ABSTRACT Purpose: To report the clinical findings, treatments, and outcomes in a series of patients with vitreous metastasis from cutaneous melanoma. Methods: This single-center, retrospective, interventional case series included patients with biopsy-confirmed vitreous metastasis from cutaneous melanoma diagnosed between 1997 and 2020. Standard 23- or 25-gauge pars plana vitrectomy was performed for diagnostic sampling. Sclerotomies were treated with double or triple freeze-thaw cryotherapy. Perioperative intravitreal injections of melphalan (32 µg/0.075 mL) were administered, when indicated. Visual acuity, intraocular pressure, and systemic and ocular treatment responses were reported. Results: Five eyes of five patients with unilateral vitreous metastasis from cutaneous melanoma were identified. The median age at diagnosis was 84 (range, 37-88) years. The median follow-up after ophthalmic diagnosis was 28 (8.5-36) months; one patient did not have a follow-up. The initial visual acuity ranged from 20/30 to hand motions. Baseline clinical findings included pigmented or non-pigmented cellular infiltration of the vitreous (5/5), anterior segment (4/5), and retina (3/5). Four patients had secondary glaucoma. Systemic therapy included checkpoint inhibitor immunotherapy (n=3, all with partial/complete response), systemic chemotherapy (n=2), surgical resection (n=3), and radiation (n=2). The median time from primary diagnosis to vitreous metastasis was 2 (2-15) years. One patient had an active systemic disease at the time of vitreous metastasis. The final visual acuity ranged from 20/40 to no light perception. Ophthalmic treatment included vitrectomy in all five patients, intravitreal administration of melphalan in three, and intravitreal administration of methotrexate in one. One patient required enucleation, and histopathology revealed extensive invasion by melanoma cells. Conclusions: Vitreous metastasis from cutaneous melanoma can present as a diffuse infiltration of pigmented or non-pigmented cells into the vitreous and may be misdiagnosed as uveitis. Diagnostic pars plana vitrectomy and periodic intravitreal chemotherapy may be indicated.

RESUMO Objetivo: Descrever os achados clínicos, tratamentos, e desfechos em uma série de pacientes com me tástases vítreas de melanoma cutâneo. Métodos: Série retrospectiva de casos de único centro com intervenção. Pacientes incluídos tiveram seu diagnóstico de MVMC confirmado por biópsia entre 1997 e 2020. Vitrectomia via pars plana com 23 ou 25 gauge foram realizadas para obter espécimens. Esclerotomias foram tratadas com crioterapia em duplo ou triplo congelamento. Injeção intravítrea perioperatória de melfalano (32 ug/0,075 mL) foi administrada quando necessário. Foram relatados acuidade visual, pressão intraocular, resposta terapêutica sistêmica e ocular. Resultados: Cinco olhos de 5 pacientes com metástases vítreas de melanoma cutâneo unilateral foram identificados. Idade média de diagnóstico foi 84 anos (variando de 37-88). Seguimento médio após diagnóstico oftalmológico foi 28 (8,5-36) meses; 1 paciente não teve acompanhamento. Acuidade visual inicial variou de 20/30 a movimentos de mão. Achados clínicos iniciais incluíram infiltração de células pigmentadas e não-pigmentadas no vítreo (5/5), segmento anterior (4/5), e retina (3/5). Quatro pacientes tiveram glaucoma secundário. Tratamento sistêmico incluiu imunoterapia com inibidores da via de sinalização (3 - todos com resposta parcial/completa), quimioterapia sistêmica (2), ressecção cirúrgica (3), e irradiação (2). Intervalo médio entre diagnóstico primário e metástases vítreas foi 2 (2-15) anos. Um paciente teve doença sistêmica ativa simultânea as metástases vítreas. Acuidade visual final variou entre 20/40 e SPL. Tratamento oftalmológico incluiu vitrectomia nos 5 pacientes, melfalano intravítreo em 3 e metotrexato intravítreo em 1. Um paciente precisou de enucleação. A histopatologia revelou invasão celular extensa de melanoma. Conclusões: Metástases vítreas de melanoma cutâneo pode se manifestar como uma infiltração difusa de células pigmentadas e não-pigmentadas no vítreo e erroneamente diagnosticada como uveites. Vitrectomia diagnóstica e quimioterapia intravítrea periódica podem estar indicadas.

