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In Italy, the production of Origanum vulgare L. is lower than the national market demand, so there is an increasing interest in this crop, even if the manual harvest and bunch binding represent ca. 60% of the production cost. The aim of this work is to evaluate the harvest efficiency, as well as the working capacity, productivity and quality of mechanical harvesting by means of a reaper-binder designed for cereal and forage crops and assisted harvesting by means of a long-reach edge trimmer. In fact, the final aim is to suggest a machine and a method for oregano harvesting that could significantly reduce the time and, therefore, the cost of this crop operation, while achieving a product quality similar to that obtained by manual harvesting. Tests of mechanical and assisted harvesting were carried out using a reaper-binder after modifying it (i.e., reducing its forward speed, cutting height and bunch size to improve its working capacity, productivity and quality) and an edge trimmer, respectively. The tests of mechanical and assisted harvesting were compared with manual harvesting. In the testing field, with an irregular shape and an area of one hectare, nine rows were selected and divided into three replications, each comprising three tests, i.e., mechanical, assisted and manual harvesting. The modified reaper-binder allowed us to achieve working capacity and productivity rates much higher than those obtained with manual harvesting. Moreover, its harvest quality, in terms of bunch weight and binding height, favourably compares with that manually obtained. Furthermore, the edge trimmer allowed us to achieve working capacity and productivity rates lower than those obtained by means of the reaper-binder but much higher than in manual harvesting. Thus, the reaper-binder can minimise the harvest time and, therefore, cost while harvesting bunches slightly bigger than those manually harvested, even if it requires a high initial investment cost. Instead, the edge trimmer can be a cheap solution for reducing the harvest time and cost. Therefore, mechanical and assisted harvesting could spread oregano production in areas of inland Sicily and other Mediterranean regions that are often cultivated with low-profit herbaceous plant species or lie fallow. Thus, it would be possible to increase farmers' incomes and job opportunities, as well as preventing or minimising the hydrogeological instability in these areas. [ABSTRACT FROM AUTHOR]

Simple Summary: Brain metastases (BM) may affect a large portion of metastatic HER2-positive BC patients. Dual human epidermal growth factor receptor 2 (HER2) blockade with Pertuzumab and Trastuzumab (PT) in conjunction with chemotherapy represents the first line therapy of metastatic HER2- positive breast cancer (BC) and shows to prolong time to BM development as the first site of disease progression. When limited brain disease occurs with stable extracranial disease, current guidelines suggest to continue systemic therapies and add local brain treatment. However not data are available on the association between PT and stereotactic brain radiotherapy (SRT). This study aims to assess the safety and efficacy of fractionated SRT (fSRT) and PT in patients with breast cancer BM. (1) Background: This study aims to assess the safety and efficacy of fractionated SRT (fSRT) and pertuzumab–trastuzumab (PT) in patients with breast cancer brain metastases (BCBM). (2) Methods: Patients with HER2+ BCBM who received FSRT from 2015 to 2019 were identified. Patients were included if they were treated with fSRT within 21 days of receiving PT. All lesions were treated with LINAC-based fSRT to a total dose of 27 Gy delivered in three consecutive fractions. All patients received concurrent PT. Patients were evaluated 4–6 weeks after SRS and subsequently every 2–3 months with MRI re-imaging (3) Results: A total of 49 patients with HER2+ brain metastases were identified. Of these patients, a total of 10 patients with 32 HER2+ BCBM were treated with concurrent SRT and PT and included in the analysis. No local progression was observed. Overall response rate was 68.7%. Only one patient developed asymptomatic radionecrosis. Median time to BM occurrence was 15.6 (range: 1–40.5 months). Distant intracranial failure occurred in 4/10 patients (40.0%). Overall BCBM median survival was 33.9 months (95%CI 24.1–43.6). Mean duration of PT treatment was 27.9 months (range: 10.1–53.7 months). (4) Conclusions: In our single institution experience, fSRT and PT showed to be a safe treatment for patients with BCBM with an adequate overall response rate. [ABSTRACT FROM AUTHOR]

