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The building sector is a major player in the world’s contribution to climate change, partly due to its dependence on large quantities of materials. The circular economy model of material flow has been gaining attention in the past decade as it seeks to promote the use of construction, renovation, and demolition (CRD) waste as inputs for new buildings or other applications, which would result in the diversion of materials from landfills. Developing a system capable of handling such waste requires a comprehensive knowledge of the composition of the building stock materials. This information, however, is rarely available. Thus, this research is proposing a conceptual model to aid city planners when considering the existing built environment as a resource for new construction. The methodology followed by this review includes a thorough analysis of 82 articles on quantity takeoff methods in the Urban Mining (UM) and CRD Waste Management (WM) fields. These articles were analyzed by considering a framework of four layers, i.e., (i) the approach, (ii) the analysis method, (iii) the granularity, and (iv) the performance analysis. The comprehensive analysis of the literature has highlighted the fact that the existing quantity takeoff methods need to consider more in-depth attributes and that the works performed by using machine learning methods are very important in the path toward the direction of improving these methods. With this conceptual model, waste management planners can select the appropriate methodology based on the available input data, and the type of output that they are looking.

Introdução: A Esporotricose e a Leishmaniose Cutânea (LC) são doenças de manifestação cutânea com elevada importância epidemiológica, sobretudo no Estado do Amazonas. A esporotricose é uma micose subcutânea crônica causada por fungos do gênero Sporothrix, enquanto a LC é uma doença causada por protozoários do gênero Leishmania. Sob essa perspectiva, é importante salientar que, apesar de etiologias diferentes, uma pode simular a outra clinicamente, visto que ambas apresentam lesões granulomatosas ulceradas que podem se assemelhar em aparência, localização e evolução, dificultando o diagnóstico. Objetivo: Discutir semelhanças clínicas entre esporotricose e leishmaniose cutânea. O estudo visa destacar os desafios enfrentados na distinção entre essas doenças, fornecendo uma análise das características clínicas. Método: Trata-se de uma análise comparativa de casos clínicos documentados de esporotricose e LC que apresentam manifestações cutâneas em um hospital de referência em Medicina Tropical no Estado do Amazonas. Além disso, propõe-se um estudo comparativo que instiga a elaboração de uma hipótese diagnóstica a partir de imagens das lesões cutâneas, obtidas com consentimento dos respectivos pacientes diagnosticados com uma das duas doenças. Resultados: A úlcera da LC possui bordas infiltradas, elevadas e bem definidas, granulação central, coloração vermelho vivo e secreção serosa. Já na esporotricose, a lesão inicialmente pode ser descrita como uma pequena pápula eritematosa ou pústula e, posteriomente, nodular, com possibilidade de ulceração, apresentando borda irregular, eritematosa, elevada e de fundo granular. A forma cutâneo-linfática pode apresentar uma cadeia de infecção dos linfonodos, com aspecto de ''contas de rosário'', manifestando-se por nódulos ou gomas com possibilidade de ulceração. Conclusão: Portanto, devido a aparência clínica das úlceras da Leishmaniose cutânea e da Esporotricose serem semelhantes, a descrição meticulosa e a associação com os dados epidemiológicos e clínicos do paciente são essenciais para o diagnóstico adequado. Além disso, também se faz necessário o exame laboratorial em alguns casos, a fim de promover um tratamento mais efetivo ao paciente.

Alzheimer’s disease (AD) is the leading neurodegenerative pathology in aged individuals, but many questions remain on its pathogenesis, and a cure is still not available. Recent research efforts have generated measurements of multiple omics in individuals that were healthy or diagnosed with AD. Although machine learning approaches are well-suited to handle the complexity of omics data, the models typically lack interpretability. Additionally, while the genetic landscape of AD is somewhat more established, the proteomic landscape of the diseased brain is less well-understood. Here, we establish a deep learning method that takes advantage of an ensemble of autoencoders (AEs) — EnsembleOmicsAE–to reduce the complexity of proteomics data into a reduced space containing a small number of latent features. We combine brain proteomic data from 559 individuals across three AD cohorts and demonstrate that the ensemble autoencoder models generate stable latent features which are well-suited for downstream biological interpretation. We present an algorithm to calculate feature importance scores based on the iterative scrambling of individual input features (i.e., proteins) and show that the algorithm identifies signaling modules (AE signaling modules) that are significantly enriched in protein–protein interactions. The molecular drivers of AD identified within the AE signaling modules derived with EnsembleOmicsAE were missed by linear methods, including integrin signaling and cell adhesion. Finally, we characterize the relationship between the AE signaling modules and the age of death of the patients and identify a differential regulation of vimentin and MAPK signaling in younger compared with older AD patients.

