Low Cubilin/Myeloperoxidase ratio as a promising biomarker for prognosis of high-grade T1 bladder cancer.

PURPOSE: T1 bladder cancer is known for its high progression and recurrence rates. Identifying aggressive tumours at the non-muscle-invasive stage is crucial to allow early interventions and subsequently increase patient survival. This study aimed to investigate the potential of the cubilin/myeloperoxidase (CUBN/MPO) ratio as a high-grade T1 bladder cancer biomarker. METHODS: Urine samples were collected from 30 patients who underwent transurethral resection of the tumour with high-grade T1 bladder cancer (June 2015 to December 2019) before surgery. The urinary proteome was analysed using high-resolution mass spectrometry and the CUBN/MPO ratio was calculated. The primary outcome was the recurrence during the follow-up (around 31.5 months after resection). Univariate Cox regression and Kaplan-Meier curves were used for data analysis. RESULTS: Patients with a low CUBN/MPO ratio exhibited upregulated MPO and/or downregulated CUBN. This group of patients had a higher incidence of disease recurrence and progression. Low CUBN/MPO ratio was significantly associated with a higher likelihood of recurrence, progression, and death. It is worth noting that this study was exploratory and conducted on a small sample size, so further research is needed to validate these findings in larger cohorts. CONCLUSION: This study highlights the potential of the CUBN/MPO ratio as a prognostic biomarker for high-grade T1 bladder cancer.

Urinary microbiota is associated to clinicopathological features in benign prostatic hyperplasia.

BACKGROUND: The urinary microbiota of patients with benign prostatic hyperplasia (BPH) has been associated with lower urinary tract symptoms (LUTS), however, little is known about urinary microbiota correlations with clinicopathological parameters associated with BPH. Here, we investigate associations between the urinary microbiota and clinical parameters of patients with BPH undergoing surgery. METHODS: Forty-one patients with BPH undergoing surgery were recruited from two medical centers. Catheterized urine specimens were collected and the microbiota was characterized by 16S rRNA gene sequencing. Patients were segregated into two groups according to each clinical parameter and differences in urinary microbiota diversity and composition were evaluated. RESULTS: Higher prostate weight and prostate-specific antigen (PSA) levels were associated with higher alpha diversity in the urinary microbiota of BPH patients. At the specific microbe level, we found that the greater the prostatic weight, the lower the relative abundance of Streptococcus, while the greater the PSA levels, the higher the abundance of Lactobacillus. Treatment with 5-α-reductase inhibitor was associated with overall urinary microbiota composition, in part due to a higher abundance of Corynebacterium and Anaerococcus in this group. CONCLUSIONS: We demonstrated that the urinary microbiota of BPH patients is associated with clinicopathological features, paving the way for larger studies in which causality between urinary microbiota and BPH can be appropriately explored.

The bladder microbiota is not significantly altered by intravesical BCG therapy.

INTRODUCTION: Bladder microbiota dysbiosis has been associated with several urological disorders. However, dysbiosis markers in bladder cancer have not been identified and little is known about the effect of Bacillus Calmette-Guérin (BCG) intravesical therapy on the bladder microbiota. In this study, we compared the bladder microbiota of patients with non-muscle-invasive bladder cancer (NMIBC) undergoing BCG therapy to nononcological controls. We also longitudinally analyzed the impact of BCG therapy on the bladder microbiota of NMIBC patients and addressed whether bladder microbiota is associated with BCG efficacy. METHODS: We collected catheterized urine samples from males with intermediate/high-risk NMIBC (cancer group, n = 32) or benign prostatic hyperplasia (control group, n = 41). The cancer group also provided urine samples during and after BCG induction. We used 16S rRNA gene sequencing to characterize the bladder microbiota. Bladder microbiota parameters, such as diversity and taxonomic composition, were compared between groups and associated with clinicopathological data and BCG efficacy. RESULTS: We observed no significant differences between the bladder microbiota of NMIBC patients and controls. BCG intravesical instillations did not significantly alter the bladder microbiota of NMIBC patients, and BCG was rarely detected in the bladder during and after BCG therapy. Microbiota diversity and overall composition before BCG induction did not influence disease persistence at 3 months. However, higher abundance of Lactobacillus, Streptococcus, and Cutibacterium in the pre-BCG bladder microbiota was associated with BCG effectiveness. CONCLUSION: We were unable to identify markers of bladder microbiota dysbiosis among male NMIBC patients. Moreover, we demonstrated for the first time using longitudinally collected samples that BCG cannot persist in the bladder microbiota nor significantly alter its diversity and composition. The associations found between bladder microbes and BCG efficacy highlight the potential of microbial-based therapeutic and risk-stratification strategies in the intermediate/high-risk NMIBC setting.

