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Purpose: To describe a case of plateau iris syndrome (PIS) and angle-closure glaucoma (ACG) in a patient with nail-patella syndrome (NPS). Observation: A 33 year-old woman of Slovakian ancestry from Norway with a history of NPS presented with angle-closure secondary to plateau iris. At the time of her NPS diagnosis, she had no ocular pathology. Genetic testing revealed a rare de novo mutation in LMX1B [c.668G>C (p.Arg223Pro)]. Two years later, she experienced acute bilateral ocular pain and blurred vision in the setting of one year of reported visual loss. Subsequent ophthalmic examinations revealed closed angles and plateau iris OU with ACG OD and angle-closure OS. Perimetry showed superonasal visual field defects OD and no defects OS. Ocular coherence tomography (OCT) revealed thinning of the inferior pole of the optic nerve OD. Medical management proved ineffective. A laser peripheral iridotomy (LPI) OD was performed, without resolution of the angle-closure, and a diagnosis of plateau iris syndrome (PIS) was made. She was then treated with an argon laser peripheral iridoplasty (ALPI) and clear lens extraction with a posterior chamber intraocular lens (PCIOL) and goniosynechialysis OD, but her IOP remained elevated OU. She was referred to New York Eye and Ear Infirmary of Mount Sinai, where an LPI OS was performed, but angle-closure persisted, consistent with PIS. An ALPI OS with touch-up was performed, and her IOP normalized with dark-room gonioscopy revealing open angles OU. Conclusions And importance: NPS has been associated with ocular hypertension (OHTN) and open-angle glaucoma (OAG); however, to our knowledge, no association between NPS and angle-closure has previously been reported. The case described here, of a patient with a rare de novo mutation and ocular findings of PIS with associated ACG, represents a novel genetic and clinical presentation of NPS.

Objetivo: mapear a produção científica sobre Bibliografia no Portal de Periódicos da Capes, desde o ano de 1960 a 2019, buscando-se refletir sobre os direcionamentos de pesquisa que essa disciplina vem recebendo em seu arcabouço teórico. Método: a pesquisa foi efetuada junto ao portal de periódicos da Capes, nos dias 09 e 10 de outubro de 2019, mediante unicamente a seleção de publicações (artigos) relacionadas à temática “Bibliografia”. As buscas foram editadas e personalizadas a partir do item “Buscar Assunto”, optando-se pelo refinamento no item “Busca Avançada”. O preenchimento dos campos foi limitado aos fins da investigação, utilizando-se termos específicos e operadores booleanos. Foram determinados os períodos entre 1º de janeiro de 1960 a 10 de outubro de 2019 para as buscas. A investigação apresenta abordagem qualitativa e trata-se de um estudo exploratório e descritivo executado também por meio de revisão da literatura concernente à área. Resultado: levantou-se que as publicações sobre Bibliografia dentro de um determinado período direcionam-se mais para sua funcionalidade como ferramenta de mapeamento e representação dos saberes e do conhecimento para outras áreas, ou seja, sua aplicação como produto e atividade. No entanto, a partir das duas últimas décadas, pelo menos no que se refere às publicações científicas em forma de artigos de periódicos, já se percebeu um maior aprofundamento da sua esfera como campo disciplinar científico, bem como por suas interfaces teóricas. Conclusões: este estudo limitou-se à investigação dos artigos científicos publicados nos últimos 59 anos. Nesse sentido, entende-se e sugere-se o desenvolvimento de trabalhos que tratem das publicações em diferentes formatos como de livros, bases de repertórios ou repositórios, eventos científicos, entre outras áreas de disseminação científicas e em variados períodos temporais e/ou recortes disciplinares, para preenchimento das lacunas investigativas ainda existentes. Iniciativas que fortaleceriam ainda mais o arcabouço científico da Bibliografia.

In this paper, we propose to quantitatively compare loss functions based on parameterized Tsallis–Havrda–Charvat entropy and classical Shannon entropy for the training of a deep network in the case of small datasets which are usually encountered in medical applications. Shannon cross-entropy is widely used as a loss function for most neural networks applied to the segmentation, classification and detection of images. Shannon entropy is a particular case of Tsallis–Havrda–Charvat entropy. In this work, we compare these two entropies through a medical application for predicting recurrence in patients with head–neck and lung cancers after treatment. Based on both CT images and patient information, a multitask deep neural network is proposed to perform a recurrence prediction task using cross-entropy as a loss function and an image reconstruction task. Tsallis–Havrda–Charvat cross-entropy is a parameterized cross-entropy with the parameter α. Shannon entropy is a particular case of Tsallis–Havrda–Charvat entropy for α=1. The influence of this parameter on the final prediction results is studied. In this paper, the experiments are conducted on two datasets including in total 580 patients, of whom 434 suffered from head–neck cancers and 146 from lung cancers. The results show that Tsallis–Havrda–Charvat entropy can achieve better performance in terms of prediction accuracy with some values of α.

