Oncologic outcomes of patients with incidental prostate cancer who underwent RARC: a comparison between nerve sparing and non-nerve sparing approach.

BACKGROUND: Incidental Prostate cancer (iPCa) is a relatively common finding during histopathological evaluation of radical cystectomy (RC) specimens. To reduce the high impact of RC on erectile function, several sexual-preserving techniques have been proposed. The aim of this study was to evaluate and compare the oncologic outcomes of patients with iPCa who underwent nerve spring and no-nerve sparing robot-assisted radical cystectomy (RARC). METHODS: The clinicopathologic data of male patients who underwent RARC at our institution between 2006 and 2016 were retrospectively analysed. Patients with iPCa at definitive pathological examinations were stratified in two groups, according to the preservation of the neurovascular bundles (nerve sparing vs no nerve sparing). Significant PCa was defined as any Gleason score ≥ 3 + 4. Biochemical recurrence (BR) was defined as a sustained PSA level > 0.2 ng/mL on two or more consecutive appraisals. BR rate was assessed only in patients with incidental prostate cancer and at least 2 years of follow-up. Differences in categorical and continuous variables were analysed using the chi-squared test and the Mann-Withney U test, respectively. Biochemical recurrence curves were generated using the Kaplan-Meier method and compared with the Log-rank test. RESULTS: Overall, 343 male patients underwent RARC for bladder cancer within the study period. Nerve-sparing surgery was performed in 143 patients (41%), of these 110 had at least 2 years of follow up after surgery. Patients who underwent nerve-sparing surgery were significantly younger (p < 0.001). Clinically significant PCa was found in 24% of patients. No significant differences regarding preoperative PSA value (p = 0.3), PCa pathological stage (p = 0.5), Gleason score (p = 0.3) and positive surgical margin rates (p = 0.3) were found between the two groups. After a median follow-up of 51 months only one patient, in the no-nerve-sparing group had developed a biochemical recurrence (p = 0.4). CONCLUSIONS: In our series most of the iPca detected in RC specimens can be considered as insignificant with a low rate of BR (0.9%). Nerve-sparing RARC is a safe procedure which did not affect oncological outcomes of patients with iPCa.

Changes in access to educational and healthcare services for individuals with intellectual and developmental disabilities during COVID-19 restrictions.

BACKGROUND: COVID-19 restrictions have significantly limited access to in-person educational and healthcare services for all, including individuals with intellectual and developmental disabilities (IDDs). The objectives of this online survey that included both national and international families were to capture changes in access to healthcare and educational services for individuals with IDDs that occurred shortly after restrictions were initiated and to survey families on resources that could improve services for these individuals. METHODS: This was an online survey for caregivers of individuals with (1) a genetic diagnosis and (2) a neurodevelopmental diagnosis, including developmental delay, intellectual disability, autism spectrum disorder or epilepsy. The survey assessed (1) demographics, (2) changes in access to educational and healthcare services and (3) available and preferred resources to help families navigate the changes in service allocation. RESULTS: Of the 818 responses (669 within the USA and 149 outside of the USA), most families reported a loss of at least some educational or healthcare services. Seventy-four per cent of parents reported that their child lost access to at least one therapy or education service, and 36% of respondents lost access to a healthcare provider. Only 56% reported that their child received at least some continued services through tele-education. Those that needed to access healthcare providers did so primarily through telemedicine. Telehealth (both tele-education and telemedicine) was reported to be helpful when available, and caregivers most often endorsed a need for an augmentation of these remote delivery services, such as 1:1 videoconference sessions, as well as increased access to 1:1 aides in the home. CONCLUSIONS: COVID-19 restrictions have greatly affected access to services for individuals with syndromic IDDs. Telehealth may provide opportunities for delivery of care and education in a sustainable way, not only as restrictions endure but also after they have been lifted.

The cosmic ray shadow of the Moon observed with the ANTARES neutrino telescope.

One of the main objectives of the ANTARES telescope is the search for point-like neutrino sources. Both the pointing accuracy and the angular resolution of the detector are important in this context and a reliable way to evaluate this performance is needed. In order to measure the pointing accuracy of the detector, one possibility is to study the shadow of the Moon, i.e. the deficit of the atmospheric muon flux from the direction of the Moon induced by the absorption of cosmic rays. Analysing the data taken between 2007 and 2016, the Moon shadow is observed with 3.5 σ statistical significance. The detector angular resolution for downward-going muons is 0 . 73 ∘ ± 0 . 14 ∘ . The resulting pointing performance is consistent with the expectations. An independent check of the telescope pointing accuracy is realised with the data collected by a shower array detector onboard of a ship temporarily moving around the ANTARES location.

An algorithm for the reconstruction of high-energy neutrino-induced particle showers and its application to the ANTARES neutrino telescope.

A novel algorithm to reconstruct neutrino-induced particle showers within the ANTARES neutrino telescope is presented. The method achieves a median angular resolution of [Formula: see text] for shower energies below 100 TeV. Applying this algorithm to 6 years of data taken with the ANTARES detector, 8 events with reconstructed shower energies above 10 TeV are observed. This is consistent with the expectation of about 5 events from atmospheric backgrounds, but also compatible with diffuse astrophysical flux measurements by the IceCube collaboration, from which 2-4 additional events are expected. A [Formula: see text] C.L. upper limit on the diffuse astrophysical neutrino flux with a value per neutrino flavour of [Formula: see text] is set, applicable to the energy range from 23 TeV to 7.8 PeV, assuming an unbroken [Formula: see text] spectrum and neutrino flavour equipartition at Earth.

