Usefulness of neck ultrasonography in the follow-up of patients with differentiated thyroid cancer

Neck ultrasonography (US) is recommended for the assessment of all patients with thyroid carcinoma after initial therapy, since even low-risk patients with undetectable stimulated thyroglobulin (Tg) may present cervical metastases. In the case of these metastases, US is the most sensitive method and is superior to whole-body 131I scanning. Cervical lymph nodes with a diameter > 5 mm presenting thin calcifications and/or cystic degeneration have almost always a malignant etiology. In the absence of these characteristics, a round shape and the absence of an echogenic hilum are suspicious findings, whereas elongated lymph nodes with a visible echogenic hilum are considered benign. Doppler flow analysis helps with the differential diagnosis, usually revealing peripheral or mixed hypervascularization in malignant cases. In the presence of suspicious lymph nodes upon US, fine-needle aspiration cytology and measurement of Tg in the needle lavage fluid are useful and complementary exams for the definition of the etiology, with the combination of the two methods showing elevated sensitivity and 100% specificity. US is also useful before thyroidectomy, even contributing in some cases to modify the surgical planning, and before ablation for the measurement of thyroid remnants and detection of persistent lymph node metastases. Another application of this imaging method is to guide the injection of ethanol (sclerotherapy) or the introduction of electrodes for radiofrequency ablation in selected cases of isolated lymph node metastases as an alternative to traditional therapies.A ultra-sonografia (US) cervical é recomendada na avaliação de todos pacientes com carcinoma de tireóide após a terapia inicial, pois mesmo indivíduos de baixo risco com tireoglobulina (Tg) estimulada indetectável podem apresentar metástases cervicais. Para estas metástases, a US é o método mais sensível, superior à pesquisa de corpo inteiro (PCI) com 131I. Linfonodos cervicais com diâmetro > 5 mm com calcificações finas e/ou degeneração cística quase sempre são de etiologia maligna. Na ausência destas características, o formato arredondado e a ausência do hilo ecogênico são achados suspeitos, enquanto linfonodos alongados e com hilo ecogênico visível são considerados benignos. A avaliação do fluxo, através do doppler, auxilia no diagnóstico diferencial, usualmente revelando hipervascularização periférica ou mista nos casos malignos. Na presença de linfonodos suspeitos na US, a avaliação citológica do material obtido através da punção aspirativa por agulha fina (PAAF) e a dosagem da Tg, obtida do lavado da agulha, são testes úteis e complementares para definir a etiologia, com elevada sensibilidade quando combinados e especificidade de 100%. A US também é útil antes da tiroidectomia, auxiliando e até, em alguns casos, modificando o planejamento cirúrgico; e antes da ablação, para mensuração dos remanescentes tireoidianos e pesquisa de metástases linfonodais persistentes. Outra aplicação desse método de imagem é guiar a injeção de etanol (escleroterapia) ou a introdução de eletrodos para ablação com radiofreqüência em casos selecionados de metástases linfonodais isoladas, como alternativa às terapias convencionais.Santa Casa de Belo Horizonte Serviço de EndocrinologiaInstituto Alpha de GastroenterologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de MedicinaUNIFESP, EPM, Depto. de MedicinaSciEL

Sequence-aware multimodal page classification of Brazilian legal documents

The Brazilian Supreme Court receives tens of thousands of cases each semester. Court employees spend thousands of hours to execute the initial analysis and classification of those cases -- which takes effort away from posterior, more complex stages of the case management workflow. In this paper, we explore multimodal classification of documents from Brazil's Supreme Court. We train and evaluate our methods on a novel multimodal dataset of 6,510 lawsuits (339,478 pages) with manual annotation assigning each page to one of six classes. Each lawsuit is an ordered sequence of pages, which are stored both as an image and as a corresponding text extracted through optical character recognition. We first train two unimodal classifiers: a ResNet pre-trained on ImageNet is fine-tuned on the images, and a convolutional network with filters of multiple kernel sizes is trained from scratch on document texts. We use them as extractors of visual and textual features, which are then combined through our proposed Fusion Module. Our Fusion Module can handle missing textual or visual input by using learned embeddings for missing data. Moreover, we experiment with bi-directional Long Short-Term Memory (biLSTM) networks and linear-chain conditional random fields to model the sequential nature of the pages. The multimodal approaches outperform both textual and visual classifiers, especially when leveraging the sequential nature of the pages.Comment: 11 pages, 6 figures. This preprint, which was originally written on 8 April 2021, has not undergone peer review or any post-submission improvements or corrections. The Version of Record of this article is published in the International Journal on Document Analysis and Recognition, and is available online at https://doi.org/10.1007/s10032-022-00406-7 and https://rdcu.be/cRvv