Abstract Background Despite being a major advancement in modern medicine, vaccines face widespread hesitancy and refusal, posing challenges to immunization campaigns. The COVID-19 pandemic accentuated vaccine hesitancy, emphasizing the pivotal role of beliefs in efficacy and safety on vaccine acceptance rates. This study explores the influence of efficacy and safety perceptions on vaccine uptake in Italy during the pandemic. Methods We administered a 70-item questionnaire to a representative sample of 600 Italian speakers. Participants were tasked with assessing the perceived effectiveness and safety of each vaccine dose, along with providing reasons influencing their vaccination choices. Additionally, we conducted an experimental manipulation, exploring the effects of four framing messages that emphasized safety and/or efficacy on participants’ willingness to receive a hypothetical fourth vaccine dose. Furthermore, participants were asked about their level of trust in the scientific community and public authorities, as well as their use of different information channels for obtaining COVID-19-related information. Results Our study reveals a dynamic shift in vaccine efficacy and safety perceptions throughout the COVID-19 pandemic, potentially influencing vaccination compliance. Initially perceived as more effective than safe, this assessment reversed by the time of the third dose. Beliefs regarding safety, rather than efficacy, played a significant role in anticipating future vaccinations (e.g., the booster dose). Safety-focused messages positively affected vaccination intent, while efficacy-focused messages showed limited impact. We also observed a changing trend in reasons for vaccination, with a decline in infection-related reasons and an increase in social related ones. Furthermore, trust dynamics evolved differently for public authorities and the scientific community. Conclusions Vaccine perception is a dynamic process shaped by evolving factors like efficacy and safety perceptions, trust levels, and individual motivations. Our study sheds light on the complex dynamics that underlie the perception of vaccine safety and efficacy, and their impact on willingness to vaccinate. We discuss these results in light of bounded rationality, loss aversion and classic utility theory.

BackgroundProgrammed cell death ligand 1 (PD-L1) inhibitors have limited efficacy as monotherapy in patients with recurrent/metastatic (R/M) Human Papilloma Virus (HPV) oropharyngeal squamous cell carcinoma (OPSCC). A phase I study of the therapeutic HPV-16 DNA vaccine AMV002 in curatively treated patients with OPSCC demonstrated a measurable immune response against HPV while being associated with high safety and tolerability. This prospective phase Ib single centre pilot study aims to test the safety and tolerability of combined PD-L1 inhibitor, Durvalumab, with AMV002 in 12 patients with recurrent OPSCC.MethodsParticipants had evidence of R/M HPV-associated OPSCC. They received three intradermal administrations of AMV002 with Durvalumab followed by Durvalumab maintenance. Safety and tolerability data was the primary endpoint. The study was conducted with ethical approval (HREC/2018/QMS/47293) in Brisbane, Australia.FindingsThe most common adverse event (AE) related to vaccine administration was erythema at the injection site. There were no grade 3 or 4 vaccine related AEs. There was one presumed immune-related grade 3 elevation in lipase secondary to Durvalumab with no intervention required. No patient ceased study due to treatment-related AEs. At week 16, objective response rate was 8% (N=1) and disease control rate was 17% (N=2). At a median follow up of 25.6 (20.0-26.6) months there was one long term complete response while all other participants developed progressive disease. Of the 11 evaluated patients, 9, (82%) had E6 and/or E7-specific T cell responses to the vaccine.ConclusionThe combination of AMV002 therapeutic HPV-16 vaccine and Durvalumab was found to be safe and well tolerated with no increased safety signals generated. T cell responses to vaccine were observed but further work will be required to improve efficacy.