BackgroundInflammatory factors and low HDL-C relate to CHD risk, but whether inflammation attenuates any protective association of high HDL-C is unknown.ObjectiveInvestigate inflammatory markers' individual and collective impact on the association of HDL-C with incident coronary heart disease (CHD).MethodsIn 3,888 older adults without known cardiovascular disease (CVD), we examined if the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and lipoprotein-associated phospholipase A2 (Lp-PLA2) modify the relation of HDL-C with CHD. HDL-C, CRP, IL-6, and Lp-PLA2 values were grouped as using gender-specific tertiles. Also, an inflammation index of z-score sums for CRP, IL-6, and Lp-PLA2 was categorized into tertiles. We calculated CHD incidence for each HDL-C/inflammation group and performed Cox regression, adjusted for standard CVD risk factors and triglycerides to examine the relationship of combined HDL-C-inflammation groups with incident events.ResultsCHD incidence (per 1,000 person years) was higher for higher levels of CRP, IL-6, and the index, and lower for higher levels of HDL-C. Compared to high HDL-C/low-inflammation categories (referent), adjusted HRs for incident CHD were increased for those with high HDL-C and high CRP (HR=1.50, p

RESUMO Objetivo avaliar a influência da variável sexo nos valores da latência e amplitude da onda V do potencial evocado auditivo de tronco encefálico, com diferentes estímulos em neonatos. Métodos participaram deste estudo 62 neonatos nascidos a termo (29 do sexo feminino e 33 do sexo masculino). Realizou-se a pesquisa de limiar eletrofisiológico do potencial evocado auditivo de tronco encefálico com quatro estímulos diferentes (clique, Ichirp banda larga-BL, tone burst e Ichirp-frequência específica-FE), nas intensidades de 60, 40 e 20 dBnNA. A variável sexo foi comparada para cada estímulo e intensidade. Resultados os resultados obtidos demonstraram menor latência e maior amplitude no sexo feminino para o estímulo clique. Entretanto, para o estímulo tone burst, o sexo feminino apresentou maior latência e maior amplitude. Quando utilizados os estímulos Ichirp-BL e Ichirp-FE, a variável sexo não apresentou diferença estatisticamente significativa para os valores de latência e amplitude. Conclusão a onda V do PEATE de neonatos sofre influência da variável sexo, quando utilizados os estímulos clique e tone burst. Entretanto, não houve tal influência quando utilizado o estímulo Ichirp banda larga–BL e o estímulo Ichirp frequência específica-FE.

A distribuição do sistema radicular (SR) da videira em profundidade depende das condições físicas e químicas do solo e do porta-enxerto utilizado. Em um Nitossolo Vermelho em Videira, SC, onde o crescimento do SR da videira geralmente está limitado à camada superficial. Em condições de campo, foi implantado experimento com o cultivar copa Niágara Rosada cultivado sobre seis porta-enxertos. Em casa de vegetação foram testados oito porta-enxertos em colunas de solo com e sem calagem subsuperficial. No campo os porta-enxertos 101-14 Mgt e SO4 apresentaram SR mais profundo, enquanto VR 043-43 e Isabel foram bastante superficiais. Em colunas de solo os porta-enxertos VR 043-43, Rupestris du Lot e IAC 572 mostraram maior aprofundamento do SR. Os porta-enxertos SO4 e Rupestris du Lot tiveram o crescimento de raiz aumentado na camada de até 20cm em solo sem calagem subsuperficial quando comparado ao com calagem, enquanto os demais porta-enxertos não responderam à calagem subsuperficial. A análise conjunta dos experimentos indica que a acidez das camadas subsuperficiais do solo não é um fator restritivo para o aprofundamento do SR da videira.

