Paolo Dini

Introduction:About one-fifth of patients with resectable non-small cell lung cancer (NSCLC) are unsuitable for surgical treatment. Radiofrequency ablation offers an alternative minimally invasive option. We report the result of an intention-to-treat study with long-term follow-up.Methods:From 2001 to 2009, we performed 80 percutaneous radiofrequency ablations of 59 stage I NSCLC in 57 inoperable patients. Two patients were treated for two separate lesions. The study group consisted of 45 males and 12 females, with mean age of 74 years (range, 40–88 years). All patients had pathological evidence of NSCLC, which was in stage IA in 44 cases and in stage IB in the other 15 cases. The mean size of the lesions was 2.6 cm (range, 1.1–5 cm). Fourteen lesions were retreated up to five times. The procedure was always performed under local anesthesia and conscious sedation. Most of the procedures were performed under computed tomography guidance, with nine under ultrasonography guidance.Results:In all cases, the procedure was technically successful. No mortality was recorded, and major morbidity consisted of four cases of pneumothorax requiring pleural drainage. At a mean follow-up of 47 months, the complete response rate was 59.3% (stage Ia 65.9%, stage Ib 40%, p = 0.01), with a mean local recurrence interval of 25.9 months. Median overall survival and cancer-specific survival were 33.4 and 41.4 months, respectively. Cancer-specific actuarial survival was 89% at 1 year, 59% at 3 years, and 40% at 5 years.Conclusions:Radiofrequency ablation treatment of early-stage NSCLC seems to be a effective minimally invasive therapy even in the long-term period, particularly for stage Ia tumors.

The narrow dip observed at 1.9 GeV/c2 by the Fermilab experiment E687 in diffractive photoproduction of 3π+3π− is examined. The E687 data are refitted, a mechanism is proposed to explain why this resonance appears as a dip, and possible interpretations are discussed.

Radiofrequency ablation (RFA) of lung tumours has recently received much attention for the promising results achieved. Herein, we report the 5 years experience of a single referral centre in Europe, with particular reference to the mid-term results.Between October 2001 and June 2005, we performed 88 RFAs of lung tumours, 9 of which were followed by surgical resection. The remaining 79 RFAs, the object of this paper, were performed to treat 64 lesions in 54 patients: 39 males and 15 females with a mean age of 71.7 years (range of 51-89). All patients had clinical or pathological evidence of the neoplastic lesion, which was non-small cell lung cancer (NSCLC) in 40 cases and a metastasis in 24 cases. The mean size of the lesions was 2.4 cm (range of 1-5). Ten lesions were re-treated from one to as many as four times. The procedure was always performed under local anaesthesia and conscious sedation. A generator of RF with max power output of 200W was utilised together with a needle with nine deployable electrodes, to achieve a target temperature of 90 degrees C that was maintained for 15-27 min according to the size of the lesions.In all cases, except two, the procedure was technically successful. Morbidity consisted in 10 cases (12.7%) of partial pneumothorax, 1 haematoma of the chest wall and 1 pleural effusion. At a mean follow-up of 23.7 months (range of 6-50) we recorded a 61.9% of complete responses, with a higher rate in the metastatic lesions (70.8%) and in those smaller than 3 cm (69.7%). Mean (median) overall survival and local progression-free interval were 17.3 (28.9) months and 12.9 (24.1) months, respectively.Efficacy of RFA in the mid-term seems to settle at a promising level, with better results for metastatic lesions and, above all, for lesions smaller than 3 cm. Notwithstanding these encouraging results, RFA remains an alternative local therapy only when surgery cannot be performed, especially in NSCLC.

Using data from the FOCUS experiment we analyze the D+π− and D0π+ invariant mass distributions. We measure the D2∗0 mass MD2∗0=(2464.5±1.1±1.9)MeV/c2 and width ΓD2∗0=(38.7±5.3±2.9)MeV/c2, and the D2∗+ mass MD2∗+=(2467.6±1.5±0.76)MeV/c2 and width ΓD2∗+=(34.1±6.5±4.2)MeV/c2. We find evidence for broad structures over background in both the neutral and charged final state. If each is interpreted as evidence for a single L=1, jq=1/2 excited charm meson resonance, the masses and widths are M1/20=(2407±21±35)MeV/c2, Γ1/20=(240±55±59)MeV/c2, and M1/2+=(2403±14±35)MeV/c2, Γ1/2+=(283±24±34)MeV/c2, respectively.

Chiral symmetry and its spontaneous breaking play an important role both in the light hadron and heavy hadron systems. The chiral perturbation theory (χPT) is the low energy effective field theory of the Quantum Chromodynamics. In this work, we shall review the investigations on the chiral corrections to the properties of the heavy mesons and baryons within the framework of χPT. We will also review the scatterings of the light pseudoscalar mesons and heavy hadrons, through which many new resonances such as the Ds0∗(2317) could be understood.Moreover, many new hadron states were observed experimentally in the past decades. A large group of these states is near-threshold resonances, such as the charged charmoniumlike Zc and Zcs states, bottomoniumlike Zb states, hidden-charm pentaquark Pc and Pcs states and the doubly charmed Tcc state, etc. They are very good candidates of the loosely bound molecular states composed of a pair of charmed (bottom) hadrons, which are very similar to the loosely bound deuteron. The modern nuclear force was built upon the chiral effective field theory (χEFT), which is the extension of the χPT to the systems with two matter fields. The long-range and medium-long-range interactions between two nucleons arise from the single- and double-pion exchange respectively, which are well constrained by the chiral symmetry and its spontaneous breaking. The short-distance interactions can be described by the low energy constants. Such a framework works very well for the nucleon–nucleon scattering and nuclei. In this work, we will perform an extensive review of the progress on the heavy hadronic molecular states within the framework of χEFT. We shall emphasize that the same chiral dynamics not only govern the nuclei and forms the deuteron, but also dictates the shallow bound states or resonances composed of two heavy hadrons.

We have performed a search for CPT violation in neutral charm meson oscillations. While flavor mixing in the charm sector is predicted to be small by the Standard Model, it is still possible to investigate CPT violation through a study of the proper time dependence of a CPT asymmetry in right-sign decay rates for D0→K−π+ and D0→K+π−. This asymmetry is related to the CPT violating complex parameter ξ and the mixing parameters x and y: ACPT∝(Reξ)y−(Imξ)x. Our 95% confidence level limit is −0.0068<(Reξ)y−(Imξ)x<0.0234. Within the framework of the Standard Model Extension incorporating general CPT violation, we also find 95% confidence level limits for the expressions involving coefficients of Lorentz violation of (−2.8<N(x,y,δ)(Δa0+0.6ΔaZ)<4.8)×10−16 GeV, (−7.0<N(x,y,δ)ΔaX<3.8)×10−16 GeV, and (−7.0<N(x,y,δ)ΔaY<3.8)×10−16 GeV, where N(x,y,δ) is the factor which incorporates mixing parameters x, y and the doubly Cabibbo-suppressed to Cabibbo-favored relative strong phase δ.

Using a high statistics sample of photoproduced charm particles from the FOCUS experiment at Fermilab, we compare the lifetimes of neutral D mesons decaying via D0 to K- pi+ and K- K+ to measure the lifetime differences between CP even and CP odd final states. These measurements bear on the phenomenology of D0 - D0bar mixing. If the D0 to K-pi+ is an equal mixture of CP even and CP odd eigenstates, we measure yCP = 0.0342 \pm 0.0139 \pm 0.0074.

Using a large sample of charm semileptonic decays collected by the FOCUS photoproduction experiment at Fermilab, we present evidence for a small, even spin K−π+ amplitude that interferes with the dominant K̄∗0 component in the D+→K−π+μ+ν final state. Although this interference significantly distorts the D+→K−π+μ+ν decay angular distributions, the new amplitude creates only a very small distortion to the observed kaon pion mass distribution when integrated over the other kinematic variables describing the decay. Our data can be described by K̄∗0 interference with either a constant amplitude or broad spin zero resonance.

FOCUS results from Dalitz plot analyses of D+s and D+ to π+π−π+ are presented. The K-matrix formalism is applied to charm decays for the first time, which allows us to fully exploit the already existing knowledge coming from light-meson spectroscopy experiments. In particular all the measured dynamics of the S-wave ππ scattering, characterized by broad/overlapping resonances and large non-resonant background, can be properly included. This Letter studies the extent to which the K-matrix approach is able to reproduce the observed Dalitz plot and thus help us to understand the underlying dynamics. The results are discussed along with their possible implications for the controversial σ meson.

As the European population ages, surgeons are regularly faced with octogenarians with resectable early stage non-small cell lung cancer (NSCLC). We compared our experience with those reported in the literature to comprehend the feasibility, outcomes and lessons learned regarding surgical treatment. We reviewed octogenarians who underwent lung resection for NSCLC in the past nine years in our Department. The purpose of this paper is to retrospectively analyse postoperative surgical and oncological outcomes of our series, trying to find possible correlations between mortality, morbidity, survival and preoperative oncological and functional assessment, surgical approach and extent of resection. Eighty-two patients (M/F=63/19), with a mean age 81.0 years (range 80–87 years) underwent lung resection for NSCLC: 63 lobectomies, one inferior bilobectomy, three segmentectomies, and 15 wedge resections. There were two perioperative deaths (2.4%). The overall complication rate was 30.0%, with a major complication rate of 2.5%. Actuarial cancer-related survival rates at one, three and five years were 90%, 44% and 36%, respectively, with a statistically-significant correlation with pathological stage. Octogenarians may benefit from surgical treatment of NSCLC with an acceptable morbidity and mortality rate, if an accurate preoperative selection is pursued.

We describe the algorithm used to identify charged tracks in the fixed-target charm-photoproduction experiment FOCUS.

Using a large sample of D0→K−μ+ν and D0→π−μ+ν decays collected by the FOCUS photoproduction experiment at Fermilab, we present new measurements of the q2 dependence for the f+(q2) form factor. These measured f+(q2) form factors are fit to common parameterizations such as the pole dominance form and compared to recent unquenched Lattice QCD calculations. We find mpole=1.93±0.05±0.03GeV/c2 for D0→K−μ+ν and mpole=1.91−0.15+0.30±0.07GeV/c2 for D0→π−μ+ν and f−(K)(0)/f+(K)(0)=−1.7−1.4+1.5±0.3.

Sleeve and wedge bronchial resections without parenchymal resection may represent a surgical option in selected cases of low-grade neoplasms of the airway. We reviewed our experience analyzing the indications, the operative technique, and the results of such operations.From 1980 to 2006, we performed 248 bronchoplastic procedures, and 26 of those were bronchoplastic procedures without parenchymal resection for low-grade neoplasms of the airway. There were 17 men and 9 women with a mean age of 49.4 years (range 19-74 years). All patients underwent a preoperative bronchoscopic study, which gave indication for such a procedure, and an intraoperative bronchoscopic examination confirming the feasibility and the good quality of the bronchial suture. The bronchial resection involved the trachea and the carina (n = 5), the main bronchi (n = 7), the intermediate bronchus (n = 2), the bronchial corner (n = 6), and the lobar bronchus (n = 6).The resection margins were always tumor free. There was no operative mortality. The mean hospital stay was 6.7 days (range 4-16 days). One minimal dehiscence and no stenosis of the anastomosis were observed. In 1 case we experienced a granulation that required an endoscopic treatment. The histologic type was carcinoid (n = 18), mucoepidermoid (n = 2), adenoid cystic (n = 1), chondroma (n = 2), hamartoma (n = 1), melanoma endobronchial metastasis (n = 1), and glomic tumor (n = 1). The mean follow-up was 134 months and no local relapse occurred.Bronchoplastic procedures without resection of the lung parenchyma are a suitable and fascinating technique for selected cases of low-grade endobronchial neoplasms.

