Volume 12 - 2025 | doi: 10.3389/fnut.2025.1551048 formatted version of the article will be published soon You have multiple emails registered with Frontiers: If you already have an account, please login You don't have a Frontiers account ? You can register here Malnutrition and inflammation are associated with poorer surgical outcomes in patients with gastrointestinal cancer it is debated which parameters should be used to assess nutritional and inflammatory status The aim of the present study was to investigate the prognostic role of specific parameters in predicting postoperative outcomes in this subgroup of patients This retrospective study included 391 adult patients was assessed by preoperative validated Malnutrition Universal Screening Tool (MUST) score ≥2 Platelet-to-Lymphocyte Ratio (PLR) >150 and Lymphocyte-to-Monocyte Ratio (LMR) 1 or albumin levels Keywords: Nutritional tools Received: 24 Dec 2024; Accepted: 23 Apr 2025 Copyright: © 2025 Casalone, Bellomo, Berrino, Bo, Favaro, Mellano, Fenocchio, Marchiò and Sapino. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) distribution or reproduction in other forums is permitted provided the original author(s) or licensor are credited and that the original publication in this journal is cited in accordance with accepted academic practice distribution or reproduction is permitted which does not comply with these terms Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher 94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish They have also devised an experimental therapy to bypass or prevent the emergence of drug-resistance. The results are published in Nature Immunology The research was coordinated by Antonella Sistigu and Martina Musella Department of Translational Medicine and Surgery section of General Pathology and Clinical Pathology directed by Professor Ruggero De Maria and Ilio Vitale of the IIGM Foundation—Italian Institute for Genomic Medicine (part of the Compagnia di San Paolo Foundation) can reprogram residual cancer cells and transform them into cancer stem cells The scientists discovered how the tumor evolves during treatment and develops resistance to therapies "More specifically," Sistigu and Musella explain "we have demonstrated that some tumor cells release in the tumor microenvironment a group of factors called 'alarmins,' which normally alert and activate the immune system for disease recurrence and metastasis."  Cancer stem cells escape the control of the immune system and have high invasive and aggressive potential The scientists have discovered that this mechanism of drug resistance depends on activation of a protein called "KDM1B" KDM1B controls and regulates gene expression "we studied 5 different cohorts of patients and confirmed that this mechanism is valid also in patients."  Finally in laboratory experiments the scientists saw that inhibition of KDM1B prevented cancer stem cells formation and increased the effectiveness of therapy "Based on these results we propose a combination therapy (some specific chemotherapeutics and immunotherapeutics together with the experimental drug that inhibits KDM1B to prevent formation and possibly effectively target this subpopulation of stem cells otherwise resistant to any treatment," the researchers say.  The next step of this research will be to evaluate the combination therapy in trial clinic on patients Source: Universita Cattolica del Sacro Cuore                                                                                               A rare variant of a protein present in nearly all human cells may hold the key to improving the effectiveness of breast cancer treatment according to University of Manchester research Using a new technology and computational method researchers have uncovered a biomarker capable of accurately predicting the aggressiveness of meningioma brain tumors and breast cancers New insights gained from 3D cell cultures of breast and prostate cancer grown on the International Space Station (ISS) National Laboratory could lead to a way to treat not just these but all cancers This website uses cookies to give our readers the best website experience. Please refer to our privacy policy to find out how we use cookies and how you can edit your preferences Leggi in italiano Coloured scanning electron micrograph (SEM) of a cancer cell from the human colon (large intestine) Credit: Steve Gschmeissner/Spl/Getty Images As they set out to investigate the behaviour of cancer cells, the authors were inspired by the pioneering experiment on virus resistance in bacteria by Salvador Luria and Max Delbrück in the 1940s2 and designed their experiments on colon cancer cell lines (CRCs) in a similar way “We knew from our previous work that human CRCs treated with certain therapies display an up-regulation of error-prone DNA polymerases that are enzymes involved in DNA replication and a reduction in their ability to repair DNA damage,” explains Cosentino Lagomarsino cancer cells can adapt to therapeutic pressure by enhancing their mutability” when exposed to stress induced by molecularly targeted therapies cancer cells initiate a response known as “adaptive mutability” very similar to bacteria’s response to antibiotics which is the basis of antibiotic resistance the authors have characterized and quantified this temporary increase in the cells’ ability to mutate The experiments involved several weeks of controlled culture growth and death in order to build a statistic from thousands of wells where the cells were cultivated The scientists first measured how the growth parameters of CRCs were affected by drug treatment they deployed a two-step fluctuation test (the experimental technique originally developed by Luria and Delbruck) to assess the rate of phenotypic mutations This assay discriminates pre-existing resistant clones from newly developed ones allowing to quantify both spontaneous and drug-induced mutation rates This work shows that cancer cells have a trump card which they use to get around the action of therapies often leading to treatment failure and disease recurrence it also reveals new weak points of the same cancer cells Future experiments could focus on the identification of key proteins that modulate the mutation ability in cancer cells possibly allowing to block them with drugs and prevent tumour relapse doi: https://doi.org/10.1038/d43978-022-00096-z Download references HT is an interdisciplinary research institute, created and supported by the Italian government, whose aim is to develop innovative strategies to pr... UNIL is a leading international teaching and research institution, with over 5,000 employees and 17,000 students split between its Dorigny campus, ... Department of Energy and Environmental Materials, Suzhou Laboratory Lead bold science at ONJCRI. Shape strategy, drive impact, and advance cancer research in a leading translational institute. Olivia Newton-John Cancer Research Institute We are seeking a tenure-track associate professor to promote interdisciplinary research in nanoprobe life sciences or related interdisciplinary field. Nano Life Science Institute, Kanazawa University An essential round-up of science news, opinion and analysis, delivered to your inbox every weekday. Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily. CHICAGO - MRI-based computer-aided detection (CAD) can improve detection sensitivity for prostate cancer for most readers, while reducing reading time fourfold, according to a Tuesday presentation at RSNA 2016. The study examined the clinical use of a CAD system based on multiparametric MRI of prostate cancer, comparing CAD as a first reader to unaided interpretation of prostate cancers by three readers, recording lesion size, a five-point confidence score for both reading methods, and interpretation time. Use of the CAD system resulted in greater lesion-detection sensitivity for most readers. "CAD used as the first reader significantly improves the sensitivity in detecting lesions with a diameter of 10 mm or greater and [Gleason] score greater than 6, without altering specificity," said Dr. Valentina Giannini from Candiolo Cancer Institute in Italy. Correlation with radical prostatectomy has shown that multiparametric MRI, which associates T2-weighted imaging with diffusion-weighted imaging, dynamic contrast-enhanced imaging, or H1-spectroscopy, has excellent sensitivity for detecting and localizing clinically significant cancers. Unfortunately, the technique also delivers high interreader variability, and it is time-consuming and labor-intensive, Giannini said. Moreover, depending on the radiologist's experience level, as many as 30% of prostate cancer detections turn out to be false negatives. An April 2016 study of