Reading emotional faces in deaf and hard-of-hearing and typically hearing children.

Reading emotions from other people's facial expressions is an important skill that guides social interactions. With limited auditory input and atypical emotion socialization, deaf and hard-of-hearing (DHH) children may develop atypical processing patterns when reading emotional faces. The current study aimed at understanding whether and how DHH and typically hearing (TH) children differed at 3 emotion processing levels: gaze patterns, physiological arousal, and interpretation. Fifty-five DHH children and 72 TH children completed an emotional face matching task in which they were presented with happy, angry, fearful, and emotionally neutral faces. During the task participants' eye gazes and pupil diameter were measured by an eye-tracking device. The DHH and TH children both paid most attention to the eye region when reading emotional faces. Yet, a contrast between happy faces and nonhappy faces was observed in physiological arousal and interpretation tendency in the DHH children only: Nonhappy facial expressions were more arousing and were confused more often than happy expressions, which may reflect the DHH children being less experienced in processing nonhappy expressions due to limited access to the social environment. The results highlighted the importance of looking into the qualitative differences between typical and atypical development. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Inmunotherapy in prostate cancer.

Prostate cancer (PCa) is the second most commonly diagnosed cancer. Although systemic chemotherapeutic agents, such as cabazitaxel, abiraterone and enzalutamde have become available to patients over the last decade, metastatic PCa is still an incurable disease. Immunotherapy is showing great promise in a wide range of other cancer types. To this day, the only immunotherapy approved by the FDA for PCa is the Sipuleucel-T vaccine, which showed significant clinical efficacy. Multiple clinical studies on immunotherapy in PCa are currently underway. OBJECTIVES: Recent clinical trials have shown promising results in immunotherapeutic in treatment for PCa. The authors review previous clinical trials, as well as discuss and emphasize important emerging immunotherapies for PCa. METHODS: Review of the published evidence related to immunotherapy in PCa. PubMed and clinicaltrials.gov databases were used to search for English papers and clinical trials. RESULTS: Multiple clinical trials are testing different immunotherapeuticagents, as well as combinations thereof. The low grade of toxicity associated with these immunotherapies is an appealing advantage for patients, leading to an increased appreciation of theses types of treatments. Until now, only one clinical trial led to a new immunotherapeutic agent to be FDA approved. Importantphase II/III clinical trials are being conducted, and in the near future the concept of PCa treatment might be re-challenged. CONCLUSIONS: Many trials are ongoing to determine the effects of immunotherapy in PCa. These studies may harvest important confirmatory data in the next years, with the potential to reshape PCa treatment.

El cáncer de próstata (CaP) es el segundo cáncer más frecuente. Aunque durante la última década se han hecho disponibles agentes quimioterápicos como Cabazitaxel, Abiraterona y Enzalutamida, el CaP metastásico es todavía una enfermedad incurable. La inmunoterapia está mostrándose muy prometedora en un amplio rango de cánceres de otro tipo. Hasta la fecha, la única inmunoterapia aprobada por la FDA para el CaP es la vacuna Sipuleucel-T, que demostró eficacia clínica significativa. Actualmente, hay múltiples ensayosclínicos de inmunoterapia en CaP en marcha. OBJETIVOS: Ensayos clínicos recientes han mostrado resultadosprometedores de la inmunoterapia en CaP. Los autores revisan los ensayos clínicos previos y también discuten y enfatizan importantes tratamientos inmunoterapéuticos emergentes en CaP.MÉTODOS: Revisión de la evidencia publicada relacionada con inmunoterapia en CaP. Se utilizaron las bases de datos PubMed y clinicaltrials.gov para buscarartículos en inglés y ensayos clínicos. RESULTADOS: Múltiples ensayos clínicos están evaluando diferentes agentes inmunoterapicos, así como combinaciones. El bajo grado de toxicidad asociado con estas inmunoterapias es una ventaja atractiva para los pacientes, que conduce a un aumento de la valoración de este tipo de tratamientos. Hasta ahora, solamente un ensayo clínico ha llevado a la aprobación por la FDAde un nuevo agente inmunoterapico. Se están llevando a cabo importantes ensayos clínicos fase II/III, y en un futuro próximo el concepto de tratamiento del CaP podría ser desafiado de nuevo. CONCLUSIONES: Están en marcha muchos ensayos clínicos para determinar los efectos de la inmunoterapia en CaP. Estos estudios pueden obtener importantesdatos confirmatorios en los próximos años, con el potencial de redefinir el tratamiento del CaP.

Transurethral Resection of Bladder Tumors: Next-generation Virtual Reality Training for Surgeons.