Using data collected by the high-energy photoproduction experiment FOCUS at Fermilab we performed a Dalitz plot analysis of the Cabibbo favored decay D+→K−π+π+. This study uses 53653 Dalitz-plot events with a signal fraction of ∼97%, and represents the highest statistics, most complete Dalitz plot analysis for this channel. Results are presented and discussed using two different formalisms. The first is a simple sum of Breit–Wigner functions with freely fitted masses and widths. It is the model traditionally adopted and serves as comparison with the already published analyses. The second uses a K-matrix approach for the dominant S-wave, in which the parameters are fixed by first fitting Kπ scattering data and continued to threshold by Chiral Perturbation Theory. We show that the Dalitz plot distribution for this decay is consistent with the assumption of two-body dominance of the final state interactions and the description of these interactions is in agreement with other data on the Kπ final state.

The aim of this study was to analyse the results of robotic lobectomy for lung cancer. The evolution of technique and technology was evaluated. During the period 2004–12, all patients who underwent robotic lobectomy for clinical early-stage lung cancer were retrospectively reviewed. The patients were divided into two groups. Group 1 included 69 patients operated by the first generation of surgical robotic system. Group 2 included 160 patients treated with the latest generation of surgical robotic system. Age, gender, comorbidities, operative time, docking time, conversion rate, morbidity, mortality and length of postoperative stay were compared in both groups. The two groups were homogeneous in terms of age, gender and comorbidities. Histopathological analysis showed 41 and 107 adenocarcinomas, 27 and 37 squamous cell carcinomas, 1 and 7 large cell carcinomas, in Groups 1 and 2, respectively, and 5 sarcomatoid carcinomas and 4 carcinoids in Group 2. The pathological stage for Group 1 was Stage I (48 cases), Stage II (17 cases) and Stage III (4 cases). For Group 2, Stage I was found in 115 cases, Stage II in 30 cases and Stage III in 15 cases. The mean operative time was 237 (standard deviation (SD) + 66.9) and 172 (SD ± 39.6) min for Groups 1 and 2 (P = 0.002), respectively. The conversion rates were, respectively, 10.1 and 5.6% (P = 0.21), mortality rates 1.4 and 0% (P = 0.30) and morbidity rates 22 and 15% (P = 0.12). The mean length of postoperative stay was 4.4 (SD ± 3.1) and 3.8 days (SD ± 2.2) (P = 0.26), respectively. This study suggests a positive trend in the outcomes for patients who underwent the upgraded robotic system surgery compared with those treated by the standard system.

The main aim of this study was to compare radiofrequency ablation (RFA) and wedge resection in terms of disease recurrence and survival, as intent-to-treat therapy for stage I nonsmall cell lung cancer (NSCLC) in marginal or non-surgical candidates. 121 high-risk patients, treated for stage I NSCLC with wedge resection (n=59) or RFA (n=62) in a 7-year period, were analysed. Age, sex, comorbidity score, performance status, forced expiratory volume in 1 s and forced vital capacity values, body mass index, T-stage and histology were evaluated as possible risk factors affecting disease recurrence and survival. At a median follow-up of 36 and 42 months for wedge resection and for RFA (p=0.232), local recurrence rate was 2 and 23%, respectively (p=0.002). The 1-, 2- and 5-year overall survival (disease-free interval) rates were 100% (96%), 96% (90%) and 52% (76%) for wedge resection, and 93% (87%), 72% (63%), and 35% (55%) for RFA (p=0.044 and p=0.01, respectively). None of the analysed parameters was found to be risk factor for disease recurrence and survival, except stage T2, which significantly affected disease-recurrence, overall and cancer-related survival and disease-free interval in the RFA group. Whenever possible, surgical resection, even if limited, should be preferred due to its higher disease control and survival rates. RFA can be considered a valid option for inoperable patients, especially for those with stage T1N0.

Objective: In literature only few reports focused on the resection of solitary adrenal gland metastasis in patients operated on for non-small cell lung cancer (NSCLC). We report our experience on laparoscopic adrenalectomy for suspected or confirmed metachronous solitary adrenal metastasis from NSCLC and discuss its therapeutic role. Methods: From June 1993 to March 2003, 14 patients (pts), who had been undergone lung resection for NSCLC, with suspected or confirmed solitary adrenal gland metastasis at the follow-up, underwent 15 laparoscopic adrenalectomy (in 1 patient it was bilateral). All the patients had enlarged adrenal glands at the abdominal ultrasound or CT. All but 2 pts underwent at least 1 adrenal fine needle aspiration. All the patients underwent a careful staging to exclude other sites of metastasis. The adrenal gland was in 6 cases the right, in 9 cases the left. Results: In 7 cases we had a preoperative cytological diagnosis of metastasis. In 1 case adrenalectomy was not performed because of infiltration of vena cava and in 1 case it was necessary to perform a small laparotomy because of bleeding. The pathologic examination confirmed in 11 cases a NSCLC metastasis while in 4 cases it was a cortical adenoma. Regarding the 10 patients with NSCLC metastases, 3 are still alive and well at 37–80 months from the lung resection. One patient (who underwent bilateral adrenalectomy) is still alive at 44 months with local relapse. Two patients died 5 and 6 months after the adrenalectomy for other causes, 1 died at 14 months for local and systemic relapse and the remaining 3 patients died at 12 to 38 months for systemic relapse. Conclusions: Laparoscopic adrenalectomy in patients resected for NSCLC is a safe mini-invasive procedure. Even though this series is still too small, laparoscopic adrenalectomy should be considered an effective therapeutic tool in case of progressive adrenal gland enlargement, also with negative cytological examinations. A bigger series and other institution experiences will clarify its oncological value.

Objective: From therapeutic nihilism to extremely aggressive management, there is a wide range of possibilities in the treatment of malignant pleural mesothelioma (MPM). Unfortunately, there is little evidence as regards the best treatment to offer to the MPM patients. In 1999, we started a phase II study based on the multimodality treatment of stage II–III MPM, the results of which have been analysed and reported. Methods: From 1999 to 2004, 49 patients with IMIG stage II–III MPM underwent a multimodality treatment including: intrapleural pre-operative interleukin 2 (IL-2, 18 × 106 UI/day per 3 days), pleurectomy/decortication, intrapleural post-operative epidoxorubicin (25 mg/m2 per 3 days), IL-2 (18 × 106 UI/day per 3 days), adjuvant radiotherapy (30 Gy), systemic chemotherapy (cisplatin 80 mg/m2 day 1, gemcitabine 1250 mg/m2 day 1 and 8 up to 6 courses) and long-term sub-cutaneous IL-2 (3 × 106 UI/day 3 days per week). Results: There were 41 males and 8 females with a median age of 61 years (range 41–77). All the patients had a diagnosis of MPM by thoracoscopy before inclusion. We did not experience any post-operative mortality. The histology was: 39 epitheliomorf, 6 bifasic and 4 sarcomatous. According to the IMIG the post-operative staging was III in 40 cases and II in 9 cases. With a median follow-up of 59 months (range 14–81) 13 patients are still alive and the median actuarial survival is 26 months (31 and 21 months for stage II and III, respectively). Only the Performance Status at the diagnosis affected survival significantly. Conclusions: The multimodality treatment we adopted for stage II–III MPM was feasible, well tolerated by most of the patients and produced a favourable outcome. New targeted therapies are awaited for further improvements in the treatment of this disease.

Using data from FOCUS (E831) experiment at Fermilab, we present a model independent partial-wave analysis of the K−π+ S-wave amplitude from the decay D+→K−π+π+. The S-wave is a generic complex function to be determined directly from the data fit. The P- and D-waves are parameterized by a sum of Breit–Wigner amplitudes. The measurement of the S-wave amplitude covers the whole elastic range of the K−π+ system.

A narrow dip structure has been observed at 1.9 GeV/c2 in a study of diffractive photoproduction of the 3π+3π− final state performed by the Fermilab experiment E687.

BackgroundSince 1989 we have enrolled patients with clinical-radiological stage III-IVA thymomas, independent of the surgeon's judgment of resectability, into a prospective study of neoadjuvant chemotherapy–surgery and postoperative radiotherapy. In this article, we review our long-term experience of neoadjuvant chemotherapy of advanced stage (III-IVA) thymomas.MethodsFrom 1989 to 2004, 30 patients with Masaoka stage III and IVA thymomas underwent neoadjuvant chemotherapy, surgery, and postoperative radiotherapy. The neoadjuvant and adjuvant chemotherapy consisted of three courses of cisplatin, epidoxorubicin, and etoposide every 3 weeks. Adjuvant radiotherapy consisted of 45 Gy for complete resections or 60 Gy for incomplete resections.ResultsThe preoperative diagnosis of invasive thymomas was obtained for 16 patients: five by mediastinotomy, seven by video-assisted thoracic surgery, and four by fine needle aspiration. For 14 patients, no histological diagnosis was available, but a thymus-related syndrome was present in all.Twenty-seven patients are still alive (25 disease-free) and three have died (one disease-free). The 10-year survival rates were 85.7% and 76.1% for stage III and IVA thymomas, respectively (difference not significant). Only the World Health Organization pathological diagnosis significantly affected the survival, with type B3 having a worse prognosis than type AB, B1, and B2 thymomas (p = 0.02).ConclusionThe multimodality treatment of stage III and IVA thymomas by means of neoadjuvant chemotherapy provides good long-term outcomes in both stages of the disease. Since 1989 we have enrolled patients with clinical-radiological stage III-IVA thymomas, independent of the surgeon's judgment of resectability, into a prospective study of neoadjuvant chemotherapy–surgery and postoperative radiotherapy. In this article, we review our long-term experience of neoadjuvant chemotherapy of advanced stage (III-IVA) thymomas. From 1989 to 2004, 30 patients with Masaoka stage III and IVA thymomas underwent neoadjuvant chemotherapy, surgery, and postoperative radiotherapy. The neoadjuvant and adjuvant chemotherapy consisted of three courses of cisplatin, epidoxorubicin, and etoposide every 3 weeks. Adjuvant radiotherapy consisted of 45 Gy for complete resections or 60 Gy for incomplete resections. The preoperative diagnosis of invasive thymomas was obtained for 16 patients: five by mediastinotomy, seven by video-assisted thoracic surgery, and four by fine needle aspiration. For 14 patients, no histological diagnosis was available, but a thymus-related syndrome was present in all. Twenty-seven patients are still alive (25 disease-free) and three have died (one disease-free). The 10-year survival rates were 85.7% and 76.1% for stage III and IVA thymomas, respectively (difference not significant). Only the World Health Organization pathological diagnosis significantly affected the survival, with type B3 having a worse prognosis than type AB, B1, and B2 thymomas (p = 0.02). The multimodality treatment of stage III and IVA thymomas by means of neoadjuvant chemotherapy provides good long-term outcomes in both stages of the disease.

