The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Gaia Early Data Release 3: Structure and properties of the Magellanic Clouds

We compare the Gaia DR2 and Gaia EDR3 performances in the study of the Magellanic Clouds and show the clear improvements in precision and accuracy in the new release. We also show that the systematics still present in the data make the determination of the 3D geometry of the LMC a difficult endeavour; this is at the very limit of the usefulness of the Gaia EDR3 astrometry, but it may become feasible with the use of additional external data. We derive radial and tangential velocity maps and global profiles for the LMC for the several subsamples we defined. To our knowledge, this is the first time that the two planar components of the ordered and random motions are derived for multiple stellar evolutionary phases in a galactic disc outside the Milky Way, showing the differences between younger and older phases. We also analyse the spatial structure and motions in the central region, the bar, and the disc, providing new insights into features and kinematics. Finally, we show that the Gaia EDR3 data allows clearly resolving the Magellanic Bridge, and we trace the density and velocity flow of the stars from the SMC towards the LMC not only globally, but also separately for young and evolved populations. This allows us to confirm an evolved population in the Bridge that is slightly shift from the younger population. Additionally, we were able to study the outskirts of both Magellanic Clouds, in which we detected some well-known features and indications of new ones

The Gaia mission

Gaia is a cornerstone mission in the science programme of the EuropeanSpace Agency (ESA). The spacecraft construction was approved in 2006, following a study in which the original interferometric concept was changed to a direct-imaging approach. Both the spacecraft and the payload were built by European industry. The involvement of the scientific community focusses on data processing for which the international Gaia Data Processing and Analysis Consortium (DPAC) was selected in 2007. Gaia was launched on 19 December 2013 and arrived at its operating point, the second Lagrange point of the Sun-Earth-Moon system, a few weeks later. The commissioning of the spacecraft and payload was completed on 19 July 2014. The nominal five-year mission started with four weeks of special, ecliptic-pole scanning and subsequently transferred into full-sky scanning mode. We recall the scientific goals of Gaia and give a description of the as-built spacecraft that is currently (mid-2016) being operated to achieve these goals. We pay special attention to the payload module, the performance of which is closely related to the scientific performance of the mission. We provide a summary of the commissioning activities and findings, followed by a description of the routine operational mode. We summarise scientific performance estimates on the basis of in-orbit operations. Several intermediate Gaia data releases are planned and the data can be retrieved from the Gaia Archive, which is available through the Gaia home page. http://www.cosmos.esa.int/gai

Estrutura e composição da ictiofauna de riachos da bacia do Rio Grande no estado de São Paulo, sudeste do Brasil

