A new CCCH-type zinc finger-related lncRNA signature predicts the prognosis of clear cell renal cell carcinoma patients.

Background: Clear cell renal cell carcinoma (ccRCC) is the main component of renal cell carcinoma (RCC), and advanced ccRCC frequently indicates a poor prognosis. The significance of the CCCH-type zinc finger (CTZF) gene in cancer has been increasingly demonstrated during the past few years. According to studies, targeted radical therapy for cancer treatment may be a revolutionary therapeutic approach. Both lncRNAs and CCCH-type zinc finger genes are essential in ccRCC. However, the predictive role of long non-coding RNA (lncRNA) associated with the CCCH-type zinc finger gene in ccRCC needs further elucidation. This study aims to predict patient prognosis and investigate the immunological profile of ccRCC patients using CCCH-type zinc finger-associated lncRNAs (CTZFLs). Methods: From the Cancer Genome Atlas database, RNA-seq and corresponding clinical and prognostic data of ccRCC patients were downloaded. Univariate and multivariate Cox regression analyses were conducted to acquire CTZFLs for constructing prediction models. The risk model was verified using receiver operating characteristic curve analysis. The Kaplan-Meier method was used to analyze the overall survival (OS) of high-risk and low-risk groups. Multivariate Cox and stratified analyses were used to assess the prognostic value of the predictive feature in the entire cohort and different subgroups. In addition, the relationship between risk scores, immunological status, and treatment response was studied. Results: We constructed a signature consisting of eight CTZFLs (LINC02100, AC002451.1, DBH-AS1, AC105105.3, AL357140.2, LINC00460, DLGAP1-AS2, AL162377.1). The results demonstrated that the prognosis of ccRCC patients was independently predicted by CTZFLs signature and that the prognosis of high-risk groups was poorer than that of the lower group. CTZFLs markers had the highest diagnostic adequacy compared to single clinicopathologic factors, and their AUC (area under the receiver operating characteristic curve) was 0.806. The overall survival of high-risk groups was shorter than that of low-risk groups when patients were divided into groups based on several clinicopathologic factors. There were substantial differences in immunological function, immune cell score, and immune checkpoint expression between high- and low-risk groups. Additionally, Four agents, including ABT737, WIKI4, afuresertib, and GNE 317, were more sensitive in the high-risk group. Conclusion: The Eight-CTZFLs prognostic signature may be a helpful prognostic indicator and may help with medication selection for clear cell renal cell carcinoma.

COVID-19 Impact on the Italian Community-based System of Mental Health Care: Reflections and Lessons Learned for the Future

Surface longwave downward radiation (LWDR) is a key factor affecting the surface energy balance. The daily LWDR and the diurnal variations of LWDR are of great significance for studies of climate change and surface processes. How to obtain LWDR at an averaged temporal scale from instantaneous LWDR is one of the longstanding problems in the field of radiation budget from remote sensing. In this paper, two temporal upscaling methods are introduced, namely, a method based on the diurnal variations of LWDR (diurnal variation based, DVB) and a method based on random forest regression (RFR). The results reveal that: (1) The DVB method has a global hourly and daily LWDR root-mean-square error (RMSE) of less than 21 W/m2 and 15 W/m2, respectively, and the RMSE of the daily LWDR based on RFR is less than 7 W/m2;(2) When compared with four existing statistical interpolation methods, the DVB method can not only ensure the accuracy, but also can overcome the problem of missing samples and/or an abnormal samples during upscaling;(3) Except for directly predict daily LWDR, the DVB methods can also obtain more accurate LWDR diurnal variations such as hourly, half-hourly etc. The RFR method enables high-efficiency and accurate estimation of daily averaged LWDR from instantaneous measurements. Compared with existing methods and products, the proposed methods are not only efficient, but also have a superior applicability and reliable accuracy. The proposed strategies provide new ideas for the community in estimating LWDR at continuous temporal scales from remotely sensed measurements.

