Characterization of a kg-scale archaeological lead-based PbWO4 cryogenic detector for the RES-NOVA experiment

Core-collapse Supernovae (SNe) are one of the most energetic events in the Universe, during which almost all the star's binding energy is released in the form of neutrinos. These particles are direct probes of the processes occurring in the stellar core and provide unique insights into the gravitational collapse. RES-NOVA will revolutionize how we detect neutrinos from astrophysical sources, by deploying the first ton-scale array of cryogenic detectors made from archaeological lead. Pb offers the highest neutrino interaction cross-section via coherent elastic neutrino-nucleus scattering (CEνNS). Such process will enable RES-NOVA to be equally sensitive to all neutrino flavours. For the first time, we propose the use archaeological Pb as sensitive target material in order to achieve an ultra-low background level in the region of interest (O(1 keV)). All these features make possible the deployment of the first cm-scale neutrino telescope for the investigation of astrophysical sources. In this contribution, we will characterize the radiopurity level and the performance of a small-scale proof-of-principle detector of RES-NOVA, consisting in a PbWO₄ crystal made from archaeological-Pb operated as cryogenic detector.

Secular equilibrium assessment in a CaWO4 target crystal from the dark matter experiment CRESST using Bayesian likelihood normalisation

CRESST is a leading direct detection sub-GeVc^-2 dark matter experiment. During its second phase, cryogenic bolometers were used to detect nuclear recoils off the CaWO₄ target crystal nuclei. The previously established electromagnetic background model relies on Secular Equilibrium (SE) assumptions. In this work, a validation of SE is attempted by comparing two likelihood-based normalisation results using a recently developed spectral template normalisation method based on Bayesian likelihood. Albeit we find deviations from SE in some cases we conclude that these deviations are artefacts of the fit and that the assumptions of SE is physically meaningful.

New Direct Limit on Neutrinoless Double Beta Decay Half-Life of ^{128}Te with CUORE

The Cryogenic Underground Observatory for Rare Events (CUORE) at Laboratori Nazionali del Gran Sasso of INFN in Italy is an experiment searching for neutrinoless double beta (0νββ) decay. Its main goal is to investigate this decay in ^{130}Te, but its ton-scale mass and low background make CUORE sensitive to other rare processes as well. In this Letter, we present our first results on the search for 0νββ decay of ^{128}Te, the Te isotope with the second highest natural isotopic abundance. We find no evidence for this decay, and using a Bayesian analysis we set a lower limit on the ^{128}Te 0νββ decay half-life of T_{1/2}>3.6×10^{24}  yr (90% CI). This represents the most stringent limit on the half-life of this isotope, improving by over a factor of 30 the previous direct search results, and exceeding those from geochemical experiments for the first time.

Geant4-based electromagnetic background model for the CRESST dark matter experiment

The CRESST (Cryogenic Rare Event Search with Superconducting Thermometers) dark matter search experiment aims for the detection of dark matter particles via elastic scattering off nuclei in CaWO 4 crystals. To understand the CRESST electromagnetic background due to the bulk contamination in the employed materials, a model based on Monte Carlo simulations was developed using the Geant4 simulation toolkit. The results of the simulation are applied to the TUM40 detector module of CRESST-II phase 2. We are able to explain up to ( 68 ± 16 ) % of the electromagnetic background in the energy range between 1 and 40 keV .

SURGICAL CORRECTION OF LABIA MINORA HYPERTROPHY, A PERSONAL TECHNIQUE

BACKGROUND

Labia minora hypertrophy is a congenital or acquired condition in which both labia minora (or more rarely only one) protrude beyond the edge of the labia majora. The authors present a surgical technique of volumetric reduction of hypertrophic labia minora, associated with lipofilling of the labia majora.

METHODS

Between 2005 and 2014, 27 patients underwent surgical reduction of labia minora, as described by Altier and Rouzier. The indications for surgical treatment varied and were as follows: interference with sexual intercourse; poor hygiene; difficulty wearing tight-fitting pants; difficulty while performing sporting activities such as cycling; aesthetic complaints. The surgical resection was associated with fat graft injection in labia majora in order to protect and cover the labia minora. The mean follow up was 1 year.

RESULTS

The labia majora, increased in volume and firmness, cover and protect the labia minora slightly hypertrophic or surgically reduced. All patients reported an improvement in comfort, aesthetic appearance, when wearing close-fitting clothes and an improvement in their sexuality. In one case we recorded a "recurrence", with an increase of dimensions in width of labia minora, still lower than the preoperative situation but greater than the immediate postop.

