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This work constitutes the analysis of environmental systems and mitigation proposals of the sub-basin of the river Bom Jesus, Taperuaba- Sobral (CE), and is located at the southern end of the river basin of the Coast, the top course Aracatiaçu on river basin. The same is embedded in the matrix letters SUDENE / DSG, SB.24-V-B-II (Taperuaba), SA. 24-X- -D-IV (Sobral) SB.24-V-B-I (Santa Quitéria) SA. 24-Y-D-V (Irauçuba), corresponding to an area of 262.85 square kilometers. For this analysis, we have the theoretical and methodological basis of the systemic approach applied to geographical studies. Where was possible identified five environmental systems: River Riverine Plain Bom Jesus, Eastern Sertões and Feet of Serra Grande Bag, Eshu and Jurema, the Western Barrens and Feet Serra de São João, Boa Vista and Bom Jesus, Dry saws and saws Dry Sub-humid with Strands, pointing in each system, its capabilities and limitations and the use and occupation. In the last stage, identify the key environmental impacts and present the mitigation proposals.

Moyamoya disease is an unusual form of occlusive, cerebrovascular disorder that affects the arteries of the central nervous system, causing acquired language alterations and learning difficulties. The study aim was to describe the oral/written language and cognitive skills in a seven-year-and-seven-month-old girl diagnosed with Moyamoya disease. The assessment consisted of interviews with her parents and application of the following instruments: Observation of Communicative Behavior, Peabody Picture Vocabulary Test, Academic Performance Test, Profile of Phonological Awareness, Raven’s Progressive Matrices Test, Special Scale, Wechsler Intelligence Scale for Children, Bender Visual Motor Gestalt Test, and Wisconsin Card Sorting Test. Two episodes of stroke in the left and right temporal-parietal and left frontal areas occurred until the age of six years and five months. Revascularization surgery and medication treatment were conducted. The audiologic and ophthalmologic assessments indicated normality. At the time of the study, the girl was attending the second grade of elementary school. She presented changes in oral and written language (syllabic-alphabetic), non-naming of all graphemes, low arithmetic and writing means, reading skill below first grade level and psycholinguistic delay, and pre-school level phonological processing skills. The psychological evaluation indicated satisfactory intellectual level; however, it also showed cognitive performance impairment in verbal and execution tasks and limitations on graphic-perceptual-motor skills and sequential logic organization. The stroke episodes influenced the performance of learning processes, affecting the analysis, integration, and interpretation of relevant visual and auditory information.

A presente pesquisa busca realizar uma descrição dos componentes físico-naturais, assim como identificar os principais impactos ambientais na Sub-bacia hidrográfica do riacho Bilheira, como forma de subsidiar o planejamento ambiental. A área em estudo possui uma extensão territorial de 75 km², totalmente alocada no sistema hidrográfico do rio Aracatiaçu, onde este por sua vez está inserido na bacia hidrográfica do litoral. A área em estudo está inserida dentre os limites municipais de Sobral mais precisamente nos distritos de Taperuaba e Aracatiaçu. A metodologia consiste na descrição fisiográfica que se tratando de bacias hidrográficas como unidade de estudo, recai como imprescindível. Contudo, a pesquisa se desenvolveu por meio de um levantamento bibliográfico e geocartográfico de autores que discutem a temática abordada, e a realização de trabalhos de campo com o objetivo de correlacionar os resultados alcançados. Dessa forma, percebeu que o processo de uso e ocupação da área se deve a prática da agricultura de subsistência, do extrativismo vegetal e a pecuária extensiva, vindo a provocar desmatamento, solos desnudos, assoreamento, etc.

Using the observational properties of Einstein’s gravitational field it is shown that a minimum of four non-coplanar mass probes are necessary for a Michelson and Morley interferometer to detect gravitational waves within the context of General Relativity. With fewer probes, some alternative theories of gravitation can also explain the observations. The conversion of the existing gravitational wave detectors to four probes is also suggested.

An updated review of Kraichnan’s derivation of Einstein’s equations from quantum field theory is presented, including the period after the discovery of the Higgs mechanism and the inclusion of gravitation within the Standard Model of Fundamental Interactions.

