Homologous recombination deficiency in ovarian cancer: a review of its epidemiology and management

Ovarian cancer patients with homologous recombination deficiencies exhibit specific clinical behaviors, and improved responses to treatments, such as platinum-based chemotherapy and poly (ADP-ribose) polymerase (PARP) inhibitors, have been observed. Germline mutations in the BRCA 1/2 genes are the most well-known mechanisms of homologous recombination deficiency. However, other mechanisms, such as germline and somatic mutations in other homologous recombination genes and epigenetic modifications, have also been implicated in homologous recombination deficiency. The epidemiology and implications of these other mechanisms need to be better understood to improve the treatment strategies for these patients. Furthermore, an evaluation of various diagnostic tests to investigate homologous recombination deficiency is essential. Comprehension of the role of homologous recombination deficiency in ovarian cancer also allows the development of therapeutic combinations that can improve the efficacy of treatment. In this review, we discuss the epidemiology and management of homologous recombination deficiency in ovarian cancer patients

Carcinoma of the cervix – risk factors, prevention, diagnosis and treatment

O câncer de colo uterino é o segundo tipo de câncer mais frequente entre as mulheresde todo o mundo e também no Brasil. Sua maior incidência se dá em mulheres entre45 e 49 anos de idade e estima-se que o rastreamento sistemático e o tratamento de lesõesprecursoras possam reduzir a mortalidade pela doença em até 80%. O principal fator de riscoé a infecção pelo Papiloma Vírus Humano (HPV) e já foram desenvolvidas vacinas contra osprincipais tipos oncogênicos do vírus. A redução da mortalidade decorrente dessa doençadepende da adoção de medidas de prevenção primária, de diagnóstico e tratamento de lesõesprecursoras bem como do diagnóstico e tratamento adequados das lesões invasivas.The cervical cancer is the second leading cause of cancer between womenaround the world, as in Brazil. The highest incidence is in women aged 45-49 years and themortality can be reduced by 80% with the systematic screening and treatment of precursorlesions. Human papillomavirus is the major risk factor and vaccines were recent developed.Strategies to reduction of cervical cancer mortality include prevention measures, diagnosis andtreatment of early and invasive lesions

¿Estamos avanzando hacía una socio-ecología? Reflexiones sobre la integración de las dimensiones "humanas" en la ecología en el sur de América

