Gynecological carcinosarcomas: Overview and future perspectives.

Gynecologic carcinosarcoma (CS) are rare and aggressive tumors composed of high-grade carcinoma and sarcoma. Carcinosarcoma account for less than 5% of uterine and ovarian carcinoma and patients have poor outcome with a 5-year overall survival of less than 30%. In early-stage setting, the treatment mainstay is surgery and adjuvant chemoradiotherapy or adjuvant chemotherapy in uterine (UCS) and ovarian CS (OCS), respectively. In metastatic or advanced stage disease, chemotherapy is the rule with a lower response rate and poorer prognosis compared to other high-grade carcinomas. Although very few treatment options are available, CS are often excluded from the clinical trials precluding therapeutic improvement. However, recent molecular advances are paving the way for new therapeutic strategies. In the current proposal, we extensively review the uterine and ovarian carcinosarcomas including epidemiology, pathology, genomic landscape, as well as current therapies and future perspectives.

Immune Environment and Immunotherapy in Endometrial Carcinoma and Cervical Tumors.

Endometrial cancer (EC) is the seventh most common tumor in women, and prognosis of recurrent and metastatic disease is poor. Cervical cancer (CC) represents the fifth most common gynecological cancer. While ECs are more common in developed countries, the incidence of CC has decreased due to the recent implementation of large screening and vaccination programs. Until very recently, patients with advanced or unresectable EC or CC had very limited treatment options and were receiving in first line setting platinum/taxane-based chemotherapy (CT). Significant progress in the treatment of gynecological cancers has occurred in the last few years, with the use of innovative targeted therapies and immunotherapy. However, targeting the immune system in patients with gynecological tumors remains challenging and is not always successful. In ovarian cancer, several immunotherapy treatment regimens have been investigated (as monotherapy and combination therapy in first and subsequent lines of treatment) and showed poor responses. Therefore, we specifically focused our review on EC and CC for their specific immune-related features and therapeutic results demonstrated with immunotherapy. We report recent and current immunotherapy-based clinical trials and provide a review of emerging data that are likely to impact immunotherapy development based on increased biomarkers' identification to monitor response and overcome resistance.

Electrocatalytic Palladium Nanoclusters as Versatile Indicators of Bioassays: Rapid Electroanalytical Detection of SARS-CoV-2 by Reverse Transcription Loop-Mediated Isothermal Amplification.

Quantitative polymerase chain reaction (qPCR) is considered the gold standard for pathogen detection. However, improvement is still required, especially regarding the possibilities of decentralization. Apart from other reasons, infectious diseases demand on-site analysis to avoid pathogen spreading and increase treatment efficacy. In this paper, the detection of SARS-CoV-2 is carried out by reverse transcription loop-mediated isothermal amplification, which has the advantage of requiring simple equipment, easily adaptable to decentralized analysis. It is proposed, for the first time, the use of palladium nanoclusters (PdNCs) as indicators of the amplification reaction at end point. The pH of the medium decreases during the reaction and, in turn, a variation in the catalytic activity of PdNCs on the oxygen reduction reaction (ORR) can be electrochemically observed. For the detection, flexible and small-size screen-printed electrodes can be premodified with PdNCs, which together with the use of a simple and small electrochemical equipment would greatly facilitates their integration in field-deployable devices. This would allow a faster detection of SARS-CoV-2 as well as of other future microbial threats after an easy adaptation.

Electrochemical Detection for Isothermal Loop-Mediated Amplification of Pneumolysin Gene of Streptococcus pneumoniae Based on the Oxidation of Phenol Red Indicator.

A highly sensitive electrochemical methodology for end-point detection of loop-mediated isothermal nucleic acid amplification reactions was developed. It is based on the oxidation process of phenol red (PR), commonly used as a visual indicator. The dependence of its redox process on pH, which changes during amplification, allows performing quantitative measurements. Thus, the change in the oxidation potential of PR during the amplification is used, for the first time, as the analytical signal that correlates with the number of initial DNA copies. As a proof-of-concept, the amplification of the pneumolysin gene from Streptococcus pneumoniae, one of the main pathogens causing community-acquired pneumonia, is performed. Combination of isothermal amplification with electrochemical detection, performed on small-size flexible electrodes, allows easy decentralization. Adaptation to the detection of other pathogens causing infectious diseases would be very useful in the prevention of future epidemics.

Tsunami of immunotherapy reaches mesothelioma.

Malignant pleural mesothelioma (MPM) is the most common type of malignant mesothelioma. It is a rare tumor linked to asbestos exposure and is associated with a poor prognosis. Until very recently, patients with advanced or unresectable disease had limited treatment options, primarily based on doublet chemotherapy with cisplatin and pemetrexed. In 2020 and 2021, after more than a decade with no major advances or new drugs, two phase III clinical trials published results positioning immunotherapy as a promising option for the first- and second-line treatment of MPM. Immunotherapy has revolutionized the treatment of many cancers and is also showing encouraging results in malignant mesothelioma. Both immune checkpoint inhibition and dual cytotoxic T-lymphocyte-associated antigen 4 and programmed death-ligand 1 pathway blockade resulted in significantly improved overall survival in randomized phase III trials. In the CheckMate 743 trial, first-line therapy with nivolumab plus ipilimumab outperformed standard chemotherapy, while in the CONFIRM trial, nivolumab outperformed placebo in patients previously treated with chemotherapy. These two trials represent a major milestone in the treatment of MPM and are set to position immunotherapy as a viable alternative for treatment-naïve patients and patients with progressive disease after chemotherapy.