We determine the scalar field evolution of a braneworld localized black hole with both dark matter and dark energy components, obtained within a dynamical and continuous embedding formalism by use of Nash's theorem. We further extract the associated quasinormal modes for both de Sitter-Schwarzschild-Dark matter and anti-de Sitter-Schwarzschild-Dark matter solutions, for the different causal structures (one, two or three horizon spacetimes) given by the space of parameters. By comparison with standard General Relativity solutions, we infer possible observable astrophysical differences, and remark on modifications to previous AdS/CFT correspondence scenarios., 12 pages, 15 figures

Background Li-Fraumeni syndrome (LFS) is an autosomal dominant disease that is associated with germline TP53 mutations and it predisposes affected individuals to a high risk of developing multiple tumors. In Brazil, LFS is characterized by a different pattern of TP53 variants, with the founder TP53 p.R337H mutation being predominant. The adoption of screening strategies to diagnose LFS in its early stages is a major challenge due to the diverse spectrum of tumors that LFS patients can develop. The purpose of this study was to evaluate two rounds of whole-body magnetic resonance imaging (WB-MRI) which were conducted as a screening strategy for LFS patients. Methods Over a 4-year period, 59 LFS patients underwent two rounds of WB-MRI. Each MRI was characterized as positive or negative, and positive cases were further investigated to establish a diagnosis. The parameters used to evaluate the WB-MRI results included: positive rate, number of invasive investigations of positive results, and cancer detection rate. Results A total of 118 WB-MRI scans were performed. Positive results were associated with 11 patients (9.3%). Seven of these patients (11.8%) were identified in the first round of screening and 4 patients (6.7%) were identified in the second round of screening. Biopsies were performed in three cases (2.5%), two (3.4%) after the first round of screening and one (1.7%) after the second round of screening. The histopathological results confirmed a diagnosis of cancer for all three cases. There was no indication of unnecessary invasive procedures. Conclusions WB-MRI screening of LFS carriers diagnosed cancers in their early stages. When needed, positive results were further examined with non-invasive imaging techniques. False positive results were less frequent after the first round of WB-MRI screening. Electronic supplementary material The online version of this article (10.1186/s40644-018-0162-8) contains supplementary material, which is available to authorized users.

Background: The Gait Profile Score (GPS) measures the quality of an individual’s walking by calculating the difference between the kinematic pattern and the average walking pattern of healthy individuals. Research questions: The purposes of this study were to quantify the effect of speed on the GPS and to determine whether the prediction of gait patterns at a specific speed would make the GPS outcome insensitive to gait speed in the evaluation of post-stroke individuals. Methods: The GPS was calculated for able-bodied individuals walking at different speeds and for the comparison of post-stroke individuals with able-bodied individuals using the original experimental data (standard GPS) and the predicted gait patterns at a given speed (GPS velocity, GPSv). We employed standard gait analysis for data collection of the subjects. Sixteen participants with a stroke history were recruited for the post-stroke group, and 15 age-matched, able-bodied participants formed the control group. Results: Gait speed significantly affects the GPS and the method to predict the gait patterns at any speed is able to mitigate the effects of gait speed on the GPS. Overall, the gap between the GPS and GPSv values across the post-stroke individuals was small (0.5° on average, range from 0.0° to 1.4°) and not statistically significant. However, there was a significant negative linear relationship in the absolute difference between the GPS and GPSv values for the participants of the post-stroke group with gait speed, indicating that a larger difference between the speeds of the post-stroke participant and the reference dataset resulted in a larger difference between the GPS and GPSv. Significance: The modified version of the GPS, the GPSv, is effective in reducing the impact of gait speed on GPS; however, the observed difference between the two methods was only around 1° for the slowest individuals in comparison to the reference dataset.

O feijão caupi é uma das principais culturas na região nordeste tendo seu cultivo voltado para a produção de grãos ou em vagens verdes. Desta forma, objetivou-se avaliar o desenvolvimento e a produtividade do feijão caupi em grãos e em vagens verdes em função do espaçamento entre plantas e da prática de desbaste na região do Cariri cearense. O experimento foi conduzido no Sitio Pintado, Missão Velha-CE, delineamento em blocos casualizados, em esquema fatorial 2x3, com quatro repetições. O primeiro fator foi o espaçamento entre plantas (0,5; 0,33 e 0,25 m) e o segundo a prática (ou não) do desbaste Quanto ao desenvolvimento e produtividade do feijão verde, avaliou-se a população de plantas, número de vagens por planta, massa de vagens verdes por planta, massa verde por vagem e produtividade de vagens verdes. Com relação às variáveis de feijão em grãos à 11% de umidade foi avaliado o número de grãos por vagem, a massa de grãos por planta, a massa de 100 grãos e a produtividade de grãos. A prática do desbaste permitiu maiores valores de produção por planta, porém sem melhoras na produtividade de grãos e vagens verdes. Para o espaçamento entre as plantas, observou-se que as produtividades foram maiores para o espaçamento de 0,4 m entre plantas, com valores de 1633 kg ha-1 de grãos.

