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Introduction: Single Port (SP) robotic partial nephrectomy (RPN) can be performed via retroperitoneal and transperitoneal approach. We aim to describe low anterior access (LAA) with outcomes and compare outcomes to lateral flank approach (LFA). Materials and Methods: We performed a retrospective study of patients who underwent SP retroperitoneal RPN from 2018 -2023 as part of a large multi-institute collaboration (SPARC). Baseline demographic, clinical, tumor-specific characteristics, and perioperative outcomes were compared using χ2, t-test, Fisher exact test, and Mann–Whitney U test. Multivariable analyses were conducted using robust and logistic regressions. Results: A total of 70 patients underwent SP retroperitoneal RPN, with 44 undergoing LAA. The LAA group exhibited significantly lower median RENAL scores (8 vs. 5, p < 0.001) and more varied tumor locations (p = 0.002). When controlling for other variables, LAA was associated with shorter ischemia time (p = 0.005) than LFA, but there was no significant difference in operative time (p = 0.348) and length of stay (p = 0.122). Conclusion: Both LAA and LFA are acceptable approaches for SP retroperitoneal RPN with comparable perioperative outcomes.

Background and objective: Prostate-specific antigen (PSA) remains a critical marker for prostate cancer (PCa) detection and monitoring. Recognising historical variability in PSA assays and the evolution of assay technology and calibration, this study aims to reassess interassay variability using the latest generation of five assays in a contemporary cohort of men undergoing prostate biopsy. Methods: Five different commercially available PSA assays were tested in a blood sample of 76 men before undergoing a prostate biopsy. Total PSA (tPSA) and free-to-total PSA ratio (%fPSA) were compared across assays, using Roche (Basel, Switzerland) as the benchmark, and correlated with biopsy outcome to analyse the impact on PCa diagnosis. The statistical analysis included Passing-Bablok regression and Bland-Altman plots, with a p value threshold of 0.05). The variability across assays would have resulted in discrepancies in both the sensitivity and the specificity for tPSA and %fPSA by at least 14%, depending on the cut-offs applied. Conclusions and clinical implications: Despite the use of the latest PSA assays, relevant variability of tPSA and %fPSA results can be observed among different assays. There is an urgent need for standardised calibration methods and greater awareness among practitioners concerning interassay variability. Clinicians should acknowledge that clinically relevant thresholds may depend on the specific PSA assay and that ideally the same assay is applied over time for better clinical decision-making. Patient summary: Prostate-specific antigen (PSA) is a critical marker for prostate cancer (PCa) detection and monitoring. However, significant variations were observed in the results of the latest PSA assays. Thus, standardised calibration methods and greater awareness among practitioners concerning interassay variability are needed.

Abstract Objective Despite the wide-spread adoption of robotic-assisted surgery (RAS), the cost–benefit implications for partial (PN) and radical nephrectomy (RN) versus laparoscopic surgery (Lap) is not well established. We sought to examine the trend of adoption and 1-year healthcare expenditure of PN and RN, and compare 1-year expenditures of RAS versus Lap for PN and RN. Patients and methods This cohort study used the MerativeTM MarketScan® Databases between 2013 and 2020. A total of 5,353 patients with kidney cancer undergoing PN (2,980, 55.7%) or RN (2,373, 44.3%). We compared open-conversion, length of stay (LOS), index expenditure, 1-year healthcare expenditure and utilization, and missed work-days between RAS and Lap for PN and RN. Results Adoption of PN increased overtime (47.0% to 55.8%), mainly driven by robotic PN increase. Among PN, RAS had lower open-conversion, shorter LOS and lower index expenditure than Lap. Among RN, RAS had shorter LOS, and similar open-conversion and index expenditures. During 1-year post-discharge, RAS had lower hospital outpatient visits (IRR = 0.92, 95% CI = 0.85, 0.99, p = 0.029) and office-based visits (IRR = 0.91, 95% CI = 0.86, 0.96, p = 0.002) for PN, translating to a 1-day less (95% CI = 0.25, 1.75, p = 0.008) missed from work for RAS. Following RN, RAS had lower 1-year readmission than Lap (O.R = 0.72, 95% CI = 0.55, 0.94, p = 0.018). RAS and Lap had comparable 1-year post-discharge expenditures for both PN (mean difference, MD = -$475, 95% CI = -$4362, $3412, p = 0.810) and RN (MD = -$4,204, 95% CI = -$13,837, $5430, p = 0.404). Conclusion At index surgery, RAS was associated with shorter LOS for both PN and RN, and lower open-conversion and expenditures for PN. RAS and Lap had comparable 1-year total expenditures, despite lower healthcare visits for RAS.

Introduction: Participatory approaches to health often link capacity building as an indispensable process for strengthening the social capital of communities, in order to develop empowerment processes that lead to social transformation at the local level. In Pueblo Rico (Colombia), a capacity-building program in cutaneous leishmaniasis and social skills for community work was implemented with school students, health workers and local leaders. This article seeks to evaluate the implementation, results, and impact of that program. Methods: Primary data were collected through participant observation, questioners, the development of artistic products, and a focus group. Qualitative data were coded and analyzed through thematic analysis, and the quantitative data were quantitively coded and analyzed. Results: The capacity-building program had positive results in terms of the three aspects evaluated: the pedagogical model's implementation, the learning process, and the impact of the program. Three key elements that contributed to the success of the program were identified: the application of the principles of meaningful learning as a guide for the pedagogical model, the use of Social Innovation in Health case studies to broaden participant's perspective, and the creation of artistic products as facilitators for the appropriation of knowledge. Conclusion: Participatory pedagogical models adequate to the context and its participants allow the implementation of effective training programs that develop capacities within the communities. To achieve a significant impact, it is necessary to ensure the continuity and long-term sustainability of capacity building through transfer of knowledge with cooperation between health institutions and the community. In this way, the capacities developed by the community constitute a valuable social capital for achieving transformations within and outside the health field.

IntroductionThe different strategies used worldwide to curb the COVID-19 pandemic between 2020 and 2021 had a negative psychosocial impact, which was disproportionately higher for socially and economically vulnerable groups. This article seeks to identify the psychosocial impact of the confinement period during the COVID-19 pandemic for the Colombian population by identifying profiles that predict the levels of different mental health indicators (feelings of fear, positive emotions or feelings during free time, and work impact) and based on them, characterize the risk factors and protection that allows us to propose guidelines for prevention or recovery from future health emergencies.MethodsThis is an observational, cross-sectional, retrospective ex post facto study. Multistage cluster probabilistic sampling and binary logistic regression analysis were used to predict extreme levels of various mental health indicators based on psychosocial indicators of the COVID-19 confinement period and to identify risk and protection factors,ResultsA relationship was established between the combination of some of the different psychosocial factors evaluated (this combination being the predictive profile identified) with each of the three main variables: feeling of fear (n = 8,247; R = 0.32; p = 0.00; Poverall = 62.4%; 𝜔overall = 0.25; 1-𝛽overall = 1.00), positive emotions or feelings during free time (n = 6,853; R = 0.25; p = 0.00; Poverall = 59.1%; 𝜔overall = 0.18; 1-𝛽overall = 1.00) and labour impact (n = 4,573; R = 0.47; p = 0.63; Poverall = 70.4%; 𝜔overall = 0.41; 1-𝛽overall = 1.00), with social vulnerability determined by sociodemographic factors that were common in all profiles (sex, age, ethnicity and socioeconomic level) and conditions associated with job insecurity (unemployed, loss of health insurance and significant changes to job’s requirements) and place of residence (city).ConclusionFor future health emergencies, it is necessary to (i) mitigate the socio-employment impact from emergency containment measures in a scaled and differentiated manner at the local level, (ii) propose prevention and recovery actions through psychosocial and mental health care accessible to the entire population, especially vulnerable groups, (iii) Design and implement work, educational and recreational adaptation programs that can be integrated into confinement processes.