Electrochemical micropipette-tip for low-cost environmental applications: Determination of anionic surfactants through their interaction with methylene blue.

Miniaturization is one of the main requirements in the design of portable devices that allow in-field analysis. This is especially interesting in environmental monitoring, where the time of the sample-to-result process could be decreased considerably by approaching the analytical platforms to the sampling point. We employed traditional mass-produced and low-cost elements (micropipette tips and pins) in an out-of-box application to generate an innovative and cost-effective platform for analytical purposes. We have designed simple and easy-to-use electrochemical cells inside polypropylene micropipette tips with three stainless-steel pins acting as the working, reference and counter electrodes of a potentiostatic system. The pin acting as working electrode was previously coated with carbon ink, meanwhile the rest were used unmodified. In this way, electrochemical in-the-tip measurements were done directly using low volumes (µL) of sample. The devices showed good reproducibility, with a relative standard deviation of 7% (n = 5) for five different tip-based complete electrochemical cells. As a proof-of-concept, its utility has been probed by the determination of an anionic surfactant (sodium dodecyl sulphate, SDS) in water through its interaction with methylene blue (MB). Two different alternatives were presented based on the: 1) increase in the current intensity of the cathodic peak of MB due to the presence of SDS; 2) electrochemical determination of the MB remaining in the aqueous phase after extraction of the pair SDS-MB to an organic medium.

Fulminant Emphysematous Pyelonephritis by Candida glabrata in a Kidney Allograft.

Emphysematous pyelonephritis (EPN) is a rare and serious necrotizing infection that is potentially life-threatening. It has been seldom reported in kidney grafts and is usually caused by Gram-negative bacteria, with some case reports caused by anaerobic bacteria, and has been closely associated with poorly controlled diabetes mellitus (DM) and urinary tract structural abnormalities. There are no reports of EPN of fungal etiology in kidney grafts. We present a case of a 53-year-old kidney transplant recipient with a history of DM, active vesicoureteral reflux, and recurrent urinary tract infections who developed EPN in the kidney allograft caused by Candida glabrata, 3 weeks after starting treatment with empagliflozin, with an aggressive course that required urgent transplant nephrectomy.

Micropipette Tip-Based Immunoassay with Electrochemical Detection of Antitissue Transglutaminase to Diagnose Celiac Disease Using Staples and a Paper-Based Platform.

In this work, 1-200 µL polypropylene micropipette tips were used as platforms for performing immunoassays after converting their inner surfaces on a capture zone for the analyte of interest. We have used a micropipette-tip immunoelectroanalytical platform for the detection of antitissue transglutaminase (IgA), the main biomarker for celiac disease. Modification of the tip wall with poly-l-lysine allowed adsorption of tissue transglutaminase (tTG), which will capture later anti-tTG (IgA) antibodies developed in celiac-affected people. A sandwich-type format was followed, incubating simultaneously the analyte and the detection antibody, labeled with horseradish peroxidase. With this new application for an extremely common lab material, we can perform quantitative analysis by dispensing the liquid into a low-cost and miniaturized staple-based paper electrochemical platform. The analytical signal was the reduction of the enzymatically oxidized substrate, recorded chronoamperometrically (i-t curve). The intensity of the current obtained at a fixed time after the application of the cathodic potential followed a linear relationship with anti-tTG (IgA) concentration. The relative standard deviation obtained for immunoassays performed in different tips indicates the adequate precision of this new methodology, which is very promising for decentralized analysis. Negative and positive controls produced results that were in accordance with those obtained with spectrophotometric enzyme linked-immunosorbent assays.

Homework and Academic Achievement in Latin America: A Multilevel Approach.

The relationship between homework and academic results has been widely researched. Most of that research has used English-speaking, European or Asian samples, and to date there have been no detailed studies into that relationship in Latin America and the Caribbean. The aim of this study is to examine the effect of quantitative homework characteristics on achievement in science. The sample comprised 61,938 students at 2,955 schools in the 15 Latin American countries (plus the Mexican state of New Leon) which participated in the Third Regional Comparative and Explanatory Study (TERCE), carried out by the Latin American Laboratory for Educational Quality (LLECE) in 2013. The mean age was 12.42 years old (±0.94). Within each country, three hierarchical-linear models were applied at two levels: student and school. The individual level considered time spent doing homework and the school level considered the amount and frequency of homework assignment. In addition, ten control variables were included in order to control the net effect of the characteristics of the homework on the result. The results confirmed that homework is widely assigned in the Latin American region. At the individual level, time spent on homework had little effect on academic performance, while in the quantitative homework characteristics it was the frequency of homework assignment which demonstrated a clearer effect rather than the amount of homework assigned.