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Subarachnoid neurocysticercosis (SANCC) is caused by an abnormally transformed form of the metacestode or larval form of the tapeworm  Taenia solium . In contrast to vesicular parenchymal and ventricular located cysts that contain a viable scolex and are anlage of the adult tapeworm, the subarachnoid cyst proliferates to form aberrant membranous cystic masses within the subarachnoid spaces that cause mass effects and acute and chronic arachnoiditis. How subarachnoid cyst proliferates and interacts with the human host is poorly understood, but parasite stem cells (germinative cells) likely participate. RNA-seq analysis of the subarachnoid cyst bladder wall compared to the bladder wall and scolex of the vesicular cyst revealed that the subarachnoid form exhibits activation of signaling pathways that promote proliferation and increased lipid metabolism. These adaptions allow growth in a nutrient-limited cerebral spinal fluid. In addition, we identified therapeutic drug targets that would inhibit growth of the parasite, potentially increase effectiveness of treatment, and shorten its duration.

Racemose neurocysticercosis is an aggressive disease caused by the aberrant expansion of the cyst form of Taenia solium within the subarachnoid spaces of the human brain and spinal cord resulting in a mass effect and chronic inflammation. Although expansion is likely caused by the proliferation and growth of the parasite bladder wall, there is little direct evidence of the mechanisms that underlie these processes. Since the development and growth of cysts in related cestodes involves totipotential germinative cells, we hypothesized that the expansive growth of the racemose larvae is organized and maintained by germinative cells. Here, we identified proliferative cells expressing the serine/threonine-protein kinase plk1 by in situ hybridization. Proliferative cells were present within the bladder wall of racemose form and absent from the homologous tissue surrounding the vesicular form. Cyst proliferation in the related model species Taenia crassiceps (ORF strain) occurs normally by budding from the cyst bladder wall and proliferative cells were concentrated within the growth buds. Cells isolated from bladder wall of racemose larvae were established in primary cell culture and insulin stimulated their proliferation in a dose-dependent manner. These findings indicate that the growth of racemose larvae is likely due to abnormal cell proliferation. The different distribution of proliferative cells in the racemose larvae and their sensitivity to insulin may reflect significant changes at the cellular and molecular levels involved in their tumor-like growth. Parasite cell cultures offer a powerful tool to characterize the nature and formation of the racemose form, understand the developmental biology of T . solium , and to identify new effective drugs for treatment.

Background and objective Awake craniotomy (AC) is a valuable technique for surgical interventions in eloquent areas, but its adoption in low- and middle-income countries faces challenges like limited infrastructure, trained personnel shortage, and inadequate funding. This scoping review explores AC techniques in Latin American countries, focusing on patient characteristics, tumor location, symptomatology, and outcomes. Methods A scoping review followed PRISMA guidelines, searching five databases in English, Spanish, and Portuguese. We included 28 studies with 258 patients (mean age: 43, range: 11–92). Patterns in AC use in Latin America were analyzed. Results Most studies were from Brazil and Mexico (53.6%) and public institutions (70%). Low-grade gliomas were the most common lesions (55%), most of them located in the left hemisphere (52.3%) and frontal lobe (52.3%). Gross-total resection was achieved in 34.3% of cases. 62.9% used an Asleep-Awake-Asleep protocol, and 14.8% used Awake-Awake-Awake. The main complication was seizures (14.6%). Mean post-surgery discharge time was 68 h. Challenges included limited training, infrastructure, and instrumentation availability. Strategies discussed involve training in specialized centers, seeking sponsorships, applying for awards, and multidisciplinary collaborations with neuropsychology. Conclusion Improved accessibility to resources, infrastructure, and adequate instrumentation is crucial for wider AC availability in Latin America. Despite disparities, AC implementation with proper training and teamwork yields favorable outcomes in resource-limited centers. Efforts should focus on addressing challenges and promoting equitable access to this valuable surgical technique in the region.

Mesial temporal lobe epilepsy, one of the most common forms of epilepsy, is often linked with drug resistance. Surgical intervention is a reliable and safe treatment option, though research into postsurgical outcomes in our locality remains limited. We performed a retrospective observational study included 91 patients with mesial temporal lobe epilepsy and hippocampal sclerosis who had undergone anterior temporal lobectomy between 2012 and 2020 at a surgical epilepsy center located in Lima, Peru. Postoperative outcomes were analyzed using bivariate and multivariate analysis based on the Engel classification. We found that after 12 months of follow‐up, 78.65% of the 91 patients achieved an Engel IA classification, while 9.09% attained Engel IB classification and 11.24% were designated as Engel II, with only 1.12% classified as Engel IVA. The median QOLIE31 score was 84 (IQR: 75–90), with 74.16% of the participants successfully reintegrating into academic or employment activities. After 24 months, only 68 patients completed the follow‐up, with 69.12% achieving an Engel IA classification. Individuals with a secondary education or higher were more likely to achieve an Engel IA classification at 12 months (OR: 5.11; P = 0.005; CI: 1.63–16.01), after adjusting for sex and age. We concluded that most patients exhibited favorable outcomes after 1 year of follow‐up. However, lower educational attainment was linked to worse postsurgical outcomes.

