recent policies are promoting Renewable Energy Communities (RECs), which consist of aggregations of end-users aiming to produce and share renewable energy, generating and managing cost-effective energy supply chains autonomously. A comprehensive analysis of REC potential requires tools that integrate socio-economic, environmental, and spatial evaluations for renewable energy assessment. The objective of this study is to present the current status and capabilities of tools for REC modelling. This paper reviews twelve energy modelling tools which have the potential for the evaluation of RECs. The review structure follows the steps of a REC assessment process, which is structured in background, inputs, simulation or optimisation and outputs. Technical, economic, and environmental aspects of REC projects should be included without leaving behind the spatialisation and geographical planning of the new energy systems. Findings reveal that the co-existence of multiple criteria is not satisfied in any of the current tools, as most of them mainly analyse a few areas of interest and partially consider other aspects. The comparison reveals that the energy and financial outputs are mainly deepened. Meanwhile, environmental and spatial criteria have a marginal role among both inputs and outputs. Finally, software marginally spatializes the workflow steps except for CEA and URBANopt, which are revealed to be the most complete options for REC design.

In recent years, there has been a heightened emphasis improving visual comfort and energy efficiency. Various solutions have been explored to achieve high-performance design. Shading devices play a crucial role in enhancing building performance by redusing solar gains, excessive daylight, and improving both energy efficiency and occupants' visual comfort. This research aims to investigate the effect of facade geometry on visual comfort and energy consumption in four different climates of Iran and categorize each variable based on effectiveness for each location. Parametric office modeling was done by using Grasshopper and Rhino software. Then, the effect of the facade on the interior lighting and energy consumption was analyzed by Radiance, Daysim, and EnergyPlus calculation engines. The Non-Dominated Sorting Genetic Algorithm (NSGA-II) was selected to optimize solutions, minimize energy consumption, maximize useful daylight illuminance, and view quality. In addition, the methodology was used to explore the framework for optimizing office facade design in Iran's diverse climatic zones. The simulation results indicate that window-to-wall ratio and inclined wall were essential for balancing daylighting performance and energy consumption. This research stated that using a self-shading design could increase the quality of view up to 75% while reducing energy consumption and the risk of glare. Results proposed a design framework to improve visual comfort and save energy. The rotating façade's wall 10°-30° reduced cooling energy demand and energy usage intensity in selected models. So, an inclined wall could be an efficient shading device to improve building's performance in Iran.

In view of developing photoelectrosynthetic cells which are able to store solar energy in chemical bonds, water splitting is usually the reaction of choice when targeting hydrogen production. However, alternative approaches can be considered, aimed at substituting the anodic reaction of water oxidation with more commercially capitalizable oxidations. Among them, the production of bromine from bromide ions was investigated long back in the 1980s by Texas Instruments. Herein we present optimized perylene-diimide (PDI)-sensitized antimony-doped tin oxide (ATO) photoanodes enabling the photoinduced HBr splitting with >4 mA/cm2photocurrent densities under 0.1 W/cm2AM1.5G illumination and 91 ± 3% faradaic efficiencies for bromine production. These remarkable results, among the best currently reported for the photoelectrochemical Br–oxidation by dye sensitized photoanodes, are strongly related to the occupancy extent of ATO’s intragap (IG) states, generated upon Sb-doping, as demonstrated by comparing their performances with PDI-sensitized analogues on both undoped SnO2- and TiO2-passivated ATO scaffolds by means of (spectro)electrochemistry and electrochemical impedance spectroscopy. The architecture of the ATO–PDI photoanodic assembly was further modified via the introduction of a molecular iridium-based water oxidation catalyst, thus proving the versatility of the proposed hybrid interfaces as photoanodic platforms for photoinduced oxidations in PEC devices.