Background: Prediction of extracapsular extension (ECE) is essential to achieve a balance between oncologic resection and neural tissue preservation. Microultrasound (MUS) is an attractive alternative to multiparametric magnetic resonance imaging (mpMRI) in the staging scenario. Objective: To create a side-specific nomogram integrating clinicopathologic parameters and MUS findings to predict ipsilateral ECE and guide nerve sparing. Design, setting, and participants: Prospective data were collected from consecutive patients who underwent robotic-assisted radical prostatectomy from June 2021 to May 2022 and had preoperative MUS and mpMRI. A total of 391 patients and 612 lobes were included in the analysis. Outcome measurements and statistical analysis: ECE on surgical pathology was the primary outcome. Multivariate regression analyses were carried out to identify predictors for ECE. The resultant multivariable model's performance was visualized using the receiver-operating characteristic curve. A nomogram was developed based on the coefficients of the logit function for the MUS-based model. A decision curve analysis (DCA) was performed to assess clinical utility. Results and limitations: The areas under the receiver-operating characteristic curve (AUCs) of the MUS-based model were 81.4% and 80.9% (95% confidence interval [CI] 75.6, 84.6) after internal validation. The AUC of the mpMRI-model was also 80.9% (95% CI 77.2, 85.7). The DCA demonstrated the net clinical benefit of the MUS-based nomogram and its superiority compared with MUS and MRI alone for detecting ECE. Limitations of our study included its sample size and moderate inter-reader agreement. Conclusions: We developed a side-specific nomogram to predict ECE based on clinicopathologic variables and MUS findings. Its performance was comparable with that of a mpMRI-based model. External validation and prospective trials are required to corroborate our results. Patient summary: The integration of clinical parameters and microultrasound can predict extracapsular extension with similar results to models based on magnetic resonance imaging findings. This can be useful for tailoring the preservation of nerves during surgery.

Abstract Background The role of lung ultrasound (LUS) in evaluating the mid- and long-term prognoses of patients with COVID-19 pneumonia is not yet known. The objectives of this study were to evaluate associations between LUS signs at the time of screening and clinical outcomes 1 month after LUS and to assess LUS signs at the time of presentation with known risk factors for COVID-19 pneumonia. Methods This was a retrospective study of data prospectively collected 1 month after LUS screening of 447 adult patients diagnosed with COVID-19 pneumonia. Sonographic examination was performed in screening tents with the participants seated. The LUS signs (B-lines > 2, coalescent B-lines, and subpleural consolidations) were captured in six areas of each hemithorax and a LUS aeration score was calculated; in addition, the categories of disease probability based on patterns of LUS findings (high-probability, intermediate-probability, alternate, and low-probability patterns) were evaluated. The LUS signs at patients’ initial evaluation were related to the following outcomes: symptomatology, the need for hospitalization or invasive mechanical ventilation (IMV), and COVID-19-related death. Results According to the evaluations performed 1 month after LUS screening, 36 patients were hospitalised, eight of whom required intensive care unit (ICU) admission and three of whom died. The presence of coalescent B-lines was associated with the need for hospitalization (p = 0.008). The presence of subpleural consolidations was associated with dyspnoea (p

Objectives: To estimate typologies of Intimate Partner Violence against women in some Latin-American countries.Methods: Multistage sampling survey included women aged 15 to 49 (n = 63,321). Latent class analysis was estimated, including psychological, physical, and sexual violence and control.Results: The three-class model had a better fit. 1) The high-level IPV class (23%) comprised those suffering high levels of violence. They had higher education and wealth index, lived in urban settings, and their husbands used alcohol more. 2) The middle-level IPV class (45%) suffered high levels of control but low levels of other violence. They justified IPV more than other classes and this group had a high proportion of women without education. 3) Women in the non-IPV class (32%) did not report IPV.Conclusion: Three typologies of IPV were found: high-level, middle-level, and non-IPV. Policies should create screening, early prevention strategies, and programs based on these typologies. The high-level IPV group can benefit from intense legal and mental health interventions, including alcohol reduction and women’s empowerment. The middle-level IPV group could benefit from interventions to reduce violence justification and increase women’s education.