An amplitude analysis of the D+, Ds+ → π−π+π+ Dalitz plots is presented using data collected by the Fermilab high-energy photoproduction experiment E687. The data are fitted to a model consisting of a sum of relativistic Breit-Wigner amplitudes for the intermediate two-body resonant decay modes plus a flat non-resonant contribution. From the fit we derive decay fractions and relative phases. We also present measurements of Γ(D+→π−π+π+)Γ(D+→K−π+π+) and Γ(Ds+→π−π+π+)Γ(Ds+→K−K+π+).

Using data from the FOCUS (E831) experiment, we have searched for T violation in charm meson decays using the four-body decay channels $D^0 \to K^-K^+\pi^-\pi^+$, $D^+ \to K^0_SK^+\pi^-\pi^+$, and $D^+_s \to K^0_SK^+\pi^-\pi^+$. The T violation asymmetry is obtained using triple-product correlations and assuming the validity of the CPT theorem. We find the asymmetry values to be $A_Tviol (D^0) = 0.010 \pm 0.057(stat.) \pm 0.037(syst.)$, $A_Tviol (D^+) = 0.023 \pm 0.062(stat.) \pm 0.022(syst.)$, and $A_Tviol (D^+_s) = -0.036 \pm 0.067(stat.) \pm 0.023(syst.)$. Each measurement is consistent with no T violation. New measurements of the CP asymmetries for some of these decay modes are also presented.

Using a large sample of D+ to K- pi+ mu+ nu decays collected by the FOCUS photoproduction experiment at Fermilab, we present new measurements of two semileptonic form factor ratios: rv and r2. We find rv = 1.504 \pm 0.057 \pm 0.039 and r2 = 0.875 \pm 0.049 \pm 0.064. Our form factor results include the effects of the s-wave interference discussed in a previous paper.

We present a Kπ mass spectrum analysis of the four-body semileptonic charm decay D+→K−π+μ+ν in the range of 0.65GeV/c2<mKπ<1.5GeV/c2. We observe a non-resonant contribution of 5.30±0.74−0.96+0.99% with respect to the total D+→K−π+μ+ν decay. For the K∗(892)0 resonance, we obtain a mass of 895.41±0.32−0.43+0.35MeV/c2, a width of 47.79±0.86−1.06+1.32MeV/c2, and a Blatt–Weisskopf damping factor parameter of 3.96±0.54−0.90+1.31GeV−1. We also report 90% CL upper limits of 4% and 0.64% for the branching ratios Γ(D+→K¯∗(1680)0μ+ν)Γ(D+→K−π+μ+ν) and Γ(D+→K¯0∗(1430)0μ+ν)Γ(D+→K−π+μ+ν), respectively.

We describe a silicon microstrip detector interleaved with segments of a beryllium oxide target which was used in the FOCUS photoproduction experiment at Fermilab. The detector was designed to improve the vertex resolution and to enhance the reconstruction efficiency of short-lived charm particles.

We present an analysis of the decay D0→K+π− based on FOCUS data. From a sample of 234 signal events, we find a branching ratio of Γ(D0→K+π−)Γ(D0→K−π+)=(0.429−0.061+0.063±0.027)% under the assumptions of no mixing and no CP violation. Allowing for CP violation, we find a branching ratio of (0.429±0.063±0.028)% and a CP asymmetry of 0.18±0.14±0.04. The branching ratio for the case of mixing with no CP violation is (0.381−0.163+0.167±0.092)%. We also present limits on charm mixing.

A high statistics sample of photoproduced charm particles from the FOCUS (E831) experiment at Fermilab has been used to search for CP violation in the Cabibbo suppressed decay modes D+→K−K+π+, D0→K−K+ and D0→π−π+. We have measured the following CP asymmetry parameters: ACP(K−K+π+)=+0.006±0.011±0.005, ACP(K−K+)=−0.001±0.022±0.015 and ACP(π−π+)=+0.048±0.039±0.025 where the first error is statistical and the second error is systematic. These asymmetries are consistent with zero with smaller errors than previous measurements.

A high-statistics sample of photoproduced charm from the FOCUS experiment has been used to search for direct CP violation in the decay rates for D+-->K(S)pi+ and D+-->K(S)K+. We have measured the following asymmetry parameters relative to D+-->K-pi+pi+: A(CP)(K(S)pi+) = (-1.6+/-1.5+/-0.9)%, A(CP)(K(S)K+) = (+6.9+/-6.0+/-1.5)%, and A(CP)(K(S)K+) = (+7.1+/-6.1+/-1.2)% relative to D+-->K(S)pi+. We have also measured the relative branching ratios and found Gamma(D+-->K(0)pi+)/Gamma(D+-->K-pi+pi+) = (30.60+/-0.46+/-0.32)%, Gamma(D+-->K(0)K+)/Gamma(D+-->K-pi+pi+) = (6.04+/-0.35+/-0.30)%, and Gamma(D+-->K(0)K+)/Gamma(D+-->K(0)pi+) = (19.96+/-1.19+/-0.96)%.

Using data from the FOCUS (E831) experiment at Fermilab, we present a new measurement for the branching ratios of the Cabibbo-suppressed decay modes D0→π−π+ and D0→K−K+. We measured: Γ(D0→K−K+)/Γ(D0→π−π+)=2.81±0.10(stat)±0.06(syst), Γ(D0→K−K+)/Γ(D0→K−π+)=0.0993±0.0014(stat)±0.0014(syst), and Γ(D0→π−π+)/Γ(D0→K−π+)=0.0353±0.0012(stat)±0.0006(syst). These values have been combined with other experimental data to extract the ratios of isospin amplitudes and the phase shifts for the D→KK and D→ππ decay channels.

We review genetic programming principles, their application to FOCUS data samples, and use the method to study the doubly Cabibbo suppressed decay D+ -> K+ pi+ pi- relative to its Cabibbo favored counterpart, D+ -> K- pi+ pi+. We find that this technique is able to improve upon more traditional analysis methods. To our knowledge, this is the first application of the genetic programming technique to High Energy Physics data.

Background:Treatment approaches in malignant pleural mesothelioma (MPM) patients range from mere palliation to aggressive anticancer therapy, and there is currently no consensus on the optimal therapeutic strategy. In 1999, we began a phase II study to investigate four-modality treatment of advanced stage MPM.Methods:From 1999 to 2004, 49 patients with International Mesothelioma Interest Group stage II–III MPM underwent four-modality treatment with intrapleural preoperative interleukin-2 (18 × 106 UI/day for 3 days), pleurectomy/decortication, intrapleural postoperative epidoxorubicin (25 mg/m2 for 3 days), interleukin-2 (18 × 106 UI/day for 3 days), adjuvant radiotherapy (30 Gy), systemic chemotherapy (cisplatin 80 mg/m2 day 1, gemcitabine 1250 mg/m2 days 1 and 8 for up to six courses) and long-term subcutaneous interleukin-2 (3 × 106 UI/day on 3 days per week).Results:Patients included 41 men and eight women with a median age of 61 years (range, 41–77). All patients were diagnosed with MPM by thoracoscopy before inclusion. There was no postoperative mortality. Postoperative morbidity included bleeding (n = 1) and arrhythmias (n = 3). After a median follow-up of 59 months (range, 14–81), 13 patients are still alive and the median actuarial survival is 26 months (31 and 21 months for stages II and III, respectively). The 2- and 5-year actuarial survival rates were 60.2% and 23.3%, respectively. Baseline Eastern Cooperative Oncology Group performance status significantly influenced survival time (p = 0.02).Conclusion:The four-modality treatment that we adopted for advanced-stage MPM was feasible, well tolerated by most of the patients, and produced a favorable median survival. This treatment approach warrants further investigation. Treatment approaches in malignant pleural mesothelioma (MPM) patients range from mere palliation to aggressive anticancer therapy, and there is currently no consensus on the optimal therapeutic strategy. In 1999, we began a phase II study to investigate four-modality treatment of advanced stage MPM. From 1999 to 2004, 49 patients with International Mesothelioma Interest Group stage II–III MPM underwent four-modality treatment with intrapleural preoperative interleukin-2 (18 × 106 UI/day for 3 days), pleurectomy/decortication, intrapleural postoperative epidoxorubicin (25 mg/m2 for 3 days), interleukin-2 (18 × 106 UI/day for 3 days), adjuvant radiotherapy (30 Gy), systemic chemotherapy (cisplatin 80 mg/m2 day 1, gemcitabine 1250 mg/m2 days 1 and 8 for up to six courses) and long-term subcutaneous interleukin-2 (3 × 106 UI/day on 3 days per week). Patients included 41 men and eight women with a median age of 61 years (range, 41–77). All patients were diagnosed with MPM by thoracoscopy before inclusion. There was no postoperative mortality. Postoperative morbidity included bleeding (n = 1) and arrhythmias (n = 3). After a median follow-up of 59 months (range, 14–81), 13 patients are still alive and the median actuarial survival is 26 months (31 and 21 months for stages II and III, respectively). The 2- and 5-year actuarial survival rates were 60.2% and 23.3%, respectively. Baseline Eastern Cooperative Oncology Group performance status significantly influenced survival time (p = 0.02). The four-modality treatment that we adopted for advanced-stage MPM was feasible, well tolerated by most of the patients, and produced a favorable median survival. This treatment approach warrants further investigation.

Using data from the FOCUS (E831) experiment at Fermilab, we present a new measurement of the weak decay-asymmetry parameter αΛc in Λc+→Λπ+ decay. Comparing particle with antiparticle decays, we obtain the first measurement of the CP violation parameter A≡αΛc+αΛ¯cαΛc−αΛ¯c. We obtain αΛc=−0.78±0.16±0.19 and A=−0.07±0.19±0.24 where errors are statistical and systematic.

Background and Objectives Lobectomy is the gold standard treatment for resectable Non‐Small Cell Lung Cancer (NSCLC). We compared oncological outcomes of patients undergoing a “multi‐segmentectomy” (trisegmentectomy or lingulectomy) and left upper lobectomy for early stage (T1‐2, N0) NSCLC of the left upper lobe. Methods We retrospectively analyzed all patients with pathological early stage (T1‐T2 N0) NSCLC located in left upper lobe who underwent a lobectomy, a trisegmentectomy, or a lingulectomy between 2006 and 2013, focusing on surgical and oncological outcomes. Results Among 159 patients, 105 patients underwent a lobectomy and 54 patients a multi‐segmentectomy (33 lingulectomy and 21 trisegmentectomy). Actuarial mean Overall Survival was 87 months (95%CI 79‐95) and 89 months (95%CI 76‐101) for lobectomies and multi‐segmentectomies, respectively ( P ‐value: 0.895), while actuarial mean Disease Free Interval was 91 months (95%CI 82‐100) and 96 months (95%CI 84‐108) respectively ( P ‐value: 0.565). We did not observe any difference in terms of local recurrence rate between the two groups ( P = 0.337). Conclusions Lingulectomy and trisegmentectomy lead to similar oncological outcomes compared to left upper lobectomy for T1 and T2 N0 NSCLC, and they could be used as an alternative to lobectomy even in patients with a good pulmonary function.