Climate change and water security are among the grand challenges of the 21st century, but literacy on these matters among high-school students is often unsystematic and/or detached from the real world. This study aims to introduce the educational objectives, methods, and early results of “Water and Us”, a three-module initiative that can contribute to advancing water education in a warming climate by focusing on the natural and anthropogenic water cycle, climate change, and emerging water conflicts. The method of Water and Us revolves around storytelling to aid understanding and generate new knowledge, learning by doing, a flipped-classroom environment, and a constant link to examples from the real world (such as ongoing droughts across the world or seeds of conflict regarding transnational river basins). Water and Us was established in 2021–2022 and, during that school year, involved ≥200 students as part of a proof of concept to test the complete didactic approach using small-scale experiments. Results from ≥40 h of proof-of-concept events confirmed the effectiveness of this approach with respect to conveying the essential elements of the natural and anthropogenic water cycle, the most commonly recurring concepts related to climate change and water as well as the possible conflicts and solutions related to water scarcity in a warming climate. The Water and Us team remains interested in networking with colleagues and potential recipients to upscale and further develop this work.

This paper presents an enhanced probabilistic flood displacement risk assessment methodology. Several techniques have been proposed to estimate the number of people at risk of being displaced triggered due to climatic extremes. Among these methods, the probabilistic approach is promising for its quantitative nature and versatility at different scales. However, it has so far been limited to assessing loss of housing as the sole cause of displacement. The proposed methodology addresses this limitation by considering two additional elements beyond the traditional evaluation of housing loss: the likelihood of losing means of livelihood, directly included in the computation, and the likelihood of losing access to essential services, such as schools and health centers, provided as a factor to increase the propensity to displace. This new methodology is applied to assess flood disaster displacement risk in Fiji and Vanuatu, where climate change, coupled with the vulnerability of exposed assets, poses an existential threat to these Pacific islands, potentially leading to internal and cross-border population movements. Different climate scenarios were considered: current climate conditions (1979–2016 period), medium-term projected climate conditions (2016–2060), and long-term projected climate conditions (2061–2100). The average annual displacement increases in Fiji and Vanuatu by a factor of 3 and 4, respectively, in the projected long-term pessimistic climate scenario compared to current conditions. Depending on the country and climate change scenario, 20 to 40% of these displacements stem from loss of livelihoods as a dominant factor, highlighting the importance of considering this aspect in the vulnerability approach. The outcomes of these scenarios serve as the foundation for implementing displacement risk adaptation and management measures. This novel quantitative methodology holds significant potential for applications in larger domains and even globally.

Abstract The Atlantic Forest has one of the richest floras in the world and floristic surveys are essential to understand its biodiversity and promote its conservation. This study aims to contribute to the floristic understanding of Anacardiaceae in the Iguaçu National Park (Brazil) and the Iguazú National Park (Argentina). Monthly samplings were performed from 03/2019 to 02/2020 and sporadic samplings from 11/2020 to 01/2021 in the main trails from both parks, as well as herbarium review and surveys on virtual platforms. Two native species: Lithraea molleoides and Schinus terebinthifolia, and two exotic cultivated species: Mangifera indica and Spondias purpurea were found in the Iguaçu National Park and only one native species, Schinus terebinthifolia, in the Iguazú National Park. Identification key, descriptions, photographs with diagnostic characters of the taxa, taxonomic comments, geographical distribution, phenology, common names, uses and observations are provided.