standalone CAD performance by the group revealed high sensitivities for peripheral zone cancers in the range of 96% per lesion and 97% per patient for the multiparametric imaging-based CAD. Although the standalone results have been quite promising, "the impact of CAD on radiologists' performance ... was never assessed," Giannini said in her presentation. This study brought the CAD into clinical use, comparing the sensitivity and specificity of three expert readers for detecting prostate cancers, both unassisted by CAD and with CAD used as the first reader. The researchers also assessed whether using CAD as the first reader could reduce reporting time and interobserver variability. The readers first reported CAD in the first-reader paradigm, by analyzing the probability map of the CAD results superimposed on the T2-weighted MR images, and confirming the CAD marks that they considered to be prostate cancers. The dataset consisted of 35 patients who had at least one clinically significant tumor (38 prostate cancers) and 54 negative patients who remained so during a one-year follow-up. The mean per-patient sensitivity of first-reader CAD and unassisted reading did not differ significantly (81% versus 88%, p = 0.105) when looking at lesions of all sizes and Gleason score levels. "Considering all the lesions, we observed an increase in sensitivity for all readers when using the CAD system," Giannini said. "However, it was interesting that when we stratified tumors above Gleason score 6, we observed a significant increase in sensitivity. ... Similarly, stratifying tumors for maximum diameter of 10 mm or larger versus 6 mm or larger also increased the sensitivity." CAD sensitivity rose significantly -- from 81% to 91% -- for patients who had a Gleason score of 6 or greater and a lesion size of 10 mm or larger. Even so, the increase in specificity was not significant (75.3% versus 78.4%, p = 0.25) when using first-reader CAD. The average reading time fell sharply with the use of CAD, from an average of 220 seconds to an average of 60 seconds (p < 0.0001). Finally, a Fleiss' kappa analysis of interreader agreement increased with CAD, both per patient (0.55 versus 0.60) and per lesion (0.46 versus 0.55). As for study limitations, "we used the first-reader paradigm for CAD, which is quite unnatural for this type of tumor," Giannini said. "We need to test other reading paradigms." The next study will also be a multicenter trial. This type of CAD may be an attractive reading strategy to work into the clinical environment, especially if multiparametric MRI results are used to select patients for biopsy, she concluded. The increasing population of survivors of head and neck carcinomas is becoming more conspicuous. Consequently, the pivotal role of quality of life, particularly elucidated through the assessment of dysphagia and dysphonia, is progressively influencing the decision-making process. The current study aims to assess whether VITOM 3D could offer a comparable post-treatment quality of life to traditional approaches for patients with laryngeal cancer and oro-hypopharyngeal cancer. Assessments of quality of life, conducted through the University of Washington Quality of Life Questionnaire questionnaire, dysphonia evaluations using the Voice Handicap Index-10, and dysphagia assessments employing the M.D. Anderson Dysphagia Inventory questionnaire, demonstrate analogous outcomes between conventional treatment modalities and transoral interventions utilizing the 3D exoscope. Otorhinolaryngology - Head and Neck Surgery Volume 11 - 2024 | https://doi.org/10.3389/fsurg.2024.1358500 This article is part of the Research TopicTransoral Laser Microsurgery - State of the Art and the PerspectivesView all articles Introduction: The increasing population of survivors of head and neck carcinomas is becoming more conspicuous particularly elucidated through the assessment of dysphagia and dysphonia is progressively influencing the decision-making process The current study aims to assess whether VITOM 3D could offer a comparable post-treatment quality of life to traditional approaches for patients with laryngeal cancer and oro-hypopharyngeal cancer Methods: A case series of laryngeal cancer and oro-hypopharyngeal cancer patients treated either with an exoscopic-assisted surgical setup and with conventional treatments (transoral microsurgery and radio-chemotherapy) at the Otolaryngology Unit of IRCCS San Martino Hospital The post-treatment quality of life of the two cohorts were compared through the administration of the University of Washington Quality of Life Questionnaire Anderson Dysphagia Inventory were administrated to both cohorts of patients 50.1% underwent transoral exoscope-assisted surgery while 49.9% underwent primary transoral microscopic-assisted surgical approach No significant differences were observed in terms of the University of Washington Quality of Life Questionnaire and Voice Handicap Index-10 between the two subgroups 37.2% underwent primary transoral exoscope-assisted surgery while 62.8% received (chemo)radiotherapy No notable differences were reported in terms of the University of Washington Quality of Life Questionnaire and M.D Anderson Dysphagia Inventory between the transoral exoscope-assisted surgery and (chemo)radiotherapy subgroups Conclusions: Assessments of quality of life conducted through the University of Washington Quality of Life Questionnaire questionnaire dysphonia evaluations using the Voice Handicap Index-10 and dysphagia assessments employing the M.D Anderson Dysphagia Inventory questionnaire demonstrate analogous outcomes between conventional treatment modalities and transoral interventions utilizing the 3D exoscope While the treatment of any malignancy traditionally prioritizes disease control, particularly local or regional control, with an emphasis on extended survival as the ultimate goal, more recent times have seen quality of life recognized as a critical factor in the decision making process (9, 10) In oropharyngeal cancer (OPC), dysphagia has been strongly linked to a lower QOL and can be assessed using various questionnaires, such as the M.D. Anderson Dysphagia Inventory (MDADI) (5, 11–13) On the other hand, the Voice Handicap Index-10 (VHI-10) (14) is a widely used patient perceptual questionnaire that evaluates the impact of voice problem on an individual's life in patient affected by laryngeal cancer (LC) Informed decisions about future treatment options require knowledge of how contemporary therapies affect life of HNC patients (15) In the recent times, there has been a surge in technological innovations aimed at improving patients' QOL (16) Lately, various devices, including exoscopes like VITOM 3D exoscope (Karl Storz—Tuttlingen, Germany), which are high-definition cameras equipped with optical and digital zoom capabilities and paired with a light source capable of providing 3D vision, have been developed (17–20). This technology was recently introduced in the field of otorhinolaryngology (21–24) The exploration of emerging technologies should prioritize “patients” outcomes’ considerations instead of embracing technology merely for the sake of it Within the realm of technological advancements certain decisions are straightforward and align with natural evolution whereas others necessitate a thorough analysis of tangible benefits The aim of the current study is to assess whether exoscopes could represent a valuable option in terms of improving the quality of life for LC and OPC or hypopharyngeal (HPC) patients when compared to well-established treatments We retrospectively analyzed two groups of patients who were referred to the Otorhinolaryngology unit of S Martino Hospital in Genoa from February 2019 to January 2023 The study was conducted in accordance with the Declaration of Helsinki and was approved by the local Ethics Committee (CER Liguria: 230/2019) All the cases in the study underwent multidisciplinary discussion and were directed towards first-line treatments which could be either surgical or non-surgical Surgical options included Transoral exoscopic laser surgery (TOELS) for OPC and (Transoral laser microsurgery) TOLMS or TOELS for LC while non-surgical approaches involved (chemio)radiotherapy [(CT)RT] for OPC equipped with a 3D-HD camera and ARTipTM robotic cruise system allowing manual control via a joystick or robotic arm producing either 4K or 3D images displayed on a 3D-HD screen Stereoscopic image processing is facilitated by polarized glasses worn by operators and operating room staff we administered various types of questionnaires to the patients to assess their quality of life duration of surgical procedure and surgical outcomes (hospital stay and margins status) were