The accurate diagnosis of pulmonary thromboembolism is essential to reducing the morbidity and mortality associated with the disease. The diagnosis of pulmonary thromboembolism is challenging because of the nonspecific nature of the clinical profile and the risk factors. Imaging methods provide the definitive diagnosis. Currently, the imaging method most commonly used in the evaluation of pulmonary thromboembolism is computed tomography. The recent development of dual-energy computed tomography has provided a promising tool for the evaluation of pulmonary perfusion through iodine mapping. In this article, we will review the importance of diagnosing pulmonary thromboembolism, as well as the imaging methods employed, primarily dual-energy computed tomography. Resumo A acurácia no diagnóstico de tromboembolismo pulmonar é essencial para reduzir a morbimortalidade causada por esta enfermidade. Devido ao quadro clínico e fatores de risco inespecíficos, o diagnóstico de tromboembolismo pulmonar torna-se um desafio. Os métodos de imagem fornecem o diagnóstico definitivo, sendo a tomografia computadorizada o método mais utilizado atualmente. Nos últimos anos, houve o desenvolvimento da tomografia computadorizada com dupla energia e essa ferramenta tem se mostrado promissora para avaliação da perfusão pulmonar por meio do mapa de iodo. Neste artigo é feita revisão acerca da importância do diagnóstico de tromboembolismo pulmonar, bem como os métodos de imagem disponíveis, com ênfase na tomografia computadorizada com dupla energia.

Background The purpose of this phase II trial was to evaluate the tolerability, safety, and efficacy of a non–5-fluorouracil (5-FU)-based induction chemotherapy followed by chemoradiotherapy (CRT) for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Methods Sixty patients with stage III to IV HNSCC were treated with induction paclitaxel and cisplatin (TP; paclitaxel 175 mg/m2 and cisplatin 80 mg/m2, 3 cycles) followed by CRT (cisplatin 100 mg/m2; D1, 22, and 43 of radiotherapy). Results Fifty-six patients (93.3%) completed 3 cycles of induction TP (no treatment-related deaths), 52 (86.7%) completed definitive CRT per protocol (adverse event [AE] grade ≥2 in 53.3%). The overall response rate after induction TP was 82.5% for patients with resectable disease and 55.5% for unresectable disease (p = .023), and complete response (CR) rate after CRT was 70.0% for patients with resectable disease and 30.0% for unresectable disease (p = .005). Conclusion Induction TP followed by cisplatin based-CRT was well-tolerated, safe, and had high overall response rate in selected patients with locally advanced HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

This study considers the problem of indexing fixed-income portfolios to the ANBIMA Market Index – Series B (IMA-B), composed of Brazilian National Treasury Notes – Series B (NTNBs). We propose a mathematical model that minimizes the deviations of the returns of the chosen portfolio in relation to the returns of the index’s theoretical portfolio. The resulting model is a mathematical programming problem with convex objective function, linear constraints and free and non-negative integer variables. Five numerical examples with real data are presented to illustrate the model’s practical use. The results obtained from the fits are analyzed together with data for funds indexed to the IMA-B existing in the Brazilian financial market. The proposed method resulted in fits with optimal control of the tracking errors of the indexed portfolio.

We investigated the effects on women of carrying an infant in front, focusing on the pelvic and spinal posture and the displacement of the body's center of gravity. For such, we compared mothers to non-mothers not carrying anything or carrying the same load (a doll) and the mothers carrying their infants. Twenty mothers and 44 women who did not have children were analyzed for their movement and posture during walking and standing still with a motion capture system. Walking while carrying a load was slower and with a shorter stride length than while not carrying a load. The mothers' group walked slower and with a shorter stride length than the non-mothers' group. During walking and standing still, the women decreased their angle of pelvic anteversion, increased lumbar lordosis, increased thoracic kyphosis, and increased trunk backward inclination while carrying a load in comparison with not carrying anything. In addition, we observed some small differences in the spinal angles of mothers when carrying their infants compared to when carrying a doll. When standing still, the women carrying a load displaced backwards their vertical projection of the center of gravity to exactly compensate the destabilizing load at the front that resulted in no net change of the body-plus-load center of gravity. In general, these changes are qualitatively similar to the ones observed during pregnancy.

Birt-Hogg-Dubé syndrome (BHDS) is a rare, inherited autosomal-dominant disorder characterized by the development of cutaneous lesions, renal tumors, pulmonary cysts, and spontaneous pneumothorax. The gene responsible for BHDS is located on the short arm of chromosome 17 (17p11.2) and codes for the protein folliculin, which is believed to be an oncogene suppressor protein.We reviewed currently published literature on the main characteristics of BHDS.Pulmonary cysts and spontaneous pneumothorax are often the presenting manifestations that lead to a final diagnosis in family members affected by the syndrome.Certain imaging characteristics of pulmonary cysts, including size and location, can suggest the diagnosis of BHDS based on chest computed tomography alone. The main concern in patients with BHDS is the increased risk of renal carcinoma. The aim of this review is to describe the main pathological, clinical, and imaging aspects of BHDS, ranging from its genetic basis to treatment, with emphasis on pulmonary involvement.