Objectives No clear evidence of which surgical procedure should be performed for early stage mesothelioma is available to date. We analyzed our 10-year experience in the treatment of early stage mesothelioma with surgery and Hyperthermic IntraTHOracic Chemotherapy. Methods We retrospectively analyzed all cases of histologically proven epithelioid or biphasic IMIG stage I and II mesothelioma that we operated between 2005 and 2014. We performed an open pleurectomy and partial decortication of any visible lesion on the visceral pleura in all cases and both diaphragm and pericardium were always spared; Hyperthermic IntraTHOracic Chemotherapy was ran using Cisplatin 80 mg/m2 and Doxorubicin 25 mg/m2 at a target temperature of 42.5 °C for 60 min. Results We operated on 26 patients (23 male and 3 female); epithelioid tumor was diagnosed in 23 cases. Twelve patients were in IMIG stage I and 14 in IMIG stage II; median overall survival for all patients, stage I and II were 35.6, 46 and 23 months respectively and disease free survival was 18, 18 and 16 months respectively. Our results for stage I were better than those reported in literature and were similar for stage II. We observe no 30- and 90- mortality and the rate of severe complication (all CTCAE stage 3) were 30%; the median postoperative stay was 7.5 days. Conclusions Our lung sparing approach for the treatment of pleural mesothelioma in early stages allows promising long term outcomes with a complete sparing of pulmonary and diaphragmatic function. Larger studies are needed to confirm our good results.

We describe the various techniques developed in the Fermilab Wideband Experiments, E687 and FOCUS, to reconstruct long-lived states. The techniques all involve modifications to standard tracking techniques and are useful to report for future experiments.

To evaluate the safety and efficacy of a new algorithm for automatic mode switching (AMS) from DDD-DDDR to DDIR, 26 patients, 16 females and 10 males, mean age 73 +/- 6 years of age, affected by sinus node disease, chronotropic incompetence, and recurrent paroxysmal atrial fibrillation (PAF) received the Medtronic Thera DR pacemaker. The device continuously calculates, in ms, the running average of the intrinsic atrial rate (MAR) and compares the current atrial interval (CAI) with the stored MAR. When the CAI is greater than the MAR it increases by 8 ms, and when the CAI is less than the MAR, it decreases by 23 ms. When MAR < or = 330 ms (182 beats/min), tachycardia is detected and AMS is activated. All patients had clinical evaluation, 12-lead ECG, Holter monitoring, and exercise testing after implantation and every 3 months for 1 year. The results were compared with the data stored in the pacemaker memory: AMS episodes number; the histogram of the last 14 episodes; and atrial electrogram recording. Twenty-two Holter recordings in 13 patients showed PAF and in all of them AMS occurred simultaneously. AMS lasted between 10 seconds and 20 hours, and MAR ranged from 195-400 beats/min. No episode of PAF and no AMS were recorded in 39 Holter recordings in 22 patients. Appropriate AMS was confirmed in five patients by stored atrial electrogram and in nine by 12-lead ECG and pacemaker event markers. Mean atrial sensing was 2.13 +/- 1.04 mV during PAF and 3.18 +/- 1.46 mV during sinus rhythm. No PAF episode and no AMS were recorded during exercise testing. In conclusion, this new algorithm was very reliable, sensitive, and specific.

Using data from the FOCUS (E831) experiment at Fermilab, we present new measurements for the Cabibbo-suppressed decay mode D 0 → π -π + π -π + .We measure the branching ratio0022.An amplitude analysis has been performed, a first for this channel, in order to determine the resonant substructure of this decay mode.The dominant component is the decay D 0 → a 1 (1260) + π -, accounting for 60% of the decay rate.The second most dominant contribution comes from the decay D 0 → ρ(770) 0 ρ(770) 0 , with a fraction of 25%.We also study the a 1 (1260) line shape and resonant substructure.Using the helicity formalism for the angular distribution of the decay D 0 → ρ(770) 0 ρ(770) 0 , we measure a longitudinal polarization of P L = (71 ± 4 ± 2)%.

Phrenic nerve infiltration has been described in as many as 33% of advanced thymomas; en bloc resection causes diaphragmatic loss of function, with detrimental effects on pulmonary function. We report the outcomes of selected patients operated on for invasive thymoma with a nerve-sparing technique.From 1990 to 2015 we used nerve-sparing surgery with the intention to treat all patients with advanced stage thymomas without preoperative evidence of hemidiaphragmatic palsy, but with macroscopic evidence of phrenic nerve involvement. All patients underwent adjuvant radiotherapy (45 to 60 Gy) with or without chemotherapy. Long-term outcomes and the pattern of recurrence were retrospectively analyzed.Among 140 patients with stage III and IVa operated on during the study period, 19 women and 18 men with a median age of 52 years received a nerve-sparing resection. Myasthenia gravis was associated in 25 cases. In 12 patients, phrenic palsy was observed postoperatively, and eventually 4 of them recovered. Recurrence was found in 10 patients (7 stage IVa, 3 stage III) requiring additional therapies. Three patients died of cancer-related causes, with an overall survival of 265.4 months and a disease-free survival of 233.2 months.Phrenic nerve preservation in cases of invasive thymomas is feasible and may warrant an acceptable local control of disease, if associated with radiotherapy. According to these results, this technique could be proposed to all patients with invasive thymoma, especially in those affected by severe comorbidities or with a poor performance status.

Using a high statistics sample of photo-produced charm particles from the FOCUS experiment at Fermilab, we report results of a search for eight rare and Standard-Model-forbidden decays: D+, Ds+ > h+/- muon-/+ muon+ (with h=pion or Kaon). Improvement over previous results by a factor of 1.7--14 is realized. Our branching ratio upper limit D+ > pion+ muon- muon+ of 8.8E-6 at the 90% C.L. is below the current MSSM R-Parity violating constraint.

Using data from the FOCUS (E831) experiment at Fermilab, we present a new measurement for the Cabibbo-suppressed decay mode D0→K+K−π+π−. We measure: Γ(D0→K+K−π+π−)/Γ(D0→K−π−π+π+)=0.0295±0.0011±0.0008. An amplitude analysis has been performed in order to determine the resonant substructure of this decay mode. The dominant components are the decays D0→K1(1270)+K−, D0→K1(1400)+K− and D0→ρ(770)0ϕ(1020).

Using a high statistics sample of photo-produced charm particles from the FOCUS experiment at Fermilab, we report on the measurement of the ratio of semileptonic rates \Gamma(D+ > ANTI-K pi mu+ nu)/\Gamma(D+ > ANTI-K0 mu+ nu)= 0.625 +/- 0.045 +/- 0.034. Allowing for the K pi S-wave interference measured previously by FOCUS, we extract the vector to pseudoscalar ratio \Gamma(D+ > ANTI-K*0 mu+ nu)/\Gamma(D+ > ANTI-K0 mu+ nu)= 0.594 +/- 0.043 +/- 0.033 and the ratio \Gamma(D+ > ANTI-K0 mu+ nu)/\Gamma(D+ > K- pi+ pi+)= 1.019 +/- 0.076 +/- 0.065. Our results show a lower ratio for \Gamma(D > K* \ell nu})/\Gamma(D > K \ell nu) than has been reported recently and indicate the current world average branching fractions for the decays D+ >ANTI-K0(mu+, e+) nu are low. Using the PDG world average for B(D+ > K- pi+ pi+) we extract B(D+ > ANIT-K0 mu+ nu)=(9.27 +/- 0.69 +/- 0.59 +/- 0.61)%.

We present a search for a charmed pentaquark decaying strongly to D(∗)−p. Finding no evidence for such a state, we set limits on the cross-section times branching ratio relative to D∗− and D− under particular assumptions about the production mechanism.

Using a large sample of D+ -> K- pi+ mu+ nu decays collected by the FOCUS photoproduction experiment at Fermilab, we present the first measurements of the helicity basis form factors free from the assumption of spectroscopic pole dominance. We also present the first information on the form factor that controls the s-wave interference discussed in a previous paper by the FOCUS collaboration. We find reasonable agreement with the usual assumption of spectroscopic pole dominance and measured form factor ratios.

We present a search for a pentaquark decaying strongly to pKS0 in γN collisions at a center-of-mass energy up to 25 GeV. Finding no evidence for such a state in the mass range of 1470MeV/c2 to 2200MeV/c2, we set limits on the yield and on the cross section times branching ratio relative to Σ∗(1385)± and K∗(892)+.

