Whale, whale, everywhere: increasing abundance of western South Atlantic humpback whales (Megaptera novaeangliae) in their wintering grounds

The western South Atlantic (WSA) humpback whale population inhabits the coast of Brazil during the breeding and calving season in winter and spring. This population was depleted to near extinction by whaling in the mid-twentieth century. Despite recent signs of recovery, increasing coastal and offshore development pose potential threats to these animals. Therefore, continuous monitoring is needed to assess population status and support conservation strategies. The aim of this work was to present ship-based line-transect estimates of abundance for humpback whales in their WSA breeding ground and to investigate potential changes in population size. Two cruises surveyed the coast of Brazil during August-September in 2008 and 2012. The area surveyed in 2008 corresponded to the currently recognized population breeding area; effort in 2012 was limited due to unfavorable weather conditions. WSA humpback whale population size in 2008 was estimated at 16,410 (CV = 0.228, 95% CI = 10,563–25,495) animals. In order to compare abundance between 2008 and 2012, estimates for the area between Salvador and Cabo Frio, which were consistently covered in the two years, were computed at 15,332 (CV = 0.243, 95% CI = 9,595–24,500) and 19,429 (CV = 0.101, 95% CI = 15,958–23,654) whales, respectively. The difference in the two estimates represents an increase of 26.7% in whale numbers in a 4-year period. The estimated abundance for 2008 is considered the most robust for the WSA humpback whale population because the ship survey conducted in that year minimized bias from various sources. Results presented here indicate that in 2008, the WSA humpback whale population was at least around 60% of its estimated pre-modern whaling abundance and that it may recover to its pre-exploitation size sooner than previously estimated.Publisher PDFPeer reviewe

Recommendations for the diagnosis of pediatric tuberculosis

Tuberculosis (TB) is still the world's second most frequent cause of death due to infectious diseases after HIV infection, and this has aroused greater interest in identifying and managing exposed subjects, whether they are simply infected or have developed one of the clinical variants of the disease. Unfortunately, not even the latest laboratory techniques are always successful in identifying affected children because they are more likely to have negative cultures and tuberculin skin test results, equivocal chest X-ray findings, and atypical clinical manifestations than adults. Furthermore, they are at greater risk of progressing from infection to active disease, particularly if they are very young. Consequently, pediatricians have to use different diagnostic strategies that specifically address the needs of children. This document describes the recommendations of a group of scientific societies concerning the signs and symptoms suggesting pediatric TB, and the diagnostic approach towards children with suspected disease

Comprehensive and Integrated Genomic Characterization of Adult Soft Tissue Sarcomas

Summary Sarcomas are a broad family of mesenchymal malignancies exhibiting remarkable histologic diversity. We describe the multi-platform molecular landscape of 206 adult soft tissue sarcomas representing 6 major types. Along with novel insights into the biology of individual sarcoma types, we report three overarching findings: (1) unlike most epithelial malignancies, these sarcomas (excepting synovial sarcoma) are characterized predominantly by copy-number changes, with low mutational loads and only a few genes (TP53, ATRX, RB1) highly recurrently mutated across sarcoma types; (2) within sarcoma types, genomic and regulomic diversity of driver pathways defines molecular subtypes associated with patient outcome; and (3) the immune microenvironment, inferred from DNA methylation and mRNA profiles, associates with outcome and may inform clinical trials of immune checkpoint inhibitors. Overall, this large-scale analysis reveals previously unappreciated sarcoma-type-specific changes in copy number, methylation, RNA, and protein, providing insights into refining sarcoma therapy and relationships to other cancer types

WNT/β-catenin signaling regulates mitochondrial activity to alter the oncogenic potential of melanoma in a PTEN-dependent manner

Aberrant regulation of WNT/β-catenin signaling has a crucial role in the onset and progression of cancers, where the effects are not always predictable depending on tumor context. In melanoma, for example, models of the disease predict differing effects of the WNT/β-catenin pathway on metastatic progression. Understanding the processes that underpin the highly context-dependent nature of WNT/β-catenin signaling in tumors is essential to achieve maximal therapeutic benefit from WNT inhibitory compounds. In this study, we have found that expression of the tumor suppressor, phosphatase and tensin homolog deleted on chromosome 10 (PTEN), alters the invasive potential of melanoma cells in response to WNT/β-catenin signaling, correlating with differing metabolic profiles. This alters the bioenergetic potential and mitochondrial activity of melanoma cells, triggered through regulation of pro-survival autophagy. Thus, WNT/β-catenin signaling is a regulator of catabolic processes in cancer cells, which varies depending on the metabolic requirements of tumors

Active collaboration with primary care providers increases specialist referral in chronic renal disease