From the mid-twelfth century onward, armorial devices became almost ubiquitous in western Europe. Byzantium, however, is widely believed to have had no role in the development of heraldry, which is considered a foreign custom introduced to the empire only in the aftermath of the Fourth Crusade. The received narrative of heraldry’s late adoption in Byzantium is called into question by the analysis of evidence predating the crusaders’ conquest, particularly the striking depiction of two warrior saints in the church of St. Panteleimon at Nerezi, whose frescoes were commissioned by Alexios Angelos Komnenos in 1164. These holy figures, identifiable as Saints Demetrius and Theodore the Recruit, bear distinctively heraldic animals, a lion and a griffin, on their almond-shaped shields, reflecting closely the coeval development of the first coats of arms in northern France and England. I argue that the implications of this artistic choice are twofold. First, the heraldic charges are novel features that reinforce the political message conveyed by Nerezi’s program as a whole, declaring the patron’s allegiance to his relative, the emperor Manuel I Komnenos, who is evoked through the juxtaposition of the lion and the griffin, figures that were traditionally associated with imperial power, and the saints who acted as the emperor’s personal protectors. More importantly, they allow us to observe up close a shift in the mentality of the Komnenian aristocracy, with its increased focus on values such as martial prowess—to be shown either in battle or on the tournament field—and noble descent. Thus, they provide us with an additional lens to understand the aesthetic preferences and shared aspirations of the high nobility at a pivotal moment in the (re)definition of aristocratic identity in Byzantium.

Purpose: The purpose of this study was to research studies in the literature regarding the role of the occupational therapist within penitentiary facilities. Design/methodology/approach: The study design is a systematic review using five different databases. Findings: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society. Research limitations/implications: It is necessary for clinical practice, and especially to increase the health of people within prisons, to update the occupational therapist interventions in the literature that are effective within prisons. Practical implications: According to this study, the intervention of occupational therapists in the prison setting reduces recidivism and contributes to social and work reintegration. This has positive effects in terms of costs related to incarceration. Originality/value: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society.

After examining the poetic context of Ar. Ra. 1331-1363 and focussing on the editorial assessment established by Chantry (1999, 150) for schol. vet. Ar. Ra. 1344b-d., this article aims to propose an alternative emendation for a corrupt passage in schol. 1344b, along with defending the order of the glosses as transmitted in the medieval manuscripts.

Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style changes in increasing and maintaining weight loss and ameliorating obesity-related complications and comorbidities. In patients affected by obesity and uncontrolled obesity-associated complications or high degrees of BMI (> 40 Kg/m2), metabolic bariatric surgery can be a valid therapeutic option. Many different types of surgical procedures have been developed in last decades, mainly performed via laparoscopic approaches. However, clinical indications for metabolic and bariatric surgery (MBS) and the choice of the most appropriate type of procedure have not been clarified so far.

Irinotecan-based regimens are used worldwide for the treatment of several recurrent or advanced gastrointestinal malignancies. In this paper we describe the cases of four patients treated in our institution who developed acute dysarthria while receiving intravenous infusion of irinotecan. In all our cases, dysarthria occurred during the infusion of the first course of irinotecan, and then resolved rapidly without any sequelae. Imaging of the brain was performed, but failed to show any evidence of an acute neurological event. We also reviewed the literature on this very uncommon adverse event. The pathogenesis of irinotecan-induced dysarthria is still unknown and is not completely elucidated by the current pharmacodynamic or kinetic explanations; therefore, we could only hypothesize some assumptions.