Radio frequency ablation (RFA) of lung tumors is a relatively new procedure allowing local treatment with minimal parenchymal damage. This technique is able to induce coagulative necrosis in a limited pulmonary area.1Ambrogi MC Fontanini G Lencioni R et al.A preliminary study on thermal ablation of lung tumour.Contemp Oncol. 2004; 8: 373-379Google Scholar This emerging technology is used to achieve local treatment of primary and secondary lung tumors in patients with poor clinical status or technical contraindications to surgical resection.2Steinke K King J Glenn D Morris DL Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma.J Comput Assist Tomogr. 2003; 27: 750-757Crossref PubMed Scopus (117) Google Scholar, 3Herrera LJ Fernando HC Perry Y et al.Radiofrequency ablation of pulmonary malignant tumors in non surgical candidates.J Thorac Cardiovasc Surg. 2003; 125: 929-937Abstract Full Text Full Text PDF PubMed Scopus (221) Google Scholar Preoperative patient assessment is the same methodology used for major pulmonary resection. The current election criteria include contraindication to surgical treatment; maximal diameter of the tumor less than or equal to 5 cm; lesions located more than 1 cm from major blood vessels or airways; patients with platelet count of more than 50 × 103/μL. To produce monopolar radiofrequency energy, we used an automatic apparatus with maximal power output of 150 W operating at 460 Hz (Model 1500; RITA Medical System, Mountain View, CA). It has multiple temperature displays and impedance and power monitoring, and software is available to record and graphically represent all the data on a personal computer. The energy is transferred to the tissue by means of a multi-tined expandable array (Starburst XL; RITA Medical System). It consists of a 15-gauge needle cannula with nine deployable electrodes that open flower-like up to 5 cm. Five electrodes are equipped with thermocouples that allow continuous measurement of the temperature inside the tissue. Two grounding pads are applied to each shaved leg to ground the current and to reduce risks of skin thermal injury. The procedure is performed with the patients under conscious sedation (ketorolac 0.5–0.8 mg/kg, propofol 1–2 mg/kg/h, and remifentanil 0.1mg/kg/min) and local anesthesia (subcutaneous 1% xylocaine). Vital signs are continuously, non-invasively monitored. Computed tomographic (CT) guidance is used in most cases; it is usually enhanced by the administration of contrast material before and after coagulation to obtain information about the real effectiveness of the procedure. In a selected group of patients with the tumor in contact with the thoracic wall, it is possible to work under ultrasound guidance. The needle electrode is inserted through an intercostal space after administration of local anesthesia. The correct placement is confirmed by CT or ultrasound before applying the radiofrequency energy. The target temperature of ablation is 90°C. It is maintained for 15 to 27 minutes according to the size of the tumor; this variable also determines the gradual deployment of the electrodes, starting from 2 cm and then 1 cm for each step. When technically feasible, the ablation zone should include the whole lesion and 1 cm of the surrounding lung parenchyma. After RFA, the ablation zone is generally visible at CT scan as a ground glass opacity surrounding the target lesion. After the procedure, the patient is transferred to the recovery room for observation. Twenty-four hours later, after performing a chest radiograph to exclude the occurrence of any complication (e.g., pneumothorax), the patient is discharged. Radiological follow-up includes contrast-enhanced CT at 1, 3, and 6 months and then at 6-month intervals. Since 2001, we have performed more than 100 RFA of lung tumors. In 50 cases, radiofrequency ablation was used for non-small cell lung cancer (NSCLC) for 42 men and 8 women with mean age of 73.7 years (range, 51–89 years). RFA was performed because of medical contraindication to surgery in 36 patients with stage I NSCLC and because of advanced disease in 14 cases, often with an integrated therapeutic approach. All the procedures were well tolerated. We observed no mortality, and morbidity consisted of five cases of partial pneumothorax (10%), two of which required pleural drainage. At a median follow-up period of 31 months, the overall radiological complete response rate was 59%, and median survival was 25 months (61% and 28.9 months, respectively, in stage I disease). After the first percutaneous RFA of lung lesions reported by Dupuy et al. in 2000,4Dupuy DE Zagoria RJ Akerley W Mayo-Smith WW Kavanagh PV Safran H Percutaneus radiofrequency ablation of malignancies in the lung.Am J Roentgen. 2000; 174: 57-59Crossref PubMed Scopus (550) Google Scholar a number of works have described the feasibility and safety of the procedure. In particular, an international survey with almost 500 RFA of lung tumors reported by Steinke and colleagues in 2004 stressed the low invasiveness approach of this technique, negligible mortality, low morbidity, short hospital stay, and quality of life improvement.5Steinke K Sewell PE Dupuy D et al.Pulmonary radiofrequency ablation: an international study survey.Anticancer Res. 2004; 24: 339-343PubMed Google Scholar Most of the reports address short-term results with encouraging data. Herrera et al.3Herrera LJ Fernando HC Perry Y et al.Radiofrequency ablation of pulmonary malignant tumors in non surgical candidates.J Thorac Cardiovasc Surg. 2003; 125: 929-937Abstract Full Text Full Text PDF PubMed Scopus (221) Google Scholar treated a mixed cohort of 18 patients (5 via thoracotomy and 13 percutaneously) with primary and metastatic lung tumors. They used a needle electrode with multiple tines deployable into the tumor for 2 or 4 cm. After a mean follow-up of 6 months, they reported a 55% complete or partial response rate and a 17% stable disease rate in lesions with a mean diameter of 5.3 cm. The response rates seemed to be better for smaller lesions (66% for lesions smaller than 5 cm vs 33% for lesions larger than 5 cm). Another important issue that arose in that study was the contraindication to treat central lesions because of the risk of fatal complications, as occurred in one case in that series. More recently, Fernando and colleagues from the same Institute presented an update of their experience in patients with primary NSCLC.6Fernando HC De Hoyos A Landreneau RJ et al.Radiofrequency ablation for the treatment of non-small-cell lung cancer in marginal surgical candidates.J Thorac Cardiovasc Surg. 2005; 129: 639-644Abstract Full Text Full Text PDF PubMed Scopus (189) Google Scholar At a mean follow-up period of 14 months, they reported 63% of the patients having a complete response, which is comparable to our results. In a series of 54 primary and secondary lung tumors, Akebosi et al. reported a complete necrosis rate of 59%, with a better response for smaller lesions.7Akeboshi M Yamakado K Nakatsuka A et al.Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response.J Vasc Interv Radiol. 2004; 15: 463-470Abstract Full Text Full Text PDF PubMed Scopus (217) Google Scholar They distinguished lesions smaller than or equal to 3 cm from lesions greater than 3 cm and found a statistically significant difference in the complete response rate between the two groups (69% vs 39%; p < 0.05). These findings were confirmed by Lee and colleagues,8Lee JM Jin GY Goldberg SN et al.Percutaneous radiofrequency ablation for inoperable non-small-cell lung cancer and metastasis: preliminary results.Radiology. 2004; 230: 125-134Crossref PubMed Scopus (299) Google Scholar who reported a complete necrosis rate of 38% at a mean follow-up of 12.5 months with a statistically significant difference for lesions smaller than 3 cm (100% complete necrosis rate) compared with those measuring 3 to 5 cm (38%; p < 0.05) and those larger than 5 cm (only 8% complete necrosis rate). We have recently reported our experience with medium-term results.9Ambrogi MC Lucchi M Dini P et al.Percutaneous radiofrequency ablation of lung tumours: results in the mid-term.Eur J Cardiothorac Surg. 2006; 30: 177-183Crossref PubMed Scopus (128) Google Scholar Our data confirm all the previous reports, with an overall radiological complete response rate (CRR) of 61.9% (39 of 63 lesions) at a mean follow-up period of 23.7 months (median 24; range, 6–50). The results seemed to be better for lesions smaller than 3 cm (CRR 69.7% vs 50%). Moreover, in our study, pulmonary function tests performed before and after RFA at several time points showed a slight reduction of FVC and FEV1 at the end of the first month (not statistically significant), but they returned to pretreatment values after 3 months. RFA of lung tumors may also be combined with other treatment options (e.g., radiotherapy and chemotherapy) to have more control of the disease. In fact, Grieco et al. obtained better results with RFA combined with RT compared with either modality alone. At a median follow-up period of 19.5 months, they reported a CRR of 75.6%.10Grieco CA Simon CJ Mayo-Smith WW DiPetrillo TA Ready NE Dupuy DE Percutaneous image-guided thermal ablation and radiation therapy: outcomes of combined treatment for 41 patients with inoperable stage I/II NSCLC.J Vasc Interv Radiol. 2006; 17: 1117-1124Abstract Full Text Full Text PDF PubMed Scopus (130) Google Scholar Instead, in an experimental study on an animal model, Ahmed and colleagues achieved an increase in tumor destruction combining RFA with intravenous administration of liposomal doxorubicin.11Ahmed M Monsky WL Girnun G et al.Radiofrequency thermal ablation sharply increases intratumoral liposomal doxorubicin accumulation and tumor coagulation.Cancer Res. 2003; 163: 6327-6333Google Scholar In conclusion, RFA of lung tumors may play a role in the treatment of NSCLC. Expected further improvements of the technology and combinations with other therapies may increase its efficacy. However, it is important to stress that RFA is devoted to local treatment of lesions, and this is certainly a limitation of this procedure. Compared with surgical resection, it has a higher incidence of local and distant recurrence. For this reason, this procedure should only be intended as a compromise in treating patients who are at high risk for surgical resection because of their clinical status.

Using a large sample of photoproduced charm mesons from the FOCUS experiment at Fermilab (FNAL-E831), we observe the decay D0-->K+pi- with a signal yield of 149+/-31 events compared to a similarly cut sample consisting of 36 760+/-195 D0-->K-pi+ events. We use the observed ratio of D0-->K+pi- to D0-->K-pi+ (0.404+/-0.085+/-0.025)% to obtain a relationship between the D0 mixing and doubly Cabibbo suppressed decay parameters.

Using data collected by the fixed target Fermilab experiment FOCUS, we present several first measurements for the semileptonic decay D0→K¯0π−μ+ν. Using a model that includes a K¯0π− s-wave component, we measure the form factor ratios to be rv=1.71±0.68±0.34 and r2=0.91±0.37±0.10 and the s-wave amplitude to be A=0.35±0.22±0.05GeV−1. Finally, we measure the vector semileptonic branching ratio Γ(D0→K*(892)−μ+ν)Γ(D0→K¯0π−π+)=0.337±0.034±0.013.

A high statistics sample of photoproduced charm particles from the FOCUS (E831) experiment at Fermilab has been used to measure the D0 and D+ lifetimes. Using about 210000 D0 and 110000 D+ events we obtained the following values: 409.6±1.1 (statistical)±1.5 (systematic) fs for D0 and 1039.4±4.3 (statistical)±7.0 (systematic) fs for D+.

Using a large sample of Ds to Phi mu nu decays collected by the FOCUS photoproduction experiment at Fermilab, we present new measurements of two semileptonic form factor ratios: rV and r2. We find rV = 1.549 \pm 0.250 \pm 0.145 and r2 = 0.713 \pm 0.202 \pm 0.266. These values are consistent with the rV and r2 form factors measured for the process D+ to K*bar mu nu.

We present a new measurement of the branching ratio of the Cabibbo suppressed decay D^0\to \pi^-\mu^+\nu relative to the Cabibbo favored decay D^0\to K^-\mu^+\nu and an improved measurement of the ratio |\frac{f_+^{\pi}(0)}{f_+^{K}(0)}|. Our results are 0.074 \pm 0.008 \pm 0.007 for the branching ratio and 0.85 \pm 0.04 \pm 0.04 \pm 0.01 for the form factor ratio, respectively.

In this paper we present ideas and architectural principles upon which we are basing the development of a distributed, open-source infrastructure that, in turn, will support the expression of business models, the dynamic composition of software services, and the optimisation of service chains through automatic self-organising and evolutionary algorithms derived from biology. The target users are small and medium-sized enterprises (SMEs). We call the collection of the infrastructure, the software services, and the SMEs a Digital Business Ecosystem (DBE).

We report on the results of a search for fourteen flavor changing neutral current, lepton number violating, or lepton family number violating decays of the charmed meson D+ in the large charm sample recorded by the Fermilab photoproduction experiment E687. No evidence is seen for these rare and standard-model-forbidden decays, of the form D+ → h±ℓ∓ℓ+ (with h = π, K and ℓ = e, μ); we determine 90% confidence level upper limits on their absolute branching fractions in the range (9–20) × 10−5.

A precise determination of the charm-strange baryon Cascade(c)+ lifetime is presented. The data were accumulated by the Fermilab high-energy photoproduction experiment FOCUS. The measurement is made with 300 Cascade(c)+ --> Cascade- pi+ pi+ decays, 130 Cascade(c)+ --> Sigma+ K- pi+ decays, 45 Cascade(c)+ --> p K- pi+ decays and 58 Cascade(c)+ --> Lambda K- pi+ pi+ decays. The Cascade(c)+ lifetime is measured to be 0.439+/-0.022+/-0.009 ps.

We present the first clear observation of the doubly Cabibbo suppressed decay D+→K−K+K+ and the first observation of the singly Cabibbo suppressed decay Ds+→K−K+K+. These signals have been obtained by analyzing the high statistics sample of photoproduced charm particles of the FOCUS (E831) experiment at Fermilab. We measure the following relative branching ratios: Γ(D+→K−K+K+)/Γ(D+→K−π+π+)=(9.49±2.17±0.22)×10−4 and Γ(Ds+→K−K+K+)/Γ(Ds+→K−K+π+)=(8.95±2.12+2.24−2.31)×10−3, where the first error is statistical and the second is systematic.