Um experimento em condições de casa de vegetação foi instalado na Epagri/Estação Experimental de Videira, SC, com o objetivo de verificar o potencial alelopático de diferentes extratos de espécies de plantas daninhas sobre o crescimento de estacas enraizadas do porta-enxerto de videira VR 043-43. O delineamento experimental adotado foi inteiramente casualizado, com 17 tratamentos e 4 repetições. Foram preparados extratos das partes aérea e radicular de oito espécies de plantas daninhas, os quais foram utilizados para regar, duas vezes por semana, as estacas enraizadas do porta-enxerto durante 45 dias. Após esse período, foram avaliadas as massas fresca e seca das raízes e as brotações, assim como o comprimento e o número médio de raízes das estacas. Os resultados obtidos indicam que os extratos das espécies de plantas daninhas estudadas apresentam efeitos alelopáticos positivos sobre o crescimento do porta-enxerto VR 043-43.

ABSTRACT Objective To evaluate the impact of training in the Practical Life Room on patients experience during hospitalization. Methods Subjects submitted to orthopedic surgeries were randomized to two groups (Control and Intervention) in the postoperative period. The Control Group received only the printed guidelines regarding the postoperative period, and the Intervention Group received the printed guidelines and a demonstration and training session with a physical therapist, in an environment created to simulate a house and its rooms (living room, bedroom, kitchen, laundry and bathroom). The participants of both groups answered the questionnaire Hospital Consumer Assessment of Healthcare Providers and Systems on the day of discharge. Results Sixty-eight subjects were included in the study, 30 (44.1%) in the Control Group and 38 (55.9%) in the Intervention Group. The Hospital Consumer Assessment of Healthcare Providers and Systems questionnaire score showed no significant difference between the groups (p=0.496). Conclusion There was no influence of the proposed intervention on the results of the Hospital Consumer Assessment of Healthcare Providers and Systems questionnaire, perhaps because of the limitation of the instrument or due to the fact it was employed when patients were still hospitalized. However, by reports from patients in the Intervention Group about felling better prepared and safer for performing daily activities, it is believed that patient education approaches through demonstration should be included as part of the process to prepare for discharge, whenever possible.

SARS-CoV-2 can produce both severe clinical conditions and long-term sequelae, but data describing post-acute COVID-19 syndrome (PACS) are lacking for people living with HIV (PLWH). We aimed at assessing the prevalence and factors associated with severe COVID-19 and PACS in our cohort. We included all unvaccinated adult PLWH on antiretroviral treatment and plasma HIV-RNA < 40 cp/mL since at least six months before SARS-CoV-2 infection at the Infectious and Tropical Diseases Unit of Padua (Italy), from 20 February 2020 to 31 March 2021. COVID-19 severity was defined by WHO criteria; PACS was defined as the persistence of symptoms or development of sequelae beyond four weeks from SARS-CoV-2 infection. Demographic and clinical variables were collected, and data were analyzed by non-parametric tests. 123 subjects meeting the inclusion criteria among 1800 (6.8%) PLWH in care at the Infectious and Tropical diseases Unit in Padua were diagnosed with SARS-CoV-2 infection/COVID-19 during the study period. The median age was 51 years (40–58), 79.7% were males, and 77.2% of Caucasian ethnicity. The median CD4+ T-cell count and length of HIV infection were 560 cells/mmc (444–780) and 11 years, respectively. Of the patients, 35.0% had asymptomatic SARS-CoV-2 infection, 48% developed mild COVID-19, 17.1% presented moderate or severe COVID-19 requiring hospitalization and 4.1% died. Polypharmacy was the single independent factor associated with severe COVID-19. As for PACS, among 75 patients who survived SARS-CoV-2 symptomatic infection, 20 (26.7%) reported PACS at a median follow-up of six months: asthenia (80.0%), shortness of breath (50.0%) and recurrent headache (25.0%) were the three most common complaints. Only the severity of the COVID-19 episode predicted PACS after adjusting for relevant demographic and clinical variables. In our study, PLWH with sustained viral suppression and good immunological response showed that the risk of hospital admission for COVID-19 was low, even though the severity of the disease was associated with high mortality. In addition, the likelihood of developing severe COVID-19 and PACS was mainly driven by similar risk factors to those faced by the general population, such as polypharmacy and the severity of SARS-CoV-2 infection.

