Pancreatic intraductal papillary mucinous neoplasm associated colloid carcinoma

Funding Information: Acknowledgments: Special thanks to Celso Matos, MD/PhD, for assistance with manuscrip preparation. The authors received no financial support for the publication of this article. Publisher Copyright: © 2021Colloid carcinomas are rare pancreatic tumors characterized by the presence of mucin pools with scarce malignant cells. Most of these neoplasms arise from intestinal-type intraductal papillary mucinous neoplasms (IPMNs). We report a case of a 77-year-old male patient who presented with weight loss, asthenia, lumbar pain and diabetes. Imaging studies revealed a mixed-type IPMN with high-risk features and a possible invasive component. The patient underwent surgical resection and the histology confirmed an invasive colloid carcinoma of the pancreas associated with an intestinal-type IPMN. Although invasive ductal and colloid carcinomas may look similar on imaging studies, its distinction is important because the latter have a better prognosis.publishersversionpublishe

Genetic and phenotypic variation of the malaria vector Anopheles atroparvus in southern Europe

<p>Abstract</p> <p>Background</p> <p>There is a growing concern that global climate change will affect the potential for pathogen transmission by insect species that are vectors of human diseases. One of these species is the former European malaria vector, <it>Anopheles atroparvus</it>. Levels of population differentiation of <it>An. atroparvus </it>from southern Europe were characterized as a first attempt to elucidate patterns of population structure of this former malaria vector. Results are discussed in light of a hypothetical situation of re-establishment of malaria transmission.</p> <p>Methods</p> <p>Genetic and phenotypic variation was analysed in nine mosquito samples collected from five European countries, using eight microsatellite loci and geometric morphometrics on 21 wing landmarks.</p> <p>Results</p> <p>Levels of genetic diversity were comparable to those reported for tropical malaria vectors. Low levels of genetic (0.004 <<it>F</it>_{<it>ST </it>}<0.086) and phenotypic differentiation were detected among <it>An. atroparvus </it>populations spanning over 3,000 km distance. Genetic differentiation (0.202 <<it>F</it>_{<it>ST </it>}<0.299) was higher between the sibling species <it>An. atroparvus </it>and <it>Anopheles maculipennis </it>s.s. Differentiation between sibling species was not so evident at the phenotype level.</p> <p>Conclusions</p> <p>Levels of population differentiation within <it>An. atroparvus </it>were low and not correlated with geographic distance or with putative physical barriers to gene flow (Alps and Pyrenées). While these results may suggest considerable levels of gene flow, other explanations such as the effect of historical population perturbations can also be hypothesized.</p

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection