Case Report: All That Glisters Is Not* Cancer

Properly performed staging in non-small-cell lung cancer (NSCLC) is necessary to avoid wrong therapeutic decisions. Here we present a case which manifested as advanced NSCLC but ultimately was composed of two different and rare pathologies. The first is a TTF-1 positive axillary lymph node that could be defined either as an unusual isolated differentiated cancer of unknown primary or as an even rarer case of ectopic lung epithelium which underwent malignant transformation. The second is sarcoidosis, a sarcoid-like alteration, in remission after oral steroids. The main implication of a correct diagnosis regards patient outcome and the avoidance of toxic inappropriate systemic chemotherapy

Thermal effects on the hydraulic conductivity of a granular geomaterial

Geotechnical challenges arising from thermal loading are associated with many engineering applications such as ground source energy systems (5℃-40℃) and nuclear waste disposal (in excess of 100℃). The effects of temperature on soils have been the subject of limited research, particularly in terms of the fundamental characterisation of the non-isothermal behaviour of granular geomaterials. This study describes challenges associated with determining the hydraulic conductivity (k_ℎ) of such materials at different temperatures using a bespoke temperature-controlled triaxial apparatus. A methodology is proposed for interpreting thermo-hydro-mechanical (THM) tests on isotropically consolidated specimens and is applied to data obtained for a uniform sand. It is shown that the intrinsic head losses of the system need to be minimised in order to obtain reliable measurements; this requires a detailed calibration procedure. The developed approach is used to determine the hydraulic conductivity at ambient temperature and at 40℃, showing that the increase in k_ℎ with temperature is mostly due to the reduction in the viscosity of water. A detailed analysis of the volumetric response of the sample during heating is also carried out

Identidade espectral entre cultivares de uvas viníferas em duas regiões da Campanha Gaúcha.

O uso de tecnologias de sensoriamento remoto na análise e na caracterização de assinaturas espectrais de culturas vitícolas por meio de imagens de satélite contribuem para o controle e monitoramento nas tomadas de decisões relativas à gestão da produção e qualidade dos vinhos. O presente trabalho visou separar as assinaturas espectrais de cultivares de uvas viníferas em duas regiões distintas, nos municípios de Santana do Livramento e Candiota, localizados na Campanha Gaúcha. Foram utilizados mapas georreferenciados fornecidos pelos proprietários das áreas com a localização das cultivares para delimitar as regiões de interesse a partir do produto L1B do sensor ASTER (Advanced Spaceborne Thermal and Reflection Radiometer) e coletar as informações de refletância normalizada nas faixas espectrais das bandas do VNIR (Visible Near Infrared) e SWIR (Short Wave Infrared) de 48 parcelas das cultivares Vitis vinífera Cabernet Sauvignon, Merlot, Chardonnay, Pinot Noir, Sauvignon Blanc e Tannat. As classes de estudo compreenderam as cultivares e para teste de desempenho foi incluída a classe ?banhado? nas duas regiões. As imagens foram submetidas às correções do efeito Cross Talk, reamostragem para 15 metros das bandas do SWIR e correção atmosférica utilizando o algoritmo FLAASH (Fast Line-of-Sight Atmospheric Analysis of Spectral Hypercubes). Para verificar a separabilidade das variedades foi utilizado o algoritmo de classificação Máxima Verossimilhança e também a Análise Discriminante das médias de refletância de cada parcela nas bandas (1, 2, 3N, 4, 5, 6, 7, 8 e 9). Os resultados obtidos mostraram que a Análise Discriminante (AD) distinguiu totalmente as regiões, enquanto a separabilidade das assinaturas espectrais das cultivares teve menor desempenho, com percentagens entre 37 e 75% de acurácia. O classificador de Máxima Verossimilhança, aplicado separadamente a cada região, teve desempenho de 91% de acurácia para a região de Santana do Livramento e 75% para Candiota. Os resultados indicam que dados de refletância obtidos de imagens ASTER permitem com relativo sucesso a discriminação espectral de classes de vegetação com assinaturas espectrais muito próximas entre si, como é o caso de cultivares vitícolas. A distinta separação das regiões, caracterizadas como ?terroirs? vitícolas, pode ser atribuída às diferenças físico-químicas do solo das regiões transmitidas à folhagem das videiras e em seguida às suas refletâncias. A classe ?banhado? teve assinatura espectral totalmente diferente das cultivares e, portanto, foi identificada e totalmente separada das classes como era esperado