Abstract Objectives To propose an easily applicable segmentation method (perPET-RT) for delineation of tumour volume during radiotherapy on interim fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with non-small cell lung cancer (NSCLC). Material and methods Sixty-seven patients (51 primary tumours, 60 lymph nodes), from 4 prospective studies, underwent an FDG PET/CT scan during the fifth week of radiation therapy, using different generations of PET/CT. Per-therapeutic PET/CT scans were delineated in consensus by two experienced physicians leading to the gold standard threshold to be applied. The mathematical expression of Thopt, the optimal threshold to be applied as a function of the maximum standard uptake value (SUVmax), was determined. The performance of this method (perPET-RT) was assessed by computing the DICE similarity coefficient (DSC) and was compared with 8 fixed threshold values and 3 adaptive thresholding methods. Results Thopt verified the following expression: Thopt = A.ln(1/SUVmax) + B where A and B were 2 constants. A and B were independent from the generation of PET/CT, but depended on the type of lesions (primary lung tumours vs. lymph nodes). PerPET-RT showed good to very good agreement in comparison to the gold standard. The mean and standard deviation of DSC value was 0.81 ± 0.13 for lung lesions and 0.78 ± 0.15 for lymph nodes. PerPET-RT showed a significant better agreement than the other segmentation methods (p

Abstract Background In FDG-PET, SUV images are hampered by large potential biases. Our aim was to develop an alternative method (ParaPET) to generate 3D kinetic parametric FDG-PET images easy to perform in clinical oncology. Methods The key points of our method are the use of a new error model of PET measurement extracted from a late dynamic PET acquisition of 15 min, centered over the lesion and an image-derived input function (IDIF). The 15-min acquisition is reconstructed to obtain five images of FDG mean activity concentration and images of its variance to model errors of PET measurement. Our approach is carried out on each voxel to derive 3D kinetic parameter images. ParaPET was evaluated and compared to Patlak analysis as a reference. Hunter and Barbolosi methods (Barbolosi-Bl: with blood samples or Barbolosi-Im: with IDIF) were also investigated and compared to Patlak. Our evaluation was carried on K i index, the net influx rate and its maximum value in the lesion (K i,max). Results This parameter was obtained from 41 non-small cell lung cancer lesions associated with 4 to 5 blood samples per patient, required for the Patlak analysis. Compare to Patlak, the median relative difference and associated range (median; [min;max]) in K i,max estimates were not statistically significant (Wilcoxon test) for ParaPET (− 3.0%; [− 31.9%; 47.3%]; p = 0.08) but statistically significant for Barbolosi-Bl (− 8.0%; [− 30.8%; 53.7%]; p = 0.001), Barbolosi-Im (− 7.9%; [− 38.4%; 30.6%]; p = 0.007) or Hunter (32.8%; [− 14.6%; 132.2%]; p

The Cretaceous Oceanic Anoxic Event 2 represents one of the warmest episodes in the last 250 million years. Here, the authors present spore-pollen data and temperature estimates (TEX86) across an expanded stratigraphic section illustrating the dynamic response of vegetation during this exceptionally warm interval.

Summary: Cryptococcus neoformans (C. neoformans) is estimated to cause about 220,000 new cases every year in patients with AIDS, despite advances in antifungal treatments. C. neoformans possesses a remarkable ability to disseminate through an immunocompromised host, making treatment difficult. Here, we examine the mechanism of survival of C. neoformans under varying host conditions and find a role for ceramide synthase in C. neoformans virulence. This study also provides a detailed lipidomics resource for the fungal lipid research community in addition to discovering a potential target for antifungal therapy.

Description of the subject. Hop and oak extracts have been found to possess anti-methanogenic and protein-sparing effects in the rumen. Objectives and method. An in vitro incubation with ruminal fluid was conducted to study the effects of increasing inclusions of hop pellets and oak extracts, alone or in combination, on ruminal fermentation parameters. Results. The combination of hop pellets and oak extracts reduced total volatile fatty acid (VFA) production compared with the control (no additive), whereas these additives alone had no effect. The acetate/propionate ratio decreased with the combination of hop pellets and oak extracts, as compared to the control, whereas these additives alone had no effect. Hop pellets at the highest dose alone or in combination with oak extracts reduced the methane (CH4) production, as compared to the control. The CH4/VFA molar ratio was lower than the control for hop pellets at the highest dose combined with oak extracts, whereas the additives used alone had no effect. Ammonia N concentration was reduced by oak extracts treatments at the highest dose alone or in combination with hop pellets, as compared to the control. Conclusions. Hop pellets and oak extracts altered in vitro rumen fermentation with some responses being non-linear when used in combination.