To assess the predictive and prognostic values of pretreatment platelet and hemoglobin levels in patients with locally advanced cervical cancer who underwent neoadjuvant chemotherapy followed by radical hysterectomy.The authors retrospectively assessed 140 patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB2-IIB cervical cancer who underwent chemosurgical treatment.Median pretreatment platelet and hemoglobin levels were 272,000/μL and 12.5 g/dL, respectively. Fourteen patients achieved a pathologically complete response, and 26 had an optimal partial response, with an optimal pathological response rate of 28.6%. By univariate analysis, optimal pathological response rate was associated with well/moderately differentiated grade (P = 0.02) and platinum-/paclitaxel-based chemotherapy regimen (P = 0.04), but not with platelet and hemoglobin levels. Multiple logistic regression confirmed that tumor grade (odds ratio, 2.827; 95% confidence interval [95% CI], 1.250-6.397; P = 0.01) and chemotherapy regimen (odds ratio, 5.416; 95% CI, 1.459-20.110; P = 0.01) were independent predictors of optimal pathological response. Five-year recurrence-free survival and 5-year overall survival were 66 % and 73%, respectively. By log-rank test, recurrence-free survival and overall survival were associated with pathological response (P = 0.0002 and P = 0.001), lymph node status, (P = 0.008 and P = 0.002), lymphovascular space status (P = 0.005 and P = 0.003), and parametrial and/or surgical margin status (P = 0.004 and P = 0.001), but not with platelet and hemoglobin levels. On multivariate analysis, pathological response (hazard ratio [HR], 7.999; 95% CI, 1.916-33.394; and HR, 6.007; 95% CI, 1.426-25.307) and parametrial and/or surgical margin status (HR, 2.061; 95%CI, 1.047-4.058; and HR, 2.561; 95% CI, 1.244-5.271) were independent prognostic variables of recurrence-free survival and overall survival.The achievement of an optimal pathological response is the strongest independent prognostic variable for patients with cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy, whereas pretreatment platelet and hemoglobin levels seem to be neither predictive of response to chemotherapy nor prognostic of long-term outcome. [ABSTRACT FROM AUTHOR]

In order to implement environmental protection, within the Soil Cadastre, previously proposed as a multipurpose inventory that aims to promote sustainable soil uses, the hydrogeological instability caused by human activities is the focus of this work. These activities can be aimed at sustainable agricultural soil use or the building of roads to allow the access to the fields. The soil's hydrogeological instability causes the unsustainable use and management of a cadastral parcel. Therefore, the aim of this work is to propose a nomenclature for hydrogeological instability risks, as well as the best practices of conservative soil tillage in case studies, in order to reduce environmental impact. According to the proposed Soil Cadastre, the missing environmental sustainability of a parcel and the reason for this must be communicated to the field owner or manager. In a hilly area of inland Western Sicily, four main risk types of hydrogeological instability were identified: hydrogeological instability (caused only by natural factors); hydraulic-pedological farming instability (crop not suitable for the field for missing or insufficient soil drainage and landslides); hydraulic-infrastructural instability (built up infrastructures unsuitable for the site); hydraulic-infrastructural-pedological-management instability (field improvements changing the downflow line and crop operations not suitable for the soil and climate parameters). The farm owner or manager must be informed about the risk type affecting their fields in order to perform the best practices (i.e., conservative soil tillage), for implementing or restoring a sustainable soil use or management in each cadastral parcel. [ABSTRACT FROM AUTHOR]

Purpose: To assess the pattern of local failure using 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) scans after radiotherapy (RT) in non–small-cell lung cancer (NSCLC) patients treated with definitive RT whose gross tumor volumes (GTVs) were defined with the aid of pre-RT PET data. Method and Materials: The data from 26 patients treated with involved-field RT who had local failure and a post-RT PET scan were analyzed. The patterns of failure were visually scored and defined as follows: (1) within the GTV/planning target volume (PTV); (2) within the GTV, PTV, and outward; (3) within the PTV and outward; and (4) outside the PTV. Local failure was also evaluated as originating from nodal areas vs. the primary tumor. Results: We analyzed 34 lesions. All 26 patients had recurrence originating from their primary tumor. Of the 34 lesions, 8 (24%) were in nodal areas, 5 of which (63%) were marginal or geographic misses compared with only 1 (4%) of the 26 primary recurrences (p = 0.001). Of the eight primary tumors that had received a dose of <60 Gy, six (75%) had failure within the GTV and two (25%) at the GTV margin. At doses of ≥60 Gy, 6 (33%) of 18 had failure within the GTV and 11 (61%) at the GTV margin, and 1 (6%) was a marginal miss (p < 0.05). Conclusion: At lower doses, the pattern of recurrences was mostly within the GTV, suggesting that the dose might have been a factor for tumor control. At greater doses, the treatment failures were mostly at the margin of the GTV. This suggests that visual incorporation of PET data for GTV delineation might be inadequate, and more sophisticated approaches of PET registration should be evaluated. [Copyright &y& Elsevier]

