A homological approach to a mathematical definition of pulmonary fibrosis and emphysema on computed tomography

Three-dimensional imaging is essential to evaluate local abnormalities and understand structure-function relationships in an organ. However, quantifiable and interpretable methods to localize abnormalities remain unestablished. Visual assessments are prone to bias, machine learning methods depend on training images, and the underlying decision principle is usually difficult to interpret. Here, we developed a homological approach to mathematically define emphysema and fibrosis in the lungs on computed tomography (CT). Using persistent homology, the density of homological features, including connected components, tunnels, and voids, was extracted from the volumetric CT scans of lung diseases. A pair of CT values at which each homological feature appeared (birth) and disappeared (death) was computed by sweeping the threshold levels from higher to lower CT values. Consequently, fibrosis and emphysema were defined as voxels with dense voids having a longer lifetime (birth-death difference) and voxels with dense connected components having a lower birth, respectively. In an independent dataset including subjects with idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), and combined pulmonary fibrosis and emphysema (CPFE), the proposed definition enabled accurate segmentation with comparable quality to deep learning in terms of Dice coefficients. Persistent homology-defined fibrosis was closely associated with physiological abnormalities such as impaired diffusion capacity and long-term mortality in subjects with IPF and CPFE, and persistent homology-defined emphysema was associated with impaired diffusion capacity in subjects with COPD. The present persistent homology-based evaluation of structural abnormalities could help explore the clinical and physiological impacts of structural changes and morphological mechanisms of disease progression

Relatos orais de famílias de imigrantes japoneses: elementos para a história da educação brasileira Japanese families oral history: topics for the history of Brazilian education

Este artigo dá continuidade a uma reflexão que vimos realizando há muitos anos sobre a estruturação do campo educacional paulista e as diferentes formas pelas quais a procura pela escolarização tem se configurado para diferentes setores da população rural e urbana no estado de São Paulo. Focalizamos aqui o segmento representado pelas famílias de imigrantes japoneses que vieram para São Paulo a partir de 1908. Apresentamos os resultados obtidos em estudo sobre as famílias de imigrantes japoneses na cidade de São Paulo, sendo que os relatos orais foram a fonte privilegiada que permitiu, de um lado, apreender as visões e vivências educacionais desse grupo, e, de outro, obter informações valiosas sobre a ainda desconhecida rede de escolas "japonesas" criadas por esse grupo na sociedade paulistana.<br>This paper continues a long lasting research that analyses the educational field in São Paulo and the different forms assumed by the need of instruction of different sectors of the rural and urban population. We focus on the segment represented by the Japanese immigrants' families which came to São Paulo from 1908. We present the results obtained by means of oral reports, a privileged source for collecting data. It allowed, on the one hand, to seize the educational representations and practices of these Japanese groups and, on the other hand, to obtain valuable information about the still unknown Japanese school-net created by this group within São Paulo society

A prospective cohort study of periostin as a serum biomarker in patients with idiopathic pulmonary fibrosis treated with nintedanib

Abstract This study investigated the utility of periostin, a matricellular protein, as a prognostic biomarker in patients with idiopathic pulmonary fibrosis (IPF) who received nintedanib. Monomeric and total periostin levels were measured by enzyme-linked immunosorbent assay in 87 eligible patients who participated in a multicenter prospective study. Forty-three antifibrotic drug-naive patients with IPF described in previous studies were set as historical controls. Monomeric and total periostin levels were not significantly associated with the change in forced vital capacity (FVC) or diffusing capacity of the lungs for carbon monoxide (DLCO) during any follow-up period. Higher monomeric and total periostin levels were independent risk factors for overall survival in the Cox proportional hazard model. In the analysis of nintedanib effectiveness, higher binarized monomeric periostin levels were associated with more favorable suppressive effects on decreased vital capacity (VC) and DLCO in the treatment group compared with historical controls. Higher binarized levels of total periostin were associated with more favorable suppressive effects on decreased DLCO but not VC. In conclusion, higher periostin levels were independently associated with survival and better therapeutic effectiveness in patients with IPF treated with nintedanib. Periostin assessments may contribute to determining therapeutic strategies for patients with IPF

O Japão na literatura brasileira atual

Há uma presença notável de temas japoneses na atual literatura brasileira, sem que os autores – no caso Bernardo Carvalho, Adriana Lisboa e João Paulo Cuenca – tenham ligação biográfica com o Japão; um fenômeno que apresenta leituras, interpretações e representações da cultura japonesa bem variadas, complexas e “integradoras” dessa temática no contexto literário brasileiro. Trata-se de leituras do Japão que ainda têm ligação com a dimensão histórica da imigração japonesa no Brasil e com questões da identidade brasileira, mas que tratam principalmente dos significados universais das culturas japonesa e brasileira no contexto do século XXI