Implementing human papillomavirus testing in a public health hospital : challenges and opportunities

Author's proof. The authors are indebted to Luciane Sarahyba and Nazareno dos Santos of the Molecular Biology Laboratory for their technical assistance.OBJECTIVES: Robust evidence now supports human papillomavirus (HPV) testing as a more effective option to screening and as more sensitive than cytology in detecting high-grade cervical intraepithelial neoplasia . Our goal was to analyze the performance of the Hybrid Capture II (HC2) assay for high-risk HPV (hrHPV) in women undergoing gynecological examination at a public health hospital as part of the evaluation of HPV screening as an alternative or complement to cytology. STUDY DESIGN: This analysis is a subset of a cross-sectional study carried out at a large public hospital serving a predominantly low-resource population. A total of 705 women were enrolled; the sensitivity and specificity of each test were estimated and compared. RESULTS: The analysis identified 272 hrHPV-positive women (mean age 36.3 years) and 433 hrHPV-negative women (mean age 41.2 years). HPV testing showed a significantly increased sensitivity of the HC2 assay versus cytology (84.5 vs. 69.7%; p < 0.0001) but a lower specificity (49.90 vs. 88.78%; p < 0.0001). CONCLUSION: The combination of both methods seems to be useful in improving detection of cervical lesions

Mesothelin expression remodeled the immune-matrix tumor microenvironment predicting the risk of death in patients with malignant pleural mesothelioma

BackgroundThe combination of immunobiological agents with immune checkpoint proteins is a promising treatment for malignant pleural mesothelioma (MPM). Mesothelin and anti-PD-L1 antibody-drug conjugates specifically target malignant neoplastic cells, inhibit the migration and invasion of neoplastic cells, and restore the immune landscape. In this study, we confirmed the importance of mesothelin and examined the relationship between mesothelin and the immune landscape of the tumor microenvironment (TME) in two MPM cohorts.MethodsThe discovery cohort included 82 MPM cases. Tissue microarray slides were generated, and samples were processed for hematoxylin &amp; eosin staining, immunohistochemistry, and immunofluorescence assays. The relationship between mesothelin, biomarkers of histogenesis, histological aggressiveness, PD-L1, immune cells (CD4, CD8, CD20, CD68), and collagen type I and type V fibers was evaluated by quantitative digital analyses. The outcome was the survival time until death from disease recurrence. The exploratory cohort included 87 malignant mesothelioma (MESO) patients from The Cancer Genome Atlas database.ResultsMost patients were male (70.7%) with a history of asbestos exposure (53.7%) and with the epithelioid subtype (89%). Surgical resection was performed in 85.4% of patients, and 14.6% received chemotherapy; 59.8% of patients died from disease extension to the mediastinum. Low tumor mesothelin expression was associated with tumor necrosis and nuclear grade 1, whereas high mesothelin expression was significantly associated with the epithelioid histotype and high density of T cells CD8+, macrophages CD68+, and collagen type I fibers. Cox multivariate analysis showed a high risk of death for non-operated patients [hazard ratio (HR), 3.42 (1.15–10.16)] with low tumor mesothelin levels [HR, 2.58 (1.09–6.10)] and high PD-L1 and low infiltration of T cells CD4+ [HR, 3.81 (1.58–9.18)]. In the exploratory cohort, low mesothelin and high COL1A1 and COL5A1 expression were associated with poor overall survival.ConclusionTumor mesothelin expression associated with the TME immune landscape predicts the risk of death for patients with MPM and could be a new target for immunotherapy in MPM

A new methodological contribution for the geodiversity assessment: applicability to Ceará State (Brazil)

