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Megamelus is a genus of Delphacidae widely distributed and mostly associated with plants in freshwater environments. Despite various taxonomic revisions and thorough research, the delimitation of the genus, its diversity, and its evolutionary history need to be further explored. Moreover, features originally considered distinctive of the genus exhibit variation and should be reassessed. Here, the genus Megamelus in South America was examined, describing two new species, Megamelusdelticus Remes Lenicov & Mariani, sp. nov. and Megamelusserpentinus Mariani & Remes Lenicov, sp. nov. , and providing information on their host plants and geographical distribution. The distribution and host range knowledge of Megamelusiphigeniae and Megamelustimehri are also expanded, the male brachypter of M.timehri described for the first time, and a key to distinguish the species, based on male and female genitalia and their external morphology, is provided. Moreover, the first phylogenetic analysis of the genus is presented, based on the mitochondrial COI gene to clarify the interspecific relationships among its members. Our combined findings support the monophyly of the genus and refine diagnostic features, including the importance of the pygofer's lobed appearance. This comprehensive revision highlights the need for further multidisciplinary approaches to fully understand the evolutionary history of Megamelus and its interactions with host plants and environments., Competing Interests: The authors have declared that no competing interests exist., (Nicolas A. Salinas, Roxana Mariani, Ana M. Marino de Remes Lenicov, Marcela S. Rodriguero, Alejandro J. Sosa.)

Background: Proton therapy (PT) has unique biologic properties with excellent clinical outcomes for the management of localized prostate cancer. Here, we aim to characterize the toxicity of PT for patients with localized prostate cancer and propose mitigation strategies using a large institutional database., Methods: We reviewed medical records of 2772 patients with localized prostate cancer treated with definitive PT between May 2006 through January 2020. Disease risk was stratified according to National Comprehensive Cancer Network guidelines as low [LR, n = 640]; favorable-intermediate [F-IR, n = 849]; unfavorable-intermediate [U-IR, n = 851]; high [HR, n = 315]; or very high [VHR, n = 117]. Descriptive statistics and Kaplan-Meier estimates assessed toxicity and freedom from biochemical relapse (FFBR)., Results: Median follow-up was 7.0 years. The median dose was 78 Gy(RBE)(range: 72-79.2 Gy) in 2.0 Gy(RBE) fractions; 63 % of patients received 78 Gy(RBE) in 39 fractions, and 29 % received 76 Gy(RBE) in 38 fractions. Overall rates of late grade ≥3 GU and GI toxicity were 0.87 % and 1.01 %, respectively. Two patients developed grade 4 late GU toxicity and seven patients with grade 4 late GI toxicity. All patients experiencing severe late grade 4 toxicities were treated to 78 Gy(RBE) in 39 fractions with 80 Gy(RBE) dose to the anterior rectal wall and/or bladder neck. The 10-year FFBR rates for patients with LR to U-IR disease were compared between those treated with 76 and 78 Gy(RBE); the rates were 94.5 % (95 % confidence interval [CI] 92.4-96.0 %) and 93.2 % (95 % CI 91.3-95.7 %), respectively (log-rank p = 0.22)., Conclusions: Proton therapy is associated with low rates of late grade ≥3 GU and GI toxicity. While rare, late grade 4 toxicities occurred in nine (0.3 %) patients. De-escalation to a total dose of 76 Gy(RBE) yields excellent clinical outcomes for patients with LR to U-IR disease with the potential for significant reductions in grade ≥3 late toxicity., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.)