CONCLUSIONS

The reduction of labia minora hypertrophy with conservative techniques allows achieving excellent results in terms of aesthetics and functionality. The simple lipofilling of labia majora allows preserving and protecting the labia minora through a volumetric increase of the labia majora.

Surgical repair of acute Achilles tendon rupture with an end-to-end tendon suture and tendon flap

BACKGROUND

Achilles tendon ruptures are becoming more common. Complications after open or minimally invasive surgery are: recurrent rupture (2-8%), wound breakdown, deep infections, granuloma, and fistulas. The authors expose their experience with a personal technique.

MATERIALS

In 8 patients with acute rupture of Achilles tendon the surgery was performed at least 25 days after trauma. Clinical exam and MR demonstrated in all case a total lesion of tendon. After a posterolateral skin incision the tendon stumps were debrided and suture in end-to-end fashion. A tendon flap was harvested from the proximal part of the tendon, in order to protect and reinforce the suture itself. A plaster cast was applied for 3 weeks and the patients started the rehabilitation protocol.

RESULTS

After 4 months all patients returned to pre-injury daily activities. The mean follow up was 13 months (ranged between 6 and 24 months). No major complications occurred.

CONCLUSION

The posterolateral skin incision, not above the tendon, preserves the vascularity of the soft tissues, allows identifying and not accidentally injuring the sural nerve, and prevents the cutaneous scar is overlapped the tendon. In this way is favoured physiological tendon sliding. The preparation of the flap tendon does not weaken the overall strength of the tendon and protects the tendon suture. The tension on sutured stumps is less than being spread over a larger area. In our sample of 8 patients the absence of short-and long-term complications and the rapid functional recovery after surgery suggest that the technique used is safe and effective.

"Downward steps technique" with CO2 ultrapulsed laser for the treatment of rhinophyma: our protocol

BACKGROUND

The rhinophyma is an important soft-tissue hypertrophy of the nose. In literature a wide range of surgical approaches to rhinophyma has been described such as dermoabrasion, scalpel shave, cryosurgery, electrocautery, near total excision with skin grafting, and laser excision.

PATIENTS AND METHODS

The authors describe their experience with CO(2) ultrapulsed laser in 14 elderly male patients, using their personal approach, the Downward steps technique. With this technique they removed the pathological hypertrophic tissue using a progressive reduction of the laser power during the treatment. They obtained good results from morphological and aesthetic point of view, in a single laser session.

CONCLUSIONS

Major complications such as hypertrophic scars, infections, hyperpigmentation were not observed.

Treatment of stages IIIIV of the Dupuytrens Disease using a personal approach: percutaneous needle fasciotomy (PNF) and minimal invasive selective aponeurectomy

The authors present their experience in treating 23 fingers on 20 patients affected by Dupuytrens Disease in stages III and IV of the Tubiana classification with their personal technique that involves the percutaneous needle fasciotomy followed 40 days after by a selective open aponeurectomy on the previously treated cord, by making a small cutaneous incision. The treatment requires careful selection of the patients. In fact, patients suffering from the disease for more than 5 years and all the cases with a suspicion of joint rigidity are excluded from the study. The average follow up period was approximately 48 months. 18 out of the 20 patients had excellent functional recovery. Skin grafts or local flaps are not required after selective aponeurectomy with these surgical steps. The advantages of this technique include its simplicity, minimal discomfort to patients, rapid functional recovery, low recurrence rate and low cost.

Uncommon case of symmetrical fibrous hyperplasia of the hard palate

The fibrous hyperplasia of the palate (fibroma) is a benign tumor which has its origin in the soft tissue and whose frequency is estimated to be 1.2% on adult subjects. Rarely the size exceeds the cm, but in these cases a complaint of increasing difficulty of mastication and swallowing appears. We describe the case of a young white woman affected with two peculiar symmetric lesions of the secondary hard palate, that could be the consequence of an abnormal answer to a chronic inflammatory stimulation.

Reconstruction of the face with skin-grafted muscle flaps: optimizing the aesthetic outcome

BACKGROUND

Cutaneous facial defects repaired with perforator or fasciocutaneous flaps do not always give optimal aesthetic results due to excess bulk and colour mismatch. The authors present their experience in reconstruction of cutaneous facial defects with skin-grafted free muscle flaps.