La complejidad y la velocidad de los actuales cambios ambientales a escala global presentan desafíos y oportunidades para la investigación, la gestión y la conservación de la biosfera (Millenium Ecosystem Assessment [MA] 2005). La magnitud de estos cambios derivó en la propuesta de llamar Antropoceno a nuestra época geológica (Crutzen 2002), ya que los seres humanos nos hemos convertido en la mayor fuerza de cambio planetario. Es evidente que los grandes factores promotores de este nuevo escenario (e.g., el calentamiento global, la urbanización y la globalización cultural y económica) afectan a los ecosistemas (Ellis et al. 2011), aunque también existe un reconocimiento creciente de que estos factores influyen sobre las sociedades humanas (MA 2005). Por lo tanto, se puede decir que los problemas categorizados tradicionalmente como “ambientales” (e.g., el cambio climático) poseen causas y consecuencias sociales (e.g., políticas energéticas para combustibles fósiles, impacto económico de la desertificación). De manera recíproca, los problemas “humanos” (e.g., planificación territorial y políticas de inmigración) están vinculados a los ecosistemas y a la biodiversidad (e.g., fragmentación del paisaje, introducción de especies no-nativas y homogeneización biótica). En el contexto del Antropoceno, se hace urgente integrar las dimensiones ecológicas y las sociales del ambiente para mejorar nuestro conocimiento y tomar decisiones más efectivas (Carpenter et al. 2009). El desafío llega a ser aun más relevante en Latinoamérica, que cubriendo sólo el 10% de la superficie del planeta alberga el 50% de la biodiversidad terrestre (Wilson 1989) y el 15% de la diversidad lingüística (Skutnabb-Kangas 2000). Es en Latinoamérica donde se han generado grandes conflictos socioambientales (Wagner 2010). Entonces, ¿Qué papel tiene la ecología como disciplina en Argentina y Chile con respecto a estas transformaciones? Sabemos que a nivel mundial y regional existen ejemplos de integración entre diversos campos académicos que abordan problemáticas “bioculturales” (Toledo & Barrera 2008) y “socioecológicas” (Domptail et al. 2013) de manera interdisciplinaria. Por estas razones, y para pensar juntos sobre esta conceptualización de lo “humano” y lo “natural” en la ecología en nuestros países, presentamos el simposio “Socio-ecología: Avanzando hacia la Integración de ‘la Dimensión Humana’ en el Estudio y Entendimiento de los Ecosistemas del Sur de Sudamérica” en la V Reunión Binacional de Ecología realizada en Chile en 2013. Las reflexiones y discusiones del simposio motivaron este artículo, que sin ser una revisión exhaustiva, intenta catalizar el debate sobre lo socioecológico en la ecología austral. Consideramos que la interdisciplinariedad es una propiedad emergente del análisis holístico de una problemática compleja (García 2006). De esta forma quisimos superar el sesgo de la hiper-especialización individual, obstáculo para reflexiones epistemológicas y prácticas del quehacer de la ecología (Graham & Dayton 2002). Al usar distintas perspectivas acerca de estas preguntas: a) ofrecemos una breve reseña de algunas bases epistemológicas de la dimensión humana en la ecología y revisamos las tendencias en las publicaciones socio-ecológicas a nivel mundial y regional, b) consideramos aspectos interdisciplinarios de la formación de los profesionales relacionados con la ecología y c) presentamos antecedentes de la ciencia ciudadana para ilustrar la integración de nuevos actores sociales en la investigación ecológica. Esperamos contribuir al debate sobre la postura actual y futura que pueda tener la ecología en nuestros países, y hacemos un llamado a convertirnos en agentes activos de la conceptualización y las aproximaciones de investigación y formación.Fil: Anderson, Christopher Brian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas; Argentina. Universidad Nacional de Tierra del Fuego, Antártida e Islas del Atlántico Sur. Instituto de Ciencias Polares, Recursos Naturales y Ambiente. Departamento de Biología; ArgentinaFil: Pizarro Pinochet, Jose Cristobal. University Of Waterloo; CanadáFil: Fontana Estevez, Rodrigo Javier. Pontificia Universidad Católica de Chile; ChileFil: Sapoznikow, Alexandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; ArgentinaFil: Pauchard, Aníbal. Universidad de Concepción; Chile. Instituto de Ecología y Biodiversidad; ChileFil: Barbosa, Olga. Instituto de Ecología y Biodiversidad; Chile. Universidad Austral de Chile; Chile. Centro de Desarrollo Urbano Sustentable; ChileFil: Moreira Muñoz, Andrés. Pontificia Universidad Católica de Valparaíso; ChileFil: Valenzuela, Alejandro Eduardo Jorge. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Administración de Parques Nacionales; Argentina. Universidad Nacional de Tierra del Fuego, Antártida e Islas del Atlántico Sur. Instituto de Ciencias Polares, Recursos Naturales y Ambiente. Departamento de Biología; Argentin

Percutaneous mitral repair: current and future devices

Mitral regurgitation (MR) is the second most common valvular heart disease and its prevalence is increasing with population ageing. In the recent years we have witnessed the development of several transcatheter devices to correct MR in patients at high-risk for surgery. The majority of evidence regarding safety and efficacy of this new therapy comes from MitraClip studies. However, new alternatives on the field of valve repair have emerged with promising results. The aim of this review is to portrait the landscape of transcatheter mitral repair alternatives, from currently used devices to those that will have a role in the near future

1-(2-Furo­yl)-3-(1-naphth­yl)thio­urea

In the title compound, C16H12N2O2S, the carbonyl­thio­urea group forms dihedral angles of 75.4 (1) and 13.1 (2)°, respectively, with the naphthalene ring system and furan ring. The mol­ecule adopts a trans–cis configuration with respect to the positions of the furoyl and naphthyl groups relative to the S atom across the thio­urea C—N bonds. This geometry is stabilized by an N—H⋯·O intra­molecular hydrogen bond. In the crystal structure, mol­ecules are linked by N—H⋯S hydrogen bonds, forming centrosymmetric dimers which are inter­linked through C—H⋯π inter­actions

South American Expert Roundtable : increasing adaptive governance capacity for coping with unintended side effects of digital transformation