Improving Short-Term QPF Using Geostationary Satellite All-Sky Infrared Radiances: Real-Time Ensemble Data Assimilation and Forecast during the PRECIP 2020 and 2021 Experiments

The Prediction of Rainfall Extremes Campaign In the Pacific (PRECIP) aims to improve our understanding of extreme rainfall processes in the East Asian summer monsoon. A convection-permitting ensemble-based data assimilation and forecast system (the PSU WRF-EnKF system) was run in real time in the summers of 2020–21 in advance of the 2022 field campaign, assimilating all-sky infrared (IR) radiances from the geostationary Himawari-8 and GOES-16 satellites, and providing 48-h ensemble forecasts every day for weather briefings and discussions. This is the first time that all-sky IR data assimilation has been performed in a real-time forecast system at a convection-permitting resolution for several seasons. Compared with retrospective forecasts that exclude all-sky IR radiances, rainfall predictions are statistically significantly improved out to at least 4–6 h for the real-time forecasts, which is comparable to the time scale of improvements gained from assimilating observations from the dense ground-based Doppler weather radars. The assimilation of all-sky IR radiances also reduced the forecast errors of large-scale environments and helped to maintain a more reasonable ensemble spread compared with the counterpart experiments that did not assimilate all-sky IR radiances. The results indicate strong potential for improving routine short-term quantitative precipitation forecasts using these high-spatiotemporal-resolution satellite observations in the future.Significance StatementDuring the summers of 2020/21, the PSU WRF-EnKF data assimilation and forecast system was run in real time in advance of the 2022 Prediction of Rainfall Extremes Campaign In the Pacific (PRECIP), assimilating all-sky (clear-sky and cloudy) infrared radiances from geostationary satellites into a numerical weather prediction model and providing ensemble forecasts. This study presents the first-of-its-kind systematic evaluation of the impacts of assimilating all-sky infrared radiances on short-term qualitative precipitation forecasts using multiyear, multiregion, real-time ensemble forecasts. Results suggest that rainfall forecasts are improved out to at least 4–6 h with the assimilation of all-sky infrared radiances, comparable to the influence of assimilating radar observations, with benefits in forecasting large-scale environments and representing atmospheric uncertainties as well.

Identification of berberine as a potential therapeutic strategy for kidney clear cell carcinoma and COVID-19 based on analysis of large-scale datasets.

Background: Regarding the global coronavirus disease 2019 (COVID)-19 pandemic, kidney clear cell carcinoma (KIRC) has acquired a higher infection probability and may induce fatal complications and death following COVID-19 infection. However, effective treatment strategies remain unavailable. Berberine exhibits significant antiviral and antitumour effects. Thus, this study aimed to provide a promising and reliable therapeutic strategy for clinical decision-making by exploring the therapeutic mechanism of berberine against KIRC/COVID-19. Methods: Based on large-scale data analysis, the target genes, clinical risk, and immune and pharmacological mechanisms of berberine against KIRC/COVID-19 were systematically investigated. Results: In total, 1,038 and 12,992 differentially expressed genes (DEGs) of COVID-19 and KIRC, respectively, were verified from Gene Expression Omnibus and The Cancer Genome Atlas databases, respectively, and 489 berberine target genes were obtained from official websites. After intersecting, 26 genes were considered potential berberine therapeutic targets for KIRC/COVID-19. Berberine mechanism of action against KIRC/COVID-19 was revealed by protein-protein interaction, gene ontology, and Kyoto Encyclopedia of Genes and Genomes with terms including protein interaction, cell proliferation, viral carcinogenesis, and the PI3K/Akt signalling pathway. In COVID-19 patients, ACOX1, LRRK2, MMP8, SLC1A3, CPT1A, H2AC11, H4C8, and SLC1A3 were closely related to disease severity, and the general survival of KIRC patients was closely related to ACOX1, APP, CPT1A, PLK1, and TYMS. Additionally, the risk signature accurately and sensitively depicted the overall survival and patient survival status for KIRC. Numerous neutrophils were enriched in the immune system of COVID-19 patients, and the lives of KIRC patients were endangered due to significant immune cell infiltration. Molecular docking studies indicated that berberine binds strongly to target proteins. Conclusion: This study demonstrated berberine as a potential treatment option in pharmacological, immunological, and clinical practice. Moreover, its therapeutic effects may provide potential and reliable treatment options for patients with KIRC/COVID-19.

Pembrolizumab combined with axitinib in the treatment of skin metastasis of renal clear cell carcinoma to nasal ala: A case report.