Magnetic resonance imaging (MRI) has several advantages in the evaluation of cancer patients with thoracic lesions, including involvement of the chest wall, pleura, lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis, staging, surgical planning, treatment response evaluation and follow-up of these patients. In the present review, the authors contextualize the relevance of MRI in the evaluation of thoracic lesions in cancer patients. Considering that MRI is a widely available method with high contrast and spatial resolution and without the risks associated with the use of ionizing radiation, its use combined with new techniques such as cine-MRI and functional methods such as perfusion- and diffusion-weighted imaging may be useful as an alternative tool with performance comparable or complementary to conventional radiological methods such as radiography, computed tomography and PET/CT imaging in the evaluation of patients with thoracic neoplasias.

Krukenberg tumor is a rare ovarian metastatic cancer from the gastrointestinal tract. It accounts for 1%-5% of malignant tumors of the ovaries, usually being bilateral, of solid consistency and may have cystic areas. The World Health Organization (WHO) defined it as an ovarian metastasis when the mucus-secreting cells of “signet ring” are present, associated with sarcomatous stromal proliferation. We present a 58-year-old woman with the diagnosis of peripheric cholangiocarcinoma with ovarian metastasis, showing history of pain and increased abdominal volume. Magnetic Resonance Imaging (MRI) showed multiple hepatic solid nodules with predominantly peripheral, centripetal and progressive enhancement, demonstrating hipersignal and restriction on diffusion weighted imaging (DWI). In the anexial region, bulky heterogeneous multiloculated cystic formations with solid components, of probable ovarian origin, were noted. Biopsy of the liver nodules confirmed the diagnosis of cholangiocarcinoma.

The aim of this study was to evaluate the high-resolution computed tomography (HRCT) findings in patients diagnosed with metastatic pulmonary calcification (MPC).We retrospectively reviewed the HRCT findings from 23 cases of MPC [14 men, 9 women; mean age, 54.3 (range, 26-89) years]. The patients were examined between 2000 and 2014 in nine tertiary hospitals in Brazil, Chile, and Canada. Diagnoses were established by histopathologic study in 18 patients and clinical-radiological correlation in 5 patients. Two chest radiologists analyzed the images and reached decisions by consensus.The predominant HRCT findings were centrilobular ground-glass nodules (MPC manifested with three main patterns on HRCT, most commonly centrilobular ground-glass nodules, often containing calcifications, followed by dense consolidation and small solid nodules, most of which were calcified. We also described another pattern of peripheral reticular opacities associated with small calcified nodules. These findings should suggest the diagnosis of MPC in the setting of hypercalcemia.O objetivo deste estudo foi avaliar os achados de tomografia computadorizada de alta resolução (TCAR) em pacientes com diagnóstico de calcificação pulmonar metastática (CPM).Revisamos, retrospectivamente, os achados na TCAR de 23 casos de CPM [14 homens e 9 mulheres; idade média, 54,3 (intervalo, 26-89) anos]. Os pacientes foram examinados entre 2000 e 2014 em nove hospitais terciários no Brasil, Chile e Canadá. O diagnóstico foi estabelecido por estudo histopatológico em 18 pacientes e correlação clinicorradiológica em 5 pacientes. Dois radiologistas de tórax analisaram as imagens e chegaram a decisões por consenso.Os achados predominantes na TCAR foram nódulos centrolobulares em vidro fosco (CPM manifestou-se com três padrões principais na TCAR. O aspecto mais comum foram os nódulos centrolobulares em vidro fosco, frequentemente contendo calcificações, seguido de consolidação densa e de pequenos nódulos sólidos, a maioria deles calcificada. Também descrevemos o padrão de opacidades reticulares periféricas associadas a pequenos nódulos calcificados. Esses achados devem sugerir o diagnóstico de CPM no contexto de hipercalcemia.

