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Abstract The path toward realizing the potential of seasonal forecasting and its socioeconomic benefits relies on improving general circulation model (GCM) based dynamical forecast systems. To improve dynamical seasonal forecasts, it is crucial to set up forecast benchmarks, and clarify forecast limitations posed by model initialization errors, formulation deficiencies, and internal climate variability. With huge costs in generating large forecast ensembles, and limited observations for forecast verification, the seasonal forecast benchmarking and diagnosing task proves challenging. Here, we develop a probabilistic deep learning‐based statistical forecast methodology, drawing on a wealth of climate simulations to enhance seasonal forecast capability and forecast diagnosis. By explicitly modeling the internal climate variability and GCM formulation differences, the proposed Conditional Generative Forecasting (CGF) methodology enables bypassing crucial barriers in dynamical forecast, and offers a top‐down viewpoint to examine how complicated GCMs encode the seasonal predictability information. We apply the CGF methodology for global seasonal forecast of precipitation and 2 m air temperature, based on a unique data set consisting 52,201 years of climate simulation. Results show that the CGF methodology can faithfully represent the seasonal predictability information encoded in GCMs. We successfully apply this learned relationship in real‐world seasonal forecast, achieving competitive performance compared to dynamical forecasts. Using this CGF as benchmark, we reveal the impact of insufficient forecast spread sampling that limits the skill of the considered dynamical forecast system. Finally, we introduce different strategies for composing ensembles using the CGF methodology, highlighting the potential for leveraging the strengths of multiple GCMs to achieve advantgeous seasonal forecast.

Abstract The fidelity of climate projections is often undermined by biases in climate models due to their simplification or misrepresentation of unresolved climate processes. While various bias correction methods have been developed to post‐process model outputs to match observations, existing approaches usually focus on limited, low‐order statistics, or break either the spatiotemporal consistency of the target variable, or its dependency upon model resolved dynamics. We develop a Regularized Adversarial Domain Adaptation (RADA) methodology to overcome these deficiencies, and enhance efficient identification and correction of climate model biases. Instead of pre‐assuming the spatiotemporal characteristics of model biases, we apply discriminative neural networks to distinguish historical climate simulation samples and observation samples. The evidences based on which the discriminative neural networks make distinctions are applied to train the domain adaptation neural networks to bias correct climate simulations. We regularize the domain adaptation neural networks using cycle‐consistent statistical and dynamical constraints. An application to daily precipitation projection over the contiguous United States shows that our methodology can correct all the considered moments of daily precipitation at approximately 1° resolution, ensures spatiotemporal consistency and inter‐field correlations, and can discriminate between different dynamical conditions. Our methodology offers a powerful tool for disentangling model parameterization biases from their interactions with the chaotic evolution of climate dynamics, opening a novel avenue toward big‐data enhanced climate predictions.

Abstract Background Celiac disease is an autoimmune disorder triggered by dietary gluten in genetically predisposed individuals that primarily affects the small intestine. Studies have reported differentially abundant bacterial taxa in the gut microbiota of celiac patients compared with non-celiac controls. However, findings across studies have inconsistencies and no microbial signature of celiac disease has been defined so far. Results Here, we showed, by comparing celiac patients with their non-celiac 1st-degree relatives, that bacterial communities of related individuals have similar species occurrence and abundance compared with non-relatives, regardless the disease status. We also found in celiac patients a loss of bacterial species associated with fiber degradation, and host metabolic and immune modulation, as ruminiclostridia, ruminococci, Prevotella, and Akkermansia muciniphila species. We demonstrated that the differential abundance of bacterial species correlates to different dietary patterns observed between the two groups. For instance, Ruminiclostridium siraeum, Ruminococcus bicirculans, and Bacteroides plebeious, recognized as fiber-degraders, appear more abundant in non-celiac 1st-degree relatives, which have a vegetable consumption pattern higher than celiac patients. Pattern of servings per day also suggests a possible link between these species’ abundance and daily calorie intake. Conclusions Overall, we evidenced that a kinship approach could be valuable in unveiling potential celiac disease microbial traits, as well as the significance of dietary factors in shaping microbial profiles and their influence on disease development and progression. Our results pave the way for designing and adopting novel dietary strategies based on gluten-free fiber-enriched ingredients to improve disease management and patients' quality of life.