collected We have decided to explore vocal outcomes as a means of assessing the quality of life in patients All patients underwent the VHI-10 to examine vocal quality within 2 weeks before and The VHI-10 represents a streamlined yet equally comprehensive alternative to the VHI-30 with a specific focus on assessing the impact of treatment on voice and Given that alterations in voice are a primary concern in early-stage laryngeal tumors we have selected a questionnaire tailored to evaluate this particular domain VHI-10 questionnaire consists of a 10-item scale each item being scored between 0 (never) and 4 (always) A score smaller or equal to 10 represents little or no handicap caused by dysphonia a 10 to 20 score characterizes a medium handicap and a score equal or greater than 20 describes a severe QOL impact in terms of dysphonia This group of patients consists of subjects affected by an OPC/HPC, classified as cT1-3 N0-2 with the 8th version of the TNM classification system (25). Patients were treated by means of TOELS and (CT)RT. In patients undergoing TOELS, a good exposure of the oropharyngeal corridor, with a surgical light greater than or equal to 80% was predicted using the pharyngoscore (27) Patients' demographics and tumor features were collected We have decided to explore dysphagia outcomes as a means of assessing the quality of life in patients All patients were investigated through the MDADI that is a self-administered questionnaire for evaluating the impact of dysphagia within 1 months before and 3 months after treatment(s) The MDADI stands out as one of the most frequently utilized questionnaires for assessing the quality of life in patients affected with oropharyngeal tumors Primarily designed to delve into the quality of life associated with swallowing function— a primary function often impacted by oropharyngeal tumors—it serves as a valuable tool in evaluating patient well-being The questionnaire has four subdomains: global Each item is rated on a 5-point Likert scale ranging from 1 to 5 where 1 stands for “strongly agree” 5 symbolizes “strongly disagree” while a sum of the other scores and a mean score are calculated both LC and OPC/HPC patients were administered the University of Washington Quality of Life Questionnaire (UW-QOL) which consists of 12 single-question domains Each domain has between 3 and 6 response options that are scaled evenly from 0 (worst) to 100 (best) according to the hierarchy of response This questionnaire examines different domains such as appearance Results are reported as value (%) and mean value ± standard deviation Differences in the distribution of continuous variables between two independent groups were tested using the t-student test Differences in the distribution between categorical variables were assessed through the chi square or fisher exact test A two-sided p < 0.05 was considered significant Statistical analysis was carried out using IBM SPSS Statistics software (version 28.0.1.0) A total of 79 early-stage glottic cancers were included in the current study 50.1% (40/79) underwent primary TOELS while 49.9% (39/79) underwent primary TOLMS All patients alive included in the study completed the questionaries The mean UW-QOL scores for specific domains reported by participants who completed the questionnaire were 1095 ± 246.9 for the exoscope group and 1170 ± 66.5 for the microscope group No statistically significant difference was observed between the two groups (p-value = 0.37) Post-operative VHI-10 scores between the two groups also did not show a statistically significant difference (p-value = 0.34) The mean operative time was 69.5 ± 27.0 min in the exoscope group and 77.5 ± 35.7 min in the microscope group (p-value = 0.47) Hospitalization stay duration were similar between the two groups (p-value = 0.064) Demographic data regarding the laryngeal and oropharyngeal cancer groups of patients Comparison of quality-of-life and surgical outcomes in laryngeal patients undergoing exoscope-assisted and microscopic-assisted surgical approaches Hospitalization is analyzed for glottic patients only Included in the study were 43 cases of early-stage OPC/HPC 37.2% (16/43) underwent a primary TOEOS while 62.8% (27/43) received (CT)RT The mean UW-QOL scores for specific domains reported by participants who completed the questionnaire were 1078.1 ± 182.8 for the exoscope group and 1051.9 ± 148.2 for the (CT)RT group No statistically significant difference was observed (p-value = 0.39) This is true also when considering global domains of the UW-QOL scores Post-treatment MDADI scores between the two groups did not show a statistically significant difference (p-value = 0.54). These results are summarized in Table 3 Comparison of quality-of-life outcomes in oropharyngeal patients undergoing exoscope-assisted surgery and (C)RT before advocating the widespread adoption of a new technology that may improve certain aspects of treatment it is crucial to ensure it does not cause harm The core inquiry of the study revolves around whether the VITOM 3D exoscope could indeed emerge as a valuable option for improving the QOL of LC and OPC/HPC patients when compared to well-established treatments No statistically significant differences were observed between the group treated with a microscope and the group treated with an exoscope subjected to both TOLM and TOELS treatments no postoperative complications were identified the results from UW-QOL questionnaires failed to reveal any statistically significant differences mirroring the lack of statistical distinction in pre-operative and post-operative VHI-10 scores it's worth mentioning that there is a dearth of data on this specific aspect in the current literature These findings collectively suggest that both the TOLMS and TOELS represent valuable treatment options for laryngeal carcinoma with comparable outcomes in terms of oncological efficacy Traditionally, OPC/HPC has been treated primarily with (CT)RT (37). However, over the past few decades, a less aggressive surgical alternative in the form of lateral oropharyngectomy has been gaining traction (38–40). However, direct comparisons of surgical and non-surgical approaches are limited in published literature, particularly with regard to functional outcomes (16) Our analysis aimed to discern whether there were differences in terms of QOL and dysphagia when assessed using MDADI The results revealed no statistically significant differences between the two approaches This suggests that both options hold value in the treatment of OPC/HPC based on the findings in the literature and our own results a more exhaustive exploration involves delving into the broader implications of incorporating emerging technologies into cancer treatment Additional considerations need to be made by examining the costs and learning curve associated with adopting such advanced tools While our study provides valuable insights into the immediate outcomes the long-term impact on QOL and potential complications arising from the use of the VITOM 3D exoscope warrant sustained investigation the cost-benefit analysis should not only consider the immediate clinical outcomes but also the economic feasibility and sustainability of incorporating advanced technologies into routine clinical practice The current study has several limitations that need to be acknowledged like every study investigating quality of life through a questionnaire the results are subject to the intrinsic limitations of the exploring tool A notable limitation of the MDADI questionnaire is its emphasis on a few surgical-objective functional outcomes Many questionnaire items primarily address the psychological and emotional aspects of the patient leading to an alteration of the overall questionnaire results due to the inherent structure of the questionnaire itself factors such as the surgeon's expertise with the new exoscope technology potential biases associated with the retrospective nature of the study subjectivity in responses to the questionnaires the relatively small number of enrolled patients and the nature of the questionnaires themselves—more inclined to assess psychological and emotional aspects than specific functional outcomes resulting from treatments—should be considered To gain a more comprehensive understanding of these parameters further prospective comparative studies are warranted the application of 3D exoscopes presents potential advantages demonstrate comparable outcomes between traditional treatment modalities and transoral interventions employing the 3D exoscope duration of hospitalization and margin status demonstrate overlapping characteristics between the cohort treated with the exoscope and those treated with the microscope in the LC