Introduction: Biliary tract cancers (BTC) include both gallbladder cancer and cholangiocarcinoma, both of which have a poor prognosis. The aim of our study was to evaluate the main clinical prognostic factors in this setting and to assess their impact on overall survival (OS). Methods: We retrospectively analyzed data collected on 64 patients with BTC who underwent surgery with radical intent at our institution. OS was estimated using the Kaplan–Meier method. The Cox regression model was used to perform univariate and multivariate analyses. Results: Preoperative hyponatremia was found to be an independent prognostic factor that correlated negatively with prognosis, with hyponatremic patients having a poor OS compared to the group of patients with normal serum sodium levels (9.44 vs. 15.47 months; p= 0.0215). In addition, high preoperative values for carbohydrate antigen 19-9 (Ca19.9), a tumor marker for some gastrointestinal cancers, and lactate dehydrogenase (LDH) were found to be prognostic factors for a significant reduction in OS (Ca19-9: 7.14 vs. 24.22 months, p = 0.0088; LDH: 1.70 vs. 15.47 months, p= 0.0384). Conclusion: Identification of these prognostic factors may support strategies to identify, in clinical practice, those subgroups of patients with a favorable or unfavorable prognosis before surgical treatment and, therefore, to guide therapeutic choices. In particular, to our knowledge, this is the first report of the prognostic role of serum sodium level in BTC. Early detection and careful monitoring of hyponatremia and supportive therapy can help to improve the treatment and prognosis of BTC.

Introduction: Melanoma is one of the most common cancers in younger people. The incidence of cutaneous melanoma is increasing in patients of both sexes, with female patients generally living longer than their male counterparts. The aim of this retrospective study was to evaluate and confirm the sex-based difference in survival of melanoma patients and the relationship of this difference with pathological features. Methods: A total of 1023 patients who had been treated at the Department of Medical Oncology, Università Politecnica Marche (Ancona, Italy) and the INRCA-IRCCS Department of Dermatology (Ancona, Italy) between 1987 and 2014 were enrolled in the study. Results: In terms of stage of disease at onset, there was a significant difference in disease-free survival (DFS) and overall survival (OS) in favor of female patients in disease stage I (P  = 0.001 and P  = 0.01, respectively) and II (P = 0.02 and P  = 0.009, respectively). Female patients also showed a significant improvement in 12-year DFS and 12-year OS adjusted for pathological features (Breslow thickness, ulceration, “absent” tumor-infiltrating lymphocyte (TIL) melanomas, “non-brisk” TIL pattern). Globally, female patients had an advantage over with male patients in both DFS and OS (P  < 0.001). Conclusions: Our results show that women have a survival benefit over with men after adjustment for many variables that can reduce mortality risk in female melanoma patients. In a future investigation we wish to examine possible biological sex differences in tumor–host interactions.

Abstract: Neuroendocrine neoplasms (NENs) are rare tumors with diverse clinical behaviors. Large databases like the Surveillance, Epidemiology, and End Results (SEER) program and national NEN registries have provided significant epidemiological knowledge, but they have limitations given the recent advancements in NEN diagnostics and treatments. For instance, newer imaging techniques and therapies have revolutionized NEN management, rendering older data less representative. Additionally, crucial parameters, like the Ki67 index, are missing from many databases. Acknowledging these gaps, the Italian Association for Neuroendocrine Tumors (Itanet) initiated a national multicenter prospective database in 2019, aiming to gather data on newly-diagnosed gastroenteropancreatic neuroendocrine (GEP) NENs. This observational study, coordinated by Itanet, includes patients from 37 Italian centers. The database, which is rigorously maintained and updated, focuses on diverse parameters including age, diagnostic techniques, tumor stage, treatments, and survival metrics. As of October 2023, data from 1,600 patients have been recorded, with an anticipation of reaching 3600 by the end of 2025. This study aims at understanding the epidemiology, clinical attributes, and treatment strategies for GEP-NENs in Italy, and to introduce the Itanet database project. Once comprehensive follow-up data will be acquired, the goal will be to discern predictors of treatment outcomes and disease prognosis. The Itanet database will offer an unparalleled, updated perspective on GEP-NENs, addressing the limitations of older databases and aiding in optimizing patient care. Study registration: This protocol was registered in clinicaltriasl.gov (NCT04282083).