RESUMO Objetivo: Descrever os achados clínicos, tratamentos, e desfechos em uma série de pacientes com me tástases vítreas de melanoma cutâneo. Métodos: Série retrospectiva de casos de único centro com intervenção. Pacientes incluídos tiveram seu diagnóstico de MVMC confirmado por biópsia entre 1997 e 2020. Vitrectomia via pars plana com 23 ou 25 gauge foram realizadas para obter espécimens. Esclerotomias foram tratadas com crioterapia em duplo ou triplo congelamento. Injeção intravítrea perioperatória de melfalano (32 ug/0,075 mL) foi administrada quando necessário. Foram relatados acuidade visual, pressão intraocular, resposta terapêutica sistêmica e ocular. Resultados: Cinco olhos de 5 pacientes com metástases vítreas de melanoma cutâneo unilateral foram identificados. Idade média de diagnóstico foi 84 anos (variando de 37-88). Seguimento médio após diagnóstico oftalmológico foi 28 (8,5-36) meses; 1 paciente não teve acompanhamento. Acuidade visual inicial variou de 20/30 a movimentos de mão. Achados clínicos iniciais incluíram infiltração de células pigmentadas e não-pigmentadas no vítreo (5/5), segmento anterior (4/5), e retina (3/5). Quatro pacientes tiveram glaucoma secundário. Tratamento sistêmico incluiu imunoterapia com inibidores da via de sinalização (3 - todos com resposta parcial/completa), quimioterapia sistêmica (2), ressecção cirúrgica (3), e irradiação (2). Intervalo médio entre diagnóstico primário e metástases vítreas foi 2 (2-15) anos. Um paciente teve doença sistêmica ativa simultânea as metástases vítreas. Acuidade visual final variou entre 20/40 e SPL. Tratamento oftalmológico incluiu vitrectomia nos 5 pacientes, melfalano intravítreo em 3 e metotrexato intravítreo em 1. Um paciente precisou de enucleação. A histopatologia revelou invasão celular extensa de melanoma. Conclusões: Metástases vítreas de melanoma cutâneo pode se manifestar como uma infiltração difusa de células pigmentadas e não-pigmentadas no vítreo e erroneamente diagnosticada como uveites. Vitrectomia diagnóstica e quimioterapia intravítrea periódica podem estar indicadas.

ABSTRACT Purpose: To report the clinical findings, treatments, and outcomes in a series of patients with vitreous metastasis from cutaneous melanoma. Methods: This single-center, retrospective, interventional case series included patients with biopsy-confirmed vitreous metastasis from cutaneous melanoma diagnosed between 1997 and 2020. Standard 23- or 25-gauge pars plana vitrectomy was performed for diagnostic sampling. Sclerotomies were treated with double or triple freeze-thaw cryotherapy. Perioperative intravitreal injections of melphalan (32 µg/0.075 mL) were administered, when indicated. Visual acuity, intraocular pressure, and systemic and ocular treatment responses were reported. Results: Five eyes of five patients with unilateral vitreous metastasis from cutaneous melanoma were identified. The median age at diagnosis was 84 (range, 37-88) years. The median follow-up after ophthalmic diagnosis was 28 (8.5-36) months; one patient did not have a follow-up. The initial visual acuity ranged from 20/30 to hand motions. Baseline clinical findings included pigmented or non-pigmented cellular infiltration of the vitreous (5/5), anterior segment (4/5), and retina (3/5). Four patients had secondary glaucoma. Systemic therapy included checkpoint inhibitor immunotherapy (n=3, all with partial/complete response), systemic chemotherapy (n=2), surgical resection (n=3), and radiation (n=2). The median time from primary diagnosis to vitreous metastasis was 2 (2-15) years. One patient had an active systemic disease at the time of vitreous metastasis. The final visual acuity ranged from 20/40 to no light perception. Ophthalmic treatment included vitrectomy in all five patients, intravitreal administration of melphalan in three, and intravitreal administration of methotrexate in one. One patient required enucleation, and histopathology revealed extensive invasion by melanoma cells. Conclusions: Vitreous metastasis from cutaneous melanoma can present as a diffuse infiltration of pigmented or non-pigmented cells into the vitreous and may be misdiagnosed as uveitis. Diagnostic pars plana vitrectomy and periodic intravitreal chemotherapy may be indicated.

RESUMO A manifestação oftálmica mais frequentemente relatada da infecção por SARS-CoV-2 é a conjuntivite. Trata-se de estudo de caso de retinopatia tipo Purtscher em uma paciente com coagulopatia grave associada ao COVID-19. Uma jovem com múltiplas comorbidades foi admitida por síndrome do desconforto respiratório agudo relacionado ao COVID-19. Seu quadro foi complicado pela fungemia. O exame oftálmico revelou pólo posterior bilateral, lesões intraretinianas e o fluconazol foi adicionado para tratar a retinite fúngica presumida. No decorrer de uma semana, manchas largas peripapilares de algodão e hemorragias sugestivas de retinopatia tipo Purtscher foram observadas. Os dímeros D, o fibrinogênio e a proteína c-reativa estavam acentuadamente elevados antes da nossa consulta, indicando um estado pró-trombótico e pró-inflamatório precedente. O duplex venoso subsequente revelou trombose venosa profunda nas veias subclávia direita e jugular interna. Os índices de fatores von Willebrand estavam marcadamente elevados, sugerindo coagulopatia grave associada ao COVID-19. A retinopatia tipo Purtscher, uma microangiopatia oclusiva rara foi descrita em várias condições pró-inflamatórias e pró-trombóticas. Para nosso conhecimento, este é o primeiro relatório de retinopatia tipo Purtscher com coagulopatia associada ao COVID-19.