BACKGROUND: Renal clear cell carcinoma (RCC) is a malignant tumor of the genitourinary system with a predilection for males. The most common metastatic sites are the lung, liver, lymph nodes, contralateral kidney or adrenal gland, however, skin metastasis has only been seen in 1.0%-3.3% of cases. The most common site of skin metastasis is the scalp, and metastasis to the nasal ala region is rare. CASE SUMMARY: A 55-year-old man with clear cell carcinoma of the left kidney was treated with pembrolizumab and axitinib for half a year after surgery and was found to have a red mass on his right nasal ala for 3 mo. The skin lesion of the patient grew rapidly to the size of 2.0 cm × 2.0 cm × 1.2 cm after discontinuation of targeted drug therapy due to the coronavirus disease 2019 epidemic. The patient was finally diagnosed with skin metastasis of RCC in our hospital. The patient refused to undergo surgical resection and the tumor shrank rapidly after resuming target therapy for 2 wk. CONCLUSION: It is rare for an RCC to metastasize to the skin of the nasal ala region. The tumor size change of this patient before and after treatment with targeted drugs shows the effectiveness of combination therapy for skin metastasis.

Comprehensive analysis of the novel omicron receptor AXL in cancers.

The SARS-CoV-2 is constantly mutating, and the new coronavirus such as Omicron has spread to many countries around the world. Anexelekto (AXL) is a transmembrane protein with biological functions such as promoting cell growth, migration, aggregation, metastasis and adhesion, and plays an important role in cancers and coronavirus disease 2019 (COVID-19). Unlike angiotensin-converting enzyme 2 (ACE2), AXL was highly expressed in respiratory system cells. In this study, we verified the AXL expression in cancer and normal tissues and found AXL expression was strongly correlated with cancer prognosis, tumor mutation burden (TMB), the microsatellite instability (MSI) in most tumor types. Immune infiltration analysis also demonstrated that there was an inextricable link between AXL expression and immune scores in cancer patients, especially in BLCA, BRCA and CESC. The NK-cells, plasmacytoid dendritic cells, myeloid dendritic cells, as one of the important components of the tumor microenvironment, were highly expressed AXL. In addition, AXL-related tumor neoantigens were identified and might provide the novel potential targets for tumor vaccines or SARS-Cov-2 vaccines research in cancer patients.

Nursing personnel management during COVID-19 pandemic: An exemption trend in view of health reasons.

Background: In the COVID-19 pandemic, the healthcare system faced unprecedented challenges with increased number of patients and limited resources. Managing nursing resource was a major challenge for hospital administration. They had to be on the frontline, but their safety was of paramount importance. Aim: This study aims to analyze the measures taken for the management and effective engagement of nursing personnel for deployment in the COVID area of the hospital and the exemption trend based on their health status. Methodology: A retrospective cross-sectional descriptive study was carried out to analyze the requests of nursing staff received for exemption of duty in COVID patient care areas. These requests were categorized and examined by the medical board constituted for this purpose. Microsoft Excel was used to interpret the results. Results: The study evaluated the health reasons of nursing officers on the basis of which exemption was given for deployment of nursing officers in COVID areas. They were mostly medical reasons (91.1%) and few personal reasons (8.77%). The majority suffered from diseases affecting two or more than two specialties. Out of 376 applications, 223 were exempted, 81 were not exempted, 13 were given short-term exemption, and 26 were shifted to administrative assignments. Thirty-three staff members were referred to an appropriate forum.

Subcutaneous nivolumab versus intravenous nivolumab in patients with previously treated, advanced, or metastatic clear cell renal cell carcinoma