O ponto médio de cada trecho foi georreferenciado via satélite com receptor GPS e o uso de metodologia padronizada de coleta de dados ambientais e peixes (baseada principalmente na pesca elétrica), possibilitou a obtenção das seguintes informações em cada local: 1) composição taxonômica da ictiofauna e contribuição, em termos de número de indivíduos e biomassa, de cada espécie para a ictiofauna local como um todo; 2) documentação fotográfica de espécimes representativos de cada espécie coletada com sua coloração natural; 3) descrição de cada ambiente coletado, com ilustrações fotográficas coloridas, e seus principais parâmetros bióticos e abióticos. No total foram coletados 3.070 exemplares, pertencentes a seis ordens, 18 famílias, 44 gêneros e 64 espécies, com biomassa total de 14,3 kg. Das espécies coletadas, aproximadamente 50% pertencem a ordem Characiformes, 26,5% a Siluriformes, 11% a Perciformes, 6% a Gymnotiformes, 5% a Cyprinodontiformes e 1,5% a Synbranchiformes. As espécies mais abundantes em termos de número de indivíduos foram Astyanax altiparanae (17,4%) e Hypostomus ancistroides (9%); aquelas com maior biomassa foram A. altiparanae (35%) e Geophagus brasiliensis (9%). em termos de abundância e biomassa por família, a composição da fauna de peixes estudada indica a predominância expressiva de Characidae, seguida por Loricariidae e Cichlidae. Dentre os trechos amostrados, o trecho SG6 (26 espécies) e o PG4 (três espécies), apresentaram a maior e a menor riqueza em espécies, respectivamente, coincidindo com os valores obtidos para o índice de diversidade específica de Shannon-Wiener (H'= 1,08 e 0,26, respectivamente). A riqueza média encontrada foi de 12 espécies por trecho de riacho. Na estimativa de riqueza por extrapolação para o conjunto total de riachos amostrados na bacia do Rio Grande, obtivemos um valor de 93 espécies (erro padrão igual a três) indicando ser necessário um esforço amostral adicional moderado para atingir a assíntota da curva. Das 64 espécies coletadas, quatro (aproximadamente 6% do total) são seguramente novas, sete (aproximadamente 11% do total) possuem status taxonômico ainda indefinido, enquanto outras duas (aproximadamente 3% do total) são espécies certamente introduzidas. Analisando a estrutura trófica e espacial da ictiofauna estudada as 10 espécies numericamente dominantes nos riachos amostrados dividem-se, com base em dados de literatura, em ordem decrescente de importância numérica, em cinco guildas: onívoros nectônicos; invertívoros bentônicos; perifitívoros; algívoros e onívoros bentônicos. Uma chave de identificação para todas as espécies de peixes coletadas durante este estudo é fornecida ao final deste trabalho.Each stream stretch had its midpoint located with a GPS satellite receiver and had its fish fauna sampled via a standardized environmental data and fish collection methodology (primarily utilizing electrofishing) with the aim of providing the following information about each stream: 1) the taxonomic composition of the fish fauna and the contribution of each species in that stream in terms of both number of individuals and biomass; 2) a photographic documentation of the live coloration of representative specimens of each collected species; and 3) the description of each sampled environment, with colored photographic illustrations and details of the main biotic and abiotic parameters. Overall 3,070 fishes were collected, belonging to six orders, 18 families, 44 genera, and 64 species, with a total biomass of 14.3 kg. of the collected species, approximately 50% were Characiformes, 26.5% Siluriformes, 11% Perciformes, 6% Gymnotiformes, 5% Cyprinodontiformes, and 1.5% Synbranchiformes. The most abundant species in terms of total number of individuals were Astyanax altiparanae (17.4%) and Hypostomus ancistroides (9%); the species with the largest biomasses were Astyanax altiparanae (35%) and Geophagus brasiliensis (9%). In terms of abundance and biomass collected for each family, the Characidae was clearly the predominant family followed by the Loricariidae, and Cichlidae. Among the sampled stream stretches, locality SG6 with 26 species and locality PG4 with three species yielded the highest and lowest richness in terms of species numbers, respectively. This coincides with the values obtained for the Shannon-Wiener index of specific diversity (H' = 1.08 and 0.26, respectively). The median species richness for all streams stretches was 12. In the species richness estimate by extrapolation for all 18 sampled stream stretches, a value of 93 species was obtained (with a standard error of three) indicating the need for an additional moderate sampling effort to reach the asymptote of the curve. of the 64 collected species, four (approximately 6% of the total) are clearly new to science and seven other species (approximately 11% of the total) are of indefinite taxonomic status and require further analysis. Two of the captured species are certainly introduced (approximately 3% of the total). Analysis of the trophic and spatial structure of the studied fish fauna indicates that the 10 numerically dominant species in the sampled streams can be grouped, based on published data, into five guilds that are in decreasing order of numeric importance: nektonic omnivores; benthic invertivores; periphytovores; algivores and benthic omnivores. An identification key for all the species of fish collected during this study is provided

Estrutura e composição da ictiofauna de riachos do rio Paranapanema, Sudeste e Sul do Brasil