Determination of server location in emergency care systems: an index proposal using data envelopment analysis and the hypercube queuing model.

The objective of this article is to propose a new composite index (CI) that helps to determine the most effective location of servers in an Emergency Care System (ECS), using Benefit of the Doubt (BoD)/Data Envelopment Analysis (DEA) and the Hypercube queuing model. The CI proposed was developed in four stages: (1) definition of a number of possible ECS configurations through the application of mathematical partitions and permutations; (2) application of the hypercube queuing model to determine performance parameters for each ECS configuration; (3) application of DEA/BoD to build the CI and generate performance rankings, and (4) evaluation of the rankings obtained to define the best configuration for the ECS analyzed. Data from two real cases from Brazil were used to assess the CI proposal. The results obtained confirm that: (a) the hypercube model could, relatively quickly, determine the configuration parameters generated; (b) the application of an appropriate DEA/BoD model enabled the different configurations to be ranked with good discrimination; (c) a pattern in the relationship between ambulance concentration and configuration effectiveness could be identified; and (d) the CI proposed would benefit ECS managers who are making resource location decisions.

A Meta-Analytic Framework for Developing Protocols to Attend Child and Adolescent Victims of Sexual Violence.

Violence against children and adolescents is a global public health problem. In Brazil, there are challenging boundaries for professionals in the protection network in general and for health professionals in particular. Moreover, among other factors, there is the challenge of referral, due to weaknesses in decision making, given the nature of sexual violence and how it is managed by healthcare services. This study aims to propose a Meta-Analytic framework to support the referral of young victims of sexual violence, considering levels of severity, independent of factors such as how protection systems are structured and managed and the local laws in force. We propose a Meta-Analytic approach, developed using the fundamentals of Delphi and DPSIR (Drivers, Pressures, State, Impact, and Response Model of Intervention), from the perspective of Value-Focused Thinking. The Delphi method was structured in two stages: the first stage aimed to identify and classify typical cases of sexual violence; the second stage used the DPSIR model, with the aim of identifying the decision criteria for typical cases that occur in a given municipality. The main outcomes are: (i) the application of the modified Delphi participatory method within the context of local social policies; (ii) the construction of a value tree based on Value-Focused Thinking; and (iii) the identification and systematization of criteria that most interfere with the evaluation of cases of sexual violence, which can be used for multi-criteria decision making.

Vascular endothelial growth factor (VEGF) and interleukin-1 receptor antagonist (IL-1Ra) as promising biomarkers for distinguishing active from latent tuberculosis in children and adolescents.

Since distinguishing pulmonary (PTB) from latent tuberculosis (LTBI) in pediatric patients remains a challenge, we aimed to investigate the efficacy of immune mediators in diagnosing PTB and LTBI in this population. In this cross-sectional study performed with children and adolescents, serum levels of 20 biomarkers were assessed and data were analyzed according to age groups. We included 65 participants (PTB, n = 28 and LTBI, n = 37). Overall, levels of TNF-α, IL-1Ra, IL-6, IL-17A, VEGF, MMP-1, and procalcitonin were significantly higher (P < 0.05) in adolescents and children <10 years-old with PTB. Also, principal component analysis (PCA) showed that immune mediators were able to distinguish PTB from LTBI. VEGF and IL-1Ra presented the highest area under the curve (AUC) values, both separately (AUC 0.890 and 0.785) and combined (AUC 0.99). Taken together, we showed that VEGF and IL-1Ra are promising biomarkers to distinguish PTB from LTBI in pediatric patients, especially in children <5 years-old.

Use of Digital Technologies in Home Office Work during the COVID-19 Pandemic.