Objective: The aim of this study was to evaluate the high-resolution computed tomography (HRCT) findings in patients diagnosed with metastatic pulmonary calcification (MPC). Materials and Methods: We retrospectively reviewed the HRCT findings from 23 cases of MPC [14 men, 9 women; mean age, 54.3 (range, 26-89) years]. The patients were examined between 2000 and 2014 in nine tertiary hospitals in Brazil, Chile, and Canada. Diagnoses were established by histopathologic study in 18 patients and clinical-radiological correlation in 5 patients. Two chest radiologists analyzed the images and reached decisions by consensus. Results: The predominant HRCT findings were centrilobular ground-glass nodules (n = 14; 60.9%), consolidation with high attenuation (n = 10; 43.5%), small dense nodules (n = 9; 39.1%), peripheral reticular opacities associated with small calcified nodules (n = 5; 21.7%), and ground-glass opacities without centrilobular ground-glass nodular opacity (n = 5; 21.7%). Vascular calcification within the chest wall was found in four cases and pleural effusion was observed in five cases. The abnormalities were bilateral in 21 cases. Conclusion: MPC manifested with three main patterns on HRCT, most commonly centrilobular ground-glass nodules, often containing calcifications, followed by dense consolidation and small solid nodules, most of which were calcified. We also described another pattern of peripheral reticular opacities associated with small calcified nodules. These findings should suggest the diagnosis of MPC in the setting of hypercalcemia. Resumo Objetivo: O objetivo deste estudo foi avaliar os achados de tomografia computadorizada de alta resolução (TCAR) em pacientes com diagnóstico de calcificação pulmonar metastática (CPM). Materiais e Métodos: Revisamos, retrospectivamente, os achados na TCAR de 23 casos de CPM [14 homens e 9 mulheres; idade média, 54,3 (intervalo, 26-89) anos]. Os pacientes foram examinados entre 2000 e 2014 em nove hospitais terciários no Brasil, Chile e Canadá. O diagnóstico foi estabelecido por estudo histopatológico em 18 pacientes e correlação clinicorradiológica em 5 pacientes. Dois radiologistas de tórax analisaram as imagens e chegaram a decisões por consenso. Resultados: Os achados predominantes na TCAR foram nódulos centrolobulares em vidro fosco (n = 14; 60,9%), consolidação com alta atenuação (n = 10; 43,5%), pequenos nódulos densos (n = 9; 39,1%), opacidades reticulares periféricas associadas com pequenos nódulos calcificados (n = 5; 21,7%) e opacidades em vidro fosco sem nódulos centrolobulares em vidro fosco (n = 5; 21,7%). Calcificação vascular na parede torácica foi encontrada em quatro casos e derrame pleural foi observado em cinco casos. As anormalidades foram bilaterais em 21 casos. Conclusão: CPM manifestou-se com três padrões principais na TCAR. O aspecto mais comum foram os nódulos centrolobulares em vidro fosco, frequentemente contendo calcificações, seguido de consolidação densa e de pequenos nódulos sólidos, a maioria deles calcificada. Também descrevemos o padrão de opacidades reticulares periféricas associadas a pequenos nódulos calcificados. Esses achados devem sugerir o diagnóstico de CPM no contexto de hipercalcemia.

Aim: To evaluate the effects of HepaSphere 50–100 μm (Merit Medical) as a doxorubicin carrier and embolization agent for the treatment of hepatocellular carcinoma (HCC).Material and methods: A prospective analysis of 18 patients recruited from a national cancer center was conducted. This analysis evaluated the efficacy and safety of HepaSphere, as expressed by the treatment response rate (measured by the modified Response Evaluation Criteria in Solid Tumors, mRECIST) and by the prevalence of treatment-related adverse events, respectively.Results: The cohort was predominantly male, with a mean age of 69 years. The objective response rate (complete + partial response) was 53.3%. The variable most likely to be associated with objective response was Barcelona Clinic Liver Cancer (BCLC) staging. The most prevalent adverse events were nausea, vomiting and abdominal pain.Conclusion: HepaSphere chemoembolization yielded a substantial objective response rate with an acceptable toxicity profile and should b...

O hipotireoidismo congênito (HC) é um distúrbio do metabolismo, caracterizado pela produção deficiente dos hormônios tireoidianos. A literatura ressalta que crianças podem apresentar alterações cognitivas, linguísticas e problemas comportamentais, mesmo quando o diagnóstico e o tratamento iniciaram precocemente. O estudo teve como objetivo verificar desempenho em habilidades motoras, comunicativas e cognitivas de indivíduos com hipotireoidismo congênito, tratados desde o período neonatal e comparar esses achados com seus pares sem alterações da tireoide. Participaram deste estudo 15 indivíduos com o diagnóstico de hipotireoidismo congênito do gênero feminino, com idade cronológica variando entre 36 a 71 meses, com Quociente de Inteligência superior a 70, denominado Grupo Experimental (GE); e 15 indivíduos típicos, sem alterações da tireoide, denominado Grupo Comparativo (GC). Os participantes dos dois grupos foram pareados quanto à idade cronológica e nível socioeconômico. Os instrumentos de avaliação utilizados foram: Entrevista com pais; Observação do Comportamento Comunicativo; Teste de Vocabulário por Imagem Peabody TVIP; Teste de Screening de Desenvolvimento DenverII. Foi realizada avaliação psicológica, quanto ao nível intelectual, com a aplicação da Escala de Inteligência StanfordBinet. Os resultados mostraram que o desempenho das crianças do GE quanto às habilidades comunicativas, de linguagem, cognitiva e de linguagem receptiva apresentaram diferença estatística significante quando comparado com o GC. Os achados desse trabalho confirmam a interferência do HC no desenvolvimento infantil, ressaltando que indivíduos com HC, mesmo diagnosticados e tratados precocemente, podem apresentar alterações motoras, comunicativas e cognitivas e esses prejuízos poderão afetálos no decorrer da vida, inclusive nas habilidades escolares. Reiterase que estudos longitudinais são importantes para acompanhar e prevenir essas alterações. Congenital hypothyroidism (CH) is a metabolic disorder characterized by deficient production of thyroid hormones. The literature points out that children may have cognitive, language and behavioral problems changes even when the diagnosis and treatment started early. The study aimed to verify performance in motor, communication and cognitive abilities of individuals with congenital hypothyroidism treated from the neonatal period and to compare these findings with their peers without thyroid changes. The study included 15 subjects with a diagnosis of congenital hypothyroidism females with chronological age ranging from 36 to 71 months, with Intelligence Quotient greater than 70, called Experimental Group (GE); and 15 typical individuals without thyroid changes, called Comparative Group (GC). Participants in both groups were matched for chronological age and socioeconomic status. The assessment instruments used were: Interview with parents; Observation of Communicative Behavior; Vocabulary Test Peabody Picture TVIP; Screening Test Development DenverII. Psychological assessment was conducted, on the intellectual level, with the application of the StanfordBinet Intelligence Scale. The results showed that children\'s performance of GE regarding communication skills, language, cognitive and receptive language showed statistically significant differences when compared to the GC. The findings of this study confirm the interference of HC in child development, noting that individuals with HC, even if diagnosed and treated early, may have driven, communicative and cognitive changes and these losses may affect them throughout their lives, including in school skills. It is reiterated that longitudinal studies are important to monitor and prevent these changes.