Mechanistic Insights into the Light-Driven Catalysis of an Immobilized Lipase on Plasmonic Nanomaterials

The use of light as an external stimulus to control the enzyme activity is an emerging strategy that enables accurate, remote, and noninvasive biotransformations. In this context, immobilization of enzymes on plasmonic nanoparticles offers an opportunity to create light-responsive biocatalytic materials. Nevertheless, a fundamental and mechanistic understanding of the effects of localized surface plasmon resonance (LSPR) excitation on enzyme regulation remains elusive. We herein investigate the plasmonic effects on biocatalysis using Au nanospheres (AuNSp) and nanostars (AuNSt) as model plasmonic nanoparticles, lipase from Candida antarctica fraction B (CALB) as a proof-of-concept enzyme, and 808 nm as near-infrared light excitation. Our data show that LSPR excitation enables an enhancement of 58% in the enzyme activity for CALB adsorbed on AuNSt, compared with the dark conditions. This work shows how photothermal heating over the LSPR excitation enhances the CALB activity through favoring product release in the last step of the enzyme mechanism. We propose that the results reported herein shed important mechanistic and kinetic insights into the field of plasmonic biocatalysis and may inspire the rational development of plasmonic nanomaterial-enzyme hybrids with tailored activities under external light irradiation.Peer reviewe

Dynamic blockage of drippers as a function of the application of super simple phosphate and nítric acid in localized irrigation

O superfosfato simples (SS) é uma alternativa aos adubos fosfatados que são utilizados via fertirrigação, como o ácido fosfórico, que provoca acidificação do bulbo úmido no solo, e o monofosfato de amônio purificado, que apresenta maior preço. No entanto, não se conhece o efeito de tal adubo no funcionamento de emissores, principalmente nos gotejadores, nem se é possível controlar o entupimento por SS por meio de aplicações de ácido. Assim, desenvolveu-se este trabalho com o objetivo de avaliar a possibilidade da utilização do superfosfato simples via gotejamento, como alternativa ao uso de outros adubos fosfatados, e a tentativa de controle do entupimento utilizando ácido nítrico. O trabalho foi desenvolvido em bancada de ensaios de gotejadores, localizada no Laboratório de Hidráulica da ESALQ/USP. Foram aplicadas doses de 50; 75 e 100% da solubilidade do superfosfato simples (SS), em 26 tubogotejadores de diferentes marcas comerciais, e ao fim de 360 horas de irrigação, foi aplicado ácido nítrico com pH 2, na tentativa de desentupir os gotejadores mais sensíveis. Diante dos resultados, foi possível inferir que o uso do superfosfato simples pode ser feito via fertirrigação, e o ácido nítrico, aplicado segundo esta metodologia, não proporcionou a desobstrução dos emissores.The super simple phosphate (SS) is an alternative to the phosphorous fertilizers which are used through fertigation, as the phosphoric acid, which triggers acidification of the wetted volume in the soil, and the monophosfato of purified ammonium, that has a higher price. However, the effect of such fertilizer in the emitters function, mainly in the drippers, is not known neither if it is possible to control the blockage for SS through acid applications. Thus, this study was developed in order to evaluate the possibility of the use of super simple phosphate trough drip irrigation, as an alternative to the use of other phosphorous fertilizers, and the attempt of controlling the blockage with nitric acid. The work was carried out in bench of drippers rehearsals, located at the Hydraulic laboratory in ESALQ-USP. Doses of 50; 75 and 100% of the super simple phosphate (SS) were applied in 26 emitter tubes with different commercial marks, and after 360 hours the nitric acid with a pH of 2 was applied, in the attempt of clearing the most sensitive drippers to the blockage. With the results it was possible to infer that: the use of super simple phosphate can be done by fertigation without causing damages to the system and the nitric acid, applied according to this methodology, did not provide the clearance of the emitters