group Before conducting a survival analysis involving a new technique or therapy it is important to verify that such a new approach is both effective and safe for patients the purpose of our study is not to perform a comparative survival analysis between two treatment modalities we aimed to evaluate the quality of life of patients to understand whether the use of the new exoscope impacts the quality of life compared to gold standard treatments (radiochemotherapy for oropharyngeal tumors and TOLM for laryngeal tumors) we sought to verify that this approach is technically effective by comparing outcomes such as margin status and duration of the procedure in the operating room compared to a treatment considered gold standard (TOLM for laryngeal tumors) conducting a survival analysis among different treatment methods is an interesting topic to explore but it requires adequate follow-up (generally a median of at least 2 years) it is important to verify that a treatment method is safe and does not impact the quality of life of patients we are collecting data for a subsequent study regarding survival outcomes of patients with LC treated with TOLMS vs it is worth of mention that the present study was conducted at a singular center encompassing larger patient cohorts and involving multiple centers is imperative to validate these findings and assess the generalizability of the results The raw data supporting the conclusions of this article will be made available by the authors The studies involving humans were approved by IRCCS Ospedale Policlinico San Martino The studies were conducted in accordance with the local legislation and institutional requirements The participants provided their written informed consent to participate in this study Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article The author(s) declare that no financial support was received for the research The authors appreciate the technological support provided by Karl Storz—Tuttlingen The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest The author(s) declared that they were an editorial board member of Frontiers This had no impact on the peer review process and the final decision All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher Interventions for head and neck cancer survivors: systematic review Survivorship and quality of life in head and neck cancer PubMed Abstract | Crossref Full Text | Google Scholar A patient-centered approach to counseling patients with head and neck cancer undergoing human papillomavirus testing: a Clinician’s guide Patient-reported quality of life and symptom burden measures in human papillomavirus associated oropharyngeal cancer—a review of the literature and PRO methodology The role of surgery for HPV-associated head and neck cancer The value of quality-of-life questionnaires in head and neck cancer Effectiveness of exercise-based rehabilitation on functional capacity and quality of life in head and neck cancer patients receiving chemo-radiotherapy Comparison of subjective and objective tools in transoral Laser cordectomy for early glottic cancer : importance of voice handicap index Several Studies in Recent Years Have Already Reported Good Oncologic Results with Laser Microsurgery in the Treatment Assessment of quality of life in patients with laryngeal cancer: a review of articles PubMed Abstract | Crossref Full Text | Google Scholar Quality of life after conservation surgery for laryngeal cancer PubMed Abstract | Crossref Full Text | Google Scholar Dysphagia after nonsurgical head and neck cancer treatment: Patients’ perspectives The clinical value of dysphagia preassessment in the management of head and neck cancer patients Anderson dysphagia inventory (MDADI) in patients with head and neck cancer and neurologic swallowing disturbances Development and validation of the voice handicap index-10 Quality of life in survivors of oropharyngeal cancer: a systematic review and meta-analysis of 1366 patients Functional outcomes after tors for oropharyngeal cancer: a systematic review High-definition three-dimensional exoscope for head and neck reconstruction: prospective analysis of 27 consecutive patients High definition three-dimensional exoscope (VITOM 3D) in E.N.T Surgery: a systematic review of current experience VITOM-3D-Assisted retroauricular neck surgery (RANS-3D): preliminary experience at candiolo cancer institute Is the exoscope ready to replace the operative microscope in transoral surgery Pre-clinical experience with the VITOM 3D and the ARTip cruise system for micro-laryngeal surgery Microsurgical procedures during COVID-19 pandemic: the VITOM® 3D-HD exoscopic system as alternative to the operating microscope to properly use Personal Protective Equipment (PPE) High-definition 3D exoscope-assisted soft palate excision and reconstruction VITOM 4K 3d exoscope: a preliminary experience in thyroid surgery Crossref Full Text | Google Scholar Crossref Full Text | Google Scholar Laryngeal exposure and margin Status in glottic cancer treated by transoral laser microsurgery Preoperative predictors of difficult oropharyngeal exposure for transoral robotic surgery: the pharyngoscore Late dysphagia after radiotherapy-based treatment of head and neck cancer Crossref Full Text | Google Scholar Radiotherapy side effects: integrating a survivorship clinical lens to better serve patients Crossref Full Text | Google Scholar The impact of depression on survival of head and neck cancer patients: a population-based cohort study Role of physical activity and diet after colorectal cancer diagnosis PubMed Abstract | Crossref Full Text | Google Scholar Initial clinical experience with a high-definition exoscope system for microneurosurgery Transoral laser microsurgery: feasibility of a new exoscopic HD-3D system coupled with free beam or fiber laser A multidisciplinary team guided approach to the management of CT3 laryngeal cancer: a retrospective analysis of 104 cases Impact of close and positive margins in transoral laser microsurgery for TIS-T2 glottic cancer Shrinkage of specimens after CO(2) laser cordectomy: an objective intraoperative evaluation A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation Anatomical-based classification for transoral lateral oropharyngectomy Radiotherapy for management of oropharyngeal squamous cell carcinoma e A systematic review of the literature Electrocoagulation in epitheliomas of the tonsils PubMed Abstract | Google Scholar Comparison of functional outcomes and quality of life between transoral surgery and definitive chemoradiotherapy for oropharyngeal cancer Crossref Full Text | Google Scholar Sampieri C and Peretti G (2024) Enhancing quality of life in head and neck cancer patients: a comparative analysis of 3D exoscope-assisted surgery vs Received: 19 December 2023; Accepted: 1 April 2024;Published: 16 April 2024 © 2024 Marchi, Bellini, Ioppi, Simoni, Iandelli, Filauro, Mora, Sampieri and Peretti. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited *Correspondence: Elisa Bellini ZS5lLmVsaXNhYmVsbGluaUBnbWFpbC5jb20= †ORCID Filippo Marchi orcid.org/0000-0002-7997-964X Elisa Bellini orcid.org/0000-0003-0957-8354 Alessandro Ioppi orcid.org/0000-0002-2764-715X Imaging is increasingly useful in detecting colorectal cancer (CRC) liver metastases and evaluating how these lesions respond to treatment Dr Daniele Regge reviewed all the latest advances during last September’s Madrid meeting of the European Society of Medical Oncology (ESMO) A large majority of colorectal cancer (CRC) induced metastases will develop only in the liver an organ that has long challenged radiologists ‘77% of all CRC metastatic patients have liver-only metastases and complete surgical removal of these lesions is the only treatment option that provides the best opportunity for long-term survival in 30% of patients,’ said Daniele Regge associate professor at Turin University and director of the radiology unit at the Candiolo Cancer Institute However not all patients are candidates for surgery ‘Imaging is the first stop to select which patients may benefit from surgery from those needing chemotherapy.’ Contrast-enhanced CT (CECT) is usually performed as a first test to detect and characterise metastases But MRI is increasingly used as a complementary examination for those lesions that remain uncertain Many studies have compared diagnostic accuracy of MRI and CECT to detect liver metastases One randomised study that specifically compared the value of hepatocyte-specific gadoxetic acid enhanced MRI and CECT (Thomas D Vreugdenburg et al. International Journal of Colorectal Disease 2016) offered interesting results on both modalities’ reliability Although the authors did not notice any major difference in picking up lesions using CECT or MRI altered surgical planning in significantly distinctive proportions ‘If you had a diagnostic pipeline with MRI the change in surgical planning would be 20%,’ Regge explained change would be observed in almost 50% of patients These results prove that liver MRI is better at fulfilling the ultimate role of imaging to identify suitable patients for surgery – despite being expensive.’ the combination of diffusion-weighted MRI (DWMRI) and gadoxetic acid agents boosts sensitivity up to 95% Radiologists may also use hepatospecific agents ‘Using agents provides increased lesion conspicuity on T-1-weighted images because metastatic lesions maintain their native dark signal while the liver becomes much more enhanced,’ Regge added Another study focusing on PET/CT (Eur J Nucl Med Mol Imaging 2015 Jan) showed that the incidence of extra hepatic disease detected only by PET was 32% PET also led to change in patient management in 24% of cases ‘There is no solid evidence yet showing that PET should be used in tumour response but probably it should be indicated in patients with a high risk of extra hepatic disease or in patients with unclear resectable liver metastases,’ Regge said For patients with unresectable metastases who will undergo conversion therapy imaging will also help detect potential remaining lesions or their reduction after chemotherapy and help decide whether subsequent surgery can be performed Regge strongly recommends performing MRI in these patients because CT will not reveal some of the chemo-induced changes post-therapy metastases often have reduced contrast in respect of the liver and ill defined borders This is the consequence of tumour size shrinking to sub-centimetre diameters and drug-induced steatosis which modifies the imaging aspect of the liver parenchyma,’ he explained intraoperative ultrasound (IOUS) or contrast-enhanced IOUS may be performed before surgery Regge went on sharing results that highlight MRI’s added value in detecting and characterising CRC liver metastases A study published in Annual Surgical Oncology in 2012 concluded that MRI was more sensitive than FDG PET/CT after analysing 39 articles conducted in 1989 patients and 3854 liver metastases Research also showed that gadoxetic-acid enhanced MRI had an overall sensitivity of 97% compared to 72% for MDCT in the detection of metastases smaller than 1cm in fatty liver DWMRI and CEMRI picked up previously unspotted metastases on CT and detected the largest disappearing lesion on CT Disappearing liver metastases (DLM) are an important issue to consider in treated patients Seven to 37% of patients who have undergone neoadjuvant therapy for CRC have one or more DLM; and in 35 to 80% of DLM’s resected areas ‘It’s not time to wait and see for DLM in CRC cancer Complete radiological response correlates poorly with a complete pathological response Recurrence after conservative management of liver metastases is observed in 33 to 74% of the cases So it is advisable to resect or ablate the area of the DLM considering the high microscopic residual disease rates at these sites.’ A paper (Use of imaging to predict complete response of CRC liver metastases after chemotherapy Radiology 2017) recently showed that positive predictive value of MRI for absence of tumour was almost 80% compared to 35% for CT Imaging can also help detect DLM during surgery IOUS enabled detection of 39% of all 67% detected DLM during laparotomy compared to 6% by macroscopic liver examination RECIST criteria help evaluate treatment response to medical therapy in fit patients with unrestectable disease but these criteria are limited since they are based solely on anatomical one-dimensional tumour size significant variability in the measurements is observed ‘Tumour variations do not occur in uniform and symmetrical ways and structural variations of the neoplastic tissue cavitation or changes in vascularisation are not frequently associated with dimensional variations new molecular target agents and locoregional therapies induce tumour growth inhibition or lesion necrosis rather than tumour regression,’ he said Although interesting PET research has shown that any type of morphological change probably implied there was treatment response very few studies have assessed response with anything other than RECIST.  Mixed tumour response is an additional issue and doctors need tools such as liquid biopsies The future is to put everything together: imaging data Daniele Regge is associate professor of radiology at the University of Turin and director of the radiology unit at the Candiolo Cancer Institute From 2015-2017 he was president of the European Society of Oncologic Imaging His main research focus falls on gastrointestinal and abdominal radiology and on assessment of tumour response to therapy He is familiar with the most important radiological procedures such as magnetic resonance imaging computed tomography and virtual colonoscopy and imaging cloud services for improved radiology workflows: Royal Philips announces its solutions that will be showcased at ECR 2025 in Vienna how the Get Up holding system sustainably assists both patients and medical staff New approaches to cardiovascular radiology are evolving to help clinicians gain an increasingly better insight into heart conditions Latest developments in cardiovascular radiology include… A new type of diffusion-weighted imaging (DWI) is giving conventional breast MRI a run for its money Field-of-view optimized and constrained undistorted single-shot (FOCUS) imaging can identify 85% of suspicious breast lesions Researchers have investigated DWI as a method to overcome the limitations of conventional breast MRI they've looked at the detection and characterization of breast cancer with the aim of improving the diagnostic performance of dynamic contrast MRI said Dr. Lorenzo Vassallo from the radiology department at Istituto di Candiolo-IRCCS-Fondazione Piemontese per la Ricerca sul Cancro Onlus in Candiolo because of the variability of acquisition and analysis methodologies at all the different centers there is not a set value for the differentiation between benign and malignant breast lesions the spatial resolution of standard DWI can affect the evaluation of morphological descriptors of the breast lesions "This new sequence will provide high-resolution images with more accurate characterization of masses significant reduction of architectural distortion To test this hypothesis, he and his colleagues compared the visibility of breast lesions at 1.5 tesla (Optima 450w GEM suite, GE Healthcare) using FOCUS DWI versus standard DWI and dynamic contrast-enhanced (DCE) MRI sequences They enrolled 50 consecutive women undergoing presurgical breast MRI from January to December 2016 They performed FOCUS DWI on the axial plane with limited shimming to the rectangular area target DCE MRI was considered the reference standard The type of each suspicious lesion detected at DCE MRI was evaluated and then compared with similar findings identified at both standard DWI and FOCUS DWI meaning the lesion had better visibility on FOCUS; -1 the lesion had better visibility on standard DWI; or 0 The same analysis was performed for FOCUS and DCE MRI pathologically proven lesions: 48 mass and 11 nonmass lesions All of the lesions were correctly detected at standard DWI Five lesions -- all masses ranging in size from 7 mm to 15 mm -- were not identified at FOCUS DWI "When asking readers to express a preference in terms of visibility between FOCUS and standard DWI the visibility was considered +1 or even better at FOCUS compared with standard -- and in particular for mass lesions compared with nonmass lesions," he said the visibility of the lesions was never better on FOCUS DWI although it was comparable in 10 cases of mass lesions The results suggest a future for FOCUS DWI in the evaluation of breast lesion morphology but multicenter studies are required to confirm the preliminary results in a larger series of patients Too many automated requests from this network The 2022 Commonwealth Fencing Championships continue in London Three Bermuda fencers competed on day 8 of the competition in the veteran men’s Sabre individual division Federico Candiolo finished 41st in the division Category: All, Sports The use of electronic devices for smoking tobacco is increasing rapidly with many young people taking up smoking using these devices exclusively The tobacco market is 3% covered by these devices and this figure will increase to 30% by 2025 according to market analysts Tobacco smoking is a known risk factor for several diseases awareness of the consequences of tobacco use through heat-not-burn cigarettes is low both within the scientific