Background: Social distancing as a preventive measure to contain the spread of the COVID-19 pandemic has resulted in many people working from home, using online digital resources. Staying at home has led to the adaptation of many work activities to allow continuity of people´s jobs. It can also affect home routines and ways of working, thereby leading to changes in behavior, as the main interest of this study. Objective: The study aimed to assess the impact on human behavior of working conditions in home office format due to social distancing. Methods: Data collection was done online, using a specific computational tool (Google Forms) for this type of research, using the Home Office Work Scale (HOWS) validated and published in Mental Health and Addiction Research in 2021, with a total sample of 1,056 valid questionnaires. After the data collection, a database was created for statistical analysis of the results. Results: More women than men volunteered to answer the questionnaire, although the results were similar between women and men. Home office work has impacts on human behavior and results in changes in routines and adaptations in people´s personal and professional lives. Conclusion: Proportionally, more women participated, and there was low participation by young and elderly people. In general, people accepted home office work and the possibility of continuing to work in this format. Changes to routines and restrictive adaptations were necessary. The limitations reported for applying the scale did not compromise the results.

Towards Highly Efficient Chalcopyrite Photocathodes for Water Splitting: The Use of Cocatalysts beyond Pt.

Solar radiation is a renewable and clean energy source used in photoelectrochemical cells (PEC) to produce hydrogen gas as a powerful alternative to carbon-based fuels. Semiconductors play a vital role in this approach, absorbing the incident solar photons and converting them into electrons and holes. The hydrogen evolution reaction (HER) occurs in the interface of the p-type semiconductor that works as a photocathode in the PEC. Cu-chalcopyrites such as Cu(In, Ga)(Se,S)2 (CIGS) and CuIn(Se,S)2 (CIS) present excellent semiconductor characteristics for this purpose, but drawbacks as charge recombination, deficient chemical stability, and slow charge transfer kinetics, demanding improvements like the use of n-type buffer layer, a protective layer, and a cocatalyst material. Concerning the last one, platinum (Pt) is the most efficient and stable material, but the high price due to its scarcity imposes the search for inexpensive and abundant alternative cocatalyst. The present Minireview highlighted the use of metal alloys, transition metal chalcogenides, and inorganic carbon-based nanostructures as efficient alternative cocatalysts for HER in PEC.

Children's public health: Danger of exposure to pathogenic fungi in recreational places in the middle-west region of Brazil.

BACKGROUND: Dermatophytes are keratinophilic fungi, considered etiological agents of cutaneous mycoses in man and animals. The objective of this work was to isolate dermatophytic and non-dermatophytic fungi in recreational sandboxes (rainy and dry periods) in public day-care centers located in the city of Cuiabá-MT (Middle-west of Brazil). METHODS: Samples (n=200) were collected from the superficial layer of the sandboxes at a depth of 2-5cm in 10 public nurseries in Cuiabá-MT. Hair baits measuring 1-2cm were autoclaved and dispersed in 50g of the sample in sterile plates, incubated at 28°C, moistened with chloramphenicol solution (50mg/L). After 6 weeks the baits were inoculated on Sabouraud agar plus 50mg/L chloramphenicol and 500mg/L cycloheximide. The fungi were identified according to macroscopic and micromorphological characteristics. RESULTS: From the collected sand samples, 1318 colonies and 56 species of fungi belonging to 22 genera were isolated. The most important genera were Paecilomyces spp. (30.42%), Penicillium spp. (19.12%), Fusarium spp. (11.46%) and Aspergillus spp. (11.15%). Dermatophytes were recovered in 50% of day-care centers in a total of 29 identified colonies, the Trichophyton genus (86.2%) being the most frequently isolated. CONCLUSIONS: The dermatophytes in the recreational areas of day-care centers can pose a risk to the health of its users, especially for children and the employees. Work with this profile is very important to guide actions related to health surveillance.

Endoscopic guided PCNL in the prone split-leg position versus supine PCNL: a comparative analysis stratified by Guy's stone score.