In the search for insects as biological control agents for the water primrose, the delphacid Pissonotusparaguayensis (Delphacidae) was found on Ludwigiagrandiflorasubsp.hexapetala (Onagraceae) in a wetland of Central East Argentina. The morphology of the unknown females (brachypterous and macropterous) and immature stages are described and illustrated. Adults and nymphs were collected in wetlands of Del Plata River Basin, from Buenos Aires to the northeastern part of Argentina. A rearing methodology was developed to perform biological studies. Both winged forms and structural features of the female genitalia are described for the first time at the genus level. Eggs and immature stages are described and keyed; fifth nymphal instars may be easily recognised by the yellowish colouration, blackish on dorsal of head, thorax and abdomen with conspicuous yellowish pits, ventrally only darkened on base of frons extended to lower level of eyes and dorsal surface of antennomeres I and II, and legs with distinctive black marks at femoro-tibial joint and apex. The geographical distribution is updated, expanding its range into Argentina, making Buenos Aires the southernmost limit of the genus in America. Biological information of the species is also reported here: life cycle, fecundity, oviposition behaviour, and host plant. Field observations showed that P.paraguayensis breeds, feeds, and causes damage to L.g.subsp.hexapetala. This delphacid presents a certain degree of specificity to the Ludwigia species in the Jussiaea section in host specificity tests. More studies are required to test this species as a potential biological control agent., Competing Interests: The authors have declared that no competing interests exist., (Ana M. Marino de Remes Lenicov, Ana C. Faltlhauser, Alvaro Foieri, Nicolas A. Salinas, M. Cristina Hernández, Alejandro J. Sosa.)

Background and Purpose: Proton therapy (PT) has emerged as a standard-of-care treatment option for localized prostate cancer at our comprehensive cancer center. However, there are few large-scale analyses examining the long-term clinical outcomes. Therefore, this article aims to evaluate the long-term effectiveness and toxicity of PT in patients with localized prostate cancer., Materials and Methods: Review of 2772 patients treated from May 2006 through January 2020. Disease risk was stratified according to National Comprehensive Cancer Network guidelines as low [LR, n = 640]; favorable-intermediate [F-IR, n = 850]; unfavorable-intermediate [U-IR, n = 851]; high [HR, n = 315]; or very high [VHR, n = 116]. Biochemical failure and toxicity were analyzed using Kaplan-Meier estimates and multivariate models., Results: The median patient age was 66 years; the median follow-up time was 7.0 years. Pelvic lymph node irradiation was prescribed to 28 patients (1%) (2 [0.2%] U-IR, 11 [3.5%] HR, and 15 [12.9%] VHR). The median dose was 78 Gy in 1.8-2.0 Gy(RBE) fractions. Freedom from biochemical relapse (FFBR) rates at 5 years and 10 years were 98.2% and 96.8% for the LR group; 98.3% and 93.6%, F-IR; 94.2% and 90.2%, U-IR; 94.3% and 85.2%, HR; and 86.1% and 68.5%, VHR. Two patients died of prostate cancer. Overall rates of late grade ≥ 3 GU and GI toxicity were 0.87% and 1.01%., Conclusions: Proton therapy for localized prostate cancer demonstrated excellent clinical outcomes in this large cohort, even among higher-risk groups with historically poor outcomes despite aggressive therapy., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Diabetes is a risk factor for cancer in the general population. However, few data are available on the association between post-transplant diabetes mellitus (PTDM) and cancer after transplantation., Methods: We analyzed this issue in a Spanish cohort of patients without diabetes before transplantation. PTDM was diagnosed with consensus criteria at 12 months after transplantation and 12 months before the diagnosis of cancer. The association between PTDM and cancer (overall and specific types) was evaluated with regression analysis., Results: During a follow-up of 12 years (interquartile range 8-14), 85 cases of 603 developed cancer (829/100 000/year) and 164 (27%) PTDM. The most frequent cancers were renal cell cancer (RCC) n = 15, 146/cases/100 000/year), lung (n = 12, 117/cases/100 000/year), colon (n = 9, 88/cases/100 000/year) and prostate (n = 9, 88/cases/100 000/year). In logistic regression, PTDM was not associated with cancer. Eight of the 164 patients with PTDM (4.9%) vs 7 of the 439 without PTDM developed RCC (1.6%) (P = .027). In multivariate analysis, PTDM was independently associated with RCC [odds ratio (OR) 2.92, confidence interval (CI) 1.03-8.27], adjusting for smoking (OR 4.020, 95% CI 1.34-12.02) and other covariates. PTDM was not associated with other types of cancer., Conclusions: Patients with PTDM must be considered a population at risk for RCC and accordingly, the subject of active surveillance., (© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.)

