Immunophenotypic Comparison of Testicular Sclerosing Sertoli Cell Tumors and Sertoli Cell Tumors Not Otherwise Specified

Testicular Sertoli cell tumors (SCTs) are rare, and most fall into the category of SCT–not otherwise specified (SCT-NOS). Only a few additional types of SCT are recognized. Sclerosing SCT (S-SCT), originally described in 1991, comprises a small fraction of SCTs and was considered a specific entity until the 2016 revision of the World Health Organization classification of non–germ cell tumors, where it was classified as a morphologic variant of SCT-NOS. In a recent study, differences in expression of PAX2/PAX8, inhibin, androgen receptor, and S100 protein between SCT-NOS and S-SCT were noted in a small number of cases. In this interinstitutional study, we compared the expression of these markers and β-catenin in 11 cases each of SCT-NOS and S-SCT to determine if differences exist that could justify keeping a separate classification of these neoplasms. PAX2/PAX8 cocktail was the only marker that was significantly overexpressed in S-SCT. Expression of androgen receptors was strong in S-SCT and variable in SCT-NOS but did not reach statistical significance. Expression of β-catenin was common in both, whereas inhibin was infrequent. The available material was insufficient for a conclusive evaluation of S100 protein expression. Overall, our results support the inclusion of S-SCT as a morphologic variant of SCT-NOS. Expression of PAX2/PAX8 in S-SCT may reflect an overactive epithelial-to-mesenchymal transition as has been shown in experimental models of acute and chronic seminiferous tubular injury and might be related to the process generating the stroma in these tumors

Plan de negocio: marca de cerveza artesanal

Este trabajo consiste en la realización de un plan de viabilidad sobre una idea de negocio que nos gustaría llevar a cabo. Trata de una empresa de nueva creación de una marca de cerveza, llamada “Macaronesia Cerveza Artesanal”. La actividad principal de la misma es la elaboración y comercialización de una cerveza artesanal. Con este proyecto, se pretende satisfacer las necesidades de una clientela exigente que busca un producto de mayor calidad y sabor. Esta idea de negocio, estaría geográficamente ubicada en la capital de Tenerife, Santa Cruz, dónde en la misma fábrica de cerveza, los clientes pueden acudir tanto a comprar como a consumir el producto.This project is about the viability of a business plan that we would like to carry out. That idea consists of a start-up company of a beer brand, called "Macaronesia Cerveza Artesanal". The main activity is the production and marketing of craft beer. The objective of this project is to meet the needs of demanding customers, who demand a product of better quality and taste. This company would be located in the capital of Tenerife, Santa Cruz, where in the same brewery, customers can buy the product or consume it

Experiencias de innovación educativa - Tomo 5

El laboratorio de Experiencias de Aprendizaje Inmersivo para Educación Virtual del Politécnico Grancolombiano presenta este libro que consolida once nuevos proyectos trabajados durante el año 2021. Para este año se implementan once proyectos nuevos que se presentan en este libro, de los cuales cinco son laboratorios virtuales, uno es un laboratorio de realidades hibridas que se transforma en una apuesta institucional al ser único para el área de aerolíneas, buscando fortalecer el programa virtual de Psicología se realizaron cuatro simuladores y una serie de juegos serios para la salud laboral, otro juego serio sobre la teoría de juegos y por último un simulador para la gestión de inventarios

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Adapted wavelets for pattern detection

Dans cette thèse, nous sommes intéressés à la conception d'ondelettes à support compact adaptées pour la détection de motifs dans les signaux 1-D. Abry et al. ont proposé des méthodes utilisant des combinaisons linéaires et des projections. Cependant, elles peuvent conduire à des filtres très longs approchant des filtres infinis. Nous proposons d'abord ici une technique basée sur le lifting pour construire des ondelettes adaptées à une forme donnée. Les ondelettes construites peuvent être aussi régulières que désiré et avoir plusieurs moments nuls. Nous étudions la stabilité de la méthode par rapport aux petites variations du motif ainsi que trois possibilités d'extension. Notre méthode est, en outre, comparée a celle proposé par Abry et al. dans le cas unidimensionnel. Trois applications sont ensuite développées dans ce travail. Toutes les trois sont liées aux problèmes de reconnaissance ou de détection de motifs. Nous proposons une méthodologie pour résoudre ce type de problèmes avec des ondelettes adaptées en décrivant l'intérêt de les utiliser au lieu de choisir l'une des ondelettes classiques. Les deux premières applications sont en relation avec la médecine, plus précisément avec les neurosciences. Elles consistent en le traitement des électroencéphalogrammes (EEG) : la première porte sur la détection des épis épileptiques et la seconde est liée a l'étude des potentiels évoqués. La troisième et dernière application présentée concerne la détection automatique de deux types des défauts dans la caténaire à partir des mesures de la force de contact avec le pantographe des trains. Pour finir, un chapitre décrit les outils logiciels créés lors de ce travail.In this thesis, we are interested in efficient design of compactly supported adapted wavelets for pattern detection in the 1-D case. Interesting schemes have been developed by Abry et al. using projections and linear combinations. Nevertheless, they may lead to very long filters in order to approximate IIR filters. We first propose a lifting based technique to construct adapted wavelets starting from the function to approximate. This procedure allows to constructconstructing wavelets as smooth as wanted with several vanishing moments. We study the stability of this construction method for small variations of the given pattern and three extension possibilities. We also compare the proposed approach to the one based on projection and linear combinations. Then we examine then three applications where we used adapted wavelets with satisfactory results. All of them are related to pattern recognition or detection problems so we start by proposing a methodology to solve this kind of problems with pattern adapted wavelets, describing the interest of using them instead of the classical ones. The two first applications are related with medicine, more precisely with neurosciences. They consist of the processing of electroencephalogram (EEG) signals: The first one is the detection of epileptic spikes and the second is related to the study of evoked potentials. The third and last application consists of the automatic detection of two kinds of defects in the catenary lines of trains. To end the thesis, a chapter describes some of the software tools that were implemented during this thesis.ORSAY-PARIS 11-BU Sciences (914712101) / SudocORSAY-PARIS 11-Bib. Maths (914712203) / SudocSudocFranceF