Birth control knowledge among freshmen of four Italian universities

Since sexual health education (SHE) is not mandatory in Italian schools, we conducted a survey on freshmen of four Italian university campuses in 2012 to investigate the respective level of sexual health knowledge (SHK) in relation to birth control, with the aim to inform public health policy makers. A convenience strategy was employed to sample 4,552 freshmen registered with various undergraduate courses at four Italian universities: Padua university (Veneto Region); university of Milan (Lombardy Region); university of Bergamo (Lombardy Region); university of Palermo (Sicily Region). We investigated the level of SHK on birth control using 6 proxy indicators: (1) the average length of a woman\u2019s period [outcome with 3 levels: wrong (base) vs. acceptable vs. correct]; (2) the most fertile interval within a woman\u2019s period (binary outcome: correct vs. wrong answer); (3) the event between the end of a period and the beginning of the next cycle (binary outcome: correct vs. wrong answer); (4) the average survival of spermatozoa in the womb (binary outcome: correct vs. wrong answer); (5) the concept of contraception (binary outcome: correct vs. wrong answer); (6) the efcacy of various contraceptives to prevent unintended pregnancies (linear score: 0\u201317). We ftted 6 separate models of multiple regression: multinomial for outcome 1; logistic for outcomes 2, 3, 4, 6; linear for outcome 6. Statistical estimates were adjusted for a number of socio-demographic factors. Results were expressed as odds ratios (OR) for the 4 multiple logistic regression models, linear coefcients (RC) for the linear regression model and relative risk ratio (RRR) for the multinomial logistic regression model. The level of signifcance of each risk estimate was set at 0.05. The level of SHK of freshmen sampled was rather low, as 60% interviewees did not know the average length of a woman\u2019s period, the average survival of spermatozoa in the womb and the concept of contraception, whilst the most fertile interval within a woman\u2019s period was known only to 55% of interviewees. The mean score of SHK on the efcacy of various contraceptive methods was only 5 (scale 0\u201317). Some categories of students were consistently and signifcantly less knowledgeable on birth control at multivariable analysis: males; students from the university of Palermo; those with vocational secondary school education and those not in a romantic relationship at the time the survey was conducted. The results of this survey clearly call for the introduction of SHE programs in Italian schools, as already done in several European countries. School SHE should start as early as possible, ideally even before secondary school. SHE should be holistic and delivered with a multiple agency coordinated approach involving the Ministry of Health, the Ministry of Education, University and Scientifc Research (MIUR), families, schools, public health departments, primary health care providers, pharmacists, media, other

Determinants of Length of Stay After Vaginal Deliveries in the Friuli Venezia Giulia Region (NorthEastern Italy), 2005\u20132015