Positron emission tomography-computed tomography with prostate-specific membrane antigen (PET-CT PSMA) has revolutionized the preoperative staging of prostate cancer, particularly for assessing seminal vesicle and lymph node invasion. However, its correlation and agreement with definitive histopathology remain unclear. The study aimed to evaluate the diagnostic performance, correlation, and agreement between PET-CT PSMA and final histopathological findings for seminal vesicle and lymph node invasion in patients undergoing robot-assisted radical prostatectomy. This retrospective, single-center study included 194 patients who underwent PET-CT PSMA and radical prostatectomy. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Correlation (Spearman's rho) and agreement (kappa coefficient) between PET-CT PSMA and final histopathology were analyzed. Seminal vesicle invasion was detected in 11.9% of cases by histopathology and 12.4% by PET-CT PSMA, while lymph node invasion was reported in 4.8% and 10.3%, respectively. PET-CT PSMA exhibited high specificity (91.23% for seminal vesicles, 92% for lymph nodes) and high NPVs (91.76% and 96.84%, respectively), but low sensitivity (39.13% and 40%) and low PPV for lymph nodes (20%). Correlation between PET-CT PSMA and histopathology was low for seminal vesicle invasion (rho = 0.298; p = 0.0001) and lymph node invasion (rho = 0.232; p = 0.017). Agreement was also poor for seminal vesicle invasion (kappa = 0.298) and lymph node invasion (kappa = 0.217). PET-CT PSMA demonstrates high specificity and NPV but low sensitivity, correlation, and agreement with final histopathology. While useful for ruling out disease, its positive findings should be interpreted with caution.

In this paper we explain the inexact date of the oldest archaeological sonorous object from Peru; a date that was frequently utilized in the latter three decades. The object, a flute of wood excavated by Engel in Chilca and now at The Agrarian University Museum, has not 7000 years B.P. [PUBLICATION ABSTRACT]

The evolution of Earth’s continental crust is crucial for understanding geodynamics, climate regulation, and the origins of life. The Paleoproterozoic, marked by the Great Oxidation Event and the consolidation of plate tectonics, was a critical interval for continental growth. While arc magmatism dominates crust formation in the Phanerozoic, its role in earlier Earth history remains uncertain. Three silicic LIPs in the Amazon Craton were emplaced at regular ~90-100 million-year intervals (1980 Ma, 1880 Ma, and 1790 Ma), producing high-temperature (>750 °C) silicic magmas derived from lower crust ( ~ 45 km thick). Our findings demonstrate that LIPs contributed significantly to continental crustal growth through deep-crustal partial melting of Archean-Rhyacian crust. We highlight that silicic LIP magmatism was a fundamental driver of continental differentiation and long-term stability during the Paleoproterozoic. Three silicic Large Igneous Provinces in the Amazon Craton, spaced some 90–100 Ma apart during the Paleoproterozoic, generated high-temperature magmas via deep-crustal melting—thus substantially contributing to continental crust growth and stability.

Twice-yearly subcutaneous lenacapavir has been shown to be efficacious for prevention of human immunodeficiency virus (HIV) infection in cisgender women. The efficacy of lenacapavir for preexposure prophylaxis (PrEP) in cisgender men, transgender women, transgender men, and gender-nonbinary persons is unclear. In this phase 3, double-blind, randomized, active-controlled trial, we randomly assigned participants in a 2:1 ratio to receive subcutaneous lenacapavir every 26 weeks or daily oral emtricitabine-tenofovir disoproxil fumarate (F/TDF). The primary efficacy analysis compared the incidence of HIV infection in the lenacapavir group with the background HIV incidence in the screened population. The secondary efficacy analysis compared the incidence of HIV infection in the lenacapavir group with that in the F/TDF group. Among 3265 participants who were included in the modified intention-to-treat analysis, HIV infections occurred in 2 participants in the lenacapavir group (0.10 per 100 person-years; 95% confidence interval [CI], 0.01 to 0.37) and in 9 participants in the F/TDF group (0.93 per 100 person-years; 95% CI, 0.43 to 1.77). The background HIV incidence in the screened population (4634 participants) was 2.37 per 100 person-years (95% CI, 1.65 to 3.42). The incidence of HIV infection in the lenacapavir group was significantly lower than both the background incidence (incidence rate ratio, 0.04; 95% CI, 0.01 to 0.18; P<0.001) and the incidence in the F/TDF group (incidence rate ratio, 0.11; 95% CI, 0.02 to 0.51; P = 0.002). No safety concerns were identified. A total of 26 of 2183 participants (1.2%) in the lenacapavir group and 3 of 1088 (0.3%) in the F/TDF group discontinued the trial regimen because of injection-site reactions. The HIV incidence with twice-yearly lenacapavir was significantly lower than the background incidence and the incidence with F/TDF. (Funded by Gilead Sciences; PURPOSE 2 ClinicalTrials.gov number, NCT04925752.).