Introduction: Sarcoidosis, a systemic granulomatous disorder with uncertain etiology, commonly involves the lungs and, to a lesser extent, the liver. Case Presentation: A previously healthy 35-year-old Congolese female was admitted with a 7-month history of jaundice, itching, and weight loss. Despite markedly mixed hepatitis of a cholestatic pattern of liver injury, liver function tests remained normal in admission laboratory work. Enlarged ethiological study was negative for infections, autoimmunity, heavy metal poisoning, and metabolic diseases. Imaging aligned with compatible biopsy histology led to the diagnosis of hepatic and pulmonary sarcoidosis with vanishing bile duct syndrome. Despite initial treatment with ursodeoxycholic acid and corticosteroid therapy, the patient exhibited an unexpected exacerbation of liver enzymes, prompting a careful consideration of second-line interventions. Following discussion with a tertiary center and a comprehensive review of the literature, it was determined not to intensify therapy due to an inadequate response. Recognizing the persistent challenge of managing advanced cases and the potential progressive course of the disease, the patient was referred to a tertiary transplant center. Currently, she is under outpatient follow-up, clinical and analytically stable with no targeted therapy. Conclusion: This case report details a rare presentation of hepatic sarcoidosis with an unusual laboratory pattern, emphasizing diagnostic and management challenges in recognizing atypical presentations of hepatic sarcoidosis. The complexity of managing advanced cases warrants a multidisciplinary approach and the limited literature on this subject emphasizes the urgency for a more comprehensive understanding of sarcoidosis to improve diagnostic accuracy and refine therapeutic approaches.

Abstract Necrophilic behavior (attempted copulation with corpses) has been scarcely reported in non-human primates, especially in the wild. Here is the first case of necrophilic behavior observed in wild stump-tailed macaques in Thailand. Six groups of total N > 460 individuals have been identified and habituated. The corpse of an adult female was found and directly observed for 2 days and by camera trap for 3 days. The cause of death could not be identified, but no prominent physical injury was detected. Within 3 days of the observation, three different males attempted copulation with the corpse. Noteworthy for this observation was that not only males in the group of the dead female but also males from different groups interacted with the corpse. Taken together, these observations suggest that some cues emanating from the corpse coupled with a nonresistant/passive orientation may have triggered these responses in the males. Given that necrophiliac responses have been scarcely reported in non-human primates, our findings provide new insight into these behaviors and to comparative thanatology in general.

Cavernous sinus syndrome is characterized by ophthalmoplegia, diplopia, facial hypoesthesia, Horner syndrome and proptosis. The authors present a clinical case of an 89-year-old woman presented to the emergency department with complaints of vomiting, severe left frontotemporal headache, photophobia, left ptosis and diplopia with less than 24 hours of evolution. Neurological examination revealed ptosis and limitation of all eye movements in the left eye. Cranioencephalic computed tomography and magnetic resonance imaging showed an expansive lesion with expression in the suprasellar cistern and in the left cavernous sinus, suggestive of a macroadenoma with signs of hemorrhagic transformation. Cavernous sinus syndrome has several etiologies, as cerebrovascular diseases, infectious diseases, and trauma. In addition to the clinical history and physical examination, imaging tests are essential to determine the etiology behind this syndrome.

Abstract Background Machine learning (ML) has made a significant impact in medicine and cancer research; however, its impact in these areas has been undeniably slower and more limited than in other application domains. A major reason for this has been the lack of availability of patient data to the broader ML research community, in large part due to patient privacy protection concerns. High-quality, realistic, synthetic datasets can be leveraged to accelerate methodological developments in medicine. By and large, medical data is high dimensional and often categorical. These characteristics pose multiple modeling challenges. Methods In this paper, we evaluate three classes of synthetic data generation approaches; probabilistic models, classification-based imputation models, and generative adversarial neural networks. Metrics for evaluating the quality of the generated synthetic datasets are presented and discussed. Results While the results and discussions are broadly applicable to medical data, for demonstration purposes we generate synthetic datasets for cancer based on the publicly available cancer registry data from the Surveillance Epidemiology and End Results (SEER) program. Specifically, our cohort consists of breast, respiratory, and non-solid cancer cases diagnosed between 2010 and 2015, which includes over 360,000 individual cases. Conclusions We discuss the trade-offs of the different methods and metrics, providing guidance on considerations for the generation and usage of medical synthetic data.

