Salvage cryotherapy for prostate cancer.

BACKGROUND: Most men diagnosed with prostate cancer will be candidates for active treatment and 20 to 50% of patients treated with organ preserving strategies recur within the prostate. Optimal treatment of recurrence is controversial. Prostate cryosurgery has been increasingly used as primary, recurrence and focal treatment for prostate cancer. METHODS: We analysed 55 patients submitted to cryotherapy as salvage treatment after recurrence. RESULTS: Study population presented with a mean age of 70.9 ± 6.2 years, mean initial PSA of 7.6 ng/ml and average prostate volume by ultrasound of 43.2 ± 14.7 grams. Mean follow-up was of 18.0 months. Biochemical free survival at one year of follow-up was of 85%. CONCLUSIONS: Cryotherapy can be an effective and safe treatment for recurrence after primary curative treatment failure.

Impacts of the COVID-19 pandemic on scientists' productivity in science, technology, engineering, mathematics (STEM), and medicine fields.

While studies suggested adverse impacts of COVID-19 on scientific outputs and work routines for scientists, more evidence is required to understand detailed obstacles challenging scientists' work and productivity during the pandemic, including how different people are affected (e.g., by gender). This online survey-based thematic analysis investigated how the pandemic affected scientists' perception of scientific and academic productivity in the science, technology, engineering, and mathematics (STEM) and medicine fields. The analysis examined if inequitable changes in duties and responsibilities for caregiving for children, family, and/or households exist between scientists who are mothers compared to scientists who are fathers or non-parents. The survey collected data from 2548 survey responses in six languages across 132 countries. Results indicate that many scientists suffered from delays and restrictions on research activities and administrations due to the lockdown of institutions, as well as increased workloads from adapting to online teaching environment. Caregiving responsibility for children and family increased, which compromised time for academic efforts, especially due to the temporary shutdown of social supports. Higher percentages of female parent participants than male parent participants expressed such increased burdens indicating unequal divisions of caregiving between women and men. A range of physical and mental health issues was identified mainly due to overworking and isolation. Despite numerous obstacles, some participants reported advantages during the pandemic including the efficiency of online teaching, increased funding for COVID-related research, application of alternative research methodologies, and fluidity of the workday from not commuting. Findings imply the need for rapid institutional support to aid various academic activities and diminish gender inequity in career development among academicians, highlighting how crisis can exacerbate existing inequalities.

Differences in self-perception of productivity and mental health among the STEMM-field scientists during the COVID-19 pandemic by sex and status as a parent: A survey in six languages.

The COVID-19 pandemic has caused unprecedented challenges for working conditions for scientists, but little is known for how the associations of these challenges with scientists' mental health and productivity differ by sex and status as a parent. This online survey study in six languages collected data from 4,494 scientists in Science, Technology, Engineering, Mathematics, and Medicine fields across 132 countries during October-December 2021. We compared the type of challenges for work, changes in work hours, and perception in productivity during the pandemic by sex and status as a parent (children <18 years living at home). Regression analyses analyzed the impacts of changed working conditions and work-life factors on productivity and mental health. We found that the percentage of participants with increased work hours was the highest in female participants, especially without children. Disproportionately higher increases in work hours were found for teaching and administration in women than men and for research/fundraising in non-parent participants than parent participants (p-value<0.001). Female participants were more concerned about the negative impacts of the pandemic on publications and long-term career progress, and less satisfied with their career progress than their male counterparts. There were differences in the type of institutional actions for the pandemic across study regions. The identified obstacles for work and home-life factors were associated with higher risks of experiencing depression, anxiety, and stress. Decision makers should consider the gender differences in the pandemic's adverse impacts on productivity in establishing equitable actions for career progress for scientists during pandemics.

Validation of a Novel, Sensitive, and Specific Urine-Based Test for Recurrence Surveillance of Patients With Non-Muscle-Invasive Bladder Cancer in a Comprehensive Multicenter Study.

Bladder cancer (BC), the most frequent malignancy of the urinary system, is ranked the sixth most prevalent cancer worldwide. Of all newly diagnosed patients with BC, 70-75% will present disease confined to the mucosa or submucosa, the non-muscle-invasive BC (NMIBC) subtype. Of those, approximately 70% will recur after transurethral resection (TUR). Due to high rate of recurrence, patients are submitted to an intensive follow-up program maintained throughout many years, or even throughout life, resulting in an expensive follow-up, with cystoscopy being the most cost-effective procedure for NMIBC screening. Currently, the gold standard procedure for detection and follow-up of NMIBC is based on the association of cystoscopy and urine cytology. As cystoscopy is a very invasive approach, over the years, many different noninvasive assays (both based in serum and urine samples) have been developed in order to search genetic and protein alterations related to the development, progression, and recurrence of BC. TERT promoter mutations and FGFR3 hotspot mutations are the most frequent somatic alterations in BC and constitute the most reliable biomarkers for BC. Based on these, we developed an ultra-sensitive, urine-based assay called Uromonitor®, capable of detecting trace amounts of TERT promoter (c.1-124C > T and c.1-146C > T) and FGFR3 (p.R248C and p.S249C) hotspot mutations, in tumor cells exfoliated to urine samples. Cells present in urine were concentrated by the filtration of urine through filters where tumor cells are trapped and stored until analysis, presenting long-term stability. Detection of the alterations was achieved through a custom-made, robust, and highly sensitive multiplex competitive allele-specific discrimination PCR allowing clear interpretation of results. In this study, we validate a test for NMIBC recurrence detection, using for technical validation a total of 331 urine samples and 41 formalin-fixed paraffin-embedded tissues of the primary tumor and recurrence lesions from a large cluster of urology centers. In the clinical validation, we used 185 samples to assess sensitivity/specificity in the detection of NMIBC recurrence vs. cystoscopy/cytology and in a smaller cohort its potential as a primary diagnostic tool for NMIBC. Our results show this test to be highly sensitive (73.5%) and specific (93.2%) in detecting recurrence of BC in patients under surveillance of NMIBC.