BACKGROUND: The number of virtual reality (VR) simulators is increasing. The aim of this prospective trial was to determine the benefit of VR cystoscopy (UC) and transurethral bladder tumor resection (TURBT) training in students. DESIGN, SETTING, AND PARTICIPANTS: Medical students without endoscopic experience (n=51, median age=25 yr, median 4th academic year) were prospectively randomized into groups A and B. After an initial VR-UC and VR-TURBT task, group A (n=25) underwent a video-based tutorial by a skilled expert. Group B (n=26) was trained using a VR training program (Uro-Trainer). Following the training, every participant performed a final VR-UC and VR-TURBT task. Performance indicators were recorded via the simulator. Data was analyzed by Mann-Whitney U test. INTERVENTION: VR cystoscopy and TURBT. RESULTS AND LIMITATIONS: No baseline and post-training differences were found for VR-UC between groups. During baseline, VR-TURBT group A showed higher inspected bladder surface than group B (56% vs 73%, p=0.03). Subgroup analysis detected differences related to sex before training (male: 31.2% decreased procedure time; 38.1% decreased resectoscope movement; p=0.02). After training, significant differences in procedure time (3.9min vs 2.7min, p=0.007), resectoscope movement (857mm vs 529mm, p=0.005), and accidental bladder injury (n=3.0 vs n=0.88, p=0.003) were found. Male participants showed reduced blood loss (males: 3.92ml vs females: 10.12ml; p=0.03) after training. CONCLUSIONS: Measuring endoscopic skills within a virtual environment can be done easily. Short training improved efficacy and safety of VR-TURBT. Nevertheless, transfer of improved VR performance into real world surgery needs further clarification. PATIENT SUMMARY: We investigated how students without endoscopic experience profit from simulation-based training. The safe environment and repeated simulations can improve the surgical training. It may be possible to enhance patient's safety and the training of surgeons in long term.

Molecular predictors of response to PD-1/PD-L1 inhibition in urothelial cancer.

INTRODUCTION: The survival of patients with metastatic urothelial cancer (mUC) is poor. During the last 40 years, chemotherapy was the predominant treatment modality for mUC. The discovery of the immune checkpoint inhibitors (ICI), especially the inhibitors of the programmed cell death 1 and its ligand (PD-1/PD-L1), has revolutionized cancer immunotherapy. The PD-1 and PD-L1 inhibitors provide a new and effective treatment option for patients with UC, particularly for patients with recurrence after platinum-based therapy and those who are ineligible for cisplatin. METHODS: A literature search on PubMed, ClinicalTrials.gov and selected annual congress abstracts was conducted in May 2018, using a combination of keywords, medical subject headings (MeSH) terms and free text incorporating urothelial bladder cancer; immunotherapy; immune checkpoint inhibition, biomarkers, PD1/PD-L1. RESULTS: Although some patients demonstrate complete and/or durable responses under ICI, the reliable prediction of response to ICI is not possible. In the clinical setting, physicians are not able to predict response to ICI in mUC and to adequately select patients who will benefit. Exploratory analysis of clinical trial data revealed that PD-L1 expression, tumor mutation burden, tumor-infiltrating lymphocytes and gene expression profiles might have some predictive and/or prognostic value in different patient populations. CONCLUSION: Validated robust biomarkers are still needed to overcome this hurdle to forecast response of ICI in UC patients.

Transketolase like 1 (TKTL1) expression alterations in prostate cancer tumorigenesis.

BACKGROUND: Prostate cancer (CaP) is the most common nonepidermal cancer in elderly males. Due to its heterogeneity and high variability in regards to clinical outcome and therapeutic response, urologists' handling of this disease remains a challenge. The objective of this study was to assess Transketolase like 1 (TKTL1) expression in benign prostatic tissue, peritumoral tissue and in CaP (in different stages of disease), and its correlation with clinicopathological findings, in order to detect if TKTL1 expression is associated with CaP tumorigenesis. METHODS: In total, 100 tissue samples were included: (i) 22 benign specimens, (ii) 46 specimens with nonmetastatic CaP, and (iii) 32 specimens from patients with metastatic CaP. From the tissue microarray slides, we evaluated immunohistochemically the expression of the TKTL1 protein, using the H-score. RESULTS: The TKTL1 protein expression pattern ranges from a low level in benign prostatic tissue (100 [57.5-105]), moderately low in peritumoral tissue (135.42 [100-195.16]), moderate expression in nonmetastatic CaP (200 [172.19-254.38]) to high in metastatic CaP (300 [222.50-300]). A significant rise of TKTL1 mean expression was seen throughout disease progression. A significant difference was also found in TKTL1 expression between peritumoral tissue and benign tissue. CONCLUSION: The results obtained in this study suggest that pentose phosphate pathway and its key enzyme TKTL1 is altered throughout the CaP tumorigenesis, and this pathway merits further investigation.

Single-use versus reusable ureterorenoscopes for retrograde intrarenal surgery (RIRS): systematic comparative analysis of physical and optical properties in three different devices.