Simple Summary: Radiation-induced pneumonitis and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia show overlapping clinical features. As we are facing the COVID-19 pandemic, the discrimination between these two entities is of paramount importance. In fact, lung cancer patients are at higher risk of complications from SARS-CoV-2. In this study, we aimed to investigate if a deep learning algorithm was able to discriminate between COVID-19 and radiation therapy-related pneumonitis (RP). The algorithm showed high sensitivity but low specificity in the detection of RP against COVID-19 pneumonia (sensitivity = 97.0%, specificity = 2%, area under the curve (AUC = 0.72). The specificity increased when an estimated COVID-19 risk probability cut-off of 30% was applied (sensitivity 76%, specificity 63%, AUC = 0.84). (1) Aim: To test the performance of a deep learning algorithm in discriminating radiation therapy-related pneumonitis (RP) from COVID-19 pneumonia. (2) Methods: In this retrospective study, we enrolled three groups of subjects: pneumonia-free (control group), COVID-19 pneumonia and RP patients. CT images were analyzed by mean of an artificial intelligence (AI) algorithm based on a novel deep convolutional neural network structure. The cut-off value of risk probability of COVID-19 was 30%; values higher than 30% were classified as COVID-19 High Risk, and values below 30% as COVID-19 Low Risk. The statistical analysis included the Mann–Whitney U test (significance threshold at p < 0.05) and receiver operating characteristic (ROC) curve, with fitting performed using the maximum likelihood fit of a binormal model. (3) Results: Most patients presenting RP (66.7%) were classified by the algorithm as COVID-19 Low Risk. The algorithm showed high sensitivity but low specificity in the detection of RP against COVID-19 pneumonia (sensitivity = 97.0%, specificity = 2%, area under the curve (AUC = 0.72). The specificity increased when an estimated COVID-19 risk probability cut-off of 30% was applied (sensitivity 76%, specificity 63%, AUC = 0.84). (4) Conclusions: The deep learning algorithm was able to discriminate RP from COVID-19 pneumonia, classifying most RP cases as COVID-19 Low Risk. [ABSTRACT FROM AUTHOR]

An experimental investigation on the effects of the mixing chamber length, the feedback channel minimum cross-sectional area and the nozzle-to-plate distance on the external flow field of impinging sweeping jets is performed by employing the Particle Image Velocimetry (PIV) technique. Three sweeping jet devices, characterized by different mixing chamber lengths ( L f / w = 4. 5 , 3. 5 , 2. 5 , being w the width of the exit nozzle throat section), are investigated. Furthermore, in order to analyse different minimum cross-sectional area values, the geometry of the feedback channels of the device characterized by the longest mixing chamber length is varied. In particular, five different values of g / w (1, 0.67, 0.50, 0.33, and 0.17) are taken into account, being g the minimum passage width of the feedback channels. Time-averaged and phase-averaged measurements are carried out for non-dimensional nozzle-to-plate distances H / w ranging between 2 and 10, with a spacing of 2. As for the effects of the mixing chamber length, the devices characterized by L f / w < 4. 5 do not generate an oscillating jet, thus the time-averaged flow field exhibits a single jet structure, while a twin-jet pattern is found for the device having L f / w = 4. 5 , due to the oscillating motion of the jet. Furthermore, due to the absence of the jet oscillation, the values assumed by the phase-correlated kinetic energy (PKE) are significantly lower for the devices having L f / w < 4. 5. Moreover, for the latter devices, the highest values of the turbulent kinetic energy (TKE) are reached in the jet shear layers, which are aligned to the streamwise direction, instead, for the device having L f / w = 4. 5 , the TKE assumes higher values in proximity of the jet centreline. As for the effects of the feedback channel minimum cross-sectional area, the decrease of g / w determines an increase of the oscillation frequency and a reduction of the jet oscillation amplitude, with a subsequent strong decrease of the PKE and an increase of the TKE values in proximity of the jet centreline. As regards the effects of the nozzle-to-plate distance, by increasing this parameter for the device having L f / w = 4. 5 the jet no longer sweeps in a rigid-like way between the two most deflected positions in the external flow field and the PKE values in the stagnation regions decrease. • Experimental investigation of the external flow field of impinging sweeping jets. • The triple decomposition technique is used to perform phase-averaged measurements. • Under a certain value of the mixing chamber length, no oscillation is detectable. • Reducing the feedback channel passage section, the oscillation frequency increases. • Decreasing the nozzle-to-plate distance causes the jet to move in a rigid-like way. [ABSTRACT FROM AUTHOR]

Compared to other malignancies, few studies have investigated the role of family history of cancer (FHC) in patients with lung cancer, yielding largely heterogeneous results. We performed a systematic literature review in accordance with PRISMA guidelines, searching the PubMed and Scopus databases from their inception to November 25, 2023, to identify studies reporting on the role of FHC in patients with lung cancer. A total of 53 articles were included, most with a retrospective design and encompassing a variety of geographical areas and ethnicities. Thirty studies (56.6%) assessed patients with non-small cell lung cancer (NSCLC), while 17 studies (32.1%) assessed patients with mixed histologies. Overall, the rates of FHC ranged from 8.3 to 68.9%, and the rates of family history of lung cancer ranged from 2 to 46.8%. Twenty-seven studies investigated FHC as a potential risk factor for lung cancer, with more than half reporting an increased risk for subjects with FHC. Five studies reported on the potential role of FHC in determining clinical outcomes, and twelve studies examined the relationship between FHC and germline mutations. Notably, only one study reported a significantly increased rate of germline mutations, including ATM, BRCA2, and TP53, for patients with a family history of lung cancer compared to those without, but both groups had a low prevalence of mutations (< 1%). The FAHIC—Lung (NCT06196424) is the first cross-sectional/prospective study specifically developed to identify FHC patterns and within-family clusters of other risk factors, including smoking, to guide patients with NSCLC to systematic genetic counseling. Acknowledging the largely heterogeneous results of our systematic review and considering the clinical implications of detecting pathogenic germline variants (PGVs), the FAHIC-lung study aims to identify patients potentially enriched with PGVs/likely PGVs to direct them to germline screening outside of the research setting. [ABSTRACT FROM AUTHOR]