Background: Nivolumab (NIVO), a programmed death-1 immune checkpoint inhibitor, has demonstrated clinical efficacy across patients with different tumor types, including clear cell renal cell carcinoma (ccRCC), when administered via IV infusion. As an alternative to IV infusion, subcutaneous (SC) administration alleviates the need for IV ports, thereby lowering the risk of associated complications such as infections and phlebitis. SC formulation also reduces the time for dose preparation and administration, which may decrease overall treatment burden and reduce patient time in the clinic, benefiting patients and healthcare providers and improving overall healthcare resource utilization. SC-administered NIVO consists of NIVO co-formulated with the recombinant human hyaluronidase PH20 enzyme (NIVO + rHuPH20), which aims to increase the dispersion and absorption of NIVO within the SC space. SC NIVO + rHuPH20 was shown to be safe and well tolerated in a phase 1/2 study, warranting further investigation (Lonardi S et al. J Clin Oncol 2021;39(suppl 15):2575). Methods: CheckMate 67T is a multicenter, randomized, open-label, phase 3 study that will evaluate the noninferiority of SC NIVO + rHuPH20 versus IV NIVO in patients with advanced or metastatic ccRCC who have progressed after receiving ≤ 2 prior systemic treatment regimens. Key inclusion criteria are age ≥ 18 years, histologically confirmed advanced or metastatic ccRCC, measurable disease by RECIST v1.1 within 28 days prior to randomization, and a Karnofsky performance status ≥ 70. Key exclusion criteria are untreated symptomatic metastases to the central nervous system, other malignancy, autoimmune diseases, HIV-positive status with AIDS-defining infection within past year or current CD4 count < 350 cells/μL, other serious or uncontrolled disorders including severe, acute SARS-CoV-2 infection, and prior treatment with immune checkpoint inhibitors, other T-cell-targeting antibody drugs, or live attenuated vaccines within 30 days of first study treatment. At least 454 eligible patients will be randomized to receive SC NIVO + rHuPH20 or IV NIVO. The primary objectives are to demonstrate pharmacokinetic (PK) noninferiority of SC NIVO versus IV NIVO, as measured by time-averaged serum concentration over the first 28 days (Cavgd28) and trough serum concentration at steady state (Cminss) (co-primary endpoints). Secondary endpoints include objective response rate by blinded independent central review, additional PK parameters, safety, efficacy, and immunogenicity of SC NIVO and IV NIVO. This study is currently enrolling patients globally.

Socio-Ecological Factors and Well-Being among Self-Employed in Europe during the COVID-19 Pandemic.

BACKGROUND: The self-employed are at increased risk of negative well-being outcomes when facing adversity such as the COVID-19 pandemic. Studies that examine socio-ecological factors that may protect their well-being are warranted. METHODS: Data were drawn from a cross-sectional survey of European self-employed people (n = 1665). The WHO-5 Well-being Index was used to examine the impact on well-being of factors at four socio-ecological levels. Independent sample t-tests, Pearson correlations and linear regression were applied to analyse differences between groups of self-employed and interactions between variables using SPSS. RESULTS: Well-being and the socio-ecological factors of resilience, social support, useful work and finding the rules clear were positively correlated with well-being. For self-employed who reported that it was challenging to run their business during the pandemic, social support and finding rules clear were of significantly greater importance to their well-being. CONCLUSIONS: The findings highlight that the socio-ecological factors of resilience, social support, doing useful work and finding the rules clear affect well-being. The results also indicate that it is vital to consider factors at multiple socio-ecological levels to improve the well-being of the self-employed during adversity.

Utility of Teleorthodontics in Orthodontic Emergencies during the COVID-19 Pandemic: A Systematic Review.

Background. Coronavirus disease has subjected the whole of humanity to two years of social isolation and a series of restrictions. These circumstances have led to the use of information technology in an increasingly widespread manner. Even in the dental field, telematic means have been used to respond to emergencies. The aim of this systematic review of the literature is to evaluate the types of orthodontic emergency that occurred most often and how they were managed by teleorthodontics during the COVID-19 pandemic. The secondary aim is that clinicians will use teleorthodontics not only during pandemics but as an additional tool to manage orthodontics. Materials and Methods. Out of 1695 articles available on PubMed, Science Direct, Cochrane and SciELO, eight articles were selected for this systematic literature review. Google Scholar was used as a secondary source to confirm that there were no additional articles. The screened papers comprised editorials, clinical studies, cross-sectional studies and retrospective studies in Italian, English or Spanish language. Results. The articles showed that the means by which patients most often communicated with their orthodontists were voice calls and smartphone applications such as WhatsApp® Messenger. Through these media, patients communicated their orthodontic emergencies. These mainly involved fixed multibracket appliances and the most common issues were discomfort and pain, fracture or loss of the appliance, protruding distal ends of archwires, brackets, tubes and bands or retainer detachment. Through teleorthodontics, patients could solve these issues by using orthodontic relief wax, cutting the protruding distal ends of the archwire with a nail clipper or a stronger cutter and removing or replacing detached bands, brackets, tubes or metallic ligature with a clean tweezer. Conclusions. In situations where personal contact is limited, teleorthodontics represents a valuable aid for professionals and patients facing orthodontic emergencies. The hope is that it may continue to represent a valuable aid for patients with difficulties in planning an in-office visit.