Background: While SBRT to the prostate has become a valuable option as a radical treatment, limited data support its use in the postoperative setting. Here, we report the updated results of the multicentric Post-Prostatectomy Ablative Radiation Therapy (POPART) trial, investigating possible predictors of toxicities and patient-reported outcomes. Methods: Patients with PSA levels between 0.1–2.0 ng/mL after radical prostatectomy received Linac-based SBRT to the prostate bed in five fractions every other day for a total dose of 32.5 Gy (EQD21.5 = 74.3 Gy). Late toxicity was assessed using CTCAE v.5 scale, while EPIC-CP, ICIQ-SF, IIEF 5 questionnaires and PSA levels measured quality of life and biochemical control. Pre- and post-treatment scores were compared using a paired t-test, with MID established at > 0.5 pooled SD from the baseline. A logistic regression analysis was performed to evaluate potential associations between specific patient/tumor/treatment factors and outcome deterioration. Results: From April 2021 to April 2023 a total of 50 pts were enrolled and treated. Median follow-up was 12.2 (3–27) months. No late ≥ G2 GI or GU toxicity was registered. Late G1 urinary and rectal toxicities occurred in 46 % and 4 % of patients, respectively. Among 47 patients completing all EPIC-CP domains, four (9 %) showed worsened QoL, and eleven (26 %) developed erectile dysfunction correlating with PTV D2% (P = 0.032). At Multivariate analysis bladder wall D10cc independently correlated with late G1 GU toxicity (P = 0.034). Median post-treatment PSA nadir was 0.04 ng/mL (0.00 – 0.84). At the last follow-up, six patients presented with biochemical failure, including two nodal relapses. Conclusions: Our findings show that post-prostatectomy SBRT did not result in increased toxicity nor a significant decline in QoL measures, thus showing that it can be safely extended to the postoperative setting. Long-term follow-up and randomized comparisons with different RT schedules are needed to validate this approach.

In Hong Kong, Indonesian migrant domestic workers (IMDWs) are forced to leave behind young children in their home country. Often spending the majority of their time in their employer's households, they must manage their limited personal time to maintain connections with their families back home. Many women IMDWs try to overcome distance limitations by performing transnational mothering using any available media to reach their children and to manage and witness their development. By using communication tools such as Internet-mediated calls for distance nurturing, they are able to keep up with their children's lives and monitor day-to-day developments. This research examines the role of communication technologies with an emphasis on the use of social media by women IMDWs in maintaining connections with their families back home. It examines the role social media plays in caregiving for women IMDWs, for whom the family and children's wellbeing back home are one of their most important concerns. This research incorporates netnography, which aims to understand online social interactions. The research was conducted from 2013 to 2019 physically in Hong Kong and through virtual channels. The findings indicate how social media is used as an emotional outlet by women IMDWs in Hong Kong, and how emotional care can be maintained to empower the migrant mothers. Social media and information and communication technology (ICT) have greatly improved channels of communication for IMDWs and created a new space of intimacy. Yet social media also has the possibility of creating tensions and anxiety for IMDWs. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including labor exploitation of domestic workers, women's roles during the COVID-19 pandemic, and gender-based cyber violence.

• Total Body Irradiation in-vivo dosimetry data over 10 years were analyzed. • Monitor Units' median percentage difference from planned was limited. • Median percentage dose difference at six anatomical locations was inside 10 % range. • The neck region showed the highest dosimetric differences from planned. • In-vivo dosimetry omission impact was evaluated, leading to interesting results. Myeloablative Total Body Irradiation (TBI) used in our Institution, as part of the conditioning scheme for haematopoietic stem cell transplantation, is an extended-distance supine technique that has been implemented using a 15 MV LINAC beam, lead lung compensators, PMMA, and water bolus to improve homogeneity. This study reviews in-vivo dosimetry (IVD) over 10 years of treatments, assessing the technique's robustness, accuracy, and efficiency. A 2-lateral opposite fields plan was calculated from planning CT with validated Oncentra TPS (Elekta AB, Sweden). Monitor units (MUs), lung compensators shape and thickness were calculated to deliver the prescription dose (12 Gy in 6 bi-daily fractions or 9.9 Gy in 3 daily fractions) to the patient's abdomen midline at the umbilical level, maintaining lung dose within ±5 % range of prescription. Data from 103 patients, of which more than 87 % were pediatric, were retrieved and analyzed for a total of 537 treatment fractions. The impact of IVD omission was evaluated, supposing doing it only once or in the first two fractions, if necessary. Median ΔMU from planned was −1.2 %. Median percentage dose deviation from prescription in 6 anatomical regions was below 2 %. IVD omission could have resulted in an increase of 7 patients registering at least one anatomical region outside the ±5 % dose range at the end of treatment. It is possible to confirm the implemented technique's robustness and accuracy in delivering the prescribed dose under IVD monitoring. Nevertheless, this technique and associated IVD are time-consuming and IVD omission could be assessed with limited drawbacks. [ABSTRACT FROM AUTHOR]