Summary Introduction: Pseudomyxoma peritonei (PMP) is a rare clinical condition, with an incidence of 1-2 cases per million, characterized by the dissemination of mucinous implants on the peritoneal surface and progressive gelatinous ascites. Although it usually presents an indolent behavior, its non-specific clinical presentation contributes to many cases remaining undiagnosed until a laparotomy is performed. With late diagnosis, performed after a long period of clinical deterioration and disease progression, it is common to find complications such as the formation of intestinal fistulas and obstruction. Method: Review of the medical record and search for references in the Medline, Lilacs, SciELO and MD Consult databases. Results: There are rare case reports found in the literature demonstrating atypical PMP presentations. Our report is that of a 17-year-old adolescent with a sporadic tumor diagnosed in a primary site in the transverse colon, contrary to data commonly found in the literature that mention a more frequent occurrence in women in the fifth decade of life and with a primary site in the ovary and appendix. The development of mucinous adenocarcinoma is rare in the pediatric population, and topography in the transverse colon and non-familial sporadic pattern are unusual. Conclusion: The case reported not only raises awareness about the atypical presentations of the disease, but also emphasizes the use of imaging examinations for diagnosis, which has an important impact on prognosis and survival if performed timely. Resumo Introdução: O pseudomixoma peritoneal (PMP) é uma condição clinica rara, com incidência de 1-2 casos por milhão, caracterizada pela disseminação de implantes de natureza mucinosa pela superfície peritoneal e acúmulo progressivo de ascite gelatinosa. Embora apresente geralmente um comportamento indolente, a apresentação clínica inespecífica contribui para que muitos casos permaneçam sem diagnóstico até a realização de laparotomia. Com o diagnóstico tardio, realizado após um longo período de deterioração clínica e progressão de doença, é comum encontrar complicações, como a formação de fístulas e obstruções intestinais. Método: Revisão do prontuário médico e pesquisa bibliográfica nas bases de dados Medline, Lilacs, SciELO e MD Consult. Resultados: São raros os relatos de caso encontrados na literatura que demonstram apresentações atípicas do PMP. O presente estudo apresenta o caso de um adolescente com 17 anos ao diagnóstico e sítio primário no colón transverso com tumor esporádico, contrário aos dados comumente encontrados na literatura, que referem acometimento mais comum em mulheres na quinta década de vida e com sítio primário em ovário e apêndice. O desenvolvimento de adenocarcinoma mucinoso é raro na população pediátrica e a topografia no cólon transverso e padrão esporádico não familial também são pouco usuais. Conclusão: O caso relatado alerta para as apresentações atípicas da doença e enfatiza o uso de exames de imagem para o diagnóstico, que, se realizado precocemente, impacta de maneira importante o prognóstico e a sobrevida.