Incidental adrenal hemangioma clinically suspicious for malignancy: diagnostic considerations and review of the literature

Adrenal hemangiomas are rare lesions often found incidentally during unrelated diagnostic work-up. We report a case of a 67-year-old man with history of hypertension, hyperlipidemia, anemia, arthralgia, joint swelling and unexplained weight loss, which prompted imaging studies. Computed tomography scan revealed a 5.4 cm adrenal mass. The patient had no clinical manifestations of adrenal medullary or cortical hyperfunction. Urine and plasma metanephrines and aldosterone/renin ratio were within normal range. The patient was taking prednisone for hand and ankle swelling, precluding assessment for Cushing syndrome. Given the size of the lesion, the possibility of malignancy was considered, and the patient elected for surgical management. The left adrenalectomy specimen weighed 54 g and revealed a 4.9 cm tan-brown mass with congested cut surface and a thin rim of residual adrenal gland parenchyma. Histologic examination showed thick and thin-walled vessels intermingled with adrenocortical elements at the periphery characteristic of a hemangioma. Surgical resection is the mainstay treatment for large, isolated adrenal masses to exclude malignancy and prevent retroperitoneal hemorrhage. Herein, we report a case of adrenal hemangioma, review a variety of other diagnostic considerations occurring in the adrenal gland, and highlight useful distinguishing features to assist in accurate diagnosis

Metabolic Interplay in the Tumor Microenvironment: Implications for Immune Function and Anticancer Response

Malignant tumors exhibit rapid growth and high metabolic rates, similar to embryonic stem cells, and depend on aerobic glycolysis, known as the "Warburg effect". This understanding has enabled the use of radiolabeled glucose analogs in tumor staging and therapeutic response assessment via PET scans. Traditional treatments like chemotherapy and radiotherapy target rapidly dividing cells, causing significant toxicity. Despite immunotherapy's impact on solid tumor treatment, gaps remain, leading to research on cancer cell evasion of immune response and immune tolerance induction via interactions with the tumor microenvironment (TME). The TME, consisting of immune cells, fibroblasts, vessels, and the extracellular matrix, regulates tumor progression and therapy responses. TME-targeted therapies aim to transform this environment from supporting tumor growth to impeding it and fostering an effective immune response. This review examines the metabolic disparities between immune cells and cancer cells, their impact on immune function and therapeutic targeting, the TME components, and the complex interplay between cancer cells and nontumoral cells. The success of TME-targeted therapies highlights their potential to achieve better cancer control or even a cure

A line follower robot implementation using Lego's Mindstorms Kit and Q-Learning

Un problema común al trabajar con robots móviles es que la fase de programación puede ser un proceso largo, costoso y difícil para los programadores. Los Algoritmos de Aprendizaje por Refuerzo ofrecen uno de los marcos de trabajo más generales en el ámbito de aprendizaje de máquina. Este trabajo presenta un enfoque usando el algoritmo de Q-Learning en un robot Lego para que aprenda "por sí mismo" a seguir una línea negra dibujada en una superficie blanca. El entorno de programación utilizado en este trabajo es Matlab.<br>A common problem working with mobile robots is that programming phase could be a long, expensive and heavy process for programmers. The reinforcement learning algorithms offer one of the most general frameworks in learning subjects. This work presents an approach using the Q-Learning algorithm on a Lego robot in order for it to learn by itself how to follow a blackline drawn down on a white surface, using Matlab [5] as programming environment

Prominent Pseudo-Angiovascular invasion by benign gallbladder epithelium and bile emboli in a patient with delayed cholecystectomy due to COVID-19 positive test

Lymphovascular invasion is a hallmark of malignant neoplasms, however the presence of benign epithelium within vessels has been reported in benign processes, albeit infrequently. The proposed mechanism to explain this phenomenon entails mechanical displacement of benign epithelium into the vascular spaces during surgical manipulation or diagnostic interventions. We report a case of numerous benign epithelial vascular emboli in a cholecystectomy specimen. A 29-year-old male presented with acute calculous cholecystitis. Surgery was delayed for several weeks due to COVID-19 infection. Histologic examination of the gallbladder showed subacute cholecystitis, widespread vascular epithelial emboli with associated fibrin deposition and bile embolism supporting an in vivo process. The epithelial emboli were localized in small veins and arterioles with D2–40−/CD31+/CD34+ endothelium. The displaced epithelium showed benign cytologic features, was negative for p53 expression, and had a Ki-67 labelling index like the benign background mucosa, supporting a benign process. There was no evidence of dysplasia or malignancy in the specimen after thorough sampling. Persistent inflammation, mucosal ulceration, transmural mucosal herniation (Rokitansky-Aschoff sinuses), and protracted surgical manipulation secondary to adhesive disease are favored to be the underlying causes of this unusual histologic finding. Although we presume an uneventful outcome, clinical follow up was recommended. COVID-19 infection likely contributed to this phenomenon by causing a delay in the surgical management