The concept of geodiversity aggregates the abiotic elements of nature and promotes the geoconservation. The main objective of this work is to contribute to the upgrade of the method for the assessment and quantification of geodiversity proposed by Pereira et al. (2013). The method is based on the superposition of a regular grid of 12 × 12 km on different maps (lithology, geomorphology, soil, paleonthology, mineral and geological energy resources) at scales of 1:250,000 to 1:600,000. In addition to other up- grades, the water resources are regarded here as a new com- ponent to consider when quantifying geodiversity. The sum of these maps generated the quantitative Map of Geodiversity Indices and the Map of Geodiversity Assessment, ranging from very low to very high geodiversity. The analysis of the geodiversity map of the State of Ceará (Brazil) shows the applicability and advantage of this method, highlighting two regions with higher levels of geodiversity (Northwest and South) and another region with the lowest levels (Sertões Cearenses). The results also allowed the characterization of the State of Ceará concerning the individual components of the geodiversity, especially the water resources. Geodiversity indices and maps are comprehensive and user-friendly data in the territorial planning, considering the geodiversity either as a whole, or each of its components, especially the more sensi- tive such as fossil conservation, and water, mineral, and non- renewable energy resources management.The authors express their gratitude to the Brazilian research fostering institution "Coordenação de Aperfeiçoamento de Pessoal de Nível Superior" (CAPES) for awarding the Ciência Sem Fronteiras (CsF) PhD scholarship that enabled this work. This work was partially co-funded by the European Union through the European Regional Development Fund, based on COMPETE 2020 (Programa Operacional da Competitividade e Internacionalização), project ICT (UID/GEO/04683/ 2013) with reference POCI-01-0145-FEDER-007690 and national funds provided by Fundação para a Ciência e Tecnologia

Out of Amazonia: late-Holocene climate change and the Tupi–Guarani trans-continental expansion

The late Holocene expansion of the Tupi-Guarani languages from southern Amazonia to SE South America constitutes one of the largest expansions of any linguistic family in the world, spanning ~ 4000 km between latitudes 0°S and 35°S at about 2500 yr B.P. However, the underlying reasons for this expansion are a matter of debate. Here, we compare continental-scale palaeoecological, palaeoclimate, and archaeological datasets, to examine the role of climate change in facilitating the expansion of this forestfarming culture. Because this expansion lies within the path of the South American Low-Level Jet, the key mechanism for moisture transport across lowland South America, we were able to explore the relationship between climate change, forest expansion, and the Tupi-Guarani. Our data synthesis shows broad synchrony between late Holocene increasing precipitation and southerly expansion of both tropical forest and Guarani archaeological sites – the southernmost branch of the Tupi-Guarani. We conclude that climate change likely facilitated the agricultural expansion of the Guarani forest-farming culture by increasing the area of forested landscape that they could exploit, showing a prime example of ecological opportunism

Assessment of impacts on ecosystem services provided by geodiversity in highly urbanised areas: a case study of the Taubaté Basin, Brazil

This work presents a method to identify, to evaluate and to quantify the losses of the offer of ecosystem services provided by geodiversity, using as a case study the Taubaté Basin region, a highly urbanized portion of southeastern São Paulo State, Brazil. Our method considers not only the qualitative analysis of the abiotic as- pects, but also the historical and cultural context, in which the geodiversity elements are crucial for local economy development. The method is based on: i) Qualitative evaluation and definition of six Essential Geodiversity Variables (EGVs), used as the basis for the identification of 53 ecosystem services distributed into four functions: regulating, supporting, provisioning, and cultural; ii) Definition of land use categories based on two land use maps elaborated in order to compare the transformation occurred in the region between 1986 and 2016; iii) Quantification and evaluation of the impacts on the offer of ecosystem services caused by land use transformations occurred in region in a 30–year gap. The results showed that anthropogenic action is the main factor that alter the availability of local services, with emphasis on the supply of water, soils and mineral resources, and its potentially influence on the quality of life of certain species. We reinforce the view that public policies on land management and planning should consider the ecosystem assessment, as it provides evidence to propose actions to mitigate impacts and for environmental compensation, favoring the sustainable use of re- sources by society.The authors would like to thank CAPES for the Academic Mobility Program PDSE Scholarship / Process Nr. 88,881.135227 / 2016–01 and for the PhD research scholarship in Brazil awarded to the first author