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Gilles Houvenaeghel,1 Eric Lambaudie,1 Marie Bannier,2 Sandrine Rua,2 Julien Barrou,2 Mellie Heinemann,1 Max Buttarelli,2 Jeanne Thomassin Piana,3 Monique Cohen2 1Department of Surgical Oncology, Paoli Calmettes Institute and CRCM, CNRS, INSERM, Aix Marseille Université, 13009 Marseille, France; 2Department of Surgical Oncology, Paoli Calmettes Institute, 13009 Marseille, France; 3Department of Pathology, Paoli Calmettes Institute and CRCM, CNRS, INSERM, 13009 Marseille, France Introduction: Reoperation after breast-conserving surgery (BCS) could be proposed for positive or close margins. Reoperation type, re-excision or mastectomy, depends on several factors in relation to patient’s and tumor’s characteristics. We have analyzed our breast cancer (BC) database in order to determine second and third attempts for BCS and mastectomy rates, as well as associated factors for type of surgery. Methods: All patients with BCS between 1995 and 2017 were included. Patient’s characteristics, pathologic results, and treatments were analyzed. Reoperation rate, type of reoperation, second reoperation, and associated factors of reoperation, mastectomy, and third intervention were determined. Three periods were determined: P1–P3. Results: We analyzed 10,761 patients: 1,161 with ductal carcinoma in situ (DCIS) and 9,600 with invasive BC. The reoperation rate was 41.4% for DCIS and 28.0% for invasive BC. Using multivariate analysis, we identified tumor size >20 mm as being a risk factor for reoperation, whereas age >50 years, P2–3, and some localization decreased reoperation rates. For invasive BC, age >40 years, triple-negative tumors, neoadjuvant chemotherapy, and noncentral tumors decreased reoperation rates and lobular tumor, multifocal tumors, lymphovascular invasion, DCIS component, and Her2-positive tumors increased reoperation rates. For patients requiring reoperation, re-excision was performed in 48.1% (1,523/3,168) and mastectomy was required after first re-excision in 13.46% (205/1,523). For DCIS, mastectomy rates were higher for grade 2 and tumor ≥20 mm. For invasive BC, mastectomy rates were higher for lobular, multifocal, ≥20 mm, Her2-positive tumors and diffuse positive margins and lower for age >50 years and during the last period. Even if interval time between surgery and adjuvant treatments was higher for patients with reoperation, survival rates were not different between patients with and without reoperation. Conclusion: A decrease in reoperation and mastectomy rates had been reported with several associated factors. A third intervention with mastectomy was required in 13.5% of patients. This information should be done in case of reoperation. Keywords: breast cancer, conservative surgery, mastectomy, reoperation, margins

The bandgap of CuInSe2 thin film photovoltaic absorbers depends on the Cu content, although the nature of this dependence is still a matter of debate. While theoretical results predicted a widening or stable bandgap with decreasing Cu content, the few experimental data available point to a narrowing of the bandgap. Here, we apply photoreflectance spectroscopy at room temperature to near-stoichiometric polycrystalline CuInSe2/CdS heterojunctions with a lateral Cu gradient to analyze the electronic transitions in the vicinity of the fundamental absorption edge of CuInSe2 absorber as a function of Cu deficiency. The results indicate that the lowest bandgap transition at 1.02 eV notably decreases by 20–30 meV for slightly Cu deficient samples, strengthening the case for an association of a lower Cu content with a narrower bandgap. In contrast, the higher energy transition at 1.25 eV does not show a redshift, which requires further theoretical explanation. [ABSTRACT FROM AUTHOR]

Photoluminescence (PL) is commonly used for investigations of Cu2ZnSnS(e)4 [CZTS(e)] and Cu(In,Ga)Se2 (CIGS) thin film solar cells. The influence of interference effects on these measurements is, however, largely overlooked in the community. Here, it is demonstrated that PL spectra of typical CZTS absorbers on Mo/glass substrates can be heavily distorted by interference effects. One reason for the pronounced interference in CZTS is the low reabsorption of the PL emission that typically occurs below the band gap. A similar situation occurs in band gap graded CIGS where the PL emission originates predominantly from the band gap minimum located at the notch region. Based on an optical model for interference effects of PL emitted from a thin film, several approaches to reduce the fringing are identified and tested experimentally. These approaches include the use of measured reflectance data, a calculated interference function, use of high angles of incidence during PL measurements as well as the measurement of polarized light near the Brewster angle. [ABSTRACT FROM AUTHOR]

