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Assessment of tumor-infiltrating lymphocytes (TILs) is increasingly recognized as an integral part of the prognostic workflow in triple-negative (TNBC) and HER2-positive breast cancer, as well as many other solid tumors. This recognition has come about thanks to standardized visual reporting guidelines, which helped to reduce inter-reader variability. Now, there are ripe opportunities to employ computational methods that extract spatio-morphologic predictive features, enabling computer-aided diagnostics. We detail the benefits of computational TILs assessment, the readiness of TILs scoring for computational assessment, and outline considerations for overcoming key barriers to clinical translation in this arena. Specifically, we discuss: 1. ensuring computational workflows closely capture visual guidelines and standards; 2. challenges and thoughts standards for assessment of algorithms including training, preanalytical, analytical, and clinical validation; 3. perspectives on how to realize the potential of machine learning models and to overcome the perceptual and practical limits of visual scoring.

Background Chile has one of the highest mortality rates by gastric cancer (GC) worldwide. Primary prevention of GC and detection of pre-neoplastic and early neoplastic lesions should be a national priority. Aim To assess the impact of the protocolization of endoscopy referral and the use of H. pylori stool antigen test (HPSA) in the management of dyspepsia to decrease the waiting list for endoscopy and increase the detection of gastric pre-neoplastic and early neoplastic lesions. Material and Methods We included all patients referred to the Endoscopy Unit of a regional hospital, from January 2015 to December 2017. We also included patients with known pre-neoplastic lesions and all those with first degree relatives with GC. We implemented protocols for referral of patients with dyspepsia considering the use of HPSA test, prioritizing to endoscopy those with a higher risk of GC. Results A total of 4,641 endoscopies and 2,631 HPSA tests were carried out. After the adoption of these protocols, we observed a 52% decrease in the waiting time for endoscopy. The GC detection rate in this period was 1.8 to 3.1 cases per 100 endoscopies. After the adoption of the protocols, we observed a significant increase in early GC detection rate (from none in 2015 to 13% in 2017, p = 0.03). Conclusions The protocolization of the referral for endoscopy associated with widespread use of HPSA test in the management of patients with dyspepsia, are successful strategies to decrease waiting lists for endoscopy and optimize the detection rate of pre-neoplastic lesions and early GC.

Background: To validate the BIRADS in mammography, the calculation of its predictive value in each center is required, as recommended by the American College of Radiology. Aim: To determine the predictive value of the BIRADS system in our center. Material and Methods: All ultrasound guided needle percutaneous biopsies, performed at our center between 2006 and 2010 were reviewed. Predictive value, sensitivity, specificity and diagnostic accuracy of BIRADS were calculated, with a confidence interval of 95%. Results: Of 1,313 biopsies available, 1,058 met the inclusion criteria. Fifty eight percent of biopsies were performed to women with mammographies classified as BIRADS 4 or 5. The presence of cancer in mammographies classified as BIRADS 0 was 4%. The prevalence of cancer for mammographies BIRADS 1, 2, 3, 4 and 5 were 0, 3, 2.7, 17.7 and 72.4% respectively. The positive and negative predictive values of BIRADS classification were 55 and 92 % respectively. Conclusions: In our institution BIRADS classification 4 and 5 has a high positive predictive value for detecting cancer as in developed countries.

Hepatocarcinoma with sarcomatoid transformation is uncommon. It presents clinically with ¡eucocytosis and fever, resembling a liver abscess. We report a 40 year-old male that presented pain in the right upper quadrant and fever. Abdominal imaging showed an hypodense image in the liver that resembled a liver abscess. The patient was subjected to a percutaneous drainage obtaining 150 ml of an hemorrhagic fluid whose culture was negative. The clinical picture persisted and the patient was subjected to a right hepatectomy. The pathological study of the surgical piece disclosed a hepatocarcinoma with sarcomatoid transformation. The patient was discharged sixteen days after surgery

Hepatocarcinoma with sarcomatoid transformation is uncommon. It presents clinically with ¡eucocytosis and fever, resembling a liver abscess. We report a 40 year-old male that presented pain in the right upper quadrant and fever. Abdominal imaging showed an hypodense image in the liver that resembled a liver abscess. The patient was subjected to a percutaneous drainage obtaining 150 ml of an hemorrhagic fluid whose culture was negative. The clinical picture persisted and the patient was subjected to a right hepatectomy. The pathological study of the surgical piece disclosed a hepatocarcinoma with sarcomatoid transformation. The patient was discharged sixteen days after surgery

El estudio determinó los efectos de la exposición a la vertiente, a la altitud y la producción en varios criterios de calidad taza de los cafés a partir de dos localidades altitudinales de Costa Rica, Orosi (entre 1020 y 1250 metros sobre el nivel del mar) y Santa María de Dota (entre 1550 y 1780 metros sobre el nivel del mar). - Las vertientes hacia el este, por lo general, dieron a las bebidas atributos superiores, probablemente debido a una mejor exposición a Ia luz solar durante la mañana. - Estas bebidas fueron principalmente más ácidas: en Orosi se obtuvo una medición de la acidez de 2.73 de un total de 5, (3.64 para Santa María de Dota) para las exposiciones al este, en comparación con 2.36 en el promedio (3.28 para Santa María de Dota) para otras exposiciones. - Además, se encontró en ambos localidades una relación positiva entre Ia altitud y las preferencias del catador. - También se halló una relación negativa entre la producción y la acidez de la bebida en Santa María de Dota, donde algunos cafetos produjeron hasta 13 kilogramos de cerezas del café. - Se caracterizó a los cafés de Orosi por un sabor floral que dependió de la exposición a la vertiente, mientras los de Santa María de Dota ofrecieron un sabor achocolatado, mayormente en las altas altitudes. - En ambas localidades, la cafeína, la trigonelina, los aceites, la sacarosa y los contenidos de ácidos clorogénicos no fueron bien correlacionados con las características sensoriales. (Texte intégral)

El propósito de este estudio era determinar cómo perciben diversos actores en la cadena de commodity la calidad del café. - Al encontrar los productores mencionaron espontáneamente las cualidades del café maduro, los granos y la producción, así como las características de la secuencia del manejo de la cosecha que a menudo permitió alcanzar esas cualidades, y a veces el precio del producto (94.3% de las respuestas). - Los exportadores mencionaron principalmente las características sensoriales de la bebida (75.4% de las respuestas). Los consumidores indicaron, sobre todo, las características relacionadas con el origen (el 45% de las respuestas). - Cuando se consultó preguntas directas en relación con el origen de los mejores cafés en Costa Rica, la región de Los Santos fue la que más se mencionó (sobre el 30% de las respuestas para cada categoría de los actores). - Esto sugirió que en la elaboración de la calidad se consideró de mucha importancia a las localidades. La existencia de un ligamen entre el origen, la calidad y la reputación del producto favorece el desarrollo de indicaciones geográficas. - Sin embargo, las diversas maneras en que se percibe la calidad en la cadena de commodity son un obstáculo para establecer las especificaciones del lugar cuyo propósito principal sería obtener un producto de calidad reconocido por todos. (Texte intégral)