During the last decades, the growth of concern towards different pollutants has been increasing due to population activities in large cities and the great need for food production by the agri-food industry. The effects observed in specific locations have shown the impact over the environment in air, soil and water. Specifically, the current pandemic of COVID-19 has brought into the picture the intensive use of different medical substances to treat the disease and population intensive misuse. In particular, the use of antibiotics has increased during the last 20 years with few regulations regarding their excessive use and the disposal of their residues from different sources. Within this review, an overview of sources of antibiotics to aquatic environments was done along with its impact to the environment and trophic chain, and negative effects of human health due prolonged exposure which endanger the environment, population health, water, and food sustainability. The revision indicates the differences between sources and its potential danger due toxicity, and accumulation that prevents water sustainability in the long run.

Introduction: the cultural dimension of health, now clearly acknowledged (WHO, 2017), remains insufficiently explored. Particularly, investigating the cultural influence on the effectiveness of health interventions is relevant since, insofar as when such interventions lack meaning from the target population's cosmovision or are not practical in their context, the effectiveness of those interventions may have a limited scope (Bautista-Gómez et al, 2022), creating the need for culturally adapted health interventions. Aim: tto understand how cultural adaptations have been designed and implemented, and how they have contributed to improving health outcomes in low and middle-income countries. Methods: the guiding question was designed following the PICo methodology. PubMED, Scopus, and Web of Science databases were reviewed, the descriptors were established based on the MeSH/DeSC registry, and inclusion and exclusion criteria were defined. The initial articles were selected based on the appearance of the descriptors in their title and abstract, and then a filtering process was carried out based on the full reading of the texts that led to 14 articles that met the established criteria, on which a thematic analysis was carried out. Results: it was evidenced that: a) interventions are designed based on 3 components: community participation, adjustment of content, and changes in the service delivery; b) aspects related to poverty, vulnerability, and deficiencies in the health system are the main barriers, whilst the inclusion of the community’s beliefs and customs, adaptation to their context, and articulation with the communities and local health institutions are the main facilitators; c) main outcomes are feasibility, effectiveness, improvement of disease’s knowledge and acceptability. Conclusions: cultural adaptation with ethnic groups in vulnerable settings is useful to ensure comprehensive health education and to promote behavioural change to improve mainly the effectiveness and acceptability of health interventions. [ABSTRACT FROM AUTHOR]

Microalgae and cyanobacteria are photosynthetic microorganisms’ sources of renewable biomass that can be used for bioplastic production. These microorganisms have high growth rates, and contrary to other feedstocks, such as land crops, they do not require arable land. In addition, they can be used as feedstock for bioplastic production while not competing with food sources (e.g., corn, wheat, and soy protein). In this study, we review the macromolecules from microalgae and cyanobacteria that can serve for the production of bioplastics, including starch and glycogen, polyhydroxyalkanoates (PHAs), cellulose, polylactic acid (PLA), and triacylglycerols (TAGs). In addition, we focus on the cultivation of microalgae and cyanobacteria for wastewater treatment. This approach would allow reducing nutrient supply for biomass production while treating wastewater. Thus, the combination of wastewater treatment and the production of biomass that can serve as feedstock for bioplastic production is discussed. The comprehensive information provided in this communication would expand the scope of interdisciplinary and translational research.

Introduction: A risk factor during pregnancy is dental pathology, which can pose pathological consequences on the mother and the fetus. Objective: To describe oral health and related pathological events in pregnant women who attended prenatal and dental checkups at Assbasalud Empresa Social del Estado (ESE) in Manizales, Colombia, during 2013. Materials and methods: Descriptive study in which 502 clinical records of pregnant women who attended prenatal and dental checkups in Assbasalud ESE in Manizales were reviewed. Results: 75.1% of the patients attended between 1 and 3 dental checkups and 93.2% presented with dental pathologies during pregnancy, being gingivitis (75.4%) and cavities (67.6%) the most frequent. 21.1% of the sample did not have decayed teeth, while 30.4% had missing teeth. 79% had dental filling during pregnancy and 9.9% did not attend dental checkups. Conclusion: Assbasalud ESE offers good dental coverage during prenatal checkups though the efficient promotion and prevention of dental pathologies during pregnancy. Consequently, there is a low correlation between oral pathology and systemic diseases. In addition, a proper referral plan to third-level services is provided to pregnant women at risk of perinatal complications.