Purpose: This prospective phase 3 randomized trial was designed to test whether ultra high single-dose radiation therapy (24 Gy SDRT) improves local control of oligometastatic lesions compared to a standard hypofractionated stereotactic body radiation therapy regimen (3 × 9 Gy SBRT). The secondary endpoint was to assess the associated toxicity and the impact of ablation on clinical patterns of metastatic progression.Methods and Materials: Between November 2010 and September 2015, 117 patients with 154 oligometastatic lesions (≤5/patient) were randomized in a 1:1 ratio to receive 24 Gy SDRT or 3 × 9 Gy SBRT. Local control within the irradiated field and the state of metastatic spread were assessed by periodic whole-body positron emission tomography/computed tomography and/or magnetic resonance imaging. Median follow-up was 52 months.Results: A total of 59 patients with 77 lesions were randomized to 24 Gy SDRT and 58 patients with 77 lesions to 3 × 9 Gy SBRT. The cumulative incidence of local recurrence for SDRT-treated lesions was 2.7% (95% confidence interval [CI], 0%-6.5%) and 5.8% (95% CI, 0.2%-11.5%) at years 2 and 3, respectively, compared with 9.1% (95% CI, 2.6%-15.6%) and 22% (95% CI, 11.9%-32.1%) for SBRT-treated lesions (P = .0048). The 2- and 3-year cumulative incidences of distant metastatic progression in the SDRT patients were 5.3% (95% CI, 0%-11.1%), compared with 10.7% (95% CI, 2.5%-18.8%) and 22.5% (95% CI, 11.1%-33.9%), respectively, for the SBRT patients (P = .010). No differences in toxicity were observed.Conclusions: The study confirms SDRT as a superior ablative treatment, indicating that effective ablation of oligometastatic lesions is associated with significant mitigation of distant metastatic progression. [ABSTRACT FROM AUTHOR]

Sleep-related hypermotor epilepsy (SHE) is a rare syndrome that presents with hyperkinetic asymmetric tonic/dystonic seizures with vegetative signs, vocalization, and emotional facial expression, mainly during light non-rapid eye movement sleep stages. The role of various genes (CHRNA4, CHRNB2, CHRNA2, KCNT1, DEPDC5, NPRL2, NPRL3, and PRIMA1) has previously been reported, though genetic etiology is assessed in less than 10% of cases. We report the case of a 5-year-old female carrying the TSC1 variant c.843del p.(Ser282Glnfs*36) who presented with a mild phenotype of tuberous sclerosis, including carbamazepine-responsive SHE, normal neurocognitive functioning, hypomelanotic macules, no abnormalities outside the central nervous system, and tubers at neuroimaging. The presented case extends the list of SHE-related genes to include TSC1 , thus suggesting a central pathogenic role of mammalian target of rapamycin (mTOR) cascade dysfunction in SHE and introducing a possible use of mTOR inhibitors in this epileptic syndrome. [ABSTRACT FROM AUTHOR]

In breast cancer volumetric-modulated arc therapy (VMAT) planning, the rotation of the gantry around the target implies a greater dose spreading to the whole heart, compared to tangential-field standard treatment. A consecutive cohort of 121 breast cancer patients treated with the VMAT technique was investigated. The correlation of breast volume, heart volume and lung volume with mean heart dose (mHD) and mean and maximum LAD dose (mLAD dose, MLAD dose) was tested, and a subsequent a linear regression analysis was carried out. VMAT treatment plans from 56 left breast cancer and 65 right breast cancer patients were analyzed. For right-sided patients, breast volume was significantly correlated with mHD, mLAD and MLAD dose, while for left-sided patients, breast volume was significantly correlated with mHD and mLAD, while heart volume and lung volume were correlated with mHD, mLAD and MLAD dose. Breast volume was the only predictor of increased heart and LAD dose (p ≤ 0.001) for right-sided patients. In left-sided patients, heart and lung were also predictors of increased mHD (p = 0.005, p ≤ 0.001) and mean LAD dose (p = 0.009, p ≤ 0.001). In this study, we observed an increase in heart and LAD doses in larger-breasted patients treated with VMAT planning. In right-sided patients, breast volume was shown to be the only predictor of increased heart dose and LAD dose. [ABSTRACT FROM AUTHOR]