The isotopic composition of Si in biogenic silica (BSi), such as opal buried in the oceans' sediments, has changed over time. Paleorecords suggest that the isotopic composition, described in terms of δ30Si, was generally much lower during glacial times than today. There is consensus that this variability is attributable to differing environmental conditions at the respective time of BSi production and sedimentation. The detailed links between environmental conditions and the isotopic composition of BSi in the sediments remain, however, poorly constrained. In this study, we explore the effects of a suite of offset boundary conditions during the Last Glacial Maximum (LGM) on the isotopic composition of BSi archived in sediments in an Earth System Model of intermediate complexity (EMIC). Our model results suggest that a change in the isotopic composition of Si supply to the glacial ocean is sufficient to explain the observed overall low(er) glacial δ30Si in BSi. All other processes explored trigger model responses of either wrong sign or magnitude or are inconsistent with a recent estimate of bottom water oxygenation in the Atlantic Sector of the Southern Ocean. Caveats, mainly associated with generic uncertainties in today's pelagic biogeochemical modules, remain. Key Points: We simulate the isotopic composition of biogenic silica archived in the ocean's sedimentOur simulations with an Earth System Model compare modern climate to glacial conditionsOut of several hypotheses tested, altering the isotopic composition of runoff during the LGM is most consistent with proxies [ABSTRACT FROM AUTHOR]

Background: Due to current demographic trends age-related macular degeneration (AMD) is becoming more prevalent. When disease progresses to late-stage neovascular AMD, rapid initiation of treatment is required to achieve optimal outcomes. However, many affected individuals may be unaware of their disease impeding and delaying care seeking. Therefore, in an exploratory study we assessed whether elderly persons living independently in the community were aware of their AMD. Methods: Participants were recruited in eleven seniors' community centers. Participants underwent a standardized interview followed by non-mydriatic fundus photography of the macula and the optic disc in both eyes (Canon CR-2AF, Canon, New York, USA). The images were graded by an ophthalmologist and the data were analyzed descriptively. Results: A total of 281 participants (73.9 ± 8.1 years; 71.9% women) underwent bilateral fundus photography. The fundus photographs of 208 participants (74%; 73.6 ± 7.0 years; 73.1% women) could be graded. In a third (32.2%, n = 67) no pathological changes were detected. AMD was present in 24.5% of the examined subjects (n = 51). Half of the cases had early (47.1%), followed by intermediate (41.2%) and late (11.7%) AMD. Only one third (n = 16, 31.4%) were aware of their disease. Conclusions: A quarter of community dwelling elderly had AMD but only a third of these were aware of being affected with AMD. This confirms previous studies demonstrating low awareness for age-related eye diseases in the community. Considering the increase in population aging, awareness campaigns for AMD are needed. [ABSTRACT FROM AUTHOR]

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Cu(In,Ga)Se2 (CIGS) solar cells in superstrate configuration promise improved light management and higher stability compared to substrate devices, but they have yet to deliver comparable power conversion efficiencies (PCEs). Chemical reactions between the CIGS layer and the front contact were shown in the past to deteriorate the p-n junction in superstrate devices, which led to lower efficiencies compared to the substrate-type devices. This work aims to solve this problem by identifying a buffer layer between the CIGS layer and the front contact, acting as the electron transport layer, with an optimized electron affinity, doping density and chemical stability. Using combinatorial material exploration we identified amorphous gallium oxide (a-GaO x) as a potentially suitable buffer layer material. The best results were obtained for a-GaO x with an electron affinity that was found to be comparable to that of CIGS. Based on the results of device simulations, it is assumed that detrimental interfacial acceptor states are present at the interface between CIGS and a-GaO x. However, these initial experiments indicate the potential of a-GaO x in this application, and how to reach performance parity with substrate devices, by further increase of its n-type doping density. [ABSTRACT FROM AUTHOR]

Rabies is one of the most important zoonosis in the world with high impact on public health. Studies report the presence of Lyssavirus in reservoirs of the wild cycle, highlighting the role of wild canines, marmosets, and vampire and non-vampire bats as potential vectors of the disease to domestic animals and human beings. Therefore, the reintroduction of rabies in urban environments from reservoirs of the wild cycle is a matter of concern. This study describes the profile of rabies cases documented in Brazil from 2002 to 2012, with emphasis on the wild transmission cycle of the disease. We carried out a descriptive study using records with information on the time of infection, persons with infection and location of confirmed cases of rabies in humans and animals, as well as data on anti-rabies treatments obtained from the Information System of Notifiable Diseases (Sinan) database. Within the study period, 82 cases of rabies transmitted by wild animals to humans were reported, predominantly in rural areas of the northern and north-eastern regions. Of the cases in humans, 72% did not receive post-exposure prophylaxis. Among wild mammals, vampire bats were the most frequent vectors of the disease. In the north-east region, 460 terrestrial wild mammals were reported with confirmed rabies. Over the study period, 1703 bats were reported to carry the rabies virus. In the south-east region, the most frequently reported carriers of the virus were non-vampire bats. The midwest and northern regions presented a lower number of records of rabies cases among terrestrial wild mammals. However, the high number of rabies cases among bovines reflects the role of the vampire bat as a maintainer of the rabies virus in the rural cycle. The present results are key to adjust the planning of rabies control in Brazil to the current epidemiological trends. [ABSTRACT FROM AUTHOR]