Photoelectrochemical oxidation assisted air purifiers;perspective as potential tools to control indoor SARS-CoV-2 Exposure

Coronavirus diseases 2019 (COVID-19), a viral infection pandemic, arises due to easy human-to-human transmission of severe acute respiratory syndrome coronavirus (SARS-CoV-2). The SARS-CoV-2 causes severe respiratory disorders and other life-threatening diseases (during/post-infection) such as black mold disease, diabetes, cardiovascular, and neurological disorders/diseases. COVID-19 infection emerged challenging to control as SARS-CoV-2 transmits through respiratory droplets (> 10 mu m size range), aerosols (< 5 mu m), airborne, and particulate matter (PM1.0 PM2.5 and PM10.0). SARS-CoV-2 is more infective in indoor premises due to aerodynamics where droplets, aerosols, and PM1.0/2.5/10.0 float for a longer time and distance leading to a higher probability of it entering upper and lower respiratory tracts. To avoid human-to-human transmission, it is essential to trap and destroy SARS-CoV-2 from the air and provide virus-free air that will significantly reduce indoor viral exposure concerns. In this process, an efficient nano-enable photoelectrochemical oxidation (PECO, a destructive approach to neutralize bio-organism) assisted air purification is undoubtedly a good technological choice. This technical perspective explores the role of PECO-assisted Air-Purifiers (i.e., Molekule as a focus example for proof-of-concept) to trap and destroy indoor microorganisms (bacteria and viruses including Coronaviruses), molds, and allergens, and other indoor air pollutants, such as volatile organic compounds (VOCs) and PM1.0/2.5/10.0. It is observed through various standard and non-standard tests that stimuli-responsive nanomaterials coated filter technology traps and destroys microbial particles. Due to technological advancements according to premises requirements and high-performance desired outcomes, Molekule air purifiers, Air Pro Air -Rx, Air Mini, and Air Mini+, have received Food and Drug Administration (FDA) clearance as a Class II medical device for the destruction of bacteria and viruses.

Rightly blamed the 'bad guy'? Grandparental childcare and COVID-19

This study explores the link between regular grandparental childcare and SARS-CoV-2 infection rates at the level of German counties. In our analysis, we suggest that a region's infection rates are shaped by region-, household- and individual-specific parameters. We extensively draw on the latter, exploring the intra- and extra-familial mechanisms fuelling individual contact frequency to test the potential role of regular grandparental childcare in explaining overall infection rates. We combine aggregate survey data with local administrative data for German counties and find a positive correlation between the frequency of regular grandparental childcare and local SARS-CoV-2 infection rates. However, the statistical significance of this relationship breaks down as soon as potentially confounding factors, in particular, the local Catholic population share, are controlled for. Our findings do not provide valid support for a significant role of grandparental childcare in driving SARS-CoV-2 infections, but rather suggest that the frequency of extra-familial contacts driven by religious communities might be a more relevant channel in this context. Our results cast doubt on simplistic narratives postulating a link between intergenerational contacts and infection rates.

Phase 2 study of neoadjuvant cabozantinib in patients with locally advanced non-metastatic clear cell renal cell carcinoma