Automated recognition of lung diseases in CT images based on the optimum-path forest classifier

The World Health Organization estimated that around 300 million people have asthma, and 210 million people are affected by Chronic Obstructive Pulmonary Disease (COPD). Also, it is estimated that the number of deaths from COPD increased 30% in 2015 and COPD will become the third major cause of death worldwide by 2030. These statistics about lung diseases get worse when one considers fibrosis, calcifications and other diseases. For the public health system, the early and accurate diagnosis of any pulmonary disease is mandatory for effective treatments and prevention of further deaths. In this sense, this work consists in using information from lung images to identify and classify lung diseases. Two steps are required to achieve these goals: automatically extraction of representative image features of the lungs and recognition of the possible disease using a computational classifier. As to the first step, this work proposes an approach that combines Spatial Interdependence Matrix (SIM) and Visual Information Fidelity (VIF). Concerning the second step, we propose to employ a Gaussian-based distance to be used together with the optimum-path forest (OPF) classifier to classify the lungs under study as normal or with fibrosis, or even affected by COPD. Moreover, to confirm the robustness of OPF in this classification problem, we also considered Support Vector Machines and a Multilayer Perceptron Neural Network for comparison purposes. Overall, the results confirmed the good performance of the OPF configured with the Gaussian distance when applied to SIM- and VIF-based features. The performance scores achieved by the OPF classifier were as follows: average accuracy of 98.2%, total processing time of 117 microseconds in a common personal laptop, and F-score of 95.2% for the three classification classes. These results showed that OPF is a very competitive classifier, and suitable to be used for lung disease classification

Effect of postemergence herbicides on agronomics characteristics of soybean cv. Emgopa 316

Conduziu-se um ensaio na fazenda Bela Vista, município de Serranópolis-GO, objetivando avaliar os efeitos de latifolicidas aplicados em pós-emergência, sobre algumas características agronômicas da soja cv. Emgopa 316, com ciclo de maturação precoce. Os tratamentos testados foram: lactofen (168 g/ha), chlorimuron-ethyl (15 g/ha) + óleo mineral (0,2 v/v), fomesafen (250 g/ha) + óleo mineral (0,2 v/v), imazethapyr (100 g/ha) + óleo mineral (0,2% v/v), chlorimuronethyl+ lactofen (12,5+96 g/ha), chlorimuron-ethyl+fomesafen (12,5+ 150 g/ha), chlorirnuron-ethyl+imazethapyr (12,5+50 g/ha), imazethapyr+lactofen (50+96 g/ha), imazethapyr+fomesafen (50+ 150 g/ha), além da testemunha. Os herbicidas, nas doses estudadas, provocaram injúrias às plantas de soja cv. Emgopa 316, com maior intensidade nos tratamentos contendo lactofen, porém não intluenciaram na altura das plantas aos 15,30 e 45 DAT e na colheita da soja. Também não afetaram a altura de inserção da primeira vagem, densidade de plantas, número de vagens/planta, peso de 1000 sementes e nem o rendimento de grãos. A mistura imazethapyr+fomesafen (50+ 150 g/ha) proporcionou o maior número de entrenós, porém, não diferiu estatisticamente dos demais tratamentos, exceto para lactofen (168 g/ha), que proporcionou o menor número de entrenós. O herbicida lactofen isolado ou em combinação com chlorimuron-ethyl ou com imazethapyr, pode se utilizado em soja cv. Emgopa 316, com ciclo de maturação precoce, apresentando resultados semelhantes ao fomesafen isolado ou em mistura com chlorimuron-ethyl ou imazethapyr.  A experiment was carried out at the Bela Vista Farm, in Serranópolis, State ofGoiás, with the objective to evaluate the effects of postemergence herbicides on agronomic characteristcs of soybean cv. Emgopa 316, with premature maturation cycle. Treatments consisted oflactofen (168 glha), chlorimuron-ethyl (15 glha) + mineral oil (0.2 v/v), fomesafen (250 g/ha) + mineral oil (0.2 v/v), imazethapyr (100 g/ha), chlorimuron-ethyl+lactofen (12.5+96 g/ha), chlorimuronethyl+ fomesafen (12.5+ 150 g/ha), chlorirnuron-ethyl+imazethapyr (12.5+50 g/ha), imazethapyr+lactofen (50+96 g/ha), imazethapyr+fomesafen (50+ 150 g/ha), and a handweeded control. The studied herbicide doses caused some injury to soybean, with more intensity in the treatments with lactofen. However, they did not significantly intluence the height of plants at 15, 30 and 45 days after treatments and at soybean harvest. The herbicides also did not significantly affect insertion height of the first pod, final stand, number of podslplant, weight of 1000 seeds and grain production. Imazethapyr+fomesafen (50+ 150 g/ha) gave the best result in number of internodes, but it did not differ statistically from the other treatments, except for lactofen (168 g/ha), that proportioned the lowest number of internodes. Lactofen isolated or combined with chlorimuron-ethyl or with imazethapyr can be used in soybean cv. Emgopa 316, showing results similar to fomesafen isolated or in mixture with chlorimuron-ethyl or imazethapyr