ABSTRACT The most frequently reported ophthalmic manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is conjunctivitis. We have described a case of Purtscher-like retinopathy in a patient with severe coronavirus disease 2019 (COVID-19)-associated coagulopathy. A young woman with multiple comorbidities was admitted for COVID-19-related acute respiratory distress syndrome. Her course was complicated by fungemia. Ophthalmic examination revealed bilateral posterior pole, intraretinal lesions and fluconazole was added for presumed fungal retinitis. At 1-week follow-up, widespread peripapillary cotton-wool spots and hemorrhages suggestive of Purtscher-like retinopathy were observed. The levels of D-dimers, fibrinogen, and C-reactive protein were markedly elevated prior to our consultation, indicating preceding prothrombotic and pro-inflammatory states. Subsequent venous duplex revealed deep venous thrombosis in the right subclavian and internal jugular veins. Von Willebrand factor indices were markedly elevated, suggesting severe COVID-19-associated coagulopathy. Purtscher-like retinopathy, a rare occlusive microangiopathy has been described in various pro-inflammatory and prothrombotic conditions. To the best of our knowledge, this is the first report of Purtscher-like retinopathy in COVID-19-associated coagulopathy.

This study explored the inter-ethnic relations and experiences of students at a higher education institution, using an exploratory case study approach. Purposive sampling was used to select students belonging to black South African ethnic groups. Semi-structured interviews were used to collect data from three participants; interpretative phenomenological analysis was used for analysis. The themes extracted were ethnic identity: identity confusion vs. certainty; personal experiences of inter-ethnic relations; and majority and minority ethnic groups' experiences. Identity salience was found to not particularly be integral to the cultivation of inter-ethnic relations. Moreover, participants' inter-ethnic experiences were varied; some were positive, and others, negative. Relations between majority and minority ethnic groups are seemingly supported by existing literature, as majority ethnic group members typically initiated negative interactions, more so than did minority ethnic groups. Future studies should interrogate inter-ethnic dynamics on a broader scale, and explore ethnic bullying and its impact on inter-ethnic relations.

Resumen Introducción: Existen problemas y acertijos en la comprensión de la reproducción, el crecimiento y la mortalidad en los ciclos de vida de los equinodermos. Objetivo: Explorar los problemas y acertijos en los ciclos de vida que son importantes y desafiantes. Métodos: La literatura es usada para dilucidar los problemas asociados con todas las etapas de vida. Resultados: Las fuentes de larvas que se asientan en un sitio se exploran usando modelos oceanográficos y métodos genéticos. Existen pocos estudios que han estimado la mortalidad larval del plancton bajo condiciones de campo y los resultados difieren de los resultados experimentales o los patrones de asentamiento. En un número pequeño de estudios, la tasa de mortalidad de las larvas recién asentadas parece cambiar rápidamente a medida que los organismos crecen. Existen problemas para medir tamaños y el sesgo de medición interfiere con el uso de muchos métodos de marcado para estimar el crecimiento. También hay problemas con el uso de las líneas de crecimiento natural y con los programas comúnmente usados para estimar tanto el crecimiento como la mortalidad a partir de datos de frecuencia de tamaño. Un acertijo interesante es que los equinodermos pueden mostrar senescencia negativa con una tasa de mortalidad que disminuye con el tamaño. Existe un problema con el éxito de la fertilización basado en la densidad, por lo que no debería haber especies raras cuando los sexos están separados y existe un desove libre de gametos, sin embargo, parece haber equinodermos raros. Conclusiones: Todas las partes de los ciclos de vida de los equinodermos proveen problemas y acertijos que son importantes y desafiantes.

Abstract Introduction: There are problems and puzzles in understanding reproduction, growth and mortality in echinoderm life cycles. Objective: Explore problems and puzzles in life cycles that are important and challenging. Methods: The literature is used to elucidate problems associated with all life stages. Results: Sources of larvae that settle at a site are explored using oceanographic modelling and genetic methods. There are few studies that have estimated larval mortality in the plankton under field conditions and results differ from experimental results or patterns of settlement. In a small number of studies, mortality rate of newly settled larvae appears to change rapidly as individuals grow. There are problems measuring size, and measurement bias that interferes with many tagging methods used to estimate growth. There also are problems with the use of natural growth lines and commonly used software to estimate both growth and mortality from size-frequency data. An interesting puzzle is that echinoderms may show negative senescence with mortality rate decreasing with size. There is a problem in fertilization success based on density so there should not be rare species where sexes are separate with free spawning of gametes yet there seem to be rare echinoderms. Conclusions: All parts of echinoderm life cycles provide problems and puzzles that are important and challenging.

Resumo Considerado o aumento da complexidade prática das paisagens midiáticas, a complexidade teórica da comunicação midiática tem que ser ampliada (no horizonte e na moldura) e aprofundada (no foco) — especialmente para cumprir a missão de aprimorar a qualidade dessa ciência: gerando complexidade em um nível de teoria lógica para um assunto que não é um objeto em si mesmo, mas uma metáfora de descrição culturalmente programada: comunicação, cultura, sociedade, etc. A complexidade da comunicação, da mídia ou da sociedade não é um caráter desses construtos em si, mas uma complexidade de pensamento que, na prática, espera-se que seja reduzida, ao passo que na teoria seja produzida. Encarar (mais) a comunicação como uma performance cultural da humanidade e da prática social, e encarar a mídia (mais hermeneuticamente do que tecnicamente) requer conceituar aqueles construtos como modelos de conhecimento, como programas que culturalmente buscam significados conscientes e relevância significativa da vida social. Portanto, é necessário que haja uma mudança de paradigmas de conceitos funcionais e objetivistas para outros que sejam hermeneuticamente abertos — não apenas, mas também para gerar um quadro mais amplo de análise e interpretação das mudanças sociais e culturais, referidas pelo caráter de midialidade da comunicação e da sociedade. As chamadas mídias sociais não são novas mídias, mas mostram tanto a possibilidade, quanto o desafio e a oportunidade de mudança de ordens da mídia. Sem dúvidas, isso requer outros (novos) conceitos de competência da prática social.