community and the public data has been released by the tobacco companies themselves Hence the need for observational studies aimed at understanding whether the health effects can also be applied to the new heated tobacco devices A recent paper published in the European Journal of Clinical Investigation by a team of researchers from Sapienza University of Rome the Italian Institute for Genomic Medicine in Candiolo observed changes in the profile of circulating microRNAs the RNA molecules that play a pathogenic role in cancers and cardiovascular diseases in smokers of traditional cigarettes as well as in smokers of e-cigarettes The trial was conducted on the sera of a very homogenous group of healthy young smokers recruited between 2019 and 2020 for the SUR-VAPES Chronic study The sample comprised of 20 subjects who exclusively used traditional combustion cigarettes the researchers found changes in the profile of circulating microRNAs in the serum of both groups of smokers with substantial overlap in the list of deregulated microRNAs and their targets Approximately one third of the deregulated microRNAs were in common between smokers of traditional cigarettes and smokers of heated tobacco cigarettes The data show for the first time that even heat-not-burn cigarettes which are considered modified risk products affect circulating microRNAs in a similar way to traditional combustion cigarettes the consequences of the two types of smoking on circulating microRNAs are most likely overlapping "Our new observation has several implications," says Isotta Chimenti from the Department of Medical-Surgical Sciences and Biotechnology of Sapienza University - The use of heated tobacco cigarettes cannot be considered safer than traditional combustion cigarettes because of the effects on circulating microRNAs molecules with biological roles in endocrine signalling This study therefore also draws attention to the use of modified risk products" Effect of traditional or heat-not-burn cigarette smoking on circulating miRNAs in healthy subjects - V Pagano - European Journal of Clinical Investigation 2023 DOI: 10.1111/eci.14140 Isotta Chimenti Department of Medical-Surgical Sciences and Biotechnologyisotta.chimenti@uniroma1.it  © Sapienza Università di Roma - Piazzale Aldo Moro 5 00185 Roma - (+39) 06 49911 - CF 80209930587 PI 02133771002 The 2022 Commonwealth Fencing Championships are underway Two Bermuda fencers competed on day eight of the competition in the veteran men’s foil individual division in the round of 128 Donald Treanor took on Mark Robertson from Wales Treanor advanced to the round of 64 to face John Troiano from England Treanor battled Troiano in the round of 64 Federico Candiolo went to battle against Simon Curling also from Wales Candiolo advanced by defeating Curling 10 – 1 moving on to face Richard Purdie from Australia in the round of 64 brought together her 140 performers and singers to deliver to us a thoughtfully chosen beautifully performed programme of emotionally diverse gems from the repertory of choral music Opening with Verdi’s Chorus of the Hebrew Slaves from his 1841 opera Nabucco with its expression of overwhelming grief at the loss of homeland we moved to two charming vignettes from Humperdinck’s 1893 Hansel and Gretel – Evening Prayer and Brother Come and Dance With Me – sung as a duet by Youth Choir members Gloria Candiolo and Natalia Tafur The emotional impact of the prayer of the two lost children conjuring forth guardian angels was nicely offset by the innocent fun of their romping children’s dance Borodin’s 1887 Choral Dance changed our focus to Ukraine; Borodin’s opera Prince Igor depicted a patriotic prince fighting off a barbarian invasion of Ukraine Chorister Euan Forster’s simple and unembellished solo of Mendelssohn’s O For the Wings of a Dove together with Andrea Hodgson’s simple and unembellished piano accompaniment formed an unforgettable expression of childish longing and marked the emotional high point of the first half of the concert first performed In October 1727 at George II’s coronation and most recently on May 6 of this year at Charles III’s showed the composer’s mastery of the music of solemn majestic ceremony and of joyful acclamation and brought the first half of the concert to a close Mozart’s Requiem in D Minor formed the second half of the concert and was in itself a hugely diverse emotive experience with its 13 sections ranging from apocalypse We were able to appreciate the work in some detail because our programmes contained the full text of the work in Latin and English a gift from the School of Music which greatly helped our understanding It was in this movement that our Bermuda soloists were introduced Bass singer Peter Nash set the scene of the dead arising and assembling at the sound of the last trump Next tenor Kevin Lee described the book of judgment Contralto Evangelina Ng showed the judge taking his seat and finally soprano Joanna Sherratt-Wyer hinted at possible redemption An early fan of this movement was the French novelist Stendhal who had heard a performance of the work while he was serving in Napoleon’s army occupying Vienna In 1818 he wrote a biography of Haydn and Mozart in which he recalled his experience though he was more interested in Mozart’s use of the trombone “This great work is a solemn mass in D minor hung around with funeral pomp and imagery The tuba mirum (third movement) is opened by the sonorous tromboni Every one acquainted with the powers of this instrument acknowledges the superiority of its tones for the expression of this sublime idea.” choirs and orchestra made for an unforgettable performance of this massive complex and emotionally overwhelming masterpiece The Bermuda School of Music’s Spring Concert was directed by Marjorie Pettit on June 9 and 10 at St John’s Church in Pembroke You must be Registered or to post comment or to vote Which of the Throne Speech promises is the Government best equipped to deliver on View Results 5 August 2015Re/insuranceReflecting on regulation It looks increasingly likely that the European Commission will recommend Bermuda’s commercial insurance class for equivalence in September This will be an important achievement for the Bermuda regulator and a boost for re/insurers on the Island “It is an important milestone,” says Brad Kading chief executive of the Association of Bermuda Insurers and Reinsurers (ABIR) “The benefits to Europe are clear: more reinsurance capacity and regulatory recognition will make insurance markets more competitive by eliminating cross-border collateral and removing the risk of capital add-ons “This means consumers will benefit; there will be more engagement with EU regulators and this will increase EU jurisdictional regulatory knowledge with access to prudential information about Bermuda’s commercial insurers.” Kading adds that Bermuda’s carriers are historically well integrated into both the EU and the US insurance markets The regional standards simply help secure those relationships “These regional standards are stepping stones to international standards now being created by the International Association of Insurance Supervisors (IAIS) Qualification by the US and the EU should help speed an International Monetary Fund finding about Bermuda and its adherence to international standards the next time such a Financial Sector Assessment is completed.” adds that its early commitment to attempting to secure equivalence has held Bermuda in good stead and it now faces fewer regulatory challenges as a result “In light of the hard work that went into Solvency II Bermuda does not face many insurance regulatory challenges at present Bermuda is already ahead of the curve when compared with many of its competitor jurisdictions,” Candiolo says “It was one of the first jurisdictions to commit itself to seeking equivalence and it is expected that it will be among the first jurisdictions to obtain equivalence Although whether it will be full equivalence or equivalence for its reinsurance sector only is yet to be determined.” He notes that changes made to the Insurance Act 1978 and related regulations to bring Bermuda’s insurance regulation to a position where it can be deemed equivalent to Solvency II by the European regulators have been of recent and great importance to securing equivalency “These changes are indeed welcome and sought by the large reinsurance carriers based in Bermuda and it is anticipated that the class 4 and 3B insurers will no doubt be able to reap the benefits that stem from European equivalence,” Candiolo says it is expected that the captives market in Bermuda will continue to grow without hindrance from the additional regulations that now apply to class 4 and 3B reinsurers.” that