INTRODUCTION: The optimal patient positioning for percutaneous nephrolithotomy (PCNL) based on the complexity of stone burden is not yet defined. Thus, we aimed to evaluate the intraoperative parameters, effectiveness and complications of patients undergoing PCNL between the endoscopic-guided prone split-leg PCNL (ePSL) and the supine PCNL by stratifying patients according to Guy's stone score (GSS). MATERIALS AND METHODS: A retrospective chart review was conducted of patients undergoing PCNL at two high-volume tertiary referral centers. At one center, patients underwent PCNL using the ePSL technique, while at the second center, patients underwent PCNL in supine. Patient demographics and stone characteristics, operative details, complications and effectiveness were compared between groups. The impact of obesity was also investigated. RESULTS: Of 830 subjects, a total of 449 (54%) underwent PCNL in ePSL and 381 (46%) in supine. The ePSL group had a greater mean age and body mass index. No statistical differences were found in gender, serum chemistry and Charlson comorbidity index. After stratifying patients by GSS, the differences in baseline stone burden between PSL and supine lost significance and both groups could be compared. Complications were not statistically different between both groups. Univariate analysis demonstrated that multiple tracts and lower pole access were more prevalent in supine. In addition, for GSS1-3, ePSL was correlated with reduced operative time, radiation exposure, length of hospital stay and need for secondary procedure. Multivariate analysis correlated ePSL with lower radiation exposure and need for secondary procedures (p = 0.01). In comparison to the whole trial population, the same tendencies were appreciated for obese cohort. CONCLUSIONS: This is the first report focusing on the performance differences between ePSL and supine PCNL stratified by GSS. Both techniques are safe, with a low rate of complications. For GSS1-3, ePSL reduces radiation exposure and requires less need for both multiple access and secondary procedure.

Complete supine percutaneous nephrolithotomy with GoPro®. Ten steps for success.

OBJECTIVE: To show a video of a complete supine Percutaneous Nephrolithotomy (csPCNL) performed for the treatment of a staghorn calculus, from the surgeon's point of view. The procedure was recorded with a GoPro® camera, demonstrating the ten essential steps for a successful procedure. MATERIALS AND METHODS: The patient was a 38 years-old woman with 2.4cm of left kidney lower pole stone burden who presented with 3 months of lumbar pain and recurrent urinary tract infections. She had a previous diagnosis of polycystic kidney disease and chronic renal failure stage 2. CT scan showed two 1.2cm stones in the lower pole (Guy's Stone Score 2). She had a previous ipsilateral double J insertion due to an obstructive pyelonephritis. The csPCNL was uneventful with a single access in the lower pole. The surgeon had a Full HD GoPro Hero 4 Session® camera mounted on his head, controlled by the surgical team with a remote control. All of the mains steps were recorded. Informed consent was obtained prior to the procedure. RESULTS: The surgical time was 90 minutes. Hemoglobin drop was 0.5g/dL. A post-operative CT scan was stone-free. The patient was discharged 36 hours after surgery. The camera worked properly and didn't cause pain or muscle discomfort to the surgeon. The quality of the recorded movie was excellent. CONCLUSION: GoPro® camera proved to be a very interesting tool to document surgeries without interfering with the procedure and with great educational potential. More studies should be conducted to evaluate the role of this equipment.

Scale to Assess Leaders' Perceptions about their Workers' Digital Addiction.

BACKGROUND: With the evolution of technologies and the mobility factor, new digital devices have emerged, influencing human behavior and provoking diverse dependencies due to their abusive use. Collective environments begin to exhibit the symptoms of such dependencies, compromising people's quality of life (QOL). The objective of the present study was to validate the scale to evaluate the perception of leaders on digital employee addiction (EPLDDE) initially with 17 questions. METHODS: The scale was constructed with real situations of digital addiction and through the evaluation of the semantic comprehension and consistency of the items by judges until final formatting of the instrument. Data collection was done via the internet. The sample consisted of 312 volunteers from a federal state-owned company. After data collection, a database was created for statistical analysis. Statistical program R was used. FINDINGS: Bartlett's and Kaiser-Meyer-Olkin (KMO) tests confirmed adequacy for factorial analysis. Three statistical criteria were used, and scree plot presented adequate commonalities indicating 5 factors and the withdrawal of 3 questions from the scale. In the second AF, results ratified 14 questions. Cronbach's alpha showed a positive result of 0.8131717. CONCLUSION: The 14-item EPLDDE scale was validated for the evaluation of the perception of leaders regarding digital dependence of employees in organizations. This scale can contribute to studies on organizational QOL. The limitations found did not compromise the results.