The aim of this study is to evaluate the effects of an adapted protocol of enhanced recovery after bariatric surgery (ERABS) on outcomes. This is a single-center observational study comparing patients managed according to adapted ERABS protocol (March–May 2022) with a control group of old method (January 2021–February 2022). Totally, 253 bariatric patients were included in the study (n = 68) and control (n = 185) groups. Patients were mostly females (57.3% vs 70.2%; p = 0.053), of mean age 38.8 years and body mass index 41 ± 6.53 vs. 44.60 ± 7.37 kg/m2(p = 0.007) in study and control groups, respectively. The majority (90.5%) underwent primary bariatric surgery. Adapted ERABS protocol compliance was 98.5%. The study group had shorter hospital stay (mean 2.86 ± 0.51 vs. 4.03 ± 0.28 days; p < 0.001), similar rates of total (3% vs. 2.7%, p = 0.92) and major complications (1.5% vs. 0, p = 0.10). Readmission rates were similar (1.5% vs 1.6%, p = 0.92). Applied only in the study group, early ambulation (p < 0.001), opioid restriction, and preventing postoperative nausea and vomiting (PONV), resulted in satisfactory scores (mean total visual analogue score 1.93 ± 0.80, morphine milligram equivalent 34.0 ± 14.5, and mean total PONV grade 0.17 ± 0.36). In conclusion, implementing adapted ERABS guidelines improved patients’ postoperative care, raising awareness to pain management. Length of stay was shortened without safety compromise. Efforts to abandon old-school routines seem worthwhile, even if ERABS is partially implemented.

Financial rewards can increase health behaviors, but little research has quantified the effects of different reinforcement schedules on this process. This analysis compares the average moderate-to-vigorous physical activity (MVPA) associated with six distinct positive reinforcement schedules implemented within a physical activity promotion clinical trial. In this trial, participants (N= 512) wore an accelerometer for 1 year and were prescribed one of two types of MVPA goals: a static 30-min goal or an adaptive goal based on the MVPA produced over the previous 9 days. As participants met goals, they transitioned through a sequence of reinforcement stages, beginning with a continuous-fixed magnitude (CRF-FM), then CRF-variable magnitude (CRF-VM), followed by a series of variable ratio-VM (VR-VM) schedules. The average accumulation of MVPA bouts over the last 24 days of each stage was compared to each other. Average MVPA during stage transitions was also examined. The results indicated that immediate reinforcement resulted in more MVPA relative to a comparison group and that the relative effectiveness of adaptive versus static goals was dependent on the magnitude of daily MVPA goals. Schedule effects were qualitatively different for individuals who frequently met their daily goals (Large Intervention Effect subgroup) versus those who did not (Small Intervention Effect subgroup). For the Large Intervention Effect group, the CRF-VM schedule produced the most MVPA, in particular within the adaptive goal condition, with increases observed immediately upon encountering this schedule. In contrast, the CRF-FM schedule produced small amounts of MVPA. This pattern was reversed for the Small Intervention Effect subgroup, where the most MVPA was associated with the CRF-FM stage. Future interventions should focus on discriminating small versus large intervention effects as quickly as possible so that the optimal reinforcement schedule can be used.

Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) are persistent environmental contaminants that are of increasing public concern worldwide. However, their relationship with colorectal cancer (CRC) is poorly understood. This study aims to comprehensively investigate the effect of PFOS and PFOA on the development and progression of CRC in vitrousing a series of biological techniques and metabolic profiling. Herein, the migration of three-dimensional (3D) spheroids of two CRC cell lines, SW48 KRAS wide-type (WT) and SW48 KRAS G12A, were observed after exposure to PFOS and PFOA at 2 μM and 10 μM for 7 days. The time and dose-dependent migration phenotype induced by 10 μM PFOS and PFOA was further confirmed by wound healing and trans-well migration assays. To investigate the mechanism of action, derivatization-mass spectrometry-based metabolic profiles were examined from 3D spheroids of SW48 cell lines exposed to PFOS and PFOA (2 μM and 10 μM). Our findings revealed this exposure altered epithelial-mesenchymal transition related metabolic pathways, including fatty acid β-oxidation and synthesis of proteins, nucleotides, and lipids. Furthermore, this phenotype was confirmed by the downregulation of E-cadherin and upregulation of N-cadherin and vimentin. These findings show novel insight into the relationship between PFOS, PFOA, and CRC.