As bacias hidrográficas vêm passando por diversas transformações de suas paisagens naturais por meio de intervenções antrópicas, dessa forma os corpos hídricos passam por perturbações ambientais. O objetivo do presente estudo foi avaliar os parâmetros físico-químicos e biológicos da água do Córrego da Cascata que corta o Parque Ecológico Municipal Chico Mendes (Mata do Furquim) no município de Presidente Prudente – SP. A metodologia utilizada nas amostragens e análises da água foram realizadas através dos procedimentos padrões descritos Standard Methods. Em relação a fauna, foi realizada amostragem e análise dos macroinvertebrados bentônicos seguindo a metodologia de coleta por Surber (Junqueira & Campos 1998; Junqueira et al. 2000; Vieira 2017). Para análise dos resultados foram utilizadas as Resoluções n° 357/2005, n° 430/2011 do CONAMA e Decreto 10.755/77 como referência, além do cálculo do IQA para análise da qualidade da água e o índice BMWP para análise dos macroinvertebrados bentônicos. Conforme o IQA, os três pontos foram classificados como regulares ao longo do córrego. O índice BMWP classificou um ponto como ruim e dois pontos como águas regulares. As bacias hidrográficas vêm passando por diversas transformações de suas paisagens naturais por meio de intervenções antrópicas, dessa forma os corpos hídricos passam por perturbações ambientais. O objetivo do presente estudo foi avaliar os parâmetros físico-químicos e biológicos da água do Córrego da Cascata que corta o Parque Ecológico Municipal Chico Mendes (Mata do Furquim) no município de Presidente Prudente – SP. A metodologia utilizada nas amostragens e análises da água foram realizadas através dos procedimentos padrões descritos Standard Methods. Em relação a fauna, foi realizada amostragem e análise dos macroinvertebrados bentônicos seguindo a metodologia de coleta por Surber (Junqueira & Campos 1998; Junqueira et al. 2000; Vieira 2017). Para análise dos resultados foram utilizadas as Resoluções n° 357/2005, n° 430/2011 do CONAMA e Decreto 10.755/77 como referência, além do cálculo do IQA para análise da qualidade da água e o índice BMWP para análise dos macroinvertebrados bentônicos. Conforme o IQA, os três pontos foram classificados como regulares ao longo do córrego. O índice BMWP classificou um ponto como ruim e dois pontos como águas regulares.

Chimpanzees exhibit a variety of behaviours surrounding their dead, although much less is known about how they respond towards conspecific skeletons. We tested chimpanzees' visual attention to images of conspecific and non-conspecific stimuli (cat/chimp/dog/rat), shown simultaneously in four corners of a screen in distinct orientations (frontal/diagonal/lateral) of either one of three types (faces/skulls/skull-shaped stones). Additionally, we compared their visual attention towards chimpanzee-only stimuli (faces/skulls/skull-shaped stones). Lastly, we tested their attention towards specific regions of chimpanzee skulls. We theorized that chimpanzee skulls retaining face-like features would be perceived similarly to chimpanzee faces and thus be subjected to similar biases. Overall, supporting our hypotheses, the chimpanzees preferred conspecific-related stimuli. The results showed that chimpanzees attended: (i) significantly longer towards conspecific skulls than other species skulls (particularly in forward-facing and to a lesser extent diagonal orientations); (ii) significantly longer towards conspecific faces than other species faces at forward-facing and diagonal orientations; (iii) longer towards chimpanzee faces compared with chimpanzee skulls and skull-shaped stones, and (iv) attended significantly longer to the teeth, similar to findings for elephants. We suggest that chimpanzee skulls retain relevant, face-like features that arguably activate a domain-specific face module in chimpanzees' brains, guiding their attention.

O cancro é um enorme problema de saúde em todo o mundo, com uma prevalência crescente. A dor é uma comorbilidade experienciada de uma forma complexa pelos doentes com lesões metastáticas. Devido à complexidade dos mecanismos envolvidos na génese e manutenção da dor oncológica, a abordagem clássica com a administração de medicamentos opioides parece ser insuficiente

Background: In the therapeutic decision about the malignant colon polyp, several factors predicting residual disease after the endoscopic resection guide the decision of surveillance or surgical intervention. This is a challenging decision, because even in the presence of high-risk predictors currently used, only 15–30% of the patients will have residual disease in the surgical specimen. Objective: To evaluate patients with a diagnosis of malignant colon polyp at the Hospital Center of São João, who were indicated for surgical treatment, studying the predictors of residual disease in the surgical specimen. Methods: A retrospective study was carried out, based on the patients with malignant colon polyp diagnosed and treated at the Hospital Center of São João in the city of Porto, Portugal, between 2009 and 2016. The endoscopic, anatomopathological, surgical and follow-up data were reviewed. Results: Of the total number of patients in the study (n = 96), 59 (61.5%) were indicated for surgery after a multidisciplinary discussion. Of this group, 21 patients (35.6%) had residual disease in the surgical specimen, with presence of lymph node invasion in 8 patients (13.6%). The presence of malignancy in the surgical resection specimen was statistically significantly associated with: size of the resected polyp (p = 0.023); sessile polyp (p = 0.007); piecemeal resection (p = 0.002). Conclusions: The persistence of malignancy in the surgical specimen was associated with larger sessile polyps and piecemeal removal. A significant number of patients did not show malignancy in the surgical resection specimen, with more markers being required to better stratify patients. Resumo: Contexto: Na decisão terapêutica do pólipo maligno do cólon diversos fatores preditores de doença residual após a recessão endoscópica norteiam a decisão de vigilância ou intervenção cirúrgica. Esta é uma decisão desafiadora, uma vez que mesmo na presença dos preditores de alto risco usados atualmente, apenas 15% a 30% dos doentes terão doença residual na peça cirúrgica. Objetivo: Avaliar os doentes com diagnóstico de pólipo maligno do cólon no Centro Hospitalar de São João que foram orientados para tratamento cirúrgico, estudando os preditores de doença residual na peça cirúrgica. Métodos: Foi realizado um estudo retrospetivo, tendo por base os doentes com pólipo maligno do cólon diagnosticado e tratado no Centro Hospitalar de São João no Porto, Portugal, entre 2009 e 2016. Os dados endoscópicos, anatomopatológicos, cirúrgicos e o seguimento foram revistos. Resultados: Do total de doentes em estudo (n = 96); 59 (61,5%) tiveram indicação para cirurgia após discussão multidisciplinar. Deste grupo, 21 doentes (35,6%) apresentavam doença residual na peça cirúrgica, com presença de invasão ganglionar em 8 doentes (13,6%). A presença de malignidade na peça de ressecção cirúrgica associava-se de forma estatisticamente significativa a: tamanho do pólipo ressecado (p = 0,023); pólipo séssil (p = 0,007); ressecção em piecemeal (p = 0,002). Conclusões: A persistência de malignidade na peça cirúrgica associou-se a pólipos sésseis, de maiores dimensões e à remoção em piecemeal. Um número importante de doentes não apresentava malignidade na peça de ressecção cirúrgica, sendo necessários mais marcadores para melhor estratificar os doentes. Keywords: Malignant polyp, Colon cancer, Surgery, Residual disease, Palavras-chave: Pólipo maligno, Cancro do cólon, Cirurgia, Doença residual