INTRODUCTION: Retrograde intrarenal surgery (RIRS) represents a standard option for kidney stone removal. However, RIRS is considered a cost-intensive procedure. Single-use flexible ureterorenoscopes have been introduced to improve budget predictability in RIRS. We assessed differences in physical and optical properties of single-use devices compared to standard reusable endoscopes. METHODS: In two single-use (LithoVue™, Boston Scientific; Pusen Uscope UE3011™), and one reusable ureterorenoscope (Flex-Xc™, Karl Storz), we investigated flow rates, deflection, illuminance, and intrapelvic pressure in a porcine kidney model. Subjective image quality was assessed using a standardized questionnaire. Common insertable devices were applied to investigate additional influence on physical properties. RESULTS: Significant variability in maximum flow rates was observed (Flex-Xc™: 25.8 ml/min, LithoVue™: 30.3 ml/min, Pusen™: 33.4 ml/min, p < 0.05). Insertion of a guide wire resulted in the highest reduction of flow rates in all endoscopes. Flection led to a reduction of absolute flow rates up to 9.4% (Flex-Xc™). Light intensity at 20/50 mm distance was 9090 lx/1857 lx (Flex-Xc™) and 5733 lx/1032 lx (LithoVue™) and 2160 lx/428 lx (Pusen™), respectively (p < 0.05). Subjective image quality score was highest using the Flex-Xc™ endoscope. During manipulation, maximum intrarenal pressure up to 66 mmHg (Pusen™) was measured. CONCLUSIONS: Significant differences in physical and optical properties of single-use or reusable flexible ureterorenoscopes are present, with putative influence on surgical efficacy and complications. Further comparative evaluation of single-use and reusable endoscopes in a clinical scenario is useful. Moreover, utilization of ureteral access sheaths may be considered to avoid renal damage.

Immunotherapeutic strategies for the treatment of renal cell carcinoma: Where will we go?

INTRODUCTION: Historically, renal cell carcinoma (RCC) is considered a chemotherapy-resistant tumor. The cornerstone of systemic therapy included mammalian target of rapamycin (mTOR) inhibitors, endothelial growth factor receptor (VEGFR) and tyrosine kinase inhibitors (TKIs). Currently, a new era is enteres with promising immunotherapeutic treatments, which are becoming commercially available. Areas covered: We provide a comprehensive review using PubMed and ClinicalTrials.gov about the following immunotherapies in RCC: i) vaccine therapy, ii) adoptive T Cell Transfer and CAR T cells, iii) nonspecific immunotherapy - IL-2 (new formulations), iv) Checkpoint inhibitors, v) other checkpoint-molecules. We will also discuss their mechanism of action and toxicity, the importance of developing new patient selection algorithms (immunoprofiling, guidelines updates) and new biomarkers such as PD-1 expression. Expert commentary: Immunotherapy shows promise, and the current tools used in clinical practice, including guidelines, staging-classification and algorithms should be revised and adapted to the new immunotherapeutic drugs. Although immunotherapy in RCC show promising results, more research is needed in parallel to discover biomarkers that enable the prediction of a treatment response and therefore lead to better patient selection.

[The mortality differentials by violence against adolescents according to living conditions strata and race/color in the city of Recife]. / Diferenciais da mortalidade por violência contra adolescentes segundo estrato de condição de vida e raça/cor na cidade do Recife.

An ecological study was conducted in order to analyze the differences in mortality by violence against adolescents according to living conditions strata and race/color in Recife in the period from 1998 to 2004. The average mortality coefficient for violence during this period was calculated for the city and by living conditions strata. The data related to the violence were obtained from the System of Information on Mortality. For the race/color, proportions have been calculated and within the period of 1999 to 2004. The mortality rate for violent deaths against adolescents for the city was of 88.24 per 100 thousand adolescents, being 46.93 in stratum I, of 'better living condition', and 95.00 in stratum III, of 'worse condition of life'. Amongst the violent deaths, 92.45% reached black adolescents and 7.55% white ones. The results show up inequalities in mortality by violence disclosing a tragic panorama in the trajectory of life of the adolescents.

[Violence against adolescents: differentials by gender and living conditions strata]. / Violência contra adolescentes: diferenciais segundo estratos de condição de vida e sexo.

An ecological study was conducted in order to analyze differences in mortality rates among adolescents by gender and living conditions strata in Recife from1998 to 2004. The average mortality coefficient for violence during this period was calculated by gender for the city and by living conditions strata. This analysis demonstrated a higher risk of death by violence for male adolescents in Stratum III (poorest living conditions). The mortality rates by violence for men and women were 10.89 (Recife); 10.90 (Stratum I); 11.70 (Stratum II) and 10.30 (Stratum III). The findings show that although males are at the highest risk, it is also quite clear that living conditions influence the distribution of the mortality rate due to violence.