Abstract At least since the practical complexity of media landscapes is growing, the theoretical complexity of media communication has to be widened (horizon and frame) and deepened (focus) — especially when fulfilling the mission and the quality of science: generating complexity on a level of logical theory towards a subject that is not an object by itself but a culturally programmed metaphor of description: communication, culture, society etc. The complexity of communication, media or society is not a character of those constructs themselves but a complexity of thinking, in practice hopefully reduced, in theory hopefully produced. Facing communication (more) as a cultural performance of humanness and of social practice and facing media (more hermeneutically than technically) demands to conceptualize those constructs as models of knowledge, as culturally programs in search of mindful meaning and meaningful relevance of social /societal life. Therefore, there is need of a shifting paradigm from functional, objectivist concepts to hermeneutically open concepts — not only, but also to generate a wider frame of analysis and interpretation of social and cultural change referred through the mediality character of communication and society. So called social media are not new media but show the possibility as well the challenge and chance of change of media orders. Of course, that demands other (new) competence concepts of social practice.

Abstract: The vaquita (Phocoena sinus), an endemic porpoise of the Gulf of California, México, was first described scientifically in 1958, from three skulls. It is considered a sister taxon of an ancestor of the Southern Hemisphere Burmeister’s porpoise (P. spinipinnis) and spectacled porpoise (P. dioptrica), a case of antitropical distribution and speciation. Vaquita in modern times seem to have existed largely in waters 10 to 30 m deep of the very northern Gulf of California, and may have already existed in relatively low numbers by the 1950s and 1960s. The external appearance of the vaquita was not described until the late 1970s, and not until the 1980s and 1990s did additional information about ecology and biology emerge. Those studies and more recent shipboard and aerial visual line transect surveys, as well as stationary and boat-towed acoustic arrays, mapped occurrence patterns and approximate numbers in greater detail than before. The first credible estimates of abundance appeared in the 1990s, with numbers in the mid-hundreds and declining. While several reasons for the decline were originally postulated, mortality due to entanglement in nets has been established as the only known cause of decline, especially due to bycatch in large-mesh gillnets set for the endangered croaker fish totoaba (Totoaba macdonaldi). This fish is prized in China for human consumption of its swim bladder, generally ground up for purported therapeutic purposes. An extensive, lucrative fishery for totoaba, now illegal for many decades, has existed since at least the 1920s, and has recently increased. Although there have been laudable attempts to stem or halt totoaba fishing, these have largely been unsuccessful, and as of this writing the vaquita is on the brink of extinction. However, rapid concentrated action against illegal fishing with gillnets may yet save the species, and hope (with attendant action) must be kept alive. This overview is followed by an appendix of a previously unpublished popular essay by K.S. Norris describing when, where, and how he first discovered the species, and subsequent early work relative to this newly-described porpoise.

Resumen: La vaquita marina (Phocoena sinus), una marsopa endémica del Golfo de California, México, fue descrita científicamente por primera vez en 1958, a partir de tres cráneos. Se considera un taxón hermano de un ancestro de la marsopa de Burmeister del hemisferio sur (P. spinipinnis) y la marsopa de anteojos (P. dioptrica), un caso de distribución y especiación antitropical. En los tiempos modernos, la vaquita marina parece haber existido principalmente en aguas de 10 a 30 m de profundidad en el extremo norte del Golfo de California, y es posible que ya existiera en cantidades relativamente bajas en las décadas de 1950 y 1960. La apariencia externa de la vaquita no se describió hasta fines de la década de 1970, y no fue hasta las décadas de 1980 y 1990 cuando surgió información adicional sobre ecología y biología. Esos estudios y los estudios más recientes de transectos de líneas visuales aéreas y a bordo, así como los arreglos acústicos estacionarios y remolcados por bote, cartografiaron patrones de ocurrencia y números aproximados con mayor detalle que antes. Las primeras estimaciones creíbles de abundancia aparecieron en la década de 1990, con cifras de alrededor de cientos y en declive. Si bien originalmente se postularon varias razones para la disminución, la mortalidad debida al enredo en las redes se ha establecido como la única causa conocida de disminución, especialmente debido a la captura incidental en redes de enmalle de malla grande colocadas para la totoaba corvina (Totoaba macdonaldi), en peligro de extinción. Este pescado es apreciado en China para el consumo humano de su vejiga natatoria, generalmente molido con supuestos propósitos terapéuticos. Una pesquería extensa y lucrativa de totoaba, ahora ilegal durante muchas décadas, ha existido desde al menos la década de 1920 y ha aumentado recientemente. Aunque ha habido loables intentos de detener o detener la pesca de totoaba, en gran parte no han tenido éxito y, al momento de escribir este artículo, la vaquita está al borde de la extinción. Sin embargo, una acción rápida y concentrada contra la pesca ilegal con redes de enmalle aún puede salvar a la especie, y la esperanza (con la acción correspondiente) debe mantenerse viva. A esta descripción general le sigue un apéndice de un ensayo popular inédito de K.S. Norris describiendo cuándo, dónde y cómo descubrió la especie por primera vez, y los primeros trabajos posteriores relacionados con esta marsopa recién descrita.