Sperm whale long-range echolocation sounds revealed by ANTARES, a deep-sea neutrino telescope.

Despite dedicated research has been carried out to adequately map the distribution of the sperm whale in the Mediterranean Sea, unlike other regions of the world, the species population status is still presently uncertain. The analysis of two years of continuous acoustic data provided by the ANTARES neutrino telescope revealed the year-round presence of sperm whales in the Ligurian Sea, probably associated with the availability of cephalopods in the region. The presence of the Ligurian Sea sperm whales was demonstrated through the real-time analysis of audio data streamed from a cabled-to-shore deep-sea observatory that allowed the hourly tracking of their long-range echolocation behaviour on the Internet. Interestingly, the same acoustic analysis indicated that the occurrence of surface shipping noise would apparently not condition the foraging behaviour of the sperm whale in the area, since shipping noise was almost always present when sperm whales were acoustically detected. The continuous presence of the sperm whale in the region confirms the ecological value of the Ligurian sea and the importance of ANTARES to help monitoring its ecosystems.

Effect of feeding rumen-protected rice bran on mineral status of non-lactating dairy heifers.

Adapting Ca homeostasis of dairy cows before calving can prevent milk fever. Rice bran, treated with formaldehyde to prevent ruminal degradation of phytic acid, was fed to heifers to study its effect on Ca homeostasis. For 3 weeks 18 heifers were supplemented 3 kg of two feeds: placebo (PF) and rice bran (RBF), defining three treatments: control (CRT), low dose (LD) and high dose (HD). In weeks 1 and 3, all animals received 3 kg of PF and in week 2: CRT received 3 kg of PF, LD received 1.5 kg of PF and 1.5 kg of RBF and HD received 3 kg of RBF. Treatments did not affect dry matter intake (DMI). Feed intakes and growth rates indicated that all heifers had nutritional requirements that exceeded their Ca intakes. Serum Ca, urinary Ca, calcitriol or hydroxyproline remained unaffected. Urinary Ca was consistently low indicating high renal Ca reabsorption, which is indicative of insufficient Ca supply. Rice bran feed influenced P, Mg and Zn intakes and serum and urine presence of these minerals. Most heifers already presented an upregulated Ca metabolism, being inadequate to study adaptive changes in Ca homeostasis of multiparous dry cows. This metabolic difference can be explanatory to the very low susceptibility of heifers to milk fever, further supporting the induction of homeostatic adaptation before calving to prevent milk fever. Rice bran feed did not reduce DMI, and was not detrimental to P, Mg or Zn status.

Secundarismo sifilítico y el resultado del test de VIH no retirado por el mismo paciente, un problema de salud pública: a propósito de un caso / Secondary syphilis and HIV test didn´t recovered by the same patient. A problem of public health

La sífilis es una enfermedad de transmisión sexual con mayor incidencia y prevalencia mundial desde la aparición de la infección por el Virus de la Inmundeficiencia Humana Adquirida. La presentación de este caso clínico tiene por objeto 1- Describir las lesiones de un secundarismo sifilítico en una paciente adolescente con presunción de estar infectada por el VIH. 2- Señalar la evidencia que muchos pacientes con pruebas positivas para sífilis inician tratamiento pero no retiran los resultados de la serología para VIH (como en este caso), contribuyendo así a la expansión del VIH (AU)

Syphilis is a sexual transmitted disease with more incidence and prevalence in all of the world since the Acquire Human Immunodeficiency had appeared. The objectives of the report of this case are: 1-To describe lesions of secondary syphilis of an adolescent female with HIV infection presumption. 2 - To point out the evidence that many patients with positive result for syphilis begin his treatment but does not rescue the serology for HIV, (as this case) , contributing the spreading of this virus and its consequences (AU)

Behavioral Clustering of School Children.

The intent of this article is to illustrate how a cluster analysis might be conducted, validated, and interpreted. Data normed for a behavioral assessment instrument with 14 scales on a sample drawn from a nationally representative pool of U.S. school children were utilized. The analysis discussed covers the cluster method, cluster typology, cluster validity, cluster structure, and prediction of cluster membership.

A typology of teacher-rated child behavior for a national U.S. sample.

The purpose of the current study was to build on the emerging effort to produce a meaningful typology of classroom behavior for elementary school age children. The Behavior Assessment System for Children (BASC) Teacher Rating Scales for Children (TRS-C) norming data were collected for 1,227 six- to eleven-year-old children at 116 sites representing various regions of the United States. The TRS-C has 148 items that are rated by the teacher on a 4-point scale of frequency, ranging from Never to Almost always. The Ward method of cluster analysis was used to identify the initial centroids or cluster seeds. An iterative clustering method, a K-means procedure, was used to refine the Ward cluster solution. A seven-cluster solution was selected based on both rational and empirical considerations. The resulting clusters were named well-adapted, average, learning disorder, disruptive behavior disorder, physical complaints and worry, severe psychopathology, and mildly disruptive. The seven-cluster solution resembles those of Achenbach (1991), Curry and Thompson (1985), and other researchers. The resulting typology points the way toward future cluster studies of child psychopathology by delineating additional research and theoretical questions.