Using the FOCUS spectrometer with photon beam energies between 20 and 160 \gev, we confirm the existence of a diffractively photoproduced enhancement in $K^+K^-$ at 1750 \mevcc with nearly 100 times the statistics of previous experiments. Assuming this enhancement to be a single resonance with a Breit-Wigner mass shape, we determine its mass to be $1753.5\pm 1.5\pm 2.3$ \mevcc and its width to be $122.2\pm 6.2\pm 8.0$ \mevcc. We find no corresponding enhancement at 1750 \mevcc in $K^*K$, and again neglecting any possible interference effects we place limits on the ratio $\Gamma (X(1750) \to K^*K)/\Gamma (X(1750) \to K^+K^-)$. Our results are consistent with previous photoproduction experiments, but, because of the much greater statistics, challenge the common interpretation of this enhancement as the $\phi (1680)$ seen in $e^+e^-$ annihilation experiments.

A high statistics measurement of the Lambda(+)(c) lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis technique with particular attention to the determination of the systematic uncertainty. The measured value of 204.6 +/- 3.4 (stat) +/- 2.5 (syst) fs from 8034 +/- 122 Lambda(+)(c)-->pK(-)pi(+) decays represents a significant improvement over the present world average.

Received 13 February 2002DOI:https://doi.org/10.1103/PhysRevLett.88.159903©2002 American Physical Society

Using data collected by the high energy photoproduction experiment FOCUS at Fermilab we study the doubly and singly Cabibbo suppressed decays D+ and Ds+ --> K+ pi+ pi-. Branching ratios and Dalitz plot analyses are performed.

Using data collected by the fixed target Fermilab experiment FOCUS, we measure the branching ratios of the Cabibbo-favored decays Ξc+→Σ+K−π+, Ξc+→Σ+K̄∗(892)0, and Ξc+→Λ0K−π+π+ relative to Ξc+→Ξ−π+π+ to be 0.91±0.11±0.04, 0.78±0.16±0.06, and 0.28±0.06±0.06, respectively. We report the first observation of the Cabibbo-suppressed decay Ξc+→Σ+K+K− and we measure the branching ratio relative to Ξc+→Σ+K−π+ to be 0.16±0.06±0.01. We also set 90% confidence level upper limits for Ξc+→Σ+φ and Ξc+→Ξ∗(1690)0(Σ+K−)K+ relative to Ξc+→Σ+K−π+ to be 0.12 and 0.05, respectively. We find an indication of the decays Ξc+→Ω−K+π+ and Ξc+→Σ∗(1385)+K̄0 and set 90% confidence level upper limits for the branching ratios with respect to Ξc+→Ξ−π+π+ to be 0.12 and 1.72, respectively. Finally, we determine the 90% C.L. upper limit for the resonant contribution Ξc+→Ξ∗(1530)0π+ relative to Ξc+→Ξ−π+π+ to be 0.10.

We apply a genetic programming technique to search for the doubly Cabibbo suppressed decays Λc+→pK+π− and Ds+→K+K+π−. We normalize these decays to their Cabibbo favored partners and find BR(Λc+→pK+π−)/BR(Λc+→pK−π+)=(0.05±0.26±0.02)% and BR(Ds+→K+K+π−)/BR(Ds+→K−K+π+)=(0.52±0.17±0.11)% where the first errors are statistical and the second are systematic. Expressed as 90% confidence levels (CL), we find <0.46 and <0.78%, respectively. This is the first successful use of genetic programming in a high energy physics data analysis.

The FOCUS experiment (FNAL-E831) has used two channels, Ω−π+ and Ξ−K−π+π+, to measure the lifetime of the Ωc0 charmed baryon. From a sample of 64±14 signal events at a mass of 2.698 GeV/c2, we measure an Ωc0 lifetime of 72±11 (stat.) ±11 (sys.) fs, substantially improving upon the current world average.

Using data from the FOCUS (E831) experiment at Fermilab, we present a new measurement of the branching ratio for the Cabibbo-favored decay mode D0→K−K−K+π+. From a sample of 143±19 fully reconstructed D0→K−K−K+π+ events, we measure Γ(D0→K−K−K+π+)/Γ(D0→K−π−π+π+)=0.00257±0.00034(stat.)±0.00024(syst.). A coherent amplitude analysis has been performed to determine the resonant substructure of this decay mode. This analysis reveals a dominant contribution from φ and K∗0(892) states.

T4 non-small cell lung cancer (NSCLC) is commonly considered a contraindication to surgery, indeed chemo-radiotherapy achieves a poor survival rate. We have reviewed our experience with T4 NSCLC patients who underwent surgery with the aim of debating the indications and results of surgical treatment in this highly selected group of patients.We investigated a cohort of 60 patients, 49 men and 11 women, who underwent surgery for NSCLC from January 1998 to December 2002 and whose pathological staging was T4N0-2M0. The median age was 65 years (range 46-82). The tumors were classified T4 for the following reasons: intralobar satellite metastasis in 24 cases, direct mediastinum invasion in 18 cases, malignant pleural effusion in 7 cases, involvement of the superior vena cava in 4 cases, marginal invasion of the vertebral body in 3 cases, involvement of the carena in 3 cases and invasion of the left atrium in 1 case. Thirteen patients had undergone neo-adjuvant chemotherapy while 39 underwent adjuvant therapies.Thirty-two patients resulted with N0 disease, 5 with N1 and 23 with N2 disease. Forty patients relapsed (27 systemic and 13 local relapses). The mean survival was 20 months. Of the examined parameters only metastatic nodal involvement was significantly associated with a worse prognosis (P=0.007).Surgery for T4 NSCLC may be effective in those patients without mediastinal (N2) lymph node involvement. The prognosis was neither affected by the subtype of T4 tumor nor by the use of adjuvant therapies and/or neoadjuvant chemotherapy but only by the N status. In the preoperative work-up, every possible effort should be made to achieve a careful evaluation of lymph-nodal status (primarily by mediastinoscopy and video operative staging).

The remarkable growth of Sardex as a local currency throughout the island of Sardinia over the past 5 years motivated an in-depth look at its starting assurnptions, design and operational principles, and local context. The paper looks at Sardex as a social innovation start-up, a complementary currency, a mutual credit system, and a socio-economic «circuit». The analysis relies on interviews of circuit members and its founders. The main findings are that trust was and continues to be fundamentally important for the creation and operation of the mutual credit systern, and that Sardex encompasses both economic and social value(s) in a process of re-embedding of the economy. Sardex configured itself as a crucial mediator of economic exchanges and became a valuable actor acting as an institution at the regional level. These properties make it an ideal space for experimentation in socio-economic innovation that can be characterized as a «Iaboratory for multi-Ievel governance.

Using a large sample of charm semileptonic decays collected by the FOCUS photoproduction experiment at Fermilab, we present new measurements of two semileptonic branching ratios. We obtain values of D+ to K*munu/k2pi = 0.602 +/- 0.010 +/- 0.021 and Ds to phimunu/phipi = 0.54 +/- 0.033 +/- 0.048. Our result D+ result includes the effects of s-wave interference.

Studies of DD correlations for a large sample of events containing fully and partially reconstructed pairs of charmed D mesons recorded by the Fermilab photoproduction experiment FOCUS (FNAL-E831) are presented. Correlations between D and D mesons are used to study heavy quark production dynamics. We present results for fully and partially reconstructed charm pairs and comparisons to a recent version of Pythia with default parameter settings. We also comment on the production of ψ(3770) in our data.

Using data from the FOCUS experiment (FNAL-E831), we report on the decay of $D^0$ mesons into final states containing more than one $K^0_S$. We present evidence for two Cabibbo favored decay modes, $D^0\to K^0_SK^0_S K^- \pi^+$ and $D^0\to K^0_SK^0_S K^+ \pi^-$, and measure their combined branching fraction relative to $D^0\to \bar{K} ^0\pi^+\pi^-$ to be $\frac{\Gamma(D^0\to K^0_SK^0_SK^{\pm}\pi^{\mp})}{\Gamma(D^0\to \bar{K} ^0\pi^+\pi^-)}$ = 0.0106 $\pm$ 0.0019 $\pm$ 0.0010. Further, we report new measurements of $\frac{\Gamma(D^0\to K^0_SK^0_SK^0_S)}{\Gamma(D^0\to \bar{K} ^0\pi^+\pi^-)}$ = 0.0179 $\pm$ 0.0027 $\pm$ 0.0026, $\frac{\Gamma(D^0\to K^0\bar{K} ^0)}{\Gamma(D^0\to \bar{K} ^0\pi^+\pi^-)}$ = 0.0144 $\pm$ 0.0032 $\pm$ 0.0016, and $\frac{\Gamma(D^0\to K^0_SK^0_S\pi^+\pi^-)}{\Gamma(D^0\to \bar{K} ^0\pi^+\pi^-)}$ = 0.0208 $\pm$ 0.0035 $\pm$ 0.0021 where the first error is statistical and the second is systematic.

We present a search for a pentaquark decaying strongly to Ξ−π− in γN collisions at a center-of-mass energy up to 25 GeV/c2. Finding no evidence for such a state in the mass range of 1480 MeV/c2 to 2400 MeV/c2, we set limits on the yield and on the cross section times branching ratio relative to Ξ∗(1530)0.

Using data collected by the Fermilab experiment FOCUS, we measure the lifetime of the charmed baryon (\Xi_{c}^{o}) using the decay channels (\Xi_{c}^{o}\to \Xi ^{-}\pi ^{+}) and (\Xi_{c}^{o}\to \Omega ^{-}K^{+}). From a combined sample of (110\pm 17) events we find (\tau (\Xi_{c}^{o}) =~118^{+ 14}_{- 12} \pm5) fs, where the first and second errors are statistical and systematic, respectively.

In this paper we present a measurement of the natural widths of $\Sigma_c^0$ and $\Sigma_c^{++}$. Using data from the FOCUS experiment, we find $\Gamma(\Sigma_c^0) = 1.55 +0.41/-0.37 \pm 0.38$ MeV/c^2 and $\Gamma(\Sigma_c^0) = 2.05 +0.41/-0.38 \pm 0.38$ MeV/c^2. The first errors are statistical, the second systematic. These results are obtained with a sample of 913 $\Sigma_c^0 \to \Lambda_c^+ \pi^-$ decays and 1110 $\Sigma_c^++ \to \Lambda_c^+ \pi^+$ decays. These results are compared with recent theoretical predictions. PACS numbers: 14.20.Lq 13.30Eg

We report the observation of the Cabibbo suppressed decay Ξc+→pK−π+ using data collected with the FOCUS spectrometer during the 1996–1997 Fermilab fixed target run. We find a Ξc+ signal peak of 202±35 events. We have measured the relative branching ratios BR(Ξ+c→pK−π+)/BR(Ξ+c→Ξ−π+π+)=0.234±0.047±0.022 and BR(Ξ+c→pK̄∗(892)0)/BR(Ξ+c→pK−π+)=0.54±0.09±0.05.