This article describes a public data set containing the three-dimensional kinematics of the whole human body and the ground reaction forces (with a dual force platform setup) of subjects who were standing still for 60 s in different conditions, in which the subjects’ vision and the standing surface were manipulated. Twenty-seven young subjects and 22 old subjects were evaluated. The data set comprises a file with metadata plus 1,813 files with the ground reaction force (GRF) and kinematics data for the 49 subjects (three files for each of the 12 trials plus one file for each subject). The file with metadata has information about each subject’s sociocultural, demographic, and health characteristics. The files with the GRF have the data from each force platform and from the resultant GRF (including the center of pressure data). The files with the kinematics contain the three-dimensional positions of 42 markers that were placed on each subject’s body and 73 calculated joint angles. In this text, we illustrate how to access, analyze, and visualize the data set. All the data is available at Figshare (DOI:10.6084/m9.figshare.4525082), and a companion Jupyter Notebook presents programming code to access the data set, generate analyses and other examples. The availability of a public data set on the Internet that contains these measurements and information about how to access and process this data can potentially boost the research on human postural control, increase the reproducibility of studies, and be used for training and education, among other applications.

Cancer is the leading cause of natural death in the pediatric populations of developed countries, yet cure rates are greater than 70% when a cancer is diagnosed in its early stages. Recent advances in magnetic resonance imaging methods have markedly improved diagnostic and therapeutic approaches, while avoiding the risks of ionizing radiation that are associated with most conventional radiological methods, such as computed tomography and positron emission tomography/computed tomography. The advent of whole-body magnetic resonance imaging in association with the development of metabolic- and function-based techniques has led to the use of whole-body magnetic resonance imaging for the screening, diagnosis, staging, response assessment, and post-therapeutic follow-up of children with solid sporadic tumours or those with related genetic syndromes. Here, the advantages, techniques, indications, and limitations of whole-body magnetic resonance imaging in the management of pediatric oncology patients are presented. AC Camargo Canc Ctr, Dept Imaging, Rua Prof Antonio Prudente 211, BR-01509010 Sao Paulo, SP, Brazil Univ Fed Vale Sao Francisco UNIVASF, Av Jose Sa Manicoba, BR-56304917 Petrolina, PE, Brazil AC Camargo Canc Ctr, Dept Imaging, Rua Prof Antonio Prudente 211, BR-01509010 Sao Paulo, SP, Brazil Univ Sao Paulo, Ribeirao Preto Med Sch, Div Radiol, Dept Internal Med, Av Bandeirantes 3900, BR-14049090 Ribeirao Preto, SP, Brazil Univ Fed Sao Paulo, Dept Diagnost Imagem, Disciplina Diagnost Imagem Pediat, Rua Napoleao de Barros 800, BR-04024002 Sao Paulo, SP, Brazil Univ Fed Sao Paulo, Ctr Diagnost Imagem, Inst Oncol Pediat & Med Radiol, Inst Oncol Pediat, Rua Napoleao Barros 800, BR-04024002 Sao Paulo, SP, Brazil Univ Texas MD Anderson Canc Ctr, Dept Diagnost Radiol, 1515 Holcombe Blvd, Houston, TX 77030 USA Univ Fed Ciencias Saude Porto Alegre, Dept Radiol, Ctr Hist, Rua Prof Anes Dias 285, BR-90020090 Porto Alegre, RS, Brazil Univ Fed Rio de Janeiro, Dept Radiol, Rua Thomaz Cameron 438, BR-25685129 Petropolis, RJ, Brazil Univ Fed Sao Paulo, Dept Diagnost Imagem, Disciplina Diagnost Imagem Pediat, Rua Napoleao de Barros 800, BR-04024002 Sao Paulo, SP, Brazil Univ Fed Sao Paulo, Ctr Diagnost Imagem, Inst Oncol Pediat & Med Radiol, Inst Oncol Pediat, Rua Napoleao Barros 800, BR-04024002 Sao Paulo, SP, Brazil Web of Science

Background The goals of this study were (1) to present the set of data evaluating running biomechanics (kinematics and kinetics), including data on running habits, demographics, and levels of muscle strength and flexibility made available at Figshare (DOI: 10.6084/m9.figshare.4543435); and (2) to examine the effect of running speed on selected gait-biomechanics variables related to both running injuries and running economy. Methods The lower-extremity kinematics and kinetics data of 28 regular runners were collected using a three-dimensional (3D) motion-capture system and an instrumented treadmill while the subjects ran at 2.5 m/s, 3.5 m/s, and 4.5 m/s wearing standard neutral shoes. Results A dataset comprising raw and processed kinematics and kinetics signals pertaining to this experiment is available in various file formats. In addition, a file of metadata, including demographics, running characteristics, foot-strike patterns, and muscle strength and flexibility measurements is provided. Overall, there was an effect of running speed on most of the gait-biomechanics variables selected for this study. However, the foot-strike patterns were not affected by running speed. Discussion Several applications of this dataset can be anticipated, including testing new methods of data reduction and variable selection; for educational purposes; and answering specific research questions. This last application was exemplified in the study’s second objective.