Passive methods are recognized as one of the most efficient means to achieve high heat and mass transfer in impinging jets. In a recent study, Cafiero et al. (2014) demonstrated the effectiveness of square fractal grids (SFGs, obtained repeating the same square pattern at increasingly smaller scales) in terms of heat transfer enhancement when locating the grid in correspondence of the nozzle exit section. Indeed, the capability of producing turbulence at multiple scales and the possibility of tuning the peak in the turbulence intensity profile as a function of the grid geometric parameters are both extremely appealing for heat transfer enhancement purposes. In this study, the effect of the grid geometry on the convective heat transfer rate of impinging jets is assessed and discussed. Three main effects are taken into account: the grid thickness ratio (obtained by varying the thickness of the first iteration of the SFG), the effect of the secondary grid iterations and the choice of the initial pattern. It is demonstrated how a larger thickness ratio, which in the present case corresponds to an anticipated location of the peak in the turbulence intensity profile, is beneficial to get a spotted high convective heat transfer rate at short nozzle to plate distances. Either the use of a single square grid, or the choice of a different initial pattern (for example a circular fractal grid) is instead indicated when it is desirable a uniform distribution of the convective heat transfer rate. [ABSTRACT FROM AUTHOR]

• Tomographic PIV is used to visualize the flow fields of impinging swirling jets. • IR Thermography is applied to measure simultaneously the wall jet temperature. • The unsteady evolution of the flow coherent vortex structures is analyzed. • Typical vortex patterns are identified via proper orthogonal decomposition. • The jet mixing capacity is characterized as the swirl number is increased. Laser-based three-dimensional velocimetry techniques have been recently undergone a fast and significant development enabled by the improvements in both hardware and processing methods. The benefits of this progress are huge especially in the field of the investigation of complex turbulent flows. In this paper, the application of time-resolved tomographic particle image velocimetry (TPIV) to the analysis of submerged impinging swirling jets is presented. Swirling flows recur both in natural phenomena and industrial processes and impinging swirling jets have been extensively investigated for heat transfer applications; however, three-dimensional and time-resolved investigations on the impinging flow fields of swirling jets are rare in the literature. The current study focuses mainly on the effects of the swirl number on the formation and development of the coherent vortex structures arising in this kind of flow. Five values of the swirl number, including the non-swirling case (S = 0 , 0.23, 0.43, 0.61 and 0.74) are investigated for fixed values of the Reynolds number (Re = 5,100) and the impingement distance (equal to two nozzle exit diameters). TPIV measurements are carried out both in the near field (in proximity of the nozzle exit) and in the impingement zone (in proximity of the wall). In the latter case, the water jet is set to a temperature higher than the ambient one and the wall temperature distribution is measured via time-resolved infrared (IR) thermography with the aid of a transparent IR window. The simultaneous velocity and temperature measurements elucidate the role of the vortex structures in both the flow dynamics and transport of internal energy, which is a passive scalar in the present operating conditions. Modal decomposition techniques, in particular the proper orthogonal decomposition, are also applied to identify the most characteristic structures of the turbulent flows. [ABSTRACT FROM AUTHOR]

Despite being usually delivered in oncological patients, radiotherapy can be used as a successful treatment for several non-malignant disorders. Even though this use of radiotherapy has been scarcely investigated since the 1950s, more recent interest has actually shed the light on this approach. Thus, the aim of this narrative review is to analyze the applications of non-oncological radiotherapy in different disorders. Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. This review contains a narrative report and a critical discussion of non-oncological radiotherapy approaches. In conclusion, non-oncological radiotherapy is a safe and efficacious approach to treat several disorders that needs to be further investigated and used in clinical practice. [ABSTRACT FROM AUTHOR]

Despite the rising evidence in favor of immunotherapy (IT), the treatment of oncological patients affected by so-called "cold tumors" still represents an open issue. Cold tumors are characterized by an immunosuppressive (so-called cold) tumor microenvironment (TME), which favors host immune system suppression, cancer immune-escape, and a worse response to IT. However, the TME is not a static element, but dynamically mutates and can be changed. Radiotherapy (RT) can modulate a cold microenvironment, rendering it better at tumor killing by priming the quiescent host immune system, with a consequent increase in immunotherapy response. The combination of TME radiomodulation and IT could therefore be a strategy for those patients affected by cold tumors, with limited or no response to IT. Thus, this review aims to provide an easy, rapid, and practical overview of how RT could convert the cold TME and why cold tumor radiomodulation could represent an interesting strategy in combination with IT. [ABSTRACT FROM AUTHOR]