Objective: To describe the range of potential side effects associated with modern brain metastasis treatment and provide evidenced-based guidance on the effective management of these side effects., Background: Brain metastases are the most commonly diagnosed malignant intracranial tumor and have historically been associated with very poor prognosis. The standard treatment for brain metastases until the 1990s was whole-brain radiation therapy (WBRT) alone. Since then, however, numerous advances have established the role of neurosurgical resection, stereotactic radiosurgery (SRS), targeted systemic therapy, and immunotherapy in the multidisciplinary management of brain metastases and led to improvements in intracranial control, survival, and neurocognitive preservation among patients with brain metastases. As a result, however, brain metastasis treatment is associated with a wider range of potential side effects than ever before, and clinicians are tasked with the challenge of effectively managing these side effects without compromising cancer outcomes., Methods: We performed a narrative review of peer-reviewed articles related to the management of side effects from multidisciplinary brain metastasis treatment and synthesized the data in the context of our clinical experience and practice., Conclusions: In this review, we summarize the major complications from intracranial radiotherapy, neurosurgical resection, and brain metastasis directed systemic therapy with corresponding evidenced-based, modern management principles to guide the practicing oncologist.

Environmental education seeks to foster an appreciation for nature and the impact of humans on it while introducing citizens to scientific thinking. Biological invasions affect different aspects of life on earth and mandate urgent management actions. Education and public awareness are strongly recommended for successful prevention and management of invasive alien species (IAS). This work presents a study on knowledge and perception of the educational community of Argentina about native species and IAS. We designed an on-line semi-structured questionnaire to examine perception of the environment, recognition of native species and IAS and awareness about biological invasions. Educators recognised an important number of biotic components, mostly represented by trees, birds and mammals. Recognition of native species and IAS, and awareness of biological invasions were different between NST (Natural Science Teachers) and non-NST. Respondents had different performances when they were exposed to recognising native species though written names or photographs. Out of 532 respondents, 56% knew what biological invasions are, 21% answered "Maybe" and 23% had never heard about them. We need to foster capacity-building and encourage a two-way communication between educators and scientists, formally and informally, to engage the participation of the whole society in recognition, prevention and management of IAS., (© 2021. The Author(s).)