This article considers the use of Exchange-Traded Funds (ETFs) for indexing the portfolios of pension funds in Brazil. A methodology is proposed to allow the portfolio managers to combine ETFs and the assets composing its benchmark. The methodology is based on a mathematical programming model, with the resulting problem solved by any global optimization algorithm. The results obtained for two ETFs – BOVA11 (indexed to the Ibovespa) and BRAX11 (indexed to the IBrX-100) – are presented for illustrative purposes. All constraints imposed by the Brazilian regulatory environment have been incorporated in the studies presented. The methodology proved to be an interesting alternative to pension fund managers, with good results with respect to the control of tracking errors.

In light of the wide use of cryotherapy and its potential negative effects on postural stability, little is known about how postural sway is affected, particularly when the whole lower limb is immersed. The purpose of this study was to analyze the influence of cryotherapy on postural sway in healthy males. Twenty-six subjects were randomly assigned into two intervention groups: control (tepid water at ∼26 °C) or ice (cold water at ∼11 °C). Postural sway was measured through the center of pressure (COP) position while they stood on a force plate during bipedal (70 s) and unipedal (40 s) conditions before and after the subjects were immersed in a water tub up to the umbilical level for 20 min. COP standard deviation (SD) and COP velocity were analyzed in the anterior–posterior (AP) and medial–lateral (ML) directions. Statistical analysis showed that in the bipedal condition cryotherapy increased the COP SD and COP velocity in the ML direction. During the unipedal condition, a higher COP velocity in the AP and ML direction s was also reported. Our findings indicate that cryotherapy by immersing the whole lower limb should be used with caution before engaging in challenging postural control activities.

Patients with preexisting lung cavities are at risk of developing intracavitary fungal colonization. Because Aspergillus spp. are the most commonly implicated fungi, these fungal masses are called aspergillomas. Their characteristic "ball-in-hole" appearance, however, may be found in a variety of other conditions that can produce radiologic findings mimicking aspergilloma. In this paper, we review the main diseases that may mimic the radiographic findings of aspergilloma, with brief descriptions of clinical, radiologic, and histopathologic findings.

Adrenocortical carcinoma is a rare, aggressive malignancy that features a correspondingly poor prognosis. The disease accounts for 0.2% of all malignancies and despite multimodal therapies, its prognosis remains poor, with a mean survival of

The purpose of this study was to quantify the load on the lumbar spine of subjects when they are asked to adjust from a slouched sitting posture into an upright posture with one of three different strategies: “free” (no instruction) and two coached patterns: “lumbopelvic” dominant and “thoracic” dominant. The activity of selected muscles and kinematic data was recorded from 20 volunteers while performing the three movement patterns to adjust sitting posture. Moments and forces at the lumbar spine were computed from an anatomically detailed model that uses kinematics and muscle activation as input variables. The lumbopelvic pattern produces less joint moment on the lumbar spine (on average 31.2 ± 3.9 N m) when compared to the thoracic pattern (43.8 ± 5.8 N m). However, the joint compression force was similar for these two patterns, but it was smaller in the free pattern, when no coaching was given (lumbopelvic: 1279 ± 112 N, thoracic: 1367 ± (125 N, free: 1181 ± 118 N). Lower thoracic erector muscle activity and higher lumbar erector activity were measured in the lumbopelvic pattern in comparison with the other two. In summary the lumbopelvic pattern strategy using predominantly the movement of anterior pelvic tilt results in smaller joint moments on the lumbar spine and also positions the lumbar spine closest to the neutral posture minimizing passive tissue stress. This may be the strategy of choice for people with low back flexion intolerance.

Existing data are very limited on incidentally detected pulmonary nodules or mediastinal lymph nodes in healthy children who undergo chest MDCT. We aimed to evaluate the prevalence, distribution, and average dimensions of these occasional findings in a cohort of otherwise healthy patients.Two radiologists reviewed in consensus the scans of patients referred for chest MDCT during the preoperative workup for pectus carinatum or pectus excavatum treatments. Exclusion criteria included the presence of any documented malignancy (by date of MDCT or during the 2 years after the examination), history of recent infections, or trauma. Patients' records were assessed after 2 years for the development of any malignancy.A total of 99 individuals (63 boys, 36 girls; mean age, 13.5 years; range, 4-18 years) who fulfilled the study criteria were evaluated. The presence of at least one pulmonary nodule was observed in 75% of the patients, with a mean diameter of 2.8 mm. Of a total number of 225 pulmonary nodules, only 24 (10.7%) were calcified. Mediastinal lymph nodes were also identified in 81% of the cases, with a maximum diameter of 7 mm (smallest axis).The presence of pulmonary nodules or mediastinal lymph nodes on the basis of preoperative chest MDCT scans in healthy children is frequent. Given that 95% of the nodules and 100% of the lymph nodes measured less than 6 mm and 7 mm, respectively, we conclude that incidental findings under these limits are very unlikely to be pathologic.