Background: Adult-type soft tissue sarcomas (STSs) are rare tumors representing about 1% of all adult malignant tumors. Their extreme histological heterogeneity places them among the most challenging fields of diagnostic pathology. The variability of clinical and prognostic presentation between the various histotypes reflects the different management that should be followed on a case-by-case basis. These features make STSs the case in point of how important it is a centralized and multidisciplinary approach. Summary: Surgery represents the mainstay in the treatment of localized STSs. Recently, more and more studies are making efforts to understand what the contribution of chemotherapy and radiotherapy with neoadjuvant and adjuvant intent may be both in unselected and selected histological subgroups. In fact, despite the improvement in overall survival seen in the past few years thanks to the adoption of a more radical surgical approach, mortality remains relatively high and the 5-year overall survival is around 65%. Key Messages: In this review, we comment upon the treatment of localized STSs of the extremity, trunk wall, and retroperitoneum and how surgery, radiotherapy, and chemotherapy can be integrated with each other and individually tailored. Nomograms can assist clinicians in this complex therapeutic decision-making process, through the identification of patients at higher risk of death or disease relapse. [ABSTRACT FROM AUTHOR]

The present research focuses on the experimental investigation of the effectiveness of synthetic jet actuation on a pair of counter-rotating vortices generated by an unswept, low aspect ratio, squared-tipped wing in order to preserve the mutual induction during their evolution. The synthetic jet is actuated at Crow and Widnall's instability frequencies (F + = 0.071 , 0.55) and at a fixed momentum coefficient C μ = 0.2 % with the goal of reducing the vortex strength and the induced circumferential velocity. The effect of the jet exit section area, and thus the characteristic jet velocity, has been investigated by testing three wing models equipped with a synthetic jet issuing through a rectangular slot of constant length and three different values of the height, equal to 0.01, 0.02, and 0.04 chord lengths, respectively. A phase-locked stereoscopic particle image velocimetry setup has been designed and implemented to carry out a parametric study in the near wake of the wing models at four downstream distances from the wing trailing edge, namely equal to 0.1, 0.5, 1 and 2 chord lengths. The slot with a height to chord ratio of 4%, yields the minimum vorticity level, the maximum vortex diffusion with a diameter up to 3 times greater than the baseline reference value, and lower values of the vortex circulation. This effect, together with the periodic motion along a ± 45 ∘ direction experienced by the vortex after the synthetic jet blowing, is beneficial in terms of an anticipated instability of the tip vortices as well as of the mitigation of the blade-vortex-interaction in propellers. [ABSTRACT FROM AUTHOR]

Simple Summary: Brain metastases (BMs) are common among patients with advanced HER2 breast cancer. The recent introduction of systemic therapy with central nervous system activity as well as the wider use of brain stereotactic radiotherapy (SRT) are contributing to improving the outcomes for these patients. In this review, we discuss a modified approach to the treatment of HER2-positive BMs from a radiation oncologist point of view, taking into consideration new advances in multimodal therapy and combinations of the most commonly used systemic treatments and brain radiation therapy (RT). Brain metastases (BMs) are common among patients affected by HER2+ metastatic breast cancer (>30%). The management of BMs is usually multimodal, including surgery, radiotherapy, systemic therapy and palliative care. Standard brain radiotherapy (RT) includes the use of stereotactic radiotherapy (SRT) for limited disease and whole brain radiotherapy (WBRT) for extensive disease. The latter is an effective palliative treatment but has a reduced effect on brain local control and BM overall survival, as it is also associated with severe neurocognitive sequelae. Recent advances both in radiation therapy and systemic treatment may change the paradigm in this subset of patients who can experience long survival notwithstanding BMs. In fact, in recent studies, SRT for multiple BM sites (>4) has shown similar efficacy when compared to irradiation of a limited number of lesions (one to three) without increasing toxicity. These findings, in addition to the introduction of new drugs with recognized intracranial activity, may further limit the use of WBRT in favor of SRT, which should be employed for treatment of both multiple-site BMs and for oligo-progressive brain disease. This review summarizes the supporting literature and highlights the need for optimizing combinations of the available treatments in this setting, with a particular focus on radiation therapy. [ABSTRACT FROM AUTHOR]