Background: Cabozantinib is a small molecule inhibitor of the tyrosine kinases c-Met, AXL and VEGFR2 that has been shown to reduce tumor growth, metastasis, and angiogenesis. After the promising results from the METEOR, CABOSUN and Checkmate-9ER trials, cabozantinib was approved for use in patients with advanced renal cell carcinoma (RCC). The increased response rates with cabozantinib in metastatic RCC, along with the other neoadjuvant TKI data, support an expanded role for cabozantinib in the neoadjuvant setting. Methods: Patients with clinical stage ≥ T3Nx or TanyN+ or deemed unresectable by the surgeon with biopsy-proven clear cell RCC were eligible for this study, and received cabozantinib at a starting dose of 60 mg daily for 12 weeks. The primary outcome was objective response rate per RECIST v1.1 (complete and partial responses) at week 12 after the administration of cabozantinib as determined by independent radiologist review. Secondary outcomes included safety, tolerability, clinical outcome (DFS, OS), surgical outcome and quality of life. Results: As of 20 September 2021, 16 biopsy-proven clear cell RCC patients were treated with neoadjuvant cabozantinib. The median age was 56 years (range: 41-84 years) and 81.2% male. All patients completed 12 weeks of treatment, and 15 of them underwent surgery as planned without any delay after completion of 4 weeks wash-out. One patient refused to undergo surgery due to personal reasons and received further systemic treatment. Five patients (31.2%) experienced a partial response, and 11 patients had stable disease. There was no progression of disease while on cabozantinib. Median reduction of primary renal tumor size was 24% (range: 6-45%). The one patient who was deemed to be unresectable became resectable at the end of treatment. Two patients were converted from radical to partial nephrectomy. The most common AEs were diarrhea, nausea, fatigue, hypertension, anorexia, and palmar-plantar erythrodysesthesia syndrome. Intraoperatively, we did not experience any immediate complications. Postoperatively, no surgical complications related to the drug were noted. No treatment related grade 4 or 5 AEs related to cabozantinib or surgery occurred. Two patients had died at the time of analysis (1 due to COVID and 1 unknown cause). Conclusions: Cabozantinib was clinically active and safe in the neoadjuvant setting in patients with locally advanced non-metastatic clear cell RCC. Additional data will be reported including long term outcomes, correlative studies, quality of life, and frailty/sarcopenia indices.

Improved monitoring of shipping NO2 with TROPOMI: decreasing NOx emissions in European seas during the COVID-19 pandemic

TROPOMI (TROPOspheric Monitoring Instrument) measurements of tropospheric NO2 columns provide powerful information on emissions of air pollution by ships on open sea. This information is potentially useful for authorities to help determine the (non-)compliance of ships with increasingly stringent NOx emission regulations. We find that the information quality is improved further by recent upgrades in the TROPOMI cloud retrieval and an optimal data selection. We show that the superior spatial resolution of TROPOMI allows for the detection of several lanes of NO2 pollution ranging from the Aegean Sea near Greece to the Skagerrak in Scandinavia, which have not been detected with other satellite instruments before. Additionally, we demonstrate that under conditions of sun glint TROPOMI's vertical sensitivity to NO2 in the marine boundary layer increases by up to 60 %. The benefits of sun glint are most prominent under clear-sky situations when sea surface winds are low but slightly above zero (±2 m s-1). Beyond spatial resolution and sun glint, we examine for the first time the impact of the recently improved cloud algorithm on the TROPOMI NO2 retrieval quality, both over sea and over land. We find that the new FRESCO+ (Fast Retrieval Scheme for Clouds from the Oxygen A band) wide algorithm leads to 50 hPa lower cloud pressures, correcting a known high bias, and produces 1–4×1015 molec. cm-2 higher retrieved NO2 columns, thereby at least partially correcting for the previously reported low bias in the TROPOMI NO2 product. By training an artificial neural network on the four available periods with standard and FRESCO+ wide test retrievals, we develop a historic, consistent TROPOMI NO2 data set spanning the years 2019 and 2020. This improved data set shows stronger (35 %–75 %) and sharper (10 %–35 %) shipping NO2 signals compared to co-sampled measurements from OMI. We apply our improved data set to investigate the impact of the COVID-19 pandemic on ship NO2 pollution over European seas and find indications that NOx emissions from ships reduced by 10 %–20 % during the beginning of the COVID-19 pandemic in 2020. The reductions in ship NO2 pollution start in March–April 2020, in line with changes in shipping activity inferred from automatic identification system (AIS) data on ship location, speed, and engine.