Federated learning is one of the most appealing alternatives to the standard centralized learning paradigm, allowing a heterogeneous set of devices to train a machine learning model without sharing their raw data. However, it requires a central server to coordinate the learning process, thus introducing potential scalability and security issues. In the literature, server-less federated learning approaches like gossip federated learning and blockchain-enabled federated learning have been proposed to mitigate these issues. In this work, we propose a complete overview of these three techniques proposing a comparison according to an integral set of performance indicators, including model accuracy, time complexity, communication overhead, convergence time, and energy consumption. An extensive simulation campaign permits to draw a quantitative analysis considering both feedforward and convolutional neural network models. Results show that gossip federated learning and standard federated solution are able to reach a similar level of accuracy, and their energy consumption is influenced by the machine learning model adopted, the software library, and the hardware used. Differently, blockchain-enabled federated learning represents a viable solution for implementing decentralized learning with a higher level of security, at the cost of an extra energy usage and data sharing. Finally, we identify open issues on the two decentralized federated learning implementations and provide insights on potential extensions and possible research directions in this new research field.

We report the observation of the Ξc∗+ state decaying into Ξc0π+ with Ξc0→ΛK0π+π− or ΛK−π+π+π−. We have observed 47±11 candidate events for the Ξc∗+ state and measured its mass to be 177.1±0.5±1.1 MeV/c2above the Ξc0 mass. We have also measured the Ξc0 mass to be 2470.0±2.8±2.6 MeV/c2.

Using a high statistics sample of photoproduced charmed particles from the FOCUS experiment at Fermilab (FNAL-E831), we measure the mass splittings of the charmed baryons Σc0and Σc++. We find M(Σc0−Λc+)=167.38±0.21±0.13MeV/c2 and M(Σc++−Λc+)=167.35±0.19±0.12MeV/c2 with samples of 362±36 and 461±39 events, respectively. We measure the isospin mass splitting M(Σc++−Σc0) to be −0.03±0.28±0.11MeV/c2. The first errors are statistical and the second are systematic.

We have studied the Cabibbo suppressed decay Λc+ → Σ+K*0(892) and the Cabibbo favored decays Λc+ → Σ+K+K−, Λc+ → Σ+ϕ and Λc+ → Ξ*0(Σ+K−)K+ and measured their branching ratios relative to Λc+ → Σ+π+π− to be (7.8 ± 1.8 ± 1.3)%, (7.1 ± 1.1 ± 1.1)%, (8.7 ± 1.6 ± 0.6)% and (2.2 ± 0.6 ± 0.6)%, respectively. The first error is statistical and the second is systematic. We also report two 90% confidence level limits Γ(Λc+ → Σ−K+π+)/Γ(Λc+ → Σ+K*0(892)) < 35% and Γ(Λc+ → Σ+K+K−)NR/Γ(Λc+ → Σ+π+π−) < 2.8%.

Hemothorax may be immediately life-threatening or lead to complications like empyema and fibrothorax. The first step of management is the placement of a tube thoracostomy which is efficacious in more than 80% of cases. Continuous bleeding and retained blood, instead, require surgical treatment.From 1993 to 2000, 33 patients underwent videothoracoscopic treatment of hemothorax. It was post-surgical in 19 cases, spontaneous in 8 and post-traumatic in 6. Fifteen patients had a continuous bleeding (>1500 mL/24 hrs) and 18 patients a retained hemothorax (= or >500 mL). To better assess smaller retained collection 11 patients underwent both CT scans and trans-thoracic ultrasonography. Twenty-six patients (group 1) were operated within 7 days of the diagnosis and 7 after 10 days (group 2). Standard videothoracoscopic equipment was utilised with the patient under general anaesthesia and double lumen selective intubation. Two or three incisions were performed in axillary triangle (in the postsurgical ones we always utilised the existing incisions). Hemostasis was always achieved by clip ligation and electrocautery. Clotted blood underwent fragmentation and suction with a complete evacuation followed by pleural washing with antibiotics solution.Videothoracoscopy was effective in 32 cases. One patient of group 2 required conversion to open thoracotomy due to the presence of sticky pleural adhesions. Operating time, mean drainage period and mean hospital stay were sensitively shorter in patients of group 1 with respect to patients of group 2. At a mean follow-up of 39 months no relapses or complications were observed.Videothoracoscopy seems to be safe and effective in the treatment of hemothorax. To avoid prolonged operations, conversions to thoracotomy and complications, it should be performed as soon as possible. Actually only massive hemorrhages justify the thoracotomic approach.

A high statistics measurement of the D(s)+ lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis of the two decay modes, D(s)+ --> phi(1020)pi+ and D(s)+ -->K*(892)0K+, used for the measurement. The measured lifetime is 507.4 +/- 5.5(stat) +/- 5.1(syst) fs using 8961 +/- 105 D(s)+ --> phi(1020)pi+ and 4680 +/- 90 D(s)+ --> K*(892)0K+ decays. This is a significant improvement over the present world average.

We have studied hadronic four-body decays of D(+) and D(+)(s) mesons with a K(S) in the final state using data recorded during the 1996-1997 fixed-target run of the Fermilab high energy photoproduction experiment FOCUS. We report a new branching ratio measurement of gamma(D(+)-->K(S)K-pi(+)pi(+))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0768+/-0.0041+/-0.0032. We make the first observation of three new decay modes with branching ratios gamma(D(+)-->K(S)K+pi(+)pi(-))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0562+/-0.0039+/-0.0040, gamma(D(+)-->K(S)K+K-pi(+))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0077+/-0.0015+/-0.0009, and gamma(D(+)(s)-->K(S)K+pi(+)pi(-))/gamma(D(+)(s)-->K(S)K-pi(+)pi(+)) = 0.586+/-0.052+/-0.043, where in each case the first error is statistical and the second error is systematic.

Using data from the FOCUS experiment (FNAL–E831), we study the decay of Λc+ baryons into final states containing a Λ hyperon. The branching fractions of Λc+ into Λπ+, Λπ+π+π− and ΛK¯0K+ relative to that into pK−π+ are measured to be 0.217±0.013±0.020, 0.508±0.024±0.024 and 0.142±0.018±0.022, respectively. We also report new measurements of Γ(Λc+→Σ0π+)Γ(Λc+→Λπ+)=1.09±0.11±0.19, Γ(Λc+→Σ0π+π+π−)Γ(Λc+→Λπ+π+π−)=0.26±0.06±0.09 and Γ(Λc+→Ξ(1690)0(ΛK¯0)K+)Γ(Λc+→ΛK¯0K+)=0.32±0.10±0.04. Further, an analysis of the subresonant structure for the Λc+→Λπ+π+π− decay mode is presented.

Extended resections are considered a valid therapeutic option in cases of selected locally advanced lung cancer in reason of an acceptable morbidity.1Luketich J.D van Raemdonck D.E Ginsberg R.J Extended resection for higher-stage non-small-cell lung cancer.World J Surg. 1993; 17: 719-728Crossref PubMed Scopus (16) Google Scholar, 2Pairolero P.C Extended resections for lung cancer. How far is too far?.Eur J Cardiothorac Surg. 1999; 16: S48-50Crossref PubMed Scopus (25) Google Scholar, 3Bardet E Moro-Sibilot D Le Chevalier T Massard G Douillard J.Y Theobald S et al.Standards, options and recommendations for the management of locally advanced non small cell lung carcinoma.Bull Cancer. 2001; 88: 369-387PubMed Google Scholar Multimodality treatment, including chemotherapy, radiotherapy, and surgical intervention, has proved to improve the results in terms of disease-free and overall survival,4Van Zandwijk N Neoadjuvant strategies for non-small cell lung cancer.Lung Cancer. 2001; 34: S145-150Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar, 5Non-Small Cell Lung Cancer Collaborative GroupChemotherapy in non-small cell lung cancer a meta-analysis using updated data on individual patients from 52 randomised clinical trials.BMJ. 1995; 311: 899-909Crossref PubMed Scopus (548) Google Scholar, 6Meko J Rusch V.W Neoadjuvant therapy and surgical resection for locally advanced non-small cell lung cancer.Semin Radiat Oncol. 2000; 10: 324-332Abstract Full Text PDF PubMed Scopus (15) Google Scholar despite a major postoperative morbidity.7Fowler W.C Langer C.J Curran W.J Keller S.T Post-operative complications after combined neo-adjuvant treatment of lung cancer.Ann Thorac Surg. 1993; 55: 986-989Abstract Full Text PDF PubMed Scopus (194) Google Scholar Pneumoencephalus is a rare complication of important cranial trauma8Bayo Poleo R Jimeno Torres B Antona Diaz M Fernandez de Alarcon L Traumatic disseminated pneumoencephalus.Rev Clin Esp. 1998; 198: 45-46PubMed Google Scholar or neurosurgery,9Saxena S Ambesh S.P Saxena H.N Kumar R Pneumoencephalus and convulsions after ventriculoscopy a potentially catastrophic complication.J Neurosurg Anesthesiol. 1999; 11: 200-202Crossref PubMed Scopus (21) Google Scholar but to our knowledge, it was never reported after thoracic surgery. We report a case of massive pneumoencephalus appearing late after an en bloc upper right lobectomy for lung cancer in a patient who previously underwent chemoradiotherapy. Thoracic surgeons should be aware of this possible complication when an extended lung resection involving the ribs and the vertebral bodies is performed. A 76-year-old man was referred for surgical treatment of right upper lobe squamous carcinoma infiltrating the chest wall. Previously, the patient underwent 3 cycles of neoadjuvant chemotherapy (carboplatin and paclitaxol) and radiotherapy (40 Gy) with a partial response (<50%). At the operation, we performed an en bloc right upper lobectomy with the posterior arches of the first 4 ribs and the transverse process of D2. The postoperative course was uneventful, and the patient was discharged on the ninth day. The pathologic examination showed a poorly differentiated lung carcinoma that was widely necrotic and infiltrating the chest wall. The results of biopsy on the vertebral bodies, as well as on the hilar and mediastinal nodes, were negative for neoplastic cells, and consequently, the pTNM was T3 N0 (stage IIb). Five days later, the patient complained of dyplopia, headache, and decrease of bilateral sight. He went to the first aid department, where a brain computed tomographic scan was performed, showing a massive hypotensive pneumoencephalus (Figure 1). At chest radiography, a remarkable right hydropneumothorax was present (Figure 2, A). The patient was referred to our department, where a chest tube was positioned on the middle axillary line at the VI space, evacuating about 2000 mL of sero-hematic pleural fluid and air. We placed the bed of the patient in the Trendelenburg position and the drainage in aspiration.Figure 2Chest radiographs with the right hydropneumothorax (A) and after the chest tube placement (B).View Large Image Figure ViewerDownload (PPT) The chest radiograph after these procedures showed pulmonary re-expansion (Figure 2, B). Contemporarily, we noted the resolution of the neurologic complaints and the improvement of his general condition. Twelve days later, a new brain computed tomographic scan was performed, showing a complete resolution of the intraventricular and extraventricular pneumoencephalus. Afterward, the chest tube was removed, and the patient's clinical state progressively improved. On the 15th day, the patient was discharged. Randomized trials, as well as meta-analysis, show the benefit of neoadjuvant treatments in selected patients with locally advanced stage III non–small cell lung cancer. However, a combined modality treatment can increase morbidity and mortality after surgical intervention in patients with stage III non–small cell lung cancer7Fowler W.C Langer C.J Curran W.J Keller S.T Post-operative complications after combined neo-adjuvant treatment of lung cancer.Ann Thorac Surg. 1993; 55: 986-989Abstract Full Text PDF PubMed Scopus (194) Google Scholar because it is associated with more postoperative complications, especially when extended resections have been performed. Up to now, pneumoencephalus after a thoracic operation was never documented. Speculating about its pathogenesis, we can hypothesize that the pneumoencephalus was imputable to a dura mater lesion, determined during the disarticulation of the transverse process of D2, and a hypertensive hydropneumothorax, which complicated the late postoperative course and generated a pressure gradient allowing the air to go inside the liquoral space. The chest tube, which solved the pneumothorax, and the Trendelenburg position of the patient, which allowed the air to go out of the liquoral space, were necessary and sufficient to take care of the pneumoencephalus. The dura mater lesion was small and unknown by the surgeons, who otherwise could appreciate the cerebrospinal fluid leak and attempt to repair or protect it with a pleural-muscle flap or use of fibrin glue. Moreover, if the dura mater lesion had been substantial, the pneumoencephalus could have been of early and not late onset. This report, emphasizing a possible complication of en bloc resections involving the vertebral bodies, especially after chemotherapy, radiotherapy, or both, might prompt the thoracic surgeon to evaluate a possible solution of continuity of the dura mater during extended lung resections.

