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Primary upper tract carcinoma in situ (UTcis) is a rare disease whose diagnosis and natural history are poorly understood. Radical nephroureterectomy is the standard of care but in imperatives or selected cases, topical instillations of Bacillus Calmette-Guérin (BCG) may represent a good alternative. The aim of this study was to report the histologic response to BCG instillations for the treatment of biopsy-proven UTcis and to systematically assess the current evidence on topical BCG instillation for the treatment of UTcis. This is a retrospective analysis of patients with biopsy-proven UTcis treated with BCG instillation between 1995 and 2020 in an expert center. The initial diagnosis was performed by a standardized random biopsy scheme during ureterorenoscopy (URS) in patients with positive cytology but negative CT and bladder biopsies. BCG course consisted of 6 weekly instillation of 81 mg Immucyst (Sanofi Pasteur MSD AG, Baar, Switzerland). Administration techniques were single-J, double-J and nephrostomy tube. The primary outcome was the rate of complete histological response at the 3-month 2nd-look-URS. Kaplan-Meier analysis curves assessed recurrence- and progression-free survival. A total of 22 patients (23 renal units) were included. Twenty-one (91.3%) patients completed the planned 6-week instillation cycle. Only one major complication was recorded (renal tuberculosis). Twenty patients had a 3-month 2nd-look-URS, with a complete histological response achieved in 17/20 cases (85%). After a median time of follow-up of 40 months (30-62), 8/20 patients harbored disease recurrence, including 5 cases of disease progression (≥pT2). The main limitations are the retrospective and non-comparative design of the study. Our systematic review (CRD42022324876) identified 15 studies (289 renal units). UTcis suffers from the lack of a standardized definition, and considerable heterogeneity has been found in making the diagnosis and assessing the response to treatment. Our study is the first to propose a histological diagnosis of UTcis as well as a histological re-evaluation of the response to treatment. Topical instillations of BCG appear to be a promising alternative, avoiding radical treatment in the majority of cases., Competing Interests: Declaration of Competing Interest The authors have nothing to disclose., (Copyright © 2022. Published by Elsevier Inc.)

Analyses of long-term temperature records based on satellite data have revealed an increase in the frequency and intensity of marine heatwaves (MHWs) in the world oceans, a trend directly associated with global change according to climate model simulations. However, these analyses often target open ocean pelagic systems and rarely include local scale, field temperature records that are more adequate to assess the impact of MHWs close to the land-sea interface. Here, we compared the incidence and characteristics of open ocean MHWs detected by satellites with those observed in the field over two decades (1998-2019) at two temperate intertidal locations in the central Cantabrian Sea, southern Bay of Biscay. Satellite retrievals tended to smooth out cooling events associated with intermittent, alongshore upwelling, especially during summer. These biases propagated to the characterization of MHWs and resulted in an overestimation of their incidence and duration close to the coast. To reconcile satellite and field records, we developed a downscaling approach based on regression modeling that enabled the reconstruction of past temperatures and analyze MHW trends. Despite the cooling effect due to upwelling, the temperature reconstructions revealed a six-fold increase in the incidence of MHWs in the Cantabrian Sea over the last four decades. A comparison between static (no trend) vs. dynamic (featuring a linear warming trend) MHW detection thresholds allowed us to attribute over half of the increase in MHW incidence to the ocean warming trend. Our results highlight the importance of local processes to fully characterize the complexity and impacts of MHWs on marine coastal ecosystems and call for the conservation of climate refugia associated with coastal upwelling to counter the impacts of climate warming., 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 © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Our purpose was to study the mechanical properties and phase transformations of orthodontic wires submitted to in-vivo exposure in the mouth for different periods of time., Methods: Stainless steel wires were tied to fixed orthodontic appliances of 30 patients from the orthodontics clinic of Universidade Federal do Rio de Janeiro School of Dentistry in Brazil. According to the duration of the clinical treatment, the patients were divided into 3 groups. After in-vivo exposure, the samples were studied by mechanical testing (torsion) and ferromagnetic resonance. Statistical analyses were carried out to evaluate the correlation between time of exposure, mechanical properties, and austenite-to-martensite transformation among the groups., Results: The results were compared with as-received control samples. The torque values increased as time in the mouth increased. The increase in torque resistance showed high correlations with time of exposure (P = 0.005) and austenite-martensite phase transformation., Conclusions: The resistance of stainless steel orthodontic wires increases as the time in the mouth increases; this effect is attributed to the austenite-to-martensite transformation., (Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)