Three-Dimensional Surface Downwelling Longwave Radiation Clear-Sky Effects in the Upper Colorado River Basin

In complex terrain, non-parallel surfaces receive emitted radiation from adjacent surfaces. Qualitatively, where surface skin temperatures and lower tropospheric temperature and humidity are not uniform, the downwelling longwave radiation (DLR) will be determined not just by radiation from the atmosphere above a given location, but also by adjacent surface temperatures. We quantify this three-dimensional longwave radiative effect over the Upper Colorado River Basin in clear-sky conditions by calculating surface DLR with observed land-surface temperatures from ECOSTRESS. We find that this effect is due to terrain-subtended sky-view and represents ∼22% of the surface longwave flux, rising to ∼28% and ∼24% in the East and Southeast of the Basin, respectively, and can be >50% in extreme cases. The common omission of this effect in atmospheric radiation models leads to an underestimation of DLR in complex terrain, especially at higher elevations, which has significant implications for mountainous ecohydrology simulations. © 2022 The Authors.

Breathing Air

“Breathing the air” is what we want! This is the theme of the performative action that we create through videoconferencing systems to provide a sensorial and virtual artistic experience. The narrative is created in a non-linear way by what I call Immersion Dramaturgy. The COVID devastates Brazil due to the approximately 600,000 people who cannot breathe and have had their lives interrupted by the government’s lack of control of the disease. We are also affected metaphorically due to the feeling of the impotence of those who still live, for not knowing how to change the social chaos of public health and instituted necropolitics. The performance exposes the lack of air but tries to show that a new day of sunshine, clear skies, and birdsong will return. © 2021 Association for Computing Machinery.

Exploring the diversity and predictors of histopathological findings across the European Association of Urology Guidelines Office rapid reaction group priority groups for patients with renal tumours: Implications for prioritization of renal cancer care

Introduction & Objectives: The COVID-19 pandemic has forced disruptive changes in the prioritization of care in Urology worldwide. In response to the first peak of the outbreak, the European Association of Urology (EAU) Guidelines Office Rapid Reaction Group (GORRG) provided comprehensive recommendations to guide the prioritization of surgery for patients with non-metastatic renal cell carcinoma (RCC). Notably, to date, such priority groups have not been validated from a histopathological perspective. To fill this gap, in this study we sought to explore the diversity and predictors of histopathological findings across the EAU GORRG priority groups for renal tumors at a referral Academic Centre. Materials & Methods: After Ethical Committee approval, we queried our prospectively collected Institutional database to select consecutive patients undergoing elective surgery for cT1-4 N0-1 M0 renal masses between January 2017 and December 2020. The primary outcome measures at histopathological analysis were: a) benign histology;b) non-organ confined disease (pT3-4 and/or pN1);c) adverse pathologic features for both clear cell RCC (ccRCC) and papillary RCC (pRCC) according to validated prognostic models. Results: Overall, 940 (54.2%), 358 (20.6%) and 436 (25.2%) patients were classified as low-, intermediate- and high-priority, respectively. The three groups significantly differed regarding all primary histopathological outcomes: benign histology (21.6% vs 15.9% vs 6.4% for the low-, intermediate- and high-risk group, respectively, p<0.001);b) non-organ-confined disease (5.0% vs 19.0% vs 45.4%, p<0.001);c) adverse pathologic features according to validated prognostic models (including median Leibovich score for clear cell RCC: 0 vs 2 vs 4, p<0.001). At multivariable analysis, beyond the EAU GORRG priority groups, specific patient and/or tumor-related characteristics were independent predictors of the aforementioned histopathological outcomes. s EAU22 – 37th Annual EAU Congress (Figure Presented) Conclusions: To the best of our knowledge, our study showed for the first time the value of the EAU GORRG priority groups from a histopathological standpoint, prompting the implementation of such a prioritization scheme beyond the COVID-19 pandemic.

Year 2021 in review - Paediatric anaesthesia and intensive care

The ongoing SARS-CoV-2 pandemic had significant impact on publication activities in the field of paediatric anaesthesiology and intensive care also in year 2021. The partial lossening of the restrictions had been associated with the elective surgery renewal and modification of intensive care patient's characteristics (post-operative care, injuries, etc.). Despite the available vaccination, COVID-19 remains signifficant topic, fortunately not the single one. The aim of the article Year 2021 in paediatric anaesthesia and intensive care is to highlight the important publications that should not be missed due to their impact on daily clinical practice.