Background: Cardiac and renal diseases commonly occur with bidirectional interactions. We hypothesized that cardiac and inflammatory biomarkers may assist in identification of patients with type 2 diabetes mellitus (T2DM) at high risk of worsening renal function. Methods: In this exploratory analysis from SAVOR-TIMI 53, concentrations of high-sensitivity cardiac troponin T (hs-TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP) were measured in baseline serum samples of 12310 patients. The primary end point for this analysis was a ≥40% decrease in estimated glomerular filtration rate (eGFR) at end of treatment (EOT) at a median of 2.1 years. The relationships between biomarkers and the end point were modeled using adjusted logistic and Cox regression. Results: After multivariable adjustment including baseline renal function, each biomarker was independently associated with an increased risk of ≥40% decrease in eGFR at EOT [Quartile (Q) Q4 vs Q1: hs-TnT adjusted odds ratio (OR), 5.63 (3.49-9.10); NT-proBNP adjusted OR, 3.53 (2.29-5.45); hs-CRP adjusted OR, 1.84 (95% CI, 1.27-2.68); all P values ≤0.001]. Furthermore, each biomarker was independently associated with higher risk of worsening of urinary albumin-to-creatinine ratio (UACR) category (all P values ≤0.002). Sensitivity analyses in patients without heart failure and eGFR >60 mL/min provided similar results. In an adjusted multimarker model, hs- TnT and NT-proBNP remained significantly associated with both renal outcomes (all P values <0.01). Conclusions: hs-TnT, NT-proBNP, and hs-CRP were each associated with worsening of renal function [reduction in eGFR (≥40%) and deterioration in UACR class] in high-risk patients with T2DM. Patients with high cardiac or inflammatory biomarkers should be treated not only for their risk of cardiovascular outcomes but also followed for renal deterioration.

Antecedentes: Las enfermedades cardiaca y renal se manifiestan comunmente con interacciones bidireccionales. Nuestra hipotesis es que los biomarcadores cardiacos e inflamatorios pueden ser utiles en la identificacion de pacientes con diabetes mellitus tipo 2 (DM2) de alto riesgo de deterioro de la funcion renal. Métodos: En el presente analisis exploratorio del estudio SAVOR-TIMI 53, las concentraciones de troponina T cardiaca de alta sensibilidad (TnT-us), propeptido natriuretico cerebral N-terminal (NT-proBNP) y proteina C-reactiva de alta sensibilidad (PCR-us) fueron medidas en muestras basales de suero de 12.310 pacientes. El punto final primario para este analisis fue una disminucion mayor al 40% en la tasa de filtracion glomerular estimada (TFGe) al final del tratamiento (FdT) en una mediana de seguimiento de 2,1 anos. Las relaciones entre los biomarcadores y el punto final se modelaron utilizando regresion logistica ajustada y regresion de Cox. Resultados: Despues de la regresion logistica ajustada, incluyendo la funcion renal basal, cada biomarcador se asocio independientemente con mayor riesgo de una disminucion mayor o igual al 40% en la TFGe al FdT [Cuartil (Q) Q4 vs Q1: cociente de probabilidades (CP) ajustado de TnT-us fue 5,63 (IC 95%, 3,49-9,10); para NTproBNP CP ajustado, 3,53 (IC 95%, 2,29-5,45); OR ajustado para PCR-us, 1,84 (IC 95%, 1,27-2,68); todos los valores con p≤0,001]. Ademas, cada biomarcador se asocio de manera independiente con mayor riesgo de empeoramiento en la categoria de la relacion albumina/ creatinina urinaria (RACu) (p≤0,002 en todos los casos). Los analisis de sensibilidad en pacientes sin insuficiencia cardiaca y TFGe >60 mL/min demostraron resultados similares. En un modelo ajustado de marcadores multiples (multi-marcador), TnT-us y NT-proBNP se mantuvieron significativamente asociados con ambos puntos finales renales (p<0,01 en todos los casos). Conclusiones: TnT-us, NT-proBNP y PCR-us se asociaron con el empeoramiento de la funcion renal [reduccion de la TFGe (≥40%) y deterioro en la categoria de RACu] en pacientes con DM2 de alto riesgo. Los pacientes con biomarcadores cardiacos o inflamatorios elevados deben ser tratados no solo por su riesgo de resultados cardiovasculares, sino tambien monitoreados en cuanto a su deterioro renal.