BACKGROUND: Late referral to specialist nephrological care is associated with increased morbidity, mortality, and cost. Consequently, nephrologists' associations recommend early referral. The recommendations' effectiveness remains questionable: 22–51% of referrals need renal replacement therapy (RRT) within 3–4 months. This may be due to these recommendations addressing the specialist, rather than the primary care providers (PCP). The potential of specialist intervention aiming at slowing progression of chronic renal failure was introduced individually to some 250 local PCPs, and referral strategies were discussed. To overcome the PCPs' most often expressed fears, every referred patient was asked to report back to his PCP immediately after the initial specialist examination, and new medications were prescribed directly, and thus allotted to the nephrologist's budget. METHODS: In retrospective analysis, the stage of renal disease in patients referred within three months before the introductory round (group A, n = 18), was compared to referrals two years later (group B, n = 50). RESULTS: Relative number of patients remained stable (28%) for mild/ moderate chronic kidney disease (MMCKD), while there was a noticeable shift from patients referred severe chronic kidney disease (SCKD) (group A: 44%, group B: 20%) to patients referred in moderate chronic kidney disease (MCKD) (group A: 28%, group B: 52%). CONCLUSION: Individually addressing PCPs' ignorance and concerns noticeably decreased late referral. This stresses the importance of enhancing the PCPs' problem awareness and knowledge of available resources in order to ensure timely specialist referral

An Efficient Rule-Based Distributed Reasoning Framework for Resource-bounded Systems

© 2018, The Author(s). Over the last few years, context-aware computing has received a growing amount of attention among the researchers in the IoT and ubiquitous computing community. In principle, context-aware computing transforms a physical environment into a smart space by sensing the surrounding environment and interpreting the situation of the user. This process involves three major steps: context acquisition, context modelling, and context-aware reasoning. Among other approaches, ontology-based context modelling and rule-based context reasoning are widely used techniques to enable semantic interoperability and interpreting user situations. However, implementing rich context-aware applications that perform reasoning on resource-bounded mobile devices is quite challenging. In this paper, we present a context-aware systems development framework for smart spaces, which includes a lightweight efficient rule engine and a wide range of user preferences to reduce the number of rules while inferring personalized contexts. This shows rules can be reduced in order to optimize the inference engine execution speed, and ultimately to reduce total execution time and execution cost

The High-Superior-Tension Technique: Evolution of Lipoabdominoplasty

Because abdominoplasty is associated with complications such as seroma and necrosis as well as epigastric bulging and a suprapubic scar located too high, the demand for this procedure is not as high as it otherwise might be. However, although these negative effects were common many years ago, their incidence has decreased dramatically with modern abdominoplastic techniques. One approach using a combination of abdominoplasty and liposuction or lipoabdominoplasty has resolved many of the problems faced with earlier techniques, offering aesthetically pleasing results and excellent reliability. The keys to successful lipoabdominoplasty, first developed as the high-superior-tension technique, are extensive liposuction, preservation of lymphatic trunks, preaponeurotic epigastric dissection, major muscle fascia plication, two high-tension paraumbilical sutures, hypogastric tension sutures, and closure of the dead spaces. The most recent updates to this technique are described in this article

Plate fixation or intramedullary fixation of humeral shaft fractures: An updated meta-analysis

Background The optimal approach to operative treatment of humeral shaft fractures remains debatable. Previously published trials have been limited in size and have been inconclusive regarding important patient outcome variables following treatment with either intramedullary nails or plates. We conducted a meta-analysis of available trials comparing treatment of humeral shaft fractures

Acoustic neurinomas: diagnosis and treatment

We present our experience with 83 patients with acoustic neurinomas (January 1988 to November 1996); 81 patients underwent surgery and 2 patients with intracanalicular neurinomas received conservative therapy due to their advanced age (1 case) and patient's option (1 case). The surgical approach was retrosigmoid/ trasmeatal and the goal was total removal in one procedure with preservation of facial and cochlear nerves. Radical removal of lesion was attempted in 79 cases and it was possible in 77 patients. Subtotal tumor resection was planned in 2 cases. Facial nerve function (grades 1 to III, House and Brackman) was preseved in 90% and hearing in 58% of those with preoperative hearing. Three patients died due to postoperative complications. Early diagnosis of acoustic neurinomas is the most important factor in the prognosis and is one of the most important conquest of neurophysiology and modern neuroimaging. The management of these patients still present many controversial points. This article presents the diagnostic procedures used for acoustic neurinomas, the advantages and disadvantages of the different surgical approaches and the alternative management of these lesions.Apresentamos nossa experiência no tratamento de 83 pacientes com neurinomas do acústico (Janeiro-1988 a Novembro-1996). Cirurgia foi realizada em 81 pacientes e tratamento conservador (idade avançada e escolha do paciente) em 2 casos de neurinomas intracanalicures. O objetivo da cirurgia foi ressecção radical com preservação dos nervos facial e coclear. Em 77 de 79 pacientes foi obtida remoção total. Em 2 casos foi proposta ressecção sub-total devido às más condições clínicas (1 paciente) e por tratar-se de neurofibromatose tipo 2 com lesão dos nervos facial e coclear do outro lado (1 paciente). Preservação do nervo facial (grau I a III, House e Brackman) foi possível em 90% dos casos com função facial pre-operatória normal. Dos 12 pacientes que apresentavam audição no pré-operatório, 7 mantiveram a audição. Ocorreram 3 óbitos no pós-operatório imediato. As vantagens e desvantagens dos acessos cirúrgicos mais utilizados na cirurgia do neurinoma do acústico são demonstradas. O fator mais importante no prognóstico desses pacientes é o diagnóstico precoce, possível com o desenvolvimento de novos métodos neurofisiológicos e neurorradiológicos. O tratamento no entanto pode apresentar algumas controvérsias, variando desde o simples acompanhamento clínico à remoção cirúrgica ou o uso de radiocirurgia