A pressure-transferable coarse-grained potential for modeling the shock Hugoniot of polyethylene.

We investigate the thermomechanical response of semi-crystalline polyethylene under shock compression by performing molecular dynamics (MD) simulations using a new coarse-graining scheme inspired by the embedded atom method. The coarse-graining scheme combines the iterative Boltzmann inversion method and least squares optimization to parameterize interactions between coarse-grained sites, including a many-body potential energy designed to improve the representability of the model across a wide range of thermodynamic states. We demonstrate that a coarse-grained model of polyethylene, calibrated to match target structural and thermodynamic data generated from isothermal MD simulations at different pressures, can also accurately predict the shock Hugoniot response. Analysis of the rise in temperature along the shock Hugoniot and comparison with analytical predictions from the Mie-Grüneisen equation of state are performed to thoroughly explore the thermodynamic consistency of the model. As the coarse-graining model affords nearly two orders of magnitude reduction in simulation time compared to all-atom MD simulations, the proposed model can help identify how nanoscale structure in semi-crystalline polymers, such as polyethylene, influences mechanical behavior under extreme loading.

Superhard nanobuttons: constraining crystal plasticity and dealing with extrinsic effects at the nanoscale.

The compressive plastic strength of nanosized single-crystal metallic pillars is known to depend on their diameter D. Herein, the role of pillar height h is analyzed instead, and the suppression of the generalized crystal plasticity below a critical value h(CR) is observed. Novel in situ compression tests on regular pillars as well as nanobuttons, that is, pillars with h < h(CR), show that the latter are much harder, withstanding stresses >2 GPa. A statistical model that holds for both pillars and buttons is formulated. Owing to their superhard nature, the nanobuttons examined here underline with unprecedented resolution the extrinsic effects-often overlooked-that naturally arise during testing when the Saint-Venant assumption ceases to be accurate. The bias related to such effects is identified in the test data and removed when possible. Finally, continuous hardening is observed to occur under increasing stress level, in analogy to reports on nanoparticles. From a metrological standpoint the results expose some difficulties in nanoscale testing related to current methodology and technology. The implications of the analysis of extrinsic effects go beyond nanobuttons and extend to nano-/microelectromechanical system design and nanomechanics in general.

Frecuencia de las alteraciones del metabolismo del hierro / Frequency of the iron metabolism disorders

MARCO TEORICO: Los desórdenes del metabolismo del hierro constituyen el problema nutricional de mayor prevalencia en el mundo, sobre todo en países en desarrollo como el nuestro. OBJETIVO: Conocer la frecuencia de las alteraciones del metabolismo del hierro de la población que acude al Laboratorio del Hospital A.B.C. a través de la determinación de Hb en g/dL y el porcentaje de Saturación de transferrina TIPO DE ESTUDIO: Retrospectivo RESULTADOS: Existe deficienia de hierro en promedio en 1 de cada 4 individuos estudiados (p<0.05). CONCLUSION: Es necesario establecer un sistema de detección para el tratamiento específico y oportuno de este problema.

Concordancia diagnóstica clínico-patológica en 429 autopsias del Instituto Nacional de la Nutrición Salvador Zubirán / Diagnostic concordance in 429 autopsies in the Instituto Nacional de la Nutricion Salvador Zubiran

Se revisaron los expedientes clínicos y los protocolos de las autopsias realizadas en el Departamento de Patología del Instituto Nacional de la Nutrición Salvador Zubirán, de 1984 a 1988, con el objeto de establecer el grado de concordancia entre los diagnósticos clínicos y de autopsia. El total de casos analizados fue de 429. A partir de 1985, se observó un descenso progresivo en el porcentaje de autopsias, de 34.65 por ciento que se efctuaron ese año a 21.16 por ciento en 1988, con un promedio de 27.31 por ciento en el lapso estudiado. En 229 casos (53.8 por ciento) hubo 353 hallazgos de relevancia clínica, de los cuales 86 fueron en la enfermedad principal y 267 en la causa de muerte. Hubo 171 sobrediagnósticos con implicaciones terapéuticas, 38 en la enfermedad principal y 133 en la causa de muerte. El mayor número de discordancias ocurrieron en las enfermedades infecciosas, seguidas por las gastroenterológicas y respiratorias y el menor número en enfermedades endócrinas y reumatológicas. El tiempo de hospitalización no influyó en el grado de concordancia. Se hace un breve análisis de las probables causas del descenso en el número de autopsias y se concluye que, a pesar de los notables avances tecnológicos con que contamos y del apoyo de especialistas de alto nivel, el porcentaje de discordancia diagnóstica clinico-patológica sigue siendo alto y justifica por ese sólo hecho que se continúen realizando autopsias