ABSTRACT Introduction: Tables predicting the probability of a positive bone scan in men with non-metastatic, castrate-resistant prostate cancer have recently been reported. We performed an external validation study of these bone scan positivity tables. Materials and Methods: We performed a retrospective cohort study of patients seen at a tertiary care medical center (1996-2012) to select patients with non-metastatic, castrate-resistant prostate cancer. Abstracted data included demographic, anthropometric, and disease-specific data such as patient race, BMI, PSA kinetics, and primary treatment. Primary outcome was metastasis on bone scan. Multivariable logistic regression was performed using generalized estimating equations to adjust for repeated measures. Risk table performance was assessed using ROC curves. Results: We identified 6.509 patients with prostate cancer who had received hormonal therapy with a post-hormonal therapy PSA ≥2ng/mL, 363 of whom had non-metastatic, castrate-resistant prostate cancer. Of these, 187 patients (356 bone scans) had calculable PSA kinetics and ≥1 bone scan. Median follow-up after castrate-resistant prostate cancer diagnosis was 32 months (IQR: 19-48). There were 227 (64%) negative and 129 (36%) positive bone scans. On multivariable analysis, higher PSA at castrate-resistant prostate cancer (4.67 vs. 4.4ng/mL, OR=0.57, P=0.02), shorter time from castrate-resistant prostate cancer to scan (7.9 vs. 14.6 months, OR=0.97, P=0.006) and higher PSA at scan (OR=2.91, P <0.0001) were significantly predictive of bone scan positivity. The AUC of the previously published risk tables for predicting scan positivity was 0.72. Conclusion: Previously published risk tables predicted bone scan positivity in men with non-metastatic, castrate-resistant prostate cancer with reasonable accuracy.

Resume Les fouilles archéologiques réalisées dans le cadre du Proyecto Arqueológico Río La Venta [Projet Archéologique Río La Venta] dans la Selva El Ocote, Chiapas, ont permis l’étude de plusieurs bains de vapeur (ou temazcal) dans des sites zoques datés entre le Classique récent–terminal et le Postclassique récent. Particulièrement remarquable, l’un d’entre eux, un monumental bain de vapeur rectangulaire de la période Classique récent–terminal, placé au centre du site archéologique El Higo est quasi identique à ceux provenant des fouilles de San Antonio, Chiapas, et de Malpasito, Tabasco, tous deux associés à des terrains de jeux de balle. Ces trois bains de vapeur monumentaux, datés du Classique récent–terminal, appartiennent à une même typologie attribuable à une phase de grand essor culturel des groupes zoques du Chiapas et du Tabasco. Leurs caractéristiques suggèrent une modalité spécifique de jeu de balle associée à des pratiques rituelles qui auraient fortement favorisé la cohésion sociopolitique au sein de la sphère culturelle zoque. Les nouvelles données relatives aux bains de vapeur du postclassique –de forme circulaire, et parfois associés à des plates-formes également circulaires– constituent une contribution de premier ordre dans la connaissance d’une phase tardive de la culture zoque, encore peu connue du point de vue archéologique. Dans cet article nous passons en revue les données archéologiques relatives aux bains de vapeur de l'aire zoque afin de contextualiser les découvertes faites dans le cadre du Proyecto Arqueológico Río La Venta [Projet Archéologique Río La Venta], exposées ici de manière systématique pour la première fois.

Abstract The archaeological researches carried out by the Rio La Venta Archaeological Project in the Selva El Ocote, Chiapas, led to the discovery and excavation of various sweatbaths in Zoque sites dated between the Late Classic and the Late Postclassic; foremost among them, a Late-Terminal Classic rectangular monumental sweatbath located in the site of El Higo, almost identical to those previously excavated in the sites of San Antonio, Chiapas, and Malpasito, Tabasco, both of them associated to ballcourts. The three Late Classic monumental sweatbaths, belong to the same typology ascribable to a period of great cultural flourishing of Zoquean groups in Chiapas and Tabasco. This suggests that a specific modality of ballgame and associated ritual practices helped foster sociopolitical cohesion in the Zoquean cultural sphere. The new data regarding the Postclassic sweatbaths, circular in shape and at times associated to circular platforms, constitutes a first contribution to increase our knowledge of a still poorly understood phase of pre-Hispanic Zoquean cultural history. In this article we summarize the archaeological data on Zoque sweatbaths in order to provide a meaningful context for the findings of the Rio La Venta Archaeological Project in the Selva El Ocote, systematically described herein for the first time.

Resumen Las excavaciones arqueológicas llevadas a cabo por el Proyecto Arqueológico Río La Venta en la Selva El Ocote, Chiapas, han permitido investigar varios baños de vapor en sitios zoques fechados entre el Clásico Tardío-Terminal y el Posclásico Tardío; entre ellos destaca un monumental baño de vapor rectangular del periodo Clásico Tardío-Terminal, ubicado en el centro del sitio arqueológico de El Higo. Este temazcal es casi idéntico a los previamente excavados en los sitios de San Antonio, Chiapas, y Malpasito, Tabasco, ambos asociados a juegos de pelota. Los tres baños de vapor monumentales del Clásico Tardío-Terminal pertenecen a una misma tipología relacionada con una fase de gran florecimiento cultural de los grupos zoqueanos de Chiapas y Tabasco. Sus características sugieren que una modalidad específica de juego de pelota, junto con los rituales asociados a ella, constituyó un fuerte elemento de cohesión sociopolítica de la esfera cultural zoqueana. Los datos relativos a los baños de vapor posclásicos, de forma circular y a veces asociados a plataformas también circulares, son un primer acercamiento a una fase tardía de la cultura zoque, aún poco conocida desde el punto de vista arqueológico. En el presente artículo se resumen, asimismo, los datos arqueológicos relativos a otros baños de vapor hallados en el área zoque, contextualizando así los hallazgos del Proyecto Arqueológico Río La Venta, que se describen en forma sistemática por primera vez.

