Predictors of Unilateral Arm Lymphedema in Non-obese Locoregionally Advanced Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy, Modified Radical Mastectomy, and Postoperative Irradiation

Objective

The most dreaded long-term complication of axillary lymph node dissection remains upper arm lymphedema. Our study has strategized the three most common identified causes of post treatment arm lymphedema, i.e., obesity, radiation, and neoadjuvant chemotherapy and tried to identify the histopathological and clinical or surgical factors which can predict arm lymphedema.

Materials and Methods

This is a prospective observational study was conducted at a tertiary care referral centre in India, with strict inclusion criteria of BMI <30 kg/m2, age <75 years, presence of metastatic axillary node proven by FNAC, received anthracycline based neoadjuvant chemotherapy and postoperative nodal irradiation, and completed 24 months of regular follow-up.

Results

Total of 70 patients were included in the study. The mean age of the patients was 50.3 years (±12.9). lymphovascular invasion, total number of lymph nodes removed from level III, total number of days drain was left in situ and maximum drain output were found to be significantly (p<0.05) associated with arm lymphedema.

Conclusion

In patients undergoing modified radical mastectomy with level III dissection, and postoperative irradiation, the incidence of unilateral arm lymphedema is significantly influenced by several clinicopathological factors like the total number of lymph nodes removed in level III, higher maximal drain output, prolonged duration of drain placement and the presence of lymphovascular invasion.

Thermal evolution of a polymer-nanoparticle binary mixture

We experimentally probe the microscopic variations in a model polymer-nanoparticle (NP) binary mixture (mixture of polybutadiene and clay nanoplatelets) across a thermal evolution path for which Tevolution > Tg(polymer). The evolution of the NP dispersion, NP crystallinity, polymer chain-NP interface, and nature of polymer chain-NP interaction are mapped for a spectrum of temperatures and NP concentrations constrained by experiments. Multiple pieces of evidence indicate that thermal evolution does not influence the nature of interparticle dispersion and is also independent of NP concentration in the binary mixture. However, the NP crystalline order significantly reduces across the thermal evolution path. Thermal evolution induces a transition of a sharp polymer chain-NP interface to a diffuse interfacial layer. In contrast, an already diffuse polymer-NP interface existing in the binary mixture due to particle crowding at high NP concentrations undergoes no significant change in its nature across the evolution path. At all particle concentrations, thermal evolution changes the dominant interaction from polymer chain-polymer chain to polymer chain-NP. These insights aid in explaining the molecular origins of unique and anomalous behaviors shown by polymer-nanoparticle binary mixtures while undergoing thermal evolution.

Role of free volumes and segmental dynamics on ion conductivity of PEO/LiTFSI solid polymer electrolytes filled with SiO2 nanoparticles: a positron annihilation and broadband dielectric spectroscopy study

The limited ionic conductivity of polymer electrolytes is a major issue for their industrial application. Enhancement of ionic conductivity in the poly(ethylene oxide), PEO, based electrolyte has been achieved by loading passive nanofillers such as SiO₂ nanoparticles (NPs). To investigate the role of modifications in free volume characteristics and the polymer chain dynamics induced by the loading of passive fillers on the ionic conductivity of the PEO based ternary electrolyte, a systematic investigation has been carried out using positron annihilation and broadband dielectric spectroscopy. As a result of interfacial interactions, the loading of SiO₂ NPs alters the semi-crystalline morphology of PEO resulting in a higher crystallinity at lower loadings due to the surface confinement of PEO chains, and the formation of smaller PEO crystallites at higher loadings due to interparticle nanoconfinement. These modifications are accompanied by a decrease in free volume fraction at the lowest loading (0.5 wt%) followed by an increase at higher loadings (≥2.0 wt%). The Almond-West formalism considering two different universalities in different temperature and frequency ranges has been used to explain the ion-conduction process at different NP loadings. The Li ion conductivity is observed to be maximum for a 5.0 wt% loading of SiO₂ NPs. The enhancement in ionic conductivity is observed to be directly correlated with the free volume characteristics and segmental dynamics of the PEO matrix, confirming their role in ion transport in polymer electrolytes.