The blast-furnace operating diagram proposed by Rist was revised to direct reduction and was specifically applied to the Midrex NGTM process. The use of this graphical tool in the study of an industrial process highlighted the staggered nature of the reduction in the shaft furnace with, in particular, the existence of a prereduction zone in the upper part where metallization is thermodynamically impossible. A sensitivity study also showed the impact of the in situ reforming rate on the ability of the gas to completely reduce iron oxides. Finally, we graphically defined the minimum quality required for the top gas to produce direct-reduced iron.

(1) Background: Implantation of metal-based scaffolds is a common procedure for treating several diseases. However, the success of the long-term application is limited by an insufficient endothelialization of the material surface. Nanostructured modifications of metal scaffolds represent a promising approach to faster biomaterial osteointegration through increasing of endothelial commitment of the mesenchymal stem cells (MSC). (2) Methods: Three different nanotubular Ti surfaces (TNs manufactured by electrochemical anodization with diameters of 25, 80, or 140 nm) were seeded with human MSCs (hMSCs) and their exosomes were isolated and tested with human umbilical vein endothelial cells (HUVECs) to assess whether TNs can influence the secretory functions of hMSCs and whether these in turn affect endothelial and osteogenic cell activities in vitro. (3) Results: The hMSCs adhered on all TNs and significantly expressed angiogenic-related factors after 7 days of culture when compared to untreated Ti substrates. Nanomodifications of Ti surfaces significantly improved the release of hMSCs exosomes, having dimensions below 100 nm and expressing CD63 and CD81 surface markers. These hMSC-derived exosomes were efficiently internalized by HUVECs, promoting their migration and differentiation. In addition, they selectively released a panel of miRNAs directly or indirectly related to angiogenesis. (4) Conclusions: Preconditioning of hMSCs on TNs induced elevated exosomes secretion that stimulated in vitro endothelial and cell activity, which might improve in vivo angiogenesis, supporting faster scaffold integration.

Background-: Mexican-Americans (MA) exhibit increases in various cardiovascular disease (CVD) risk factors compared to non-Hispanic Whites (NHW), yet are reported to have lower CVD mortality rates. Our aim was to help explain this apparent paradox by evaluating endothelial function and urine albumin levels in MA and NHW. Methods-: One hundred-five MA and 100 NHW adults were studied by brachial artery flow-mediated dilatation (FMD), blood and urine tests. Participants were studied by ultrasounddetermined brachial artery flow-mediated dilatation (FMD), blood and urine tests, at a single visit. Results-: Despite higher BMI and triglycerides in MA, MA demonstrated higher FMD than did NHW (9.1 +/- 7.3% vs. 7.1 +/- 6.3%, p < 0.04). Among MA, urinary albumin was consistently lower in participants with FMD = 7% FMD versus < 7% FMD (p < 0.006). In multivariate analyses in MA men, urinary albumin was inversely related to FMD (r = -0.26, p < 0.05), as were BMI and systolic blood pressure. In MA women, urinary albumin: creatinine ratio was an independent inverse predictor of FMD (p < 0.05). Conclusion-: To our knowledge, this is the first study to analyze, in asymptomatic adults, the relation of MA and NHW ethnicity to FMD and urine albumin levels. The findings confirm ethnic differences in these important subclinical CVD measures.

Aortic regurgitation (AR) and mitral regurgitation (MR) can result in serious clinical complications and death. The physiologic and clinical correlates of AR and MR in a free-living young adult population, however, have not been well defined. The prevalence and correlates of AR and MR were investigated in Coronary Artery Risk Development in Young Adults (CARDIA), a multicenter National Heart, Lung, and Blood Institute study of 4,352 men and women aged 21 to 35 years who had 2-dimensionally directed M-mode echocardiographic and spectral and color Doppler examinations. Isolated MR by color Doppler was detected in 10.4% (90.4% with trivial or mild severity). Isolated AR by color Doppler was present in 0.8% (37.7% with mild severity). Combined AR and MR occurred in 0.5%. There was no association between body mass index and the prevalence or severity of MR or AR. Left ventricular mass was greater in subjects with isolated AR (mean +/- SD 172 +/- 49 g) than in those with MR (155 +/- 48 g) and greater in both groups than in subjects without MR and AR (148 +/- 44 g). AR was associated with increased aortic root diameter, whereas subjects with isolated MR and those with AR and MR had increased left atrial dimensions and greater left ventricular internal dimensions. In conclusion, MR and AR detected by color Doppler echocardiography are relatively uncommon in a healthy young adult population, but both are associated with evidence of increased left ventricular dimensions and mass.