ABSTRACT Comparisons of the external morphology and analysis of osteological features of the postcranial and appendicular skeletons of three southwestern Atlantic flatfish species of the genus Paralichthys (P. isosceles, P. orbignyanus and P. patagonicus) were carried out. Bones are described, and detailed morphological, morphometric and meristic characteristics of these flounders are given in order to provide information about the external and internal morphology of three species of Paralichthys occurring in the south-west Atlantic waters that add new information and will help regarding within the framework of a phylogenetic study of the group. Interspecific differences were found in the number of vertebrae and intermuscular bones, as well as in the morphology and morphometry of vertebrae, caudal skeletons, pectoral and pelvic girdle bones. Relationships between bones are discussed and bone characteristics compared with those found in other species of Paralichthys and in other pleuronectiform species. The position of Paralichthys isosceles within Paralichthys is discussed, along with other congeners such as P. triocellatus and P. oblongus.

RESUMEN Se llevaron a cabo comparaciones de la morfología externa y el análisis de las características osteológicas de los esqueletos postcraneal y apendicular de tres especies de peces planos del Atlántico sudoccidental del género Paralichthys (P. isosceles, P. orbignyanus y P. patagonicus). Se describen los huesos, y se proporcionan características morfológicas, morfométricas y merísticas detalladas de estos lenguados con el fin de aportar información sobre la morfología externa e interna de tres especies de Paralichthys presentes en el Atlántico sudoccidental. Esta nueva información contribuirá al marco de un estudio filogenético del grupo. Se encontraron diferencias interespecíficas en el número de vértebras y huesos intermusculares, así como en la morfología y morfometría de las vértebras, los esqueletos caudales, los huesos de las cinturas pectoral y pélvica. Se discuten las relaciones entre los huesos y las características óseas en comparación con las encontradas en otras especies de Paralichthys y de otros Pleuronectiformes. Se discute la posición de Paralichthys isosceles dentro del género Paralichthys, junto con otros congéneres como P. oblongus y P. triocellatus.

Abstract Climatological data indicate that Gulf of California (GC) waters are warmed in spring by the exchange of waters with the Pacific Ocean. To better understand this exchange, hydrographic observations were collected across the entrance to the GC during 19-21 April 2013. Results indicated an anticyclonic exchange with the Pacific Ocean. Strong outflow of Gulf of California Water (GCW) occurred over the outer continental shelf and slope of Sinaloa with maximum velocities of 0.5 m∙s-1 at ~60 m depth and reaching ~500 m depth. Inflow close to the Baja California Peninsula was weaker (0.1-0.2 m·s-1) and transported both California Current Water and GCW. Satellite altimeter data indicated a possible reason for this flow pattern at the entrance to the GC: a couple of eddies to the east blocked the usual path of California Current flow toward Sinaloa. Horizontal transports integrated across the gulf were calculated with observed velocity and geostrophic balance. Transports were greatest in the upper 200 m, with outflow above 500 m depth, implying a net cooling of these upper layer waters in the gulf. Observations were compared with data collected in early May 1992. April 2013 exhibited much greater thermohaline variability in the upper ocean than May 1992, when a well developed cyclonic flow was observed at the entrance to the GC. The transports estimated with Pegasus for April-May 1992 were very different from those estimated for April 2013, when inflow (and heat gain) dominated above 500 m depth. The contrast between the 2013 and 1992 measurements is an example of how mesoscale eddies can reverse normal seasonal exchanges at the entrance to the GC.

Resumen Datos climatológicos indican que las aguas del golfo de California (GC) se calientan en primavera por el intercambio de aguas con el océano Pacífico. Para entender mejor este intercambio, se recolectaron datos hidrográficos en la entrada al GC del 19 al 21 de abril de 2013. Los resultados indicaron un intercambio anticiclónico. Hubo un flujo intenso de salida de Agua del Golfo de California (AGC) sobre la parte exterior de la plataforma continental y el talud continental de Sinaloa, con velocidades máximas de 0.5 m·s-1 a 60 m y hasta ~500 m de profundidad. El flujo de entrada ocurrió cerca de la península de Baja California, fue más débil (0.1-0.2 m·s-1) y transportó Agua de la Corriente de California y AGC. Los datos de altimetría satelital indicaron una posible razón para este patrón de flujo: un par de remolinos al este de la entrada bloquearon la trayectoria del flujo de la corriente de California hacia Sinaloa. Los transportes horizontales integrados fueron calculados con la velocidad observada y el balance geostrófico. Los transportes fueron mayores en los 200 m superiores, con flujo de salida arriba de 500 m de profundidad, lo que implica un enfriamiento neto de las aguas en la capa superior del golfo. Las observaciones se compararon con datos de mayo de 1992. En abril de 2013 se observó una mayor variabilidad termohalina que en mayo de 1992, con un flujo ciclónico bien desarrollado en la entrada al GC. Los transportes estimados para abril y mayo de 1992 con Pegasus fueron muy diferentes a los transportes estimados para abril de 2013, donde el flujo de entrada (y aumento de calor) dominaron por encima de los 500 m de profundidad. El contraste entre las mediciones de 2013 y 1992 es un ejemplo de cómo los remolinos de mesoescala pueden revertir los intercambios estacionales en la entrada al GC.