Although length of stay (LoS) after childbirth has been diminishing in several high-income countries in recent decades, the evidence on the impact of early discharge (ED) on healthy mothers and term newborns after vaginal deliveries (VD) is still inconclusive and little is known on the characteristics of those discharged early. We conducted a population-based study in Friuli Venezia Giulia (FVG) during 2005\u20132015, to investigate the mean LoS and the percentage of LoS longer than our proposed ED benchmarks following VD: 2 days after spontaneous vaginal deliveries (SVD) and 3 days post instrumental vaginal deliveries (IVD). We employed a multivariable logistic as well as a linear regression model, adjusting for a considerable number of factors pertaining to health-care setting and timeframe, maternal health factors, newborn clinical factors, obstetric history factors, socio-demographic background and present obstetric conditions. Results were expressed as odds ratios (OR) and regression coefcients (RC) with 95% confdence interval (95%CI). The adjusted mean LoS was calculated by level of pregnancy risk (high vs. low). Due to a very high number of multiple tests performed we employed the procedure proposed by Benjamini-Hochberg (BH) as a further selection criterion to calculate the BH p-value for the respective estimates. During 2005\u20132015, the average LoS in FVG was 2.9 and 3.3 days after SVD and IVD respectively, and the pooled regional proportion of LoS>ED was 64.4% for SVD and 32.0% for IVD. The variation of LoS across calendar years was marginal for both vaginal delivery modes (VDM). The adjusted mean LoS was higher in IVD than SVD, and although a decline of LoS>\u2009ED and mean LoS over time was observed for both VDM, there was little variation of the adjusted mean LoS by nationality of the woman and by level of pregnancy risk (high vs. low). By contrast, the adjusted fgures for hospitals with shortest (centres A and G) and longest (centre B) mean LoS were 2.3 and 3.4 days respectively, among \u201clow risk\u201d pregnancies. The corresponding fgures for \u201chigh risk\u201d pregnancies were 2.5 days for centre A/G and 3.6 days for centre B. Therefore, the shift from \u201clow\u201d to \u201chigh\u201d risk pregnancies in all three latter centres (A, B and G) increased the mean adjusted LoS just by 0.2 days. By contrast, the discrepancy between maternity centres with highest and lowest adjusted mean LoS post SVD (hospital B vs. A/G) was 1.1 days both among \u201clow risk\u201d (1.1 = 3.4\u20132.3 days) and \u201chigh risk\u201d (1.1 = 3.6\u20132.5) pregnanices. Similar patterns were obseved also for IVD. Our adjusted regression models confrmed that maternity centres were the main explanatory factor for LoS after childbirth in both VDM. Therefore, health and clinical factors were less infuential than practice patterns in determining LoS after VD. Hospitalization and discharge policies following childbirth in FVG should follow standardized guidelines, to be enforced at hospital level. Any prolonged LoS post VD (LoS>\u2009ED) should be reviewed and audited if need be. Primary care services within the catchment areas of the maternity centres of FVG should be improved to implement the follow up of puerperae undergoing ED after VD. At the beginning of the 20th century home births were the norm and hospital deliveries very rare. Women started to deliver in hospital during World War 2 (WW2), in facilities near the military areas where their respective partners were training. Tis trend continued in the decades following WW2, with standard length of stay afer childbirth (LoS) increasing up to 10 days. In the 70 ies some USA hospitals started to assess the health of mothers and newborn for eligibility to returnhome within 12\u201324 hours afer childbirth, with a midwife on call for domiciliary care up to 3 days for 2 weekspost discharge. In 1992 the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) formalized the most frequently shared defnition of early discharge (ED) afer childbirth worldwide as a LoS less than 48 h post spontaneous vaginal deliveries (SVD) and less than 96 h post cesarean section (CS). Tereafer the reduction of LoS expanded to other high-income countries, with increasing applications of ED. LoS afer childbirth remained however a controversial aspect of obstetric care, creating an open debate not only on its impact on the health of mothers and babies but also on health policies, state legislations and functioning of the respective health care systems. Nevertheless, ED of mothers and newborn has in fact increased dramatically in several high-income countries over the past 10\u201315 years. However, the evidence on the impact of ED on healthy mothers and term newborns ( 6537 weeks) afer a vaginal delivery (VD) is still inconclusive and little is known of the characteristics of those discharged early. Since LoS has become a critical indicator of efciency of health care delivery, understanding its associated factors could provide information helpful in the reduction of health care costs, improvement in the delivery of obstetric care, containment of untoward events associated with comorbidities and complications requiring readmission. For instance, in Canada (excluding Quebec) from 2003 to 2010, neonatal readmission rates were lowest for LoS of 1\u20132 days following VD and 2\u20134 days afer CS. Several factors are reportedly associated with LoS in the open literature, including readiness for discharge (clinical and perceived) of the mother8,17\u201319. However, information on the impact of medical/obstetrical conditions associated with pregnancies is scarce or totally lacking. Using a comprehensive database with information on a considerable number of factors, we previously reviewed the case mix of hospital performance by LoS post SVD as well as instrumental vaginal deliveries (IVD) during 2005\u20132015 in Friuli Venezia Giulia (FVG), a region of North-Eastern Italy. In this study we present the impact of the outstanding determinants on LoS following SVD and IVD, with the aim of inforing health care policy makers