Prediabetes and post-transplant diabetes mellitus affect about 20-30% of renal transplant patients. The latter is a risk factor for cardiovascular disease. However, no clear evidence linking prediabetes and cardiovascular disease is available. To study this we analyzed the impact of prediabetes on cardiovascular disease in 603 renal transplant patients followed with repeated oral glucose tests for up to five years and a long term survival evaluation. Prediabetes and post-transplant diabetes mellitus were defined at 12 months after transplantation to avoid their high reversibility rate before this period. 73 cardiovascular events were observed. The incidence of events was significantly higher in patients with either prediabetes, (17%; 0.023 person/year) or post-transplant diabetes mellitus (20%; 0.028 person/year) than in normal individuals, (7%; 0.0095 person/year). The incidence of events was comparable between prediabetes and post-transplant diabetes mellitus. Prediabetes at 12 months was a risk factor for cardiovascular events in univariate and multivariate Cox survival analyses (hazard ratio 2.24, 95% confidence interval 1.11-4.52). Prediabetes at three months and hemoglobin A1c at 12 months were not significantly associated with cardiovascular disease. Thus, prediabetes is a risk factor for cardiovascular disease in renal transplantation, a population at high risk for cardiovascular events. Since prediabetes is potentially a reversible condition, there is an opportunity to prevent cardiovascular disease in this population., (Copyright © 2019 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Background: To analyze the findings in the background EEG activity of infants who suffered perinatal stroke., Methods: Eleven neonates born 2009-2014 diagnosed of ischemic stroke by MRI (three of them with multistroke) underwent continuous video-EEG monitoring. Visual and spectral (power spectrum and coherence) analyses of the background EEG was performed in three moments: 1) Onset of EEG recording (prior to initiate seizure treatment), 2) Post-ictal epoch (1-2 h after the last seizure), and 3) one-two days after seizure control. All children aged 2-6 years underwent neurodevelopmental assessment., Results: Discontinuity, asymmetry, asynchrony, transients, and relative power spectrum in δ and θ frequency bands increased significantly (p < 0.05) in the post-ictal epoch with respect to onset of EEG recording. After seizure control, discontinuity, asynchrony, and θ power spectrum no longer had significant differences with those found at onset of EEG recording. Significant differences between the ischemic and unaffected hemispheres were found in transients and in β coherence (p = 0.002; p = 0.001, respectively) exclusively in the post-ictal epoch. Seizure burden and time-to-control ranged 5-38 min and 0.5-40 h respectively. Currently, only one child is affected by spastic monoparesis. The intelligence quotients ranged 96-123., Conclusions: The background EEG can undergo significant changes in the post-ictal epoch due to the seizure activity triggered by the perinatal stroke. Most of these EEG changes involve all brain activity and not exclusively the ischemic hemisphere. Many of these modifications in the EEG background reverse following the seizure control. Video-EEG monitoring allows accurate/immediate diagnosis and rapid/intensive treatment of the stroke-associated seizures., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: What constitutes a "normal" background electroencephalography (EEG) rhythm immediately after birth is not well understood. We performed video-electroencephalography recordings in the first six hours (first measure) and the third day of life (second measure) for evidence of transient changes in brain function., Methods: We performed a cohort study of an incidental sample of healthy term neonates in a single-center nursery. Main outcome measures were as follows: (1) EEG visual analysis, which included sleep-wake cycles, proportions of discontinuity and bursts with delta brushes, and number per hour of alpha/theta rolandic activity, encoches frontales, and transients; and (2) the electroencephalographic spectral analysis, which included power spectrum in the following frequency bands: delta, 0.5 to 4 Hz; theta, 4 to 8 Hz; alpha, 8 to 13 Hz; and beta, 13 to 30 Hz. Theta/delta and alpha/delta ratios were also calculated., Results: Twenty-two babies were enrolled. Significant findings (P < 0.05) in the first six hours with respect to 48 to 72 hours of life were (1) increased discontinuity, indeterminate sleep, and bursts with delta brushes; (2) higher number of transients, and lower number of alpha/theta rolandic activity and encoches frontales. Minimal changes were found in power spectrum data. However, using receiver operating characteristic curve analysis, theta/delta ratio ≤0.484 was the best cutoff to discriminate between the two measures (positive predictive value, 100.0; 95% confidence interval 71.0 to 100)., Conclusions: In healthy term neonates, immature electroencephalographic patterns, lack of clearly defined sleep-wake cycles, and frequent transients can be considered normal electroencephalographic findings in the first six hours of life. Normative power spectrum data are provided. These findings suggest that neonatal adaptation immediately after birth leads to transient changes in brain function., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Osteosarcoma is one of the most common types of cancer in childhood and adolescence and it is the most common malignant bone tumor in this group of age. Osteosarcoma is frequently found in long bones of the extremities. There are very few cases described in children under 5 years of age, and according to this review, none in infants. The telangiectatic variant is uncommon, and there are no reported cases before preschool age., Case Report: A 10-month-old female infant with a lithic tumor of the ninth right rib, which was classified after resection as a telangiectatic osteosarcoma, is presented., Conclusions: Telangiectatic osteosarcoma in the pediatric age is very uncommon. To date, the patient has presented good response to treatment, although the prognosis and survival of this condition is unknown., (Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.)

Background and Aim: Endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNA) is traditionally carried out with the stylet, as it is believed to prevent blockage or contamination of the needle by tissue coming from the gastrointestinal wall. However, this recommendation has not been demonstrated on an empirical basis. The aim of the present study was to compare the yield of EUS-FNA in a very large series of patients with (S+) and without (S-) the stylet., Methods: Until 2004, the stylet was used for EUS-FNA in our center. After that, the stylet was never used. The results of all EUS-FNA in solid lesions carried out by one endosonographer with the same needle type were compared before and after stylet use was stopped., Results: 3364 EUS-FNA procedures (in 3078 patients) in solid lesions were included (1483 S+ and 1881 S-). There was no significant difference between the S+ and S- results for any variable other than the number of passes required. The number of passes was significantly lower in the S- group when sampling lymph nodes, wall lesions and when carrying out biopsies through the gastric or rectal wall. However the statistical differences disappeared after controlling for malignancy, location and lesion size., Conclusion: This very large comparative study showed no benefit in diagnostic yield when using the stylet for EUS-FNA., (© 2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.)