This paper presents the main messages of a South American expert roundtable (ERT) on the unintended side effects (unseens) of digital transformation. The input of the ERT comprised 39 propositions from 20 experts representing 11 different perspectives. The two-day ERT discussed the main drivers and challenges as well as vulnerabilities or unseens and provided suggestions for: (i) the mechanisms underlying major unseens; (ii) understanding possible ways in which rebound effects of digital transformation may become the subject of overarching research in three main categories of impact: development factors, society, and individuals; and (iii) a set of potential action domains for transdisciplinary follow-up processes, including a case study in Brazil. A content analysis of the propositions and related mechanisms provided insights in the genesis of unseens by identifying 15 interrelated causal mechanisms related to critical issues/concerns. Additionally, a cluster analysis (CLA) was applied to structure the challenges and critical developments in South America. The discussion elaborated the genesis, dynamics, and impacts of (groups of) unseens such as the digital divide (that affects most countries that are not included in the development of digital business, management, production, etc. tools) or the challenge of restructuring small- and medium-sized enterprises (whose service is digitally substituted by digital devices). We identify specific issues and effects (for most South American countries) such as lack of governmental structure, challenging geographical structures (e.g., inclusion in high-performance transmission power), or the digital readiness of (wide parts) of society. One scientific contribution of the paper is related to the presented methodology that provides insights into the phenomena, the causal chains underlying “wanted/positive” and “unwanted/negative” effects, and the processes and mechanisms of societal changes caused by digitalization

Stakeholder engagement in the study and management of invasive alien species

Invasive alien species are a major driver of global environmental change and a range of management interventions are needed to manage their effects on biodiversity, ecosystem services, human well-being and local livelihoods. Stakeholder engagement is widely advocated to integrate diverse knowledge and perspectives in the management of invasive species and to deal with potential conflicts of interest. We reviewed the literature in the ISI Web of Science on stakeholder engagement (the process of involving stakeholders (actors) in decision making, management actions and knowledge creation) in invasion science to assess and understand what has been done (looking at approaches and methodologies used, stakeholders involved, and outcomes from engagement) and to make recommendations for future work. Research on stakeholder engagement in invasion science has increased over the last decade, helping to improve scientific knowledge and contributing towards policy formulation and co-implementation of management. However, many challenges remain and engagement could be made more effective. For example, most studies engage only one stakeholder group passively using questionnaires, primarily for assessing local knowledge and perceptions. Although useful for management and policy planning, these stakeholders are not active participants and there is no two-way flow of knowledge. To make stakeholder involvement more useful, we encourage more integrative and collaborative engagement to (1) improve co-design, co-creation and co-implementation of research and management actions; (2) promote social learning and provide feedback to stakeholders; (3) enhance collaboration and partnerships beyond the natural sciences and academia (interdisciplinary and transdisciplinary collaboration); and (4) discuss some practical and policy suggestions for improving stakeholder engagement in invasion science research and management. This will help facilitate different stakeholders to work better together, allowing problems associated with biological invasions to be tackled more holistically and successfully

Percutaneous treatment with Mitraclip for functional mitral regurgitation: medium-term follow up according to left ventricular function

Background: Functional mitral regurgitation (FMR) is a bad prognosis condition despite optimal medical treatment. Nowadays there is an open debate about the surgical versus percutaneous treatment. The main objective of this study is to evaluate the mid-term follow up clinical outcomes of patients with FMR treated with MitraClip((R)) system, according to their left ventricular ejection fraction (LVEF). Methods: Data was obtained from two experienced centers in transcatheter mitral valve repair (TMVR). All consecutive cases of severe FMR undergoing TMVR in both centers with the same inclusion criteria were included prospectively in this study and followed-up. Periodical follow-ups with clinical and echocardiographic evaluation were scheduled from the baseline procedure, at 3 months and then yearly. Results: From October 2015 to October 2019, a total of 119 patients with FMR at 2 centers in Spain underwent TMVR with the MitraClip((R)) procedure and were included in this study. The mean age was 73.8+/-8.9 years old and 32 patients (26.9%) were female. A 39.5% of cases [47] had a LVEF 30% (group 2). There was a similar distribution in cardiovascular risk factors, age and other diseases. All MitraClip((R)) implantations were elective and procedural success was achieved in 110 patients (92.4%) with a similar distribution between the groups. There were no differences in procedural time and the number of implanted clips. The median follow-up was 22.6 months (IQR, 11.43-34.98 months). The primary combined endpoint occurred in the 41.6% of the global cohort, 57.5% in group 1 and 30.99% in group 2 (P=0.036). LVEF was associated to the main event in the multivariate analysis (HR 2.09, 95% CI: 1.12-3.89; P=0.02). Conclusions: The MitraClip edge-to-edge technique is a safe and effective procedure for the treatment of FMR. In this study, patients with LVEF >30% treated with Mitraclip presented better clinical cardiovascular outcomes than those with a LVEF </=30%. Regardless clinical outcomes, at the end of the follow-up, there was a sustained reduction in MR grades and an important improvement in NYHA functional class