Using a large sample of D+→K−K+π+ decays collected by the FOCUS photoproduction experiment at Fermilab, we present the first non-parametric analysis of the K−π+ amplitudes in D+→K−K+π+ decay. The technique is similar to the technique used for our non-parametric measurements of the D+→K¯∗0e+ν form factors. Although these results are in rough agreement with those of E687, we observe a wider S-wave contribution for the K¯0∗0(1430) contribution than the PDG [W.-M. Yao, et al., J. Phys. G 33 (2006) 1], world average mass and width. We have some weaker evidence for the existence of a new, D-wave component at low values of the K−π+ mass.

The automatic classification of applications and services is an invaluable feature for new generation mobile networks. Here, we propose and validate algorithms to perform this task, at runtime, from the raw physical channel of an operative mobile network, without having to decode and/or decrypt the transmitted flows. Towards this, we decode Downlink Control Information (DCI) messages carried within the LTE Physical Downlink Control CHannel (PDCCH). DCI messages are sent by the radio cell in clear text and, in this paper, are utilized to classify the applications and services executed at the connected mobile terminals. Two datasets are collected through a large measurement campaign: one labeled, used to train the classification algorithms, and one unlabeled, collected from four radio cells in the metropolitan area of Barcelona, in Spain. Among other approaches, our Convolutional Neural Network (CNN) classifier provides the highest classification accuracy of 99%. The CNN classifier is then augmented with the capability of rejecting sessions whose patterns do not conform to those learned during the training phase, and is subsequently utilized to attain a fine grained decomposition of the traffic for the four monitored radio cells, in an online and unsupervised fashion.

New measurements of the lifetime and mass of the Ξc+ are presented. The Ξc+ has been reconstructed through the two decay channels Ξ−π+π+ and Σ+K−π+. The data were accumulated by the Fermilab high energy photoproduction experiment E687. The lifetime is measured to be 0.34+0.07−0.05(stat.)±0.02(syst.) ps while the mass is measured to be 2465.8±1.9(stat.)±2.5(syst.) MeV/c2.

Abstract The malignancy of ventricular premature complexes (VPCs) that have the R on T phenomenon has been extensively investigated in the animal model,1 as well as in the clinical settings of acute myocardial infarction2 and sudden death.3 Data are lacking relating the R on T phenomenon to the occurrence of ventricular tachyarrhythmias during episodes of transient myocardial ischemia in humans. We prospectively studied a group of patients with variant angina to establish the relation between the prematurity of VPCs during transient myocardial ischemic attacks and their malignancy.

We study the decay of D+ and D+s mesons into charged five-body final states, and report the discovery of the decay mode D+→K+K−π+π+π−, as well as measurements of the decay modes D+→K−π+π+π+π−, Ds+→K+K−π+π+π−, Ds+→φπ+π+π− and D+/Ds+→π+π+π+π−π−. An analysis of the resonant substructure for D+→K−π+π+π+π− and Ds+→K+K−π+π+π− is included, with an indication that both decays proceed primarily through an a1 vector resonance.

Using data collected by the FOCUS experiment at Fermilab, we present a new measurement of the charm semileptonic branching ratio BR(D+ -> rho0 mu+ nu)/BR(D+ -> K*0 mu+ nu). From a sample of 320+-44 and 11372+-161 D+ -> rho0 mu+ nu and D+ -> K*0 mu+ nu events respectively, we find BR(D+ -> rho0 mu+ nu)/BR(D+ -> K*0 mu+ nu)=0.041+-0.006(stat)+-0.004(syst).

The CMS silicon pixel detector is the tracking device closest to the LHC p–p collisions, which precisely reconstructs the charged particle trajectories. The planar technology used in the current innermost layer of the pixel detector will reach the design limit for radiation hardness at the end of Phase I upgrade and will need to be replaced before the Phase II upgrade in 2020. Due to its unprecedented performance in harsh radiation environments, 3D silicon technology is under consideration as a possible replacement of planar technology for the High Luminosity-LHC or HL-LHC. 3D silicon detectors are fabricated by the Deep Reactive-Ion-Etching (DRIE) technique which allows p- and n-type electrodes to be processed through the silicon substrate as opposed to being implanted through the silicon surface. The 3D CMS pixel devices presented in this paper were processed at FBK. They were bump bonded to the current CMS pixel readout chip, tested in the laboratory, and testbeams carried out at FNAL with the proton beam of 120 GeV/c. In this paper we present the laboratory and beam test results for the irradiated 3D CMS pixel devices.

Given the large investments in superfast broadband by the UK government and private broadband providers needed for reaching the outlying areas of the UK, an analysis of possible channels and modes of revenue generation towards the recovery of these investments was performed. This paper focuses on the question of whether societal value and market value can be connected directly. Rather than interpreting this connection as the commodification of social network statistics and user profiles, however, the paper addresses the question: can market value be ‘colonised’ by social value(s)? The tentative answer is encouraging. Adopting a perspective based on a combination of economic anthropology, political economy, and institutional economics, the paper compares the Local Exchange and Trading Systems (LETS) and the Wirtshaftsring (WIR) system and proposes that the latter seems to scale better than the former because its SME membership has required the WIR economic circle to develop a considerable ‘institutional infrastructure’ which, in turn, is better able to integrate these different forms of value within the same unit of account, store of value, and medium of exchange. In fact, unlike reputational currencies and other similar phenomena, the chief purpose of the WIR is not to mediate non-marketbased modes of peer production, but to support trade. It therefore seems promising as the basis of an ‘open source’ form of e-currency for the digital economy.

The main aim of this report is to provide an introductory tutorial on the Abstract State Machines (ASM) specification method for software engineering to an audience already familiar with the Temporal Logic of Actions (TLA$^+$) method. The report asks to what extent the ASM and TLA$^+$ methods are complementary in checking specifications against stated requirements and proposes some answers. A second aim is to provide a comparison between different executable frameworks that have been developed for the same specification languages. Thus, the ASM discussion is complemented by executable Corinthian ASM (CASM) and CoreASM models. Similarly, the two TLA$^+$ specifications presented, which rely on the TLC and Apalache model checkers, respectively, are complemented by a Quint specification, a new language developed by Informal Systems to serve as a user-friendly syntax layer for TLA$^+$. For the basis of comparison we use the specification of the Alternating Bit (AB) protocol because it is a simple and well-understood protocol already extensively analysed in the literature. While the models reported here and developed with the two methods are semantically equivalent, ASMs and Quint are better suited for top-down specification from abstract requirements by iterative refinement. TLA$^+$ seems to be more easily used bottom-up, to build abstractions on top of verified components in spite of the fact that it, too, emphasizes iterative refinement. In the final section, the report begins to scope out the possibility of a homomorphism between the specification of the AB protocol and its finite-state machine (FSM) through state space visualizations, motivated by a search for a formal decomposition method.

Blockchain promises to enhance distributed machine learning (ML) approaches such as federated learning (FL) by providing further decentralization, security, immutability, and trust, which are key properties for enabling collaborative intelligence in next-generation applications. Nonetheless, the intrinsic decentralized operation of peer-to-peer (P2P) blockchain nodes leads to an uncharted setting for FL, whereby the concepts of FL round and global model become meaningless, as devices' synchronization is lost without the figure of a central orchestrating server. In this paper, we study the practical implications of outsourcing the orchestration of FL to a democratic setting such as in a blockchain. In particular, we focus on the effects that model staleness and inconsistencies, endorsed by blockchains' modus operandi, have on the training procedure held by FL devices asynchronously. Using simulation, we evaluate the blockchained FL operation by applying two different ML models (ranging from low to high complexity) on the well-known MNIST and CIFAR-10 datasets, respectively, and focus on the accuracy and timeliness of the solutions. Our results show the high impact of model inconsistencies on the accuracy of the models (up to a ~35% decrease in prediction accuracy), which underscores the importance of properly designing blockchain systems based on the characteristics of the underlying FL application.

Using data collected by the FOCUS experiment at Fermilab, we report the discovery of the decay modes D^0 --> K- pi+ pi+ pi+ pi- pi- and D^0 --> pi+ pi+ pi+ pi- pi- pi-. With a sample of 48 +/- 10 reconstructed D^0 --> K- pi+ pi+ pi+ pi- pi- decays and 149 +/- 17 reconstructed D^0 --> pi+ pi+ pi+ pi- pi- pi- decays, we measure the following relative branching ratios: ${\Gamma (D^0 \to K^- \pi^+ \pi^+ \pi^+ \pi^- \pi^-) / \Gamma (D^0 \to K^- \pi^+ \pi^+ \pi^-)} = (2.70 \pm 0.58 \pm 0.38) \times 10^{-3}$ ${\Gamma (D^0 \to \pi^+ \pi^+ \pi^+ \pi^- \pi^- \pi^-) / \Gamma (D^0 \to K^- \pi^+ \pi^+ \pi^-)} = (5.23 \pm 0.59 \pm 1.35) \times 10^{-3}$ ${\Gamma (D^0 \to \pi^+ \pi^+ \pi^+ \pi^- \pi^- \pi^-) / \Gamma (D^0 \to K^- \pi^+ \pi^+ \pi^+ \pi^- \pi^-)} = 1.93 \pm 0.47 \pm 0.48$ The first errors are statistical and the second are systematic. The branching fraction of the Cabibbo suppressed six-body decay mode is measured to be a factor of two higher than the branching fraction of the Cabibbo favored six-body decay mode.

Charm meson decay-dynamics has been extensively studied in the last decade. Dalitz plot analysis has revealed as a powerful tool for investigating effects of resonant substructures, interference patterns and final-state-interactions in the charm sector. Recent results from FOCUS on D + and D s decays will be presented with particular emphasis on the decay amplitude formalism; Isobar model and K-matrix model results will be compared and discussed.