In an increasingly flammable world, wildfire is altering the terrestrial carbon balance. However, the degree to which novel wildfire regimes disrupt biological function remains unclear. Here, we synthesize the current understanding of above- and belowground processes that govern carbon loss and recovery across diverse ecosystems. We find that intensifying wildfire regimes are increasingly exceeding biological thresholds of resilience, causing ecosystems to convert to a lower carbon-carrying capacity. Growing evidence suggests that plants compensate for fire damage by allocating carbon belowground to access nutrients released by fire, while wildfire selects for microbial communities with rapid growth rates and the ability to metabolize pyrolysed carbon. Determining controls on carbon dynamics following wildfire requires integration of experimental and modelling frameworks across scales and ecosystems.

Depuis plusieurs années, les thérapies ciblées et l’immunothérapie ont considérablement amélioré le pronostic des patients avec un cancer bronchique non à petites cellules. De nouvelles questions se posent donc concernant l’admission de ces patients en réanimation. Cette question peut se poser au diagnostic, avant l’initiation de ces nouveaux traitements, ou en cours de traitement, notamment pour gérer certains effets secondaires graves. Une collaboration étroite entre oncologues et médecins intensivistes et réanimateurs est indispensable pour une prise en charge optimale de ces patients.

Obesity has been associated with improved response to immunotherapy in cancer patients. We investigated the role of body mass index (BMI) in patients from the ARON-1 study (NCT05287464) treated by dual immuno-oncology agents (IO+IO) or a combination of immuno-oncology drug and a tyrosine kinase inhibitors (TKI) as first-line therapy for metastatic renal cell carcinoma (mRCC).

The aim of our study was to assess and compare postoperative nausea and pain after one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (LSG). Patients undergoing OAGB and LSG at our institution between November 2018 and November 2021 have been prospectively asked to report postoperative nausea and pain on a numeric analogic scale. Medical records were retrospectively reviewed to collect scores of these symptoms at the 6th and 12th postoperative hour. One-way analysis of variance (ANOVA) was used to evaluate effect of type of surgery on postoperative nausea and pain scores. To adjust for baseline differences between cohorts, a propensity score algorithm was used to match LSG patients to MGB/OAGB patients in a 1:1 ratio with a 0.1 tolerance. A total number of 228 (119 SGs and 109 OAGBs) subjects were included in our study. Nausea after OAGB was significantly less severe than after LSG both at the 6th and 12th hour assessment; pain was less strong after OAGB at the 6th hour but not after 12 h. Fifty-three individuals had a rescue administration of metoclopramide after LSG and 34 after OAGB (44.5% vs 31.2%, p= 0.04); additional painkillers were required by 41 patients after LSG and 23 after OAGB (34.5% vs 21.1%, p= 0.04). Early postoperative nausea was significantly less severe after OAGB, while pain was comparable especially at the 12th hour.

New tracers for sentinel lymph node biopsy (SLNB), as indocyanine green (ICG), superparamagnetic iron oxide (SPIO) and micro bubbles, have been recently introduced in clinical practice showing promising but variable results. We reviewed the available evidence comparing these new techniques with the standard tracers to evaluate their safety. To identify all available studies, a systematic search was performed in all electronic databases. Data regarding sample size, mean number of SLN harvested for patient, number of metastatic SLN and SLN identification rate of all studies were extracted. No significant differences were found in terms of SLNs identification rates between SPIO, RI and BD but with a higher identification rate with the use of ICG. No significant differences were also found for the number of metastatic lymph nodes identified between SPIO, RI and BD and the mean number of SLNs identified between SPIO and ICG versus conventional tracers. A statistically significant differences in favor of ICG was reported for the comparison between ICG and conventional tracers for the number of metastatic lymph nodes identified. Our meta-analysis demonstrates that the use of both ICG and SPIO for the pre-operative mapping of sentinel lymph nodes in breast cancer treatment is adequately effective.