This essay aims at characterizing and discussing a route pursued by the body in the western society, from the building of the concept of the body-property to the postmodernist dilemmas which provided a gateway to a new corporeality. In modernity, the body was submitted to science and to the political and economic means of production and, under specific conditions, conducted to a utilitarian biologizing description. Postmodernity has brought an identity crisis and the subsequent hyperconsumerism, and has watched this social model lay its bioascetic guidelines on the body, redescribing it. The need to extend the time/space of body consumerism indistinctly approaches the scientific breakthroughs: drugs, bionic prostheses, plastic surgeries, wearable computers, genetic modifications. The desire to void the biological coercions, functional and aesthetic improvements of the body and even immortality give rise to a new description: the futurible body.

INTRODUCTION: Nymphoplasty or labioplasty is the most common genital plastic surgery. The objective of labioplasty is to correct hypertrophy of the labia minora and clitoral prepuce, removing excess tissue without affecting their function of protecting the vagina and aiding in genital lubrication. Several types of classifications have been proposed to facilitate the understanding of the degree of hypertrophy of the labia minora and assist in selecting the most suitable procedure in labioplasty. After analyzing several classifications, the author proposes a new classification to facilitate the understanding of hypertrophy of the labia minora, clitoral hood, and vaginal prepuce and help select the best labioplasty procedure. METHODS: A literature search was conducted in PubMed/Medline using the following terms: hipertrofia lábios vaginais, labioplastia, labiaplasty, labioplasty, labia minora hypertrophy, and labial protrusion. All the classifications described in the identified studies were analyzed. RESULTS: A new classification has been proposed. Hypertrophy of the labia minora was classified in four grades: grade 0 (< 1 cm), grade 1 (> 1 cm and < 3 cm), grade 2 (> 3 cm and > 5 cm), and grade 3 (> 5 cm). CONCLUSIONS: The new classification improves the understanding of the size and extent of hypertrophy of the labia minora and helps select the best procedure in labioplasty.

The use of magnetic nanoparticles (MNPs) in biomedical applications requires the quantitative knowledge of their quantitative distribution within the body. AC Biosusceptometry (ACB) is a biomagnetic technique recently employed to detect MNPs in vivo by measuring the MNPs response when exposed to an alternate magnetic field. The ACB technique presents some interesting characteristics: non-invasiveness, low operational cost, high portability, and no need for magnetic shielding. ACB conventional methods until now provided only qualitative information about the MNPs’ mapping in small animals. We present a theoretical model and experimentally demonstrate the feasibility of ACB reconstructing 2D quantitative images of MNPs’ distributions. We employed an ACB single-channel scanning approach, measuring at 361 sensor positions, to reconstruct MNPs’ spatial distributions. For this, we established a discrete forward problem and solved the ACB system’s inverse problem. Thus, we were able to determine the positions and quantities of MNPs in a field of view of 5×5×1 cm3 with good precision and accuracy. The results show the ACB system’s capabilities to reconstruct the quantitative spatial distribution of MNPs with a spatial resolution better than 1 cm, and a sensitivity of 1.17 mg of MNPs fixed in gypsum. These results show the system’s potential for biomedical application of MNPs in several studies, for example, electrochemical-functionalized MNPs for cancer cell targeting, quantitative sensing, and possibly in vivo imaging.