What do we know about dynamic glucose-enhanced (DGE) MRI and how close is it to the clinics? Horizon 2020 GLINT consortium report

Cancer is one of the most devastating diseases that the world is currently facing, accounting for 10 million deaths in 2020 (WHO). In the last two decades, advanced medical imaging has played an ever more important role in the early detection of the disease, as it increases the chances of survival and the potential for full recovery. To date, dynamic glucose-enhanced (DGE) MRI using glucose-based chemical exchange saturation transfer (glucoCEST) has demonstrated the sensitivity to detect both d-glucose and glucose analogs, such as 3-oxy-methyl-d-glucose (3OMG) uptake in tumors. As one of the recent international efforts aiming at pushing the boundaries of translation of the DGE MRI technique into clinical practice, a multidisciplinary team of eight partners came together to form the “glucoCEST Imaging of Neoplastic Tumors (GLINT)” consortium, funded by the Horizon 2020 European Commission. This paper summarizes the progress made to date both by these groups and others in increasing our knowledge of the underlying mechanisms related to this technique as well as translating it into clinical practice.

Perioperative Management of Pheochromocytomas and Sympathetic Paragangliomas

Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors arising from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia, respectively. PPGLs have the highest degree of heritability among endocrine tumors. Currently, ~40% of PPGL individuals have a genetic germline and there exist at least 12 different genetic syndromes related to these tumors. Metastatic PPGLs are defined by the presence of distant metastases at sites where chromaffin cells are physiologically absent. Approximately 10% of pheochromocytomas and ~40% of sympathetic paragangliomas are linked to metastases explaining why complete surgical resection is the first-choice treatment for all PPGL patients. The surgical approach is a high-risk procedure requiring perioperative management by a specialized multidisciplinary team in centers with broad expertise. In this review, we summarize and discuss the most relevant aspects of perioperative management in patients with pheochromocytomas and sympathetic paragangliomas.

Review of the research programme on the Mortella III wreck (2010-2020, Corsica, France): A contribution to the knowledge of the Mediterranean naval architecture and material culture of the Renaissance.

The Mortella wrecks are the remains of two navi, Genoese seagoing merchant ships, sunk in 1527 in the Bay of Saint-Florent (Upper-Corsica, France) during the Seventh Italian War. A programme of archaeological excavations and historical research has been held on one of them, Mortella III, between 2010 and 2020. It has involved a multidisciplinary team around a European research project called ModernShip (Horizon 2020), whose objective is to shed light on Mediterranean shipbuilding during the Renaissance, a field still little known to this day. At the end of these 10 years, the aim of the present article is to conclude this research programme with the presentation of a scientific review that complements a recently published monograph on the Mortella III wreck. This study presents the latest results on the ship's architecture obtained during the excavation of the wreck in 2019, including a study of the wood of the framework. Finally, this article broadens our understanding of the nave presenting the results of a collaborative line of research on material culture with three studies in close connection with the ship architecture: artillery, anchors and ceramics.

O cão como coterapeuta e os cuidados para a sua atuação em ambiente hospitalar

Este estudo teve por objetivo abordar a cinoterapia como modalidade terapêutica capaz de promover uma maior humanização do atendimento ao doente, atuando como ferramenta efetiva no tratamento do assistido, dando ênfase aos cuidados necessários para o emprego do cão no ambiente hospitalar. A humanização da saúde, hoje já bem discutida, apoia iniciativas que visem à transformação do ambiente hospitalar. Acredita-se que, através de pequenas ações, podemos amenizar a dor de muitos, contribuir para o sucesso dos tratamentos e para a diminuição do tempo de hospitalização. A Cinoterapia, apoiada por uma equipe multidisciplinar, tem assistido crianças e adultos hospitalizados por diferentes patologias, pacientes cardíacos, psiquiátricos, portadores de Alzheimer, Parkinson, AIDS, paralisia cerebral, acidente vascular cerebral, câncer entre outras. Mesmo diante da tendência mundial e do reconhecimento da importância da terapia, a implantação de projetos ainda tem sido dificultada pela carência de estudos que demonstrem o impacto do cão no ambiente hospitalar. O desconhecimento dos riscos inerentes à terapia, principalmente no que diz respeito à transmissão de doenças, assim como a falta de protocolos com normas específicas para a sua implantação, são alguns dos entraves para uma maior disseminação da técnica. The aim of this study was to approach Pet therapy as a therapeutic modality capable of promoting a greater humanization of patient care, acting as an effective tool in the treatment of the assisted, emphasizing the necessary care for the use of the dog in the hospital environment. The humanization of health, now well discussed, supports initiatives aimed at transforming the hospital environment. It is believed that, through small actions, we can ease the pain of many, contribute to the success of the treatments and decrease the length of hospitalization. Pet therapy, supported by a multidisciplinary team, has assisted children and adults hospitalized for different pathologies, cardiac patients, psychiatric patients with Alzheimer's, Parkinson's, AIDS, cerebral palsy, stroke, cancer, among others. Even in the face of the worldwide trend and recognition of the importance of therapy, the implementation of projects has still been hampered by the lack of studies that demonstrate the impact of the dog in the hospital environment. The lack of knowledge about the risks inherent to the therapy, especially regarding the transmission of diseases, as well as the lack of protocols with specific norms for its implantation, are some of the obstacles for a greater dissemination of the technique.

Sediments Suggest Vikings May Have Been the First to Settle the Azores

A multidisciplinary team studying lake sediments and climate change found evidence that the archipelago was inhabited 700 years earlier than historical sources claim.

Acceptability of Plant-Based Diets for People with Chronic Kidney Disease: Perspectives of Renal Dietitians

The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the acceptability of a hypothetical plant-based dietary prescription aiming for the consumption of 30 unique plant foods per week. This study used an exploratory mixed methods design. Forty-six renal dietitians participated in either an online survey (n = 35) or an in-depth interview (n = 11). Dietitians perceived that plant-based diets could address multiple clinical concerns relevant to CKD. Forty percent of survey respondents reported the hypothetical dietary prescription was realistic for people with CKD, 34.3% were unsure, and 25.7% perceived it as unrealistic. Strengths of the hypothetical prescription included shifting the focus to whole foods and using practical resources like recipes. Limited staffing, time, and follow-up opportunities with patients, as well as differing nutrition philosophies were the most commonly reported challenges to implementation; while a supportive multidisciplinary team was identified as an important enabler. To increase patient acceptance of plant-based dietary approaches, education about plant food benefits was recommended, as was implementing small, incremental dietary changes. Successful implementation of plant-based diets is perceived to require frequent patient contact and ongoing education and support by a dietitian. Buy-in from the multidisciplinary team was also considered imperative.