Flea beetles of alligator weed, Alternanthera philoxeroides (Martius) Grisebach (Amaranthaceae), were collected in Argentina, Uruguay, Paraguay, and Brazil. Species in the genera Disonycha Chevrolat, Agasicles Jacoby, Systena Chevrolat and Phenrica Bechyné were frequently found on this weed. Phenrica littoralis (Bechyn6) was the most abundant within this genus. The male is described and the holotype female is redescribed adding new diagnostic characters of the mouthparts, hind wings, metendosternite, and male and female genitalia. Larva and pupa are described and illustrated for the first time providing data for future phylogenetic studies in the subtribe Disonychina.

Background: It is well-established that the risk of postpolypectomy bleeding (PPB) increases with polyp size, but little is known about the factors that predict PPB in polyps larger than 10 mm., Aim: The aim of this study is to assess the incidence and risk factors for PPB in colorectal polyps larger than 10 mm., Methods: A historical cohort study was carried out in an open access endoscopy unit from January 2007 to December 2008. Endoscopic polypectomy was performed in 1894 (28%) patients. Clinical records of patients with polyps of at least 10 mm were reviewed. Data on demographics, comorbidity, polyp-related features, and resection technique were collected. The incidence of immediate bleeding (during polypectomy) and delayed bleeding (up to 1 month later) was assessed., Results: A total of 424 large polyps (median size=12 mm; P₂₅-P₇₅: 10-16 mm) were resected. Thirty-five episodes of PPB occurred in 33 (7.8%) polyps, of which 12 (2.8%) were delayed. Multivariate logistic regression analysis demonstrated that a polyp size of at least 14 mm was the most important predictor of PPB [odds ratio (OR) 3.17, 95% confidence interval (CI) 1.492-6.751, P=0.003], compared with the presence of a villous architecture (OR 2.23, 95% CI 1.056-4.705, P=0.035) or high-grade dysplasia (OR 2.96, 95% CI 1.305-6.692, P=0.009)., Conclusion: In the current study, the rate of PPB was almost 8% in polyps larger than 10 mm, occurring in most cases during the endoscopic procedure. A polyp of size at least 14 mm was the most important predictor for PPB. Prospective studies are needed to determine whether preventive endoscopic therapy may reduce PPB in these patients.

Study Design: A historical cohort study., Objective: To evaluate the reproducibility of this measure in proximal junctional kyphosis (PJK) and to determine whether differences exist between first and second vertebrae angles., Summary of Background Data: There are no previous studies on the precision and accuracy of selecting the first or the second vertebra above the upper instrumented vertebrae to determine the degree of spinal angulation after surgery.In several studies, the first or the second vertebrae above the upper instrumented vertebrae (UIV) have been selected to measure the angle of PJK in a surgical setting. However, to our knowledge, no studies have addressed the reliability of this measure.We aimed to evaluate the reproducibility of this measure in PJK and to determine whether differences exist between first and second vertebrae angles., Methods: A total of 38 randomly ordered radiologic digital images were obtained at 2 different times from 19 consecutive patients (aged 18.4 +/- 6.0 years at intervention) surgically treated for scoliosis. Using these images in a blinded manner, 2 surgeons independently measured angles at both the first and second vertebrae above the UIV. The measures were repeated in different periods to test intra- and intersurgeon concordances., Results: For 152 measures, intrasurgeon concordance correlation coefficients ranged from 0.78 to 0.92 (high to very high reproducibility) and comparative intersurgeon concordance correlation coefficients ranged from 0.55 to 0.80 (moderate to high reproducibility). No differences were found between the first and the second vertebrae angles., Conclusion: Good reproducibility and agreement using the first and second vertebrae above the UIV to measure the angle of PJK was found in this study.