Relation between topology and stability of bent titanocenes.

Bent metallocenes are a class of organometallic compounds that are widely used as catalysts in olefin polymerization procedures. We found a linear relation between the relative stability of bent titanocenes and the average delocalization index (DI) for Ti-C (from the cyclopentadienyl ring) atomic pairs within the evaluated compounds. As a consequence, the stability of the bent titanocenes can be estimated from their topologies. However, secondary interactions between the ligands of some of the bent titanocenes reduce the coefficient of determination for the average DI-stability relation.

[Interaction of Metarhizium anisopliae (Metsch.) Sorok., Beauveria bassiana (Bals.) Vuill. and the parasitoid Oomyzus sokolowskii (Kurdjumov) (Hymenoptera: Eulophidae) with larvae of diamondback moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae)]. / Interação de Metarhizium anisopliae (Metsch.) Sorok., Beauveria bassiana (Bals.) Vuill. e o parasitóide Oomyzus sokolowskii (Kurdjumov) (Hymenoptera: Eulophidae) sobre larvas da traga-das-cruciferas, Plutella xylostella (L.) (Lepidoptera: Plutellidae).

Chemical insecticides are broadly applied to control diamondback moth, Plutella xylostella (L.). Diamondback moth is a major pest of cruciferous worldwide, and resistance of this pest to insecticide has been often reported. Thus, this research investigated the interactions among the fungi Metarhizium anisopliae (Metsch.) Sorok., Beauveria bassiana (Bals.) Vuill., and the larval-pupal parasitoid Oomyzus sokolowskii (Kurdjumov) before and after application of the fungi on DBM larvae offered to the parasitoid. The experiment was carried out at 26+/-l degreeC, 75+/- 5% RH and 12h photophase using a completely randomized design, with eight treatments with six replications each. The isolates E9 of M. anisopliae and ESALQ 447 of B. bassiana, were used at the concentration of 10(7) conidia ml(-1). The results showed that M. anisopliae and B. bassiana reduced the parasitism of P. xylostella by O. sokolowskii. Additive effects were found on the mortality of P. xylostella with the different combinations among the fungi and parasitoid, except for the treatment B. bassiana inoculated 24h before exposition of the larvae to O. sokolowskii. The isolates were more efficacious when applied after exposition of the larvae to the parasitoid. The efficiency of O. sokolowskii was negatively influenced by the presence of the fungi, mainly when the fungi were applied 24h before diamondback's larvae were exposed to the parasitoid. The association of the fungi with the parasitoid presents potential to be tested in field. The use of these natural enemies in the integrated management of P. xylostella may economically improve the cabbage productive system, especially for organic farming.

Estudos climatológicos da Reserva Florestal Ducke - Manaus-AM. IV. Precipitação

Summary In this project, the relationship between intensity, frequency and duration of rainfall was studied, in the period since 1965 at the Principal Weather Station of the Ducke Forest Reserve belonging to the Instituto Nacional de Pesquisas da Amazônia, kilometer 26 of the Torquato Tapajós highway. The frequency distribution proposed by Gumbel and an exponential distribution were fitted to the Series of Maximum Annual Intensities and Partial Series were formed. The degree of adjustment of these distributions to observed data was determined for rainfalls with 10 minutes duration.

Resumo Neste trabalho, foi estudada a relação entre intensidade-freqüência-duração das precipitações ocorridas desde 1965 na Estação Climatológica Principal da Reserva Florestal Ducke, pertencente ao Instituto Nacional de Pesquisas da Amazônia, localizada no Km 26 da Rodovia Torquato Tapajós. A distribuição de freqüência proposta por Gumbel e uma distribuição exponencial foram ajustadas às Séries de Intensidades Máximas Anuais e Séries Parciais formadas. Determinou-se o grau de ajustamento dessas distribuições aos dados observados para precipitações com duração de 10 minutos.