Effect of a multimodal intervention in breast Cancer patients undergoing neoadjuvant therapy: A study protocol of the multimodal project.

BACKGROUND AND AIMS: To determine the effect of a multimodal intervention (nutritional behavior change and physical exercise) on quality of life, chemotherapy response rate and tolerance, histopathological level of the tumor, body composition, and biochemical parameters, in patients diagnosed with breast cancer during neoadjuvant chemotherapy treatment, and to compare them with the control group. METHODS: Anticipated 80 patients diagnosed with breast cancer aged 18-70 years will be recruited for this randomized, unblinded clinical trial based on a nutritional behavior change and physical exercise in patients during the approximately 6 months in which the patient receives neoadjuvant treatment. Participants will be randomly allocated (1:1) to one of two groups (intervention or control). Primary and secondary outcomes will be assessed before the beginning and after the neoadjuvant treatment (before surgery). The primary outcome is quality of life, whereas secondary outcomes include chemotherapy response rate and tolerance, histopathological level of the tumor and body composition (i.e., visceral adipose tissue activity, bone, lean and fat masses). We will analyze blood parameters (i.e., biochemical, inflammatory, and tumor markers) as exploratory outcomes. CONCLUSION: This study will address the influence of a practical and viable multimodal intervention (i.e., nutritional behavior change and physical exercise) on breast cancer patients undergoing neoadjuvant chemotherapy. Given the practical viability of the intervention in real-world settings, our study holds promise for significant scientific and clinical implications.

Diagnostic relevance of 2-[18 F]-FDG PET/CT in patients recently diagnosed with monoclonal gammopathy of undetermined significance.

2-[18 F]-FDG PET/CT is a useful diagnostic technique to assess bone and soft tissue disease in multiple myeloma (MM) but is not recommended by the International Myeloma Working Group for the evaluation of monoclonal gammopathy of undetermined significance (MGUS). The objective of this study was to evaluate the role of 2-[18 F]-FDG PET/CT in the management of these patients. An observational retrospective study was conducted on 338 patients with MGUS who underwent 2-[18 F]-FDG PET/CT. The mean age was 70.80 ± 11.84 years, and 69.2% of patients had cardiovascular risk factors. Patients were classified according to their progression risk (Mayo Clinic). The mean post-diagnosis follow-up was 8.35 ± 14.46 months. Pathological findings were recorded in 49 patients: 30 with myeloma bone lesions (15 in the initial study and 15 in follow-up) and 19 with other neoplastic (n = 13) or pathologically significant findings (n = 6). Body mass index, monoclonal component rate (MCR) > 1 g/dL and ≥1 risk factors for MM were significant in univariate logistic regression analyses. The MCR emerged as the main predictor of a positive 2-[18 F]-FDG PET/CT in adjusted multivariate regression analysis, with an area under the receiver operating characteristic curve of 0.785 and cutoff for optimal sensitivity/specificity of 1.0 ng/mL (71.4% sensitivity, 71.2% specificity). 2-[18 F]-FDG PET/CT results correctly classify patients with MGUS and could improve the detection of bone lesions over existing techniques, with the additional possibility of detecting neoplastic processes. The best parameter to predict a positive 2-[18 F]-FDG PET/CT was the MCR.

Shape-Memory Composites Based on Ionic Elastomers.

Shape-memory polymers tend to present rigid behavior at ambient temperature, being unable to deform in this state. To obtain soft shape-memory elastomers, composites based on a commercial rubber crosslinked by both ionic and covalent bonds were developed, as these materials do not lose their elastomeric behavior below their transition (or activation) temperature (using ionic transition for such a purpose). The introduction of fillers, such as carbon black and multiwalled carbon nanotubes (MWCNTs), was studied and compared with the unfilled matrix. By adding contents above 10 phr of MWCNT, shape-memory properties were enhanced by 10%, achieving fixing and recovery ratios above 90% and a faster response. Moreover, by adding these fillers, the conductivity of the materials increased from ~10-11 to ~10-4 S·cm-1, allowing the possibility to activate the shape-memory effect with an electric current, based on the heating of the material by the Joule effect, achieving a fast and clean stimulus requiring only a current source of 50 V.

Sulfur-Modified Carbon Nanotubes for the Development of Advanced Elastomeric Materials.

The outstanding properties of carbon nanotubes (CNTs) present some limitations when introduced into rubber matrices, especially when these nano-particles are applied in high-performance tire tread compounds. Their tendency to agglomerate into bundles due to van der Waals interactions, the strong influence of CNT on the vulcanization process, and the adsorptive nature of filler-rubber interactions contribute to increase the energy dissipation phenomena on rubber-CNT compounds. Consequently, their expected performance in terms of rolling resistance is limited. To overcome these three important issues, the CNT have been surface-modified with oxygen-bearing groups and sulfur, resulting in an improvement in the key properties of these rubber compounds for their use in tire tread applications. A deep characterization of these new materials using functionalized CNT as filler was carried out by using a combination of mechanical, equilibrium swelling and low-field NMR experiments. The outcome of this research revealed that the formation of covalent bonds between the rubber matrix and the nano-particles by the introduction of sulfur at the CNT surface has positive effects on the viscoelastic behavior and the network structure of the rubber compounds, by a decrease of both the loss factor at 60 °C (rolling resistance) and the non-elastic defects, while increasing the crosslink density of the new compounds.

The shape-memory effect in ionic elastomers: fixation through ionic interactions.

Shape-memory elastomers based on a commercial rubber cross-linked by both ionic and covalent bonds have been developed. The elastomeric matrix was a carboxylated nitrile rubber (XNBR) vulcanized with magnesium oxide (MgO) providing ionic interactions that form hierarchical structures. The so-named ionic transition is used as the unique thermal transition responsible for the shape-memory effect (SME) in these elastomers. These ionic interactions fix the temporary shape due to their behavior as dynamic cross-links with temperature changes. Covalent cross-links were incorporated with the addition of different proportions of dicumyl peroxide (DCP) to the ionic elastomer to establish and recover the permanent shape. In this article, the SME was modulated by modifying the degree of covalent cross-linking, while keeping the ionic contribution constant. In addition, different programming parameters, such as deformation temperature, heating/cooling rate, loading/unloading rate and percentage of tensile strain, were evaluated for their effects on shape-memory behavior.