Larval development of Spodoptera eridania (Cramer) fed on leaves of Bt maize expressing Cry1F and Cry1F + Cry1A.105 + Cry2Ab2 proteins and its non-Bt isoline.

This study aimed to evaluate, in controlled laboratory conditions (temperature of 25±2 C, relative humidity of 60±10%, and 14/10 h L/D photoperiod), the larval development of Spodoptera eridania (Cramer, 1784) (Lepidoptera, Noctuidae) fed with leaves of Bt maize expressing Cry1F and Cry1F + Cry1A.105 + Cry2Ab2 insecticide proteins and its non-Bt isoline. Maize leaves triggered 100% of mortality on S. eridania larvae independently of being Bt or non-Bt plants. However, it was observed that in overall Bt maize (expressing a single or pyramided protein) slightly affects the larval development of S. eridania, even under reduced leaf consumption. Therefore, these results showed that Cry1F and Cry1F + Cry1A.105 + Cry2Ab2 can affect the larval development of S. eridania, although it is not a target pest of this plant; however, more research is needed to better understand this evidence. Finally, this study confirms that non-Bt maize leaves are unsuitable food source to S. eridania larvae, suggesting that they are not a potential pest in maize fields

Biologia de Telenomus remus (Hymenoptera: platygastridae) sobre ovos de Spodoptera eridania (Lepidoptera: noctuidae) desenvolvida em soja Bt e não Bt.

No Brasil, é crescente a expansão de áreas agrícolas com cultivos Bts, porém, até o momento, poucos estudos tem sido realizados para avaliar o impacto dessa tecnologia sobre inimigos naturais de pragas não-alvo. Assim, o objetivo deste trabalho foi avaliar a biologia de Telenomus remus em ovos de Spodoptera eridania alimentadas com soja Bt e não Bt. A pesquisa foi conduzida na Embrapa Soja, em condições controladas de temperatura (25±1ºC), umidade relativa (60+10%) e fotofase (14hs). A oferta de soja Bt e não Bt ocorreu durante toda a fase larval de S. eridania. Após a emergência de adultos, os casais foram individualizados em tubos PVC, para a coleta de posturas. Em tubos de vidro, ofertou-se uma postura (~100 ovos) para cada fêmea, num total de 20 repetições (tubos) por tratamento. Após o intervalo de 24h a postura foi retirada para observação da emergência de adultos. Os parâmetros avaliados foram: longevidade das fêmeas (dias = d), período ovo-adulto (d), taxa de parasitismo, viabilidade do parasitismo (%) e razão sexual. Os dados foram submetidos ao teste F a 5% de probabilidade de erro. Foi verificada diferença estatística apenas para o parasitismo, que foi superior em posturas provenientes de lagartas alimentadas em soja não Bt (73,68%) do que em soja Bt (50,68%). Em soja Bt e não Bt, respectivamente, a longevidade média das fêmeas foi de 5,40d e 4,95d, o período ovo-adulto foi de 13,36d e 13,10d a viabilidade do parasitismo foi de 75,58% e 76,35% e a razão sexual foi de 0,72 e 0,65. A biologia (razão sexual e longevidade) de T. remus não é afetada quando parasitam posturas de S. eridania alimentadas com soja Bt, porém verificou-se menor parasitismo sobre esses ovos, sugerindo-se assim, que, em condições de campo, esse parasitoide poderá ser menos eficiente para a regulação populacional da praga