• Pelvis auto-segmentation tools were compared, from atlas-techniques to deep learning. • Deep learning showed better and faster segmentation results. • Differences found in cervical cancer tapered off in prostate cancer contouring. • Expert radiation oncologists qualitatively preferred deep learning. • Automated tools allow for faster radiotherapy workflow and high-quality treatments. Artificial intelligence can standardize and automatize highly demanding procedures, such as manual segmentation, especially in an anatomical site as common as the pelvis. This study investigated four automated segmentation tools on computed tomography (CT) images in female and male pelvic radiotherapy (RT) starting from simpler and well-known atlas-based methods to the most recent neural networks-based algorithms. The evaluation included quantitative, qualitative and time efficiency assessments. A mono-institutional consecutive series of 40 cervical cancer and 40 prostate cancer structure sets were retrospectively selected. After a preparatory phase, the remaining 20 testing sets per each site were auto-segmented by the atlas-based model STAPLE, a Random Forest-based model, and two Deep Learning-based tools (DL), MVision and LimbusAI. Setting manual segmentation as the Ground Truth, 200 structure sets were compared in terms of Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), and Distance-to-Agreement Portion (DAP). Automated segmentation and manual correction durations were recorded. Expert clinicians performed a qualitative evaluation. In cervical cancer CTs, DL outperformed the other tools with higher quantitative metrics, qualitative scores, and shorter correction times. On the other hand, in prostate cancer CTs, the performance across all the analyzed tools was comparable in terms of both quantitative and qualitative metrics. Such discrepancy in performance outcome could be explained by the wide range of anatomical variability in cervical cancer with respect to the strict bladder and rectum filling preparation in prostate Stereotactic Body Radiation Therapy (SBRT). Decreasing segmentation times can reduce the burden of pelvic radiation therapy routine in an automated workflow. [ABSTRACT FROM AUTHOR]

• Despite the significance of oncoplastic procedure, an italian database is lacking. • Senonetwork established a multidisciplinary survey to assess their safety and efficacy. • Reconstructive outcomes were positive across low and high-volume centers. • After mastectomy, implant-based techniques are common. DTI reconstruction is advantageuos. • This contributes to the global understanding of effective strategies against breast cancer. [ABSTRACT FROM AUTHOR]