• Near wake analysis of wingtip vortices features under synthetic jet actuation. • Active flow control tuned to the inherent instability frequencies of the vortices. • Synthetic jet control at high power could promote the Crow instability growth. • The highest actuation frequency offers an intense vortex strength decrease. • Phase-locked analysis reveals a strikingly impact on the vortices' dynamics. The effectiveness of synthetic jet actuation on the wingtip vortices produced by an unswept, low aspect ratio, rectangular wing at a chord Reynolds number of 8.16 × 10 4 is experimentally investigated. The synthetic jet is operated at different actuation frequencies and amplitudes in order to investigate five different control cases characterized by different momentum coefficients and dimensionless frequencies, for a comprehensive parametric study. In particular, the instability frequencies (known as Crow and Widnall) characterizing the wingtip vortex dissipation, are chosen among the tested synthetic jet actuation frequencies. A phase-locked stereoscopic particle image velocimetry is employed to analyze the development of the wingtip vortices in the near wake at a distance from the wing trailing edge of 3 chord lengths. The time-averaged results suggest that the synthetic jet actuation greatly affects the wingtip vorticity distribution causing an outward diffusion which increases with the actuation frequency, with a maximum reduction of 46% on the peak value. On the other hand, when the synthetic jet is operated at the Crow instability frequency, the wingtip induced velocity shows its maximum decrease equal to 29% with respect to the baseline case. The phase-averaged analysis reveals a clear relation between the synthetic jet blowing and suction phases and the periodic variation of the vortices features. In correspondence to the blowing phase, the wingtip vortices undergo a huge diffusion and they are characterized by a larger diameter, higher circulation, and lower induced velocity. These findings confirm that this synthetic jet control configuration can represent a useful device to promote the vortex dissipation and reduce the wake vortex hazard. [ABSTRACT FROM AUTHOR]

A wind tunnel experimental investigation of the separated flow over a back-facing ramp at 25° slant angle and equipped with an array of slotted synthetic jets (SJs) actuators for active flow control (AFC) has been conducted at height-based, h , Reynolds numbers between 9.41 × 103 ≤ Re h ≤ 2.55 × 104. Both the baseline, i.e. without control, and controlled cases were inspected by means of surface pressure measurements and planar particle image velocimetry (PIV). This study represents a fundamental investigation of the basic mechanisms promoting the mitigation of the separation by means of the SJ technology. The AFC device consists of an array of twelve finite span slotted SJs having aspect ratio equal to 15, all fed by a common resonant cavity. For the baseline cases, it is found that the streamwise extension of the separated region decreases with increasing Re h. This behavior is due to the nature of the boundary layer upstream of the ramp, which is transitional for the lowest Re h and turbulent for the highest one, as is corroborated by velocity PIV measurements within the boundary layer. For Re h = 1.06 × 104, under actuation with momentum coefficient c μ = 2.75 × 10−3 and reduced frequency F + = 0.34, the boundary layer undergoes an increment of the wall shear stress and acceleration at its edge. Phase-locked PIV measurements unveil that coherent vortical structures energize the boundary layer producing a 65% reduction of the extension of the separation bubble with respect to the corresponding baseline case. However, these benefits degrade by increasing the Reynolds number and for lower levels of c μ and F +. Phase-average flow fields reveal the existence of vortical structures over the ramp which determine characteristic wavy patterns of the streamlines. The scattering of the location of the instantaneous vortices taken at fixed phases proves the existence of concentrations of turbulent structures that participate in the buildup of the turbulence. [ABSTRACT FROM AUTHOR]

Background: Myxofibrosarcoma (MFS) is a rare soft tissue sarcoma with a high recurrence rate and a low risk of distant metastasis. It occurs mainly in the extremities of elderly men. Head and neck MFS is extremely rare. Surgery is the cornerstone of treatment. The role of radiotherapy (RT) and chemotherapy (CHT) on MFS is still debated.Case Presentation: A 67-year-old Caucasian man presented to our sarcoma referral center (SRC) with a history of MFS of the neck excised with microscopic positive surgical margins in a non-referral center. Staging imaging exams did not reveal distant metastasis. After a multidisciplinary discussion, preoperative RT was administered with a total dose of 50 Gy followed by wide surgical excision. Histological examination was negative for viable tumor cells. No relapse occurred during the 24-month postoperative follow-up.Conclusions: The case described suggests the importance of planned combined treatments with both RT and surgery for high-grade soft tissue sarcoma. RT seems to be promising within this specific histotype. Close follow-up is advisable in all cases. Further studies are needed to confirm if the observed efficacy of combined treatments results in a prolonged time of disease-free survival and overall survival. [ABSTRACT FROM AUTHOR]