Molecular dynamics, physical and thermal stability of neat amorphous amlodipine besylate and in binary mixture

In this paper, a stable amorphous solid dispersion of an antihypertensive drug, amlodipine besylate (AMB) was prepared by entrapping it in a polymer matrix, polyvinyl pyrrollidone, in different weight ratios (AMB/PVP 05:95, 10:90, 20:80, 30:70). The glass forming ability of all binary dispersions were studied by means of differential scanning calorimetry and found good correlation between experimental T_g and Fox Flory's prediction. By considering the daily dosage limit of 5 mg, a weight ratio of 05:95 was further considered for the study. The structures of neat and binary of AMB were characterized by density functional theory, Fourier transform infrared spectroscopy, Fourier transform Raman spectroscopy and UV-visible spectroscopy. Further, detailed molecular dynamics of both pure and binary were investigated using broadband dielectric spectroscopy to judge the physical stability of the amorphous dispersions. Translation-rotation coupling of AMB possibly explains the dual conductivity and dipolar nature of the secondary relaxation in neat AMB. Thus, the binary dispersion of AMB with commercially acceptable weight ratio with strong glass forming behaviour and better shelf life was prepared and characterized for practical applications.

Molecular dynamics and the translational–rotational coupling of an ionically conducting glass-former: amlodipine besylate

We studied the conductivity relaxation originating from a glass-former composed of cations and anions, and the relation to the structural α-relaxation at temperatures above and below the glass transition temperature. The material chosen was amorphous amlodipine besylate (AMB), which is also a pharmaceutical with a complex chemical structure. Measurements were made using differential scanning calorimetry (DSC), broadband dielectric spectroscopy (BDS) and X-ray diffraction, and the characterization was assisted using density functional theory (DFT). The X-ray diffraction pattern confirms the amorphous nature of vitrified AMB. Both the ionic and dipolar aspects of the dynamics of AMB were examined using these measurements and were used to probe the nature of the secondary conductivity and dipolar relaxations and their relation to the conductivity α-relaxation and the structural α-relaxation. The coupling model predictions and quantum mechanical simulations were used side by side to reveal the properties and nature of the secondary conductivity relaxation and the secondary dipolar relaxation. Remarkably, the two secondary relaxations have the same relaxation times, and are one and the same process performing dual roles in conductivity and dipolar relaxations. This is caused by the translation–rotation coupling of the AMB molecule. Thus, AMB has both conductivity α- and β-relaxations, and application of the coupling model shows that these two relaxations are related in the same way as the structural α-relaxation and the Johari–Goldstein β-relaxation are. This important result has an impact on the fundamental understanding of the dynamics of ionic conductivity.

We studied the conductivity relaxation originating from a glass-former composed of cations and anions, and the relation to the structural α-relaxation at temperatures above and below the glass transition temperature.

Growth, characterization and gas sensing properties of nanotetrapod ZnO

ZnO nanotetrapods have been obtained in large quantities by carbothermal reduction of ZnO powder. These were characterized by X-ray diffraction, X-ray photoelectron spectroscopy, scanning electron microscopy, transmission electron microscopy, selected area electron diffraction, UV-visible spectroscopy and photoluminescence. Electron microscopy revealed that the overall size of the tetrapods is 1.5-2 microm and legs are 30-50 nm in diameter. The size of tetrapods as well as diameter of the legs was found to increase with deposition temperature. Photoluminescence spectra revealed that green emission originating from oxygen vacancies overwhelmed that of the near-band-edge ultraviolet peak. A band gap of 3.27 eV was calculated from optical absorption spectra which agreed well with that estimated from PL spectra. Gas sensing properties of tetrapods were investigated and these were found to be 5 times more sensitive to H2S gas at room temperature in comparison to ZnO bulk polycrystalline material.

Growth of highly oriented crystalline polyaniline films by self-organization

Silicon substrates with (100) orientation were modified with amino-silane self-assembled monolayer (SAM) to provide amino (NH(2)) moieties at the substrate surface. Self-organization of polyaniline during chemical polymerization, on this modified surface, leads to the growth of highly oriented films at the substrate-polymer interface. The morphology studied using scanning electron microscopy and atomic force microscopy revealed the formation of polymer film with well faceted pyramidal crystallites. XPS and FTIR spectroscopy were used to analyze the chemical structure of the film. X-ray diffraction measurements show the crystalline nature of the polyaniline, whose lattice parameters are in agreement with the reported values. This study underlines the importance of a SAM in deciding the structure and morphology of the deposited polymer.

Design considerations for the rotation of a plane premirror of a monochromator for reflecting synchrotron radiation onto the same spot of the dispersing grating of the XUV beamline

The kinematic concept of employing a plane premirror rotated around an axis outside its surface to reflect the beam onto the same spot on the grating for three angular positions is formulated algebraically. Exact analytic solutions are found for determining the positions of the axis of rotation, the radius of the circle of rotation, and the central fixed spot on the grating in terms of the three angles and the height 2b of the grating above the incident beam. Typical numerical calculations are presented and discussed. It is generally observed that deviation of the reflected beam from the fixed spot is barely a few microns for b in centimeters.