MATERIALS AND METHODS

From May 2004 to May 2006, 9 serratus anterior, 2 gracilis and 1 vastus lateralis skin-grafted free muscle flaps were used on 12 patients, after cancer excision in 11 cases and after hardware exposure in 1 case. Full thickness skin grafts were taken from the supraclavicular skin in 3 cases, from the groin in 1 case and from the muscle donor site in 8.

RESULTS

No major complications were observed. Results were excellent in terms of contour and colour match. In the elderly, FTSGs taken from the muscle harvesting incision seem to eventually make a good colour match with the facial skin. No relevant donor site morbidity was observed with the muscles used in this series.

CONCLUSIONS

In the search for good aesthetic results in facial skin reconstruction, skin-grafted muscle flaps permit optimal contour and colour match to be achieved with little donor site morbidity and a shorter operating time.

Unexpected ulnar nerve schwannoma. The reasonable risk of misdiagnosis

Peripheral nerve tumors are rare clinical entities that can present with mild symptoms and no neurological deficit. The authors describe one case of asymptomatic schwannoma of the ulnar nerve in a 64-year-old man. The mass was associated with mild and sporadic discomfort due to the mass size; the clinical neurological examination was not conclusive, with Tinel's sign negative; surgery confirmed the nervous origin of the tumor and the histopathologic exam confirmed the diagnosis of schwannoma. These tumors are difficult to diagnose clinically and have often been confused with other benign tumors such as lipomas, hemangiomas, synovial cysts, neurofibromas, etc. Clinical care is important to prevent, during the surgery, the unfortunate resection of the nerve; all too frequently this diagnosis is made intraoperatively or postoperatively with the potential to compromise the outcome of the treatment. An appropriate degree of awareness is necessary for the inclusion of peripheral nerve tumors as a differential diagnosis of an upper extremity mass.

Surgical treatment of pharyngostomes in irradiated patients. Our experience with musculocutaneous pectoralis major flap and hyperbaric oxygen therapy

CONCLUSION

Our experience confirms that pectoralis major flap is the first-choice technique for repairing recurrent hypopharyngeal fistulae in previously irradiated patients in whom microsurgical techniques are not indicated, and that hyperbaric oxygen therapy helps to solve this complex pathology.

OBJECTIVES

A pharyngostome is a complication encountered when performing surgical operations on pharyngolaryngeal structures. The authors present their experience of treating recurrent complex pharyngostomes in previously irradiated patients in poor physical health. These patients need a simple, safe reconstruction with a low incidence of postoperative complications.

MATERIAL AND METHODS

A pedicled pectoralis major flap was used for reconstruction: the skin side of the flap was used to restore the continuity of the pharyngeal mucosa, while the muscle was used to reconstruct the intermediate layer. The skin layer was completed by means of a free skin graft. In all cases, surgical treatment was combined with hyperbaric oxygen therapy before and after the operation.

RESULTS

A total of 10 patients, all of whom had previously undergone surgery and radiotherapy, had recurring or pluri-recurring pharyngostomes. All patients (8 males, 2 females; age range 52-80 years) had previously been affected by carcinoma of the pharyngolaryngeal region. All underwent major local Ablation together with radical neck dissection and radiotherapy. In all cases there was mucosa on the posterior wall; a musculocutaneous pectoralis major flap was used in all cases for reconstruction.

Interferon-alpha induces apoptosis in human KB cells through a stress-dependent mitogen activated protein kinase pathway that is antagonized by epidermal growth factor

We have demonstrated that interferon-alpha2-recombinant (IFNalpha) at growth inhibitory concentrations enhances the expression and signalling activity of the epidermal growth factor receptor (EGF-R) in human epidermoid carcinoma KB cells. Here we report that KB cells exposed to IFNalpha underwent apoptotic cell death and this effect was antagonized by EGF. We have also found that IFNalpha enhanced the expression of heat shock proteins (HSP) HSP-70, HSP-90 and HSP-27 and activated the NH2-terminal Jun kinase-1 (JNK-1) and p38 mitogen activated protein kinase, the target enzymes of a stress-dependent intracellular transduction pathway. Moreover, the overexpression of the wild-type JNK-1, obtained through plasmid transfection of KB cells, induced apoptosis which was potentiated by the exposure of wild-type JNK-1 (JNK-1wt)-transfected cells to IFNalpha. All these effects were neutralized by the addition of EGF to parental and JNK-1wt-transfected KB cells exposed to IFNalpha. In conclusion, EGF has a protective effect on KB cells from apoptosis while antagonizing a stress response elicited by IFNalpha and targeted on the stress pathway terminal kinases.