The introduction of PARP inhibitors has revolutionized the management and treatment of patients with pathogenic germline variants of BRCA1/2 who have developed breast cancer. The implementation of PARP inhibitors in clinical settings can be challenging due to their overlapping indications with other drugs, including both recently approved medications and those with proven efficacy. This study utilized the Delphi method to present the first Italian consensus regarding genetic testing, the use of PARP inhibitors in both early and metastatic settings, and strategies for managing the potential toxicity of these novel drugs. The Panel unanimously agreed on various issues, including the timing, techniques, and patient characteristics for BRCA1/2 genetic testing, andthe appropriate placement of PARP inhibitors in the treatment algorithm for both early and advanced breast cancer. Nevertheless, some areas of divergence became evident, particularly regarding the use of axillary surgery for therapeutic purposes and the application of hormone replacement therapy in cases of bilateral mastectomy and risk-reducing salpingo-oophorectomy for patients treated for triple negative breast cancer. Additional research is needed in these particular domains to improve the care of patients with breast cancer who bear an increased genetic risk., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This research received no specific grants or funding., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Breast cancer stands as the most frequently diagnosed cancer and the primary cause of cancer-related mortality among women worldwide, including Italy. With the increasing number of survivors, many are enrolled in regular follow-up programs. However, adherence to recommendations from scientific societies (such as ASCO, ESMO, AIOM) for breast cancer follow-up management varies in daily clinical practice across different cancer centers, potentially resulting in unequal management and escalating costs. To address these concerns, the Italian Association of Multidisciplinary Oncology Groups (AIGOM) orchestrated a Consensus on early Breast Cancer follow-up utilizing the Estimate-Talk-Estimate methodology. Following the identification of 18 Items and 38 statements by a select Board, 46 out of 54 (85.1%) experts comprising a multidisciplinary and multiprofessional panel expressed their degree of consensus (Expert Panel). The Expert Panel underscores the potential for the multidisciplinary team to tailor follow-up intensity based on the individual risk of recurrence. In selected cases, the general practitioner may be recommended as the clinical lead for breast cancer follow-up, both after completion of adjuvant treatment and at early initiation of endocrine therapy in low-risk patients. Throughout follow-up, and alongside oncologic surveillance, the expert panel advises osteometabolic, cardiologic, and gynecologic surveillance for the early detection and management of early and late treatment toxicities. Moreover, preserving quality of life is emphasized, with provisions for psycho-oncologic support and encouragement to adopt protective lifestyle behaviors., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: None of the authors has any interests to report directly related to this manuscript. Outside the scope of this manuscript: Stefania Gori, Fiorenza De Rose, no conflict of interests to declare. Antonella Ferro, honoraria from Novartis, MDS, Daiichi Sankyo, Astra Zeneca, Ely Lilly, Gentili. Alessandra Fabi grants from Astra Zeneca (steering committee); consulting fees from Roche, Lilly, Novartis, AstraZeneca, Pfizer, Seagen, Gilead, MSD, Menarini; honoraria from Astra Zeneca, Roche, Lilly, Novartis, Gilead, Pfizer, Daiichi Sankyo Exact Sciences; travel grants from Roche, Lilly, Novartis, AstraZeneca, Pfizer, Seagen, Gilead, MSD, Menarini; advisory board from Roche, Lilly, Novartis, AstraZeneca, Pfizer, Seagen, Gilead, MSD, Menarini. Catia Angiolini, Giuseppe Azzarello, Maurizio Cancian, Michela Cinquini, Luca Arecco no conflict of interests to declare. Cynthia Aristei, grants from PRIN 2023, from the Ministry of University and Research. Project title “The microbiome in breast cancer therapy and its potential for pRobIOtics to improve treatment outcome. Acronym: BARRIO”. Daniela Bernardi, Laura Biganzoli, Anna Cariello no conflict of interests to declare. Laura Cortesi, report grants from Astra Zeneca, MSD, Pfizer; consulting fees and honoraria from Astra Zeneca, Gilead, MSD, Roche, Pfizer, Daijchii Sanchio, Novartis; travel grants from Gilead, Pfizer, Daijchi Sanchio; Advisory Board from Astra Zeneca, MSD, Novartis. Elisabetta Cretella no conflict of interests to declare. Carmen Criscitiello, grants from Seagen, Gilead; consulting fees and honoraria from Pfizer, Novartis, Lilly, MSD; Seagen, Daiichi Sankyo, Gilead, AstraZeneca, Roche. Ugo De Giorgi consulting fees from Amgen, Astellas Pharma, Astrazeneca, Bayer, Bristol-Myers Squibb, Eisai, Ipsen, Janssen, Merck KGaA, MSD, Novartis, Pfizer; travel grants from Pfizer, Ipsen, Astrazeneca. Maria Carmen De Santis, Giuseppe Deledda, Massimo