the biggest challenges Bermuda will face going forward will depend not on regulatory changes in Bermuda but in respect of the ever-changing landscape in Bermuda’s main markets: the US and Europe He cites the proposed passive foreign investment company (PFIC) regulations in the US as being one example of this 2015 the US Department of the Treasury issued proposed regulations concerning the status of non-US insurance and reinsurance companies as “passive foreign investment companies” under the US Internal Revenue Code of 1986 they will have an impact on certain Bermuda insurance-linked securities (ILS) structures,” he says Bermuda’s ability to adjust to the new regime of Solvency II represents just the latest example of its regulator adapting successfully to changes Kading argues that Bermuda is successful as an insurance hub for four reasons the Bermuda Monetary Authority (BMA) is very good at putting capital to work quickly in its licensing process the underwriting talent available makes the market a go-to place for underwriting judgement and offers of capacity it’s geographically convenient to large North American markets Kading explains the importance of the way the BMA has created a licensing class system that allows it to apply proportional regulation based on risk assessment “ABIR members are in the licensing classes that provide the most robust regulation and that meet or exceed international standards,” he says “If you are a captive insurer you get a different but proportional level of regulation tied to the solvency risk of that entity.” He adds that the BMA—in showing leadership in meeting regional standards (Europe’s Solvency II and the US state ‘certified reinsurer’ assessments) and in meeting the IAIS insurance standards and regulatory principles—has built credibility with peer group regulators and demonstrated the substance of its regulatory approach “You don’t go to Bermuda to escape insurance regulation,” he stresses “By the time Solvency II is implemented next year group supervision and group capital requirements for four years “We are currently in our third trial run of our economic balance sheet The BMA has demonstrated it can be both a substantive regulator and speed capital to market It can speed capital to market because of its knowledge of capital providers underwriting management teams—it can quickly assess reputation and quality “The BMA knows the executives who make the market It’s not impeded by a domestic market that tries to keep out competitors with seasoning requirements Since it is a wholesale market it can focus regulation on prudential matters and does not have to devote attention to consumer suitability or forms regulatory issues sophisticated commercial insurance market regulation.” Candiolo describes the BMA’s approach as pragmatic and agrees that this has been hugely important to its success over the years “The continuous development of pragmatic yet responsible legislation and regulation for the reinsurance industry is what has helped Bermuda secure its key position in the insurance industry,” he says “The BMA is committed to advancing a regulatory framework that is not only sophisticated but is also practical where licensees and service providers alike can expect regulation and supervision to be prudently and adequately calibrated on a risk-based approach “The fact that most of the developments result from the regulator’s willingness to engage in discussions with industry has facilitated optimal results for the insured and industry we had the introduction of the special purpose insurer regime in 2010.” there will never be an end game for the regulator In order for it to continue being successful the regulatory environment will need to continue to develop and change in response to sensible market demands “Bermuda has the right mix of industry specialists prudent yet sensible regulators and a sophisticated legal system that can work together and create the synergies to deliver the best solutions for the new challenges faced by the insurance industry,” Candiolo says “Through the ILS growth over the past decade Bermuda has demonstrated that this combination was instrumental in the expansion of the total capital available to meet reinsurance needs It effectively unlocked capital from the traditional capital markets and enabled it to be deployed within the reinsurance industry these actors will need to continue being responsive to meet the new challenges ahead.” Kading also stresses the wider picture of all the work the regulator has done and continues to do to retain its status “Bermuda’s commitment to international standards goes well beyond regulation,” he says Kading highlights the fact that the Bermuda government is committed to the OECD’s tax cooperation It has tax information exchange treaties with all its major trading partners and through multilateral treaty commitments has now secured cooperative tax information agreements with more than 80 jurisdictions “As deputy premier and minister of finance Bob Richards has said: you don’t come to Bermuda to evade taxes If you do you will get caught in the tax enforcement commitments the government has made,” Kading says “In recent years this commitment has been recognised by actions taken in Argentina France and most recently Italy where withholding taxes or other cross constraints have been lifted “ABIR members and the commercial insurers in Bermuda are engaged in economic substance If you want a shell corporation without economic substance you’d be best advised to do it elsewhere.” Warwick Academy has unveiled its 2023 exam results — with 100 per cent of its graduates were successful in their first choice of universities congratulated pupils on their results for the International Baccalaureate and the International General Certificate of Secondary Education exams Mr Horan said examination boards globally were returning to “the pre-Covid normal curve” School officials watched as exam results dropped around the world and in the UK “Being forewarned of this and having planned for it we are even more pleased with what our Year 13s and Year 11s produced this summer,” Mr Horan said the school enjoyed a 100 per cent pass rate compared with the world average of 79 per cent Warwick Academy had an average total point score of 32.30 versus the world average of 30.24 Mr Horan congratulated the top IB Diploma students who attained 35 points and above on the exams: Mr Horan said the school achieved 100 per cent passes on the IB individual subjects category with an average point score of 25 — and congratulated the top students taking 29 points and above: heads to the University of the West of England Mr Horan highlighted top-scoring BTEC students is to study at Nottingham Trent University in the UK He praised the group’s “resilience and flexibility” Mr Horan added: “My sincere congratulations to our graduates and our Year 11s on the hard work they have put in over the past two years “We are very pleased with the overall outcome and I am deeply proud of every one of them and greatly respect what they have achieved in the face of unprecedented circumstances “These are wonderful young people who will do great things.” A pair of schoolgirls have been recognised for their films on the dangers of radio waves at a documentary screening won a student film competition for her homemade film on the effects of electromagnetic frequencies on the environment was runner-up for her film that examined the consequences of 5G radio waves She said: “My perspective has changed about wi-fi — some people may complain ‘oh but I would be more relaxed knowing that it’s not harming me.” Both Warwick Academy pupils had their films presented last Thursday at the screening of the documentary Generation Zapped which examines the health risks of prolonged exposure to wireless technology at the Bermuda Underwater Exploration Institute which was hosted by Bermuda Advocates for Safe Technology urged schoolchildren to create films exploring the effects and dangers of electromagnetic frequencies said that her film focused on the impact on bees She explained: “The bees have something in their antennas that helps them navigate their way home and they go crazy when electromagnetic frequencies are near “So when their antennas get damaged by these EMF towers then they can’t bring pollen to their hives and then they die later.” Seri added: “Since my parents know a beekeeper we went to check him out to see if he was noticing any effects by being close to a tower “It turns out that he’s a bit far away and there are trees surrounding him so it was a bit protected Seri said that learning about the effects of these frequencies prompted her to use her phone less and stop using the family microwave