Foram amostrados 17 trechos de riachos com 100 m de extensão, todos de ordem igual ou menor a três, ao longo de ambas as margens do canal principal do Rio Paranapanema, SP e PR. O ponto médio de cada trecho foi georreferenciado via satélite com receptor GPS e o uso de metodologia padronizada de coleta de dados ambientais e peixes (baseada principalmente na pesca elétrica), possibilitou a obtenção das seguintes informações em cada local: 1) composição taxonômica da ictiofauna e contribuição, em termos de número de indivíduos e biomassa, de cada espécie para a ictiofauna local como um todo; 2) documentação fotográfica de espécimes representativos de cada espécie coletada com sua coloração natural; 3) descrição de cada ambiente coletado, com ilustrações fotográficas coloridas, e seus principais parâmetros bióticos e abióticos. No total foram coletados 3.683 exemplares, pertencentes a seis ordens, 16 famílias, 37 gêneros e 52 espécies, com biomassa total de 16,8 kg. Das espécies coletadas, aproximadamente 36% pertencem a ordem Siluriformes, 36% a Characiformes, 11% a Gymnotiformes, 10% a Perciformes, 4% a Cyprinodontiformes e 2% a Synbranchiformes. As espécies mais abundantes em termos de número de indivíduos foram Astyanax altiparanae (15,2%) e Astyanax sp. 1 (12,3%); aquelas com maior biomassa foram A. altiparanae (28%) e Geophagus brasiliensis (13%). A composição da ictiocenose em termos de abundância e biomassa por família indica a predominância expressiva de Characidae, seguida por Loricariidae, Pimelodidae e Cichlidae. Dentre os trechos amostrados, o trecho 14 (24 espécies) e o 13 (cinco espécies), apresentaram a maior e a menor riqueza em espécies, respectivamente, coincidindo com os valores obtidos para o índice de diversidade específica de Shannon-Wienner (H´= 0,99 e 0,32, respectivamente). A riqueza média encontrada foi de 11 espécies por trecho de riacho. Na estimativa de riqueza por extrapolação para o conjunto total de riachos amostrados na bacia do rio Paranapanema, obtivemos um valor de 69 espécies (erro padrão igual a quatro) indicando ser necessário um esforço amostral adicional moderado para atingir a assíntota da curva. Das 52 espécies coletadas, oito (aproximadamente 15% do total) são seguramente novas, cinco (aproximadamente 10% do total) possuem status taxonômico ainda indefinido, enquanto outras três (aproximadamente 6% do total) são espécies introduzidas. Analisando a estrutura trófica e espacial da ictiocenose estudada, as 10 espécies numericamente dominantes nos riachos estudados dividem-se, em ordem decrescente de importância numérica, em quatro guildas: onívoros nectônicos; invertívoros bentônicos; perifitívoros; e onívoros bentônicos. Uma chave de identificação para todas as espécies de peixes coletadas durante este estudo é fornecida ao final deste trabalho.Seventeen 100 m long streams stretches, none of an order higher than three, were sampled to both sides of the main channel of Rio Paranapanema in the States of São Paulo and Paraná, southeastern and southern Brazil. Each stream stretch had its midpoint located with a GPS satellite receiver and had its fish fauna sampled via a standardized environmental data and fish collection methodology (primarily utilizing electrofishing) with the aim of providing the following information about each stream: 1) the taxonomic composition of the fish fauna and the contribution of each species in that stream in terms of both number of individuals and biomass; 2) a photographic documentation of the live coloration of representative speci-mens of each collected species; and 3) the description of each sampled environment, with colored photographic illustra-tions and details of the main biotic and abiotic parameters. Overall 3,683 fishes were collected, belonging to six orders, 16 families, 37 genera, and 52 species, with a total biomass of 16.8 kg. of the collected species, approximately 36% were Siluriformes, 36% Characiformes, 11% Gymnotiformes, 10% Perciformes, 4% Cyprinodontiformes, and 2% Synbranchiformes. The most abundant species in terms of total number of individuals were Astyanax altiparanae (15.2%) and Astyanax sp. 1 (12.3%); The species with the largest biomasses were Astyanax altiparanae (28%) and Geophagus brasiliensis (13%). In terms of abundance and biomass collected for each family, the Characidae was clearly the predominant family followed by the Loricariidae, Pimelodidae, and Cichlidae. Among the sampled stream stretches, locality 14 with 24 species and locality 13 with five species yielded the highest and lowest richness in terms of species numbers, respectively. This coincides with the values obtained for the Shannon-Wienner index of specific diversity (H´ = 0.99 and 0.32, respectively). The median species richness for all streams stretches was 11. In the species richness estimate by extrapolation for all 17 sampled stream stretches, a value of 69 species was obtained (with a standard error of four) indicating the need for an additional moderate sampling effort to reach the asymptote of the curve. of the 52 collected species, eight (approximately 15% of the total) are clearly new to science and five other species (approximately 10% of the total) are of indefinite taxonomic status and require further analysis. Three of the captured species are introduced (approximately 6% of the total). Analysis of the trophic and spatial structure of the studied fish fauna indicates that the 10 numerically dominant species in the sampled streams can be grouped into four guilds that are in decreasing order of numeric importance: nektonic omnivores; benthonic invertivores; periphytovores; and benthonic omnivores. An identification key for all the species of fish collected during this study it is provided

The genetic diversity and phenotypic characterisation of Streptococcus agalactiae isolates from Rio de Janeiro, Brazil

Streptococcus agalactiae isolates are more common among pregnant women, neonates and nonpregnant adults with underlying diseases compared to other demographic groups. In this study, we evaluate the genetic and phenotypic diversity in S. agalactiae strains from Rio de Janeiro (RJ) that were isolated from asymptomatic carriers. We analysed these S. agalactiae strains using pulsed-field gel electrophoresis (PFGE), serotyping and antimicrobial susceptibility testing, as well as by determining the macrolide resistance phenotype, and detecting the presence of the ermA/B, mefA/E and lnuB genes. The serotypes Ia, II, III and V were the most prevalent serotypes observed. The 60 strains analysed were susceptible to penicillin, vancomycin and levofloxacin. Resistance to clindamycin, chloramphenicol, erythromycin, rifampin and tetracycline was observed. Among the erythromycin and/or clindamycin resistant strains, the ermA, ermB and mefA/E genes were detected and the constitutive macrolides, lincosamides and streptogramin B-type resistance was the most prevalent phenotype observed. The lnuB gene was not detected in any of the strains studied. We found 56 PFGE electrophoretic profiles and only 22 of them were allocated in polymorphism patterns. This work presents data on the genetic diversity and prevalent capsular serotypes among RJ isolates. Approximately 85% of these strains came from pregnant women; therefore, these data may be helpful in developing future prophylaxis and treatment strategies for neonatal syndromes in RJ