Brazilian Propolis: Correlation Between Chemical Composition and Antimicrobial Activity

The chemical composition of ethanol extracts from samples of Brazilian propolis (EEPs) determined by HPLC and their activity against Trypanosoma cruzi, Staphylococcus aureus, Streptococcus pneumoniae, Klebisiella pneumoniae, Candida albicans, Sporothrix schenckii and Paracoccidioides brasiliensis were determined. Based on the predominant botanical origin in the region of samples' collection, the 10 extracts were separated into three groups: A (B. dracunculifolia + Auraucaria spp), B (B. dracunculifolia) and C (Araucaria spp). Analysis by the multiple regression of all the extracts together showed a positive correlation, higher concentrations leading to higher biological effect, of S. aureus with p-coumaric acid (PCUM) and 3-(4-hydroxy-3-(oxo-butenyl)-phenylacrylic acid (DHCA1) and of trypomastigotes of T. cruzi with 3,5-diprenyl-4-hydroxycinnamic acid derivative 4 (DHCA4) and 2,2-dimethyl-6-carboxyethenyl-2H-1-benzopyran (DCBEN). When the same approach was employed for each group, due to the small number of observations, the statistical test gave unreliable results. However, an overall analysis revealed for group A an association of S. aureus with caffeic acid (CAF) and dicaffeoylquinic acid 3 (CAFQ3), of S. pneumoniae with CAFQ3 and monocaffeoylquinic acid 2 (CAFQ2) and of T. cruzi also with CAFQ3. For group B, a higher activity against S. pneumoniae was associated DCBEN and for T. cruzi with CAF. For group C no association was observed between the anitmicrobial effect and any component of the extracts. The present study reinforces the relevance of PCUM and derivatives, especially prenylated ones and also of caffeolyquinic acids, on the biological activity of Brazilian propolis

Investigação epidemiológica de um caso de leishmaniose visceral autóctone da Grande São Paulo, Brasil

Foi descrita uma investigação epidemiológica realizada na zona urbana de Diadema, município da Grande São Paulo (Brasil), com a finalidade de elucidar a fonte de infecção e o mecanismo de transmissão de um caso de leishmaniose visceral autóctone da área. Foram realizados inquéritos sorológicos através da reação de imunofluorescência indireta na população humana (591 soros) e na população canina (55 soros), e levada a efeito pesquisa entomológica no local da residência do doente e em uma área de reserva florestal situada a 500m desta residência.Description of an epidemiological survey carried out in the urban area of Diadema, a district of Great S. Paulo (Brazil), with the aim of elucidating the source of infection and the mechanism of transmission of one case of visceral leishmaniasis in the area. Serological surveys were carried out (imunofluorescent test) in the human population (591 serums) and in the canine population (55 serums). Also an entomological survey was done in the neighbourhood of the patient's house and in a florest reserve 500m from the house