• Six variables impact on the outcome in developmental and epileptic encephalopathies. • These variables includes semiological and EEG features and therapeutic options. • Neuropsychological profiling is mandatory to evaluate predictors of outcome. • Severity of epilepsy impact on neurodevelopmental and psychiatric outcome. This retrospective cohort analysis highlighted neurodevelopmental outcome predictors of genetic developmental and epileptic encephalopathies (DEE). Patients' demographic, clinical and molecular genetics data were collected. All patients underwent clinical, developmental, and neuropsychological assessments. We recruited 100 participants (53 males, 47 females) with a mean follow-up lasting 10.46 ± 8.37 years. Age at epilepsy-onset was predictive of poor adaptive and cognitive functions (VABS-II score, r = 0.350, p = 0.001; BRIEF control subscale, r = -0.253; p = 0.031). Duration of epilepsy correlated negatively with IQ (r = -0.234, p = 0.019) and VABS-II score (r = -0.367, p = 0.001). Correlations were found between delayed/lacking EEG maturation/organization and IQ (r = 0.587, p = 0.001), VABS-II score (r = 0.658, p = 0.001), BRIEF-MI and BRIEF-GEC scores (r = -0.375, p = 0.001; r = -0.236, p = 0.033), ASEBA anxiety (r = -0.220, p = 0.047) and ADHD (r = -0.233, p = 0.035) scores. The number of antiseizure medications (ASMs) correlated with IQ (r = -0.414, p = 0.001), VABS-II (r = -0.496, p = 0.001), and BRIEF-MI (r = 0.294, p = 0.012) scores; while age at the beginning of therapy with ASEBA anxiety score (r = 0.272, p = 0.013). The occurrence of status epilepticus was associated with worse adaptive performances. The linear regression analysis model showed that delayed/lacking EEG maturation/organization had a significant influence on the IQ (R2 = 0.252, p < 0.001) and the BRIEF-GEC variability (R2 = 0.042, p = 0.036). The delayed/lacking EEG maturation/organization and the duration of epilepsy also had a significant influence on the VABS-II score (R2 = 0.455, p = 0.005). Age at seizure-onset, EEG maturation/organization, duration of epilepsy, occurrence of status epilepticus, age at the introduction and number of ASMs used are reliable predictors of long-term outcomes in patients with genetic DEE. [ABSTRACT FROM AUTHOR]

Background: Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue tumor that typically affects the lower limbs of men between the ages of 50 and 60. EMC of the shoulder is rare with a high risk of local recurrence and distant metastasis. A planned surgical excision in sarcoma referral centers (SRCs) is mandatory to obtain the best outcome. The role of chemotherapy (CHT) and Radiotherapy (RT) on soft tissue chondrosarcoma is still controversial. Case presentation: A 47-year-old man presented to our referral center with a history of EMC in the right shoulder excised with microscopic positive surgical margins in a non-referral center. Staging imaging exams did not reveal distant metastasis or residual disease, but during follow-up a local recurrence was detected. After a multidisciplinary discussion, preoperative radiotherapy was administered with a total dose of 50 Gy, and then the patient underwent wide surgical excision. Histological examination was negative for viable tumor cells. No relapse occurred in a 24-months post-operative follow up. Conclusions: The case here described suggests the importance of patient's management in SRCs. A planned combined treatments with both surgery and RT seems to be the best choice to improve local control. RT seems to be promising within this specific histotype. Further studies are needed to confirm if the observed efficacy of combined treatments reflects in a consistent survival benefit for EMC patients. [ABSTRACT FROM AUTHOR]

Wingtip vortices have been proven to be detrimental to both aircraft efficiency and safety due to their adverse effects such as wake hazard, blade vortex interaction noise and induced drag. Despite the extensive literature on the subject, the number of experimental works featuring far field velocity measurements under active control is very limited. The present work deals with the experimental investigation of the effectiveness of synthetic jet actuation on the control of wingtip vortices and their wake hazard. In order to preserve the mutual induction of the counter-rotating vortices during their evolution, an unswept, low aspect ratio, squared-tipped, finite-span wing is employed. The synthetic jet actuation is based on triggering the inherent instabilities of Crow and Widnall at different values of the momentum coefficient C μ with the goal of reducing the vortex strength and obtaining an anticipated vortex break up. Different exit geometries of the synthetic jets have been tested to analyze the effects of the jet velocity and position on the wingtip vortices. Phase-locked measurements of the velocity field in the far wake at a distance from the wing trailing edge from 26 to 80 chord lengths have been performed via stereoscopic particle image velocimetry. The effects of blowing at high momentum coefficient C μ = 1 % are demonstrated to be remarkable on the mitigation of the wingtip vortices. On the other hand, both the time and phase-averaged results suggest that, at relatively low values of C μ (0.2%), using a larger synthetic jet exit section area allows to greatly affect the wingtip vortices' features causing a striking alleviation of the vorticity distribution up to 90% with respect to the baseline reference case. In fact, due to the actuation at low frequency, the vortex instability is prematurely risen up and amplified, leading to early vortices linking and their consequent dissipation. [ABSTRACT FROM AUTHOR]

Abstract Clinical development and use of novel systemic agents in combination with radiotherapy (RT) is at nowadays most advanced in the field of treatment of solid tumors. Although for many of these substances preclinical studies provide sufficient evidences on their principal capability to enhance radiation effects, the majority of them have not been investigated in even phase I clinical trials for safety in the context of RT. In clinical practice, unexpected acute and late side effects may emerge especially in combination with RT. As a matter of fact, despite combined modality treatment holds potential for enhancing the therapeutic ratio, some concerns are raised from the lack of high-quality clinical data to guide the care of patients who are treated with novel compounds in conjunction with RT. The aim of this review is to provide, from a radio-oncological point of view, an overview of the most advanced combined treatment concepts for solid tumors focusing on treatment toxicity. [ABSTRACT FROM AUTHOR]