entirely She hopes to make more videos to spread awareness about the effects of radio waves put together a PowerPoint-style presentation with narration she wrote and recorded herself while 5G brought many positive opportunities such as better medical practices the new technology also came with many downsides you would need a cellphone tower every 100 metres and you would not be able to turn it off “It can create a high metabolism in people which is the part that regulates blood sugar Gloria said that 5G radio waves could also lead to higher levels of brain cancer — a consequence she referred to in her film as getting “wi-fried” The new information also made her wary of her own internet use my family and I actually turn off our wi-fi so that we’re not exposed to that while we’re sleeping.” Gloria hopes to show her film to the school and do more to warn others about the dangers of electromagnetic frequencies More than 40 Bermuda lawyers have been listed in the IFLR 1000 a guide to the world’s leading financial law firms Conyers Dill & Pearman has 14 lawyers on the list Trott & Duncan is mentioned as “other notable” Conyers’ lawyers on the list are David Astwood ASW law lawyers listed are: Federico Candiolo Walkers Bermuda lawyers listed are: Natalie Neto Carey Olsen Bermuda lawyers listed are Michael Hanson and Mary Ward Cox Hallet Wilkinson lawyers listed are Janice Gutteridge and Ernest Morrison Ian Stone of Wakefield Quin and Andrea Moniz-DeSouza of Harneys Bermuda also make the list Rhys Swift is soaking up every moment of competing in the Commonwealth Fencing Championships in London as he continues his burgeoning career in the sport The 14-year-old Warwick Academy student is the youngest of Bermuda’s four-man team competing at the championships at the University of East London SportsDock who has been attending fencing classes at St Paul’s Church Hall in Paget for the past four years got off to an encouraging start at the event finishing tied for 37th in the Junior Men’s Sabre class “I was really pleased with my performance,” said Swift who returns to action in the Cadet Men’s Sabre event tomorrow “I managed to get through the pools but then I was beaten in the first elimination “It was an amazing experience and I had a lot of fun with it I knew it was going to be difficult because that class is for people up to the age of 21 and so my opponents were much older and a lot more experienced than I am “I knew it would be a great experience to learn from and be able to measure how far I’ve progressed It was a great experience that I really enjoyed.” While not a conventional sport that many young men would pursue Swift is determined to continue progressing having also reached the direct eliminations rounds of the Arnold Fencing Classic at the Ohio Expo Centre in Columbus in March in what was his first international competition “Like a lot of young boys I always thought swords and sword fighting was pretty cool,” he added “I went a long to a summer camp and got interested in it I always wanted to slash a sword around like you see in the movies and while fencing is not exactly that compete at college level and one day be able to challenge for medals at international level.” Swift also took the opportunity praise the guidance of his team-mates who have also been in action in the Veteran Men’s Épée Individual Division in which Candiolo finished in 64th place and Treanor 84th it has been great to for me to have those guys as team-mates,” he said “They are all so much more experienced than I am and have just been fantastic with helping me and coaching “They’ve also done really well and had some amazing performances.” Six young gymnasts from Quality Gymnastics have been praised for their performances following the Beach Classic Invitational earlier this month President of Quality Gymnastics Peter James said “Quality Gymnastics had six of its gymnasts compete overseas at the Beach Classic Invitational on May 13th I am very proud of all the girls’ performances Three of them competed in the GAP program which is to prepare them for USAG competitions.” “Everyone was impressed with how well they looked The other three competed in the USAIGC program all receiving qualifying scores for the USAIGC World Championships Kenya Robinson did exceptionally well obtaining scores of 9.55 and 9.55 in her first two events “This was the first season for Quality Gymnastics and our Head Coach Anna Balada Gene has done a fantastic job at preparing the girls to do their very best Quality Gymnastics competed both on the island and in New Jersey recently with gymnasts doing very well in both meets “Congratulations to all our gymnasts that participated in the recent meets for Quality Gymnastics We competed on island and off island; the first meet was in New Jersey for the Crystal Springs Invitational and locally at the Bermuda International Gymnastics Challenge hosted by the Bermuda Gymnastics Association [BGA] in St “Our gymnasts performed very well individually and collectively “In the Crystal Springs meet for USAG Level 4 Avani Patton placed 2nd on balance beam and floor “Blake Boden placed 2nd balance beam For the USAG Level 4 Team event we placed 2nd Kateri Zuill placed 1st in floor and 2nd in vault We also had outstanding performances from Kayla Calveley “In the Bermuda International Gymnastics Challenge for the USAG Level 4 we placed 1st on balance beam and 2nd as a team overall There were amazing performances from Isabella Stowe who placed 1st on beam and 3rd on bars; Blake Boden placed 2nd on vault and 2nd all around; Avani Patton placed 1st on vault and bars and 3rd all around; and Sean Lawrence placed 1st on floor and 3rd on beam we had Kayla Calveley who placed 1st on bars we had Ajana Patton who placed 1st on vault and bars Alyssa Andrews placed 1st on beam and floor “For USAIGC Bronze we had Celeste Candiolo who placed 1st in bars We also had a strong showing from Gloria Candiolo Our USAIGC Bronze Team placed 2nd and 1st on vault “We really appreciated the opportunity to compete on the island with the Bermuda Gymnastics Association and look forward to competing with them again on December 1 2018 when we will be hosting our first international meet.” Bermuda athletes continued competing at the 2022 Commonwealth Fencing Championships in London Two Bermuda fencers competed on Day 7 of the competition in the veteran men’s Epee individual division which saw 115 athletes from around the world take part with Federico Candiolo finishing 64th in the division Latin American corporations that could benefit from establishing a captive insurance company in Bermuda are the focus of an upcoming webinar hosted by the Bermuda Business Development Agency [BDA] to be held noon–1 pm Bermuda/Atlantic Standard Time [GMT -4] next Monday will be conducted entirely in Spanish and feature an expert panel discussing the regulatory of setting up a captive insurer in Bermuda—including risk management and efficient access to the global reinsurance market The webinar is the fourth staged by the BDA this year; previous webcasts targetted Canadian and Mike Woytowicz of Artex Risk Solutions [Bermuda] “Our webinar will be geared to private corporations and multinationals in the Latin American region,” explains Jereme Ramsay BDA Business Development Manager for the risk and LatAm sectors “Bermuda has become the first choice for LatAm captive setups The Tax Information Exchange Agreements [TIEAs] we hold with several LatAm countries have been strong catalysts for this recent peak in interest across the region.” while multilateral treaty signatories additionally include Chile Bermuda is currently home to close to 300 companies from Latin America across multiple sectors some of the largest companies from the region have formed captives and other investment vehicles on the Island “A large percentage of Latin American businesses would benefit enormously from creating a captive insurer in Bermuda but many have not yet done so because the concept is relatively new in the region,” notes the webinar’s moderator “This webinar will make LatAm companies more aware of Bermuda’s captive solution which has been successfully used for decades by North American and European markets.” Registrants will receive online access to the live webinar followed by a question-and-answer session and a post-webinar download of the presentation Featured speakers with Candiolo are Andres Carmona of Marsh and Eduardo Fox of Appleby Other professionals on hand to offer live commentary and answer questions during the webinar include: Giuliana Molero of PwC Questions during the webinar session can be emailed to info@bda.bm or tweeted to @investBermuda #BDAcaptive. To sign up, click here Category: All, Business