Dessena, Sara Donati, Arianna Dri, Gianluigi Ferretti no conflict of interests to declare. Jennifer Foglietta, honoraria from Novartis; travel grants from Roche, Sophos, Pfizer; Advisory Board from Menarini Stem Line. Davide Franceschini, Pierfrancesco Franco, Alessio Schirone no conflict of interests to declare. Daniele Generali, grants from LILT, University of Trieste, Novartis, Roche; consulting fees from Lilly, Novartis, Pfizer, Roche, Accord, Daiichi Dankyo; honoraria from Lilly, Novartis, Pfizer, Roche, Accord, Daiichi Dankyo, Astrazeneca, Istituto Gentili; travel grants from Roche, Menarini; Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid from Mednote. Lorenzo Gianni, travel grants from Novartis, Lilly, Pfizer; Advisory Board from Astra Zeneca, Novartis, Seagen. Stefano Giordani, Giovanni Grandi, Maria Cristina Leonardi, Stefano Magno, no conflict of interests to declare. Luca Malorni, consulting fees from Menarini, Pfizer, Lilly, Novartis, Roche; travel grants from Roche, Menarini, Celgene, IT Health Fusion; Advisory Board from Novartis. Carlotta Mantoan no conflict of interests to declare. Federica Martorana honoraria from Lilly, Daychii-Sankyo, Pfizer, Astra-Zeneca, Novartis; travel grants from Gilead, Roche, Pfizer, Lilly; advisory board from Amgen. Icro Meattini consulting fees from Pfizer, Astra Zeneca, Daiichi Sankyo, Novartis, Eli Lilly, Seagen, Gilead, Menarini StemLine. Bruno Meduri, Laura Merlini, Federica Miglietta, Alessandra Modena, Fabrizio Nicolis, Isabella Palumbo, no conflict of interests to declare. Pietro Panizza honoraria and travel grants from Bayer AG. Francesca Angela Rovera, Piermario Salvini, Armando Santoro, Mario Taffurelli, no conflict of interests to declare. Angela Toss consulting fees and grants from Lilly, Pfizer, Novartis, MSD, Astrazeneca, Gilead, Seagen, Daiichi Sankyo; travel grants from Gilead, Daiichi Sankyo, Menarini, Astrazeneca. Paolo Tralongo, Monica Turazza, Matteo Valerio, Matteo Verzè no conflict of interests to declare. Patrizia Vici consulting fees from Lilly, Daiichi-Sankyo, Pfizer, MSD, Novartis; honoraria from EISAI, Daiichi-Sankyo, Lilly, Novartis, Pfizer; travel grants from Roche, Pfizer, Daiichi-Sankyo, Novartis, IPSEN; advisory board from Pfizer, Novartis. Claudio Zamagni no conflict of interests to declare. Giuseppe Curigliano advisory board from Roche, Novartis, Lilly, Pfizer, Astra Zeneca, Daichii Sankyo, Ellipsis, Veracyte, Exact Science, Celcuity, Merck, BMS, Gilead, Sanofi, Menarini. Giovanni Pappagallo no conflict of interests to declare. Alberto Zambelli consulting fees Pfizer, Lilly, Novartis, Roche, AstraZeneca, DaiichiSankyo, Seagen, ExactSciences, MSD, Gentili, Gilead; travel grants from Roche, DaiichiSankyo, AstraZeneca, Novartis; advisory board from Roche., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The purpose of this clinical study is to test a broad spectral range (635-1060 nm) time-domain diffuse optical spectroscopy in monitoring the response of breast cancer patients to neoadjuvant chemotherapy (NAC). The broadband operation allows us to fully analyze tissue composition in terms of hemoglobin, water, lipids and collagen concentration, which has never been systematically studied until now during the course of therapy. Patients are subjected to multiple breast optical imaging sessions, each one performed at different stages of NAC, both on tumor-bearing and contralateral healthy breasts. We correlate the optical results with conventional imaging techniques and pathological response. Preliminary outcomes on 10 patients' data show an average significant reduction in the concentrations of oxy-hemoglobin (-53%, p  = 0.0020), collagen (-36%, p  = 0.0039) and water (-15%, p  = 0.0195), and increase in lipids (+39%, p  = 0.0137) from baseline to the end of therapy in the tumor-bearing breast of patients who responded to therapy at least partially. With respect to scattering, the scattering amplitude, a , increases slightly (+15%, p  = 0.0039) by the end of the therapy compared to the baseline, while the scattering slope, b , shows no significant change (+4%, p  = 0.9219). Some change in the constituents' concentrations was also noticed in the contralateral healthy breast, even though it was significant only for oxy-hemoglobin concentration. We observed that collagen seems to be the only component distinguishing between complete and partial responders by the end of 2-3 weeks from the baseline. In the complete responder group, collagen significantly decreased after 2-3 weeks with respect to baseline (p = 0.0423). While the partial responder group also showed a decrease, it did not reach statistical significance (p = 0.1012). This suggests that collagen could serve as a potential biomarker to measure NAC effectiveness early during treatment. Even though obtained on a small group of patients, these initial results are consistent with those of standard medical modalities and highlight the sensitivity of the technique to changes that occur in breast composition during NAC., Competing Interests: The authors declare no conflicts of interest., (© 2024 Optica Publishing Group.)