The comparison of anatomical traits between organisms has been a central topic in comparative biology. Historically, taxanomic classification and biological diversity understanding have been based on morphological descriptions. Derived from a mathematical quantitative revolution, morphological studies have experienced an important renewal due to the development of shape analysis rooted in statistical multivariate methods and novel visualisation techniques. The aim of the present review is to provide an updated perspective regarding the progress in geometric morphometrics (GMM) applied to evolutionary biology, as well as introducing to cutting-edge subjects (e.g. developmental stability, modularity, morphological integration, among other themes). Thus, it is expected to provide a broad point of view with respect to the appliaction of geometric morphometrics in evolutionary biology, highlighting its usefulness as an effective, accurate, user-friendly and inexpensive method to quantify and study shape variation.

La comparación de caracteres anatómicos entre organismos ha sido un elemento central de la biología comparada. Históricamente, la clasificación taxonómica y la comprensión de la diversidad biológica se han basado en descripciones morfológicas. En base a una revolución matemática cuantitativa, el estudio de la morfología ha tenido un importante énfasis gracias al desarrollo del análisis de la forma mediante la combinación de métodos estadísticos multivariados y nuevas maneras de visualización. El objetivo de la presente revisión es dar una visión actualizada sobre los avances del estudio de la morfometría geométrica (MG) en biología evolutiva, así como introducir a temáticas en fuerte desarrollo (e.g. estabilidad del desarrollo, integración y modularidad morfológicas, entre otras). Se espera proporcionar una visión amplia del uso de la MG en biología evolutiva, destacando la necesidad de aumentar el esfuerzo de investigación en esta disciplina, junto con llamar la atención acerca de la utilidad de la MG como una herramienta efectiva, precisa, amigable y barata para cuantificar y estudiar la variación morfológica.

The transition from hunting and gathering to agriculture has been associated with a gracilization in human form, especially in long bones. This has been interpreted as result of an increasingly sedentary lifestyle and reduced workload in the farming populations. However the majority of these evidences have been based on the application of different biomechanical techniques or the qualitative assessment of distinct morphological traits on attachment sites. Hence, this study tried to address whether is possible to distinguish between two different populations (hunter-gatherers and farmers) by quantifying their femoral morphology applying geometric morphometrics. We compared 16 male left femora belonging to two populations of Native Americans from the same geographic region, yet temporally and behaviorally distinct, in order to test if geometric morphometrics were able to differentiate these based solely on the quantitative analysis of shape. The femora were scanned and then small portions of them were segmented in order to generate comparable 3D models. Hundred twelve equidistant landmarks were collected over the whole femoral sections and a Procrustes analysis was performed in order to obtain shape variables. Several PCAs were carried out to elucidate morphometric associations and cross-validated DAs were applied to distinguish between hunter-gatherers and farmers. These procedures were sequentially repeated using different landmarks subsets in order to try to establish the anatomical locations where bone functional adaptation mostly occurs: a) femoral cortex; b) medullary cavity; c) complete femoral section. The results here presented, showed that geometric morphometrics were able to distinguish between the two distinct lifestyles. Moreover, the contrasting results obtained from the analysis of the femoral cortex and the medullary cavity, suggest that long bone remodelling caused by lifestyle differences, mostly occurs on the outer surface of the femoral shaft. This study also showed a relative gracilization of the farmer as compared to the hunter-gatherers.

La transición desde la caza y la recolección a la agricultura ha sido asociada con una gracilización en la forma humana, especialmente en los huesos largos. Esto ha sido interpretado como resultado de un estilo de vida más sedentario y con menor carga de trabajo en las poblaciones agricultoras. Sin embargo, la mayoría de estas evidencias se han basado en técnicas biomecánicas o en la evaluación cualitativa de rasgos morfológicos en los sitios de inserción muscular. Este estudio intentó distinguir entre dos poblaciones diferentes (cazadores-recolectores y agricultores) mediante la cuantificación de su morfología femoral aplicando morfometría geométrica. Dieciséis fémures masculinos pertenecientes a dos poblaciones nativo americanas de la misma región geográfica, aunque temporal y conductualmente diferentes, fueron comparadas con la finalidad de probar si la morfometría geométrica era capaz de distinguirlas. Los fémures fueron escaneados y pequeñas porciones fueron segmentadas para generar modelos 3D. Se colectaron 112 hitos equidistantes sobre toda la superficie femoral y luego se realizó un análisis de Procusto para obtener variables de la forma. Diversos análisis de componentes principales se llevaron a cabo para establecer asociaciones morfométricas, así como también análisis discriminantes con validación cruzada para distinguir entre cazadores-recolectores y agricultores. Estos procedimientos fueron repetidos utilizando diferentes subconjuntos de hitos para establecer donde ocurre mayoritariamente la adaptación funcional del hueso: a) corteza femoral; b) cavidad medular; c) sección femoral completa. Los resultados aquí presentados mostraron que la morfometría geométrica permite distinguir entre ambos modos de vida. Además, los contrastantes resultados obtenidos del análisis de la corteza femoral y cavidad medular, sugieren que el remodelamiento óseo debido a diferentes estilos de vida ocurren mayoritariamente en la superficie de la diáfisis del fémur. Este estudio también mostró una relativa gracilización de la población agricultora al ser comparada con los cazadores-recolectores.