Combined larynx large cell neuroendocrine and squamous cell carcinoma: a case report.

Laryngeal cancer ranks third among the most common head and neck neoplasms. The most common histological subtype is squamous cell carcinoma, and neuroendocrine tumors are rare. An even rarer entity is a composite tumor with both these histologies. This case reports a metastatic combined carcinoma of squamous cells and large neuroendocrine cells, presenting favorable response to treatment with a total laryngectomy followed by adjuvant therapy including chemo-, radio-, and immunotherapy.

Multilayer spintronic neural networks with radiofrequency connections.

Spintronic nano-synapses and nano-neurons perform neural network operations with high accuracy thanks to their rich, reproducible and controllable magnetization dynamics. These dynamical nanodevices could transform artificial intelligence hardware, provided they implement state-of-the-art deep neural networks. However, there is today no scalable way to connect them in multilayers. Here we show that the flagship nano-components of spintronics, magnetic tunnel junctions, can be connected into multilayer neural networks where they implement both synapses and neurons thanks to their magnetization dynamics, and communicate by processing, transmitting and receiving radiofrequency signals. We build a hardware spintronic neural network composed of nine magnetic tunnel junctions connected in two layers, and show that it natively classifies nonlinearly separable radiofrequency inputs with an accuracy of 97.7%. Using physical simulations, we demonstrate that a large network of nanoscale junctions can achieve state-of-the-art identification of drones from their radiofrequency transmissions, without digitization and consuming only a few milliwatts, which constitutes a gain of several orders of magnitude in power consumption compared to currently used techniques. This study lays the foundation for deep, dynamical, spintronic neural networks.

Risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy in thyroid nodules with diameters greater than 4 centimeters.

Objective: The risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy (FNAB) of thyroid nodules (TN) with diameters ≥ 3-4 cm remains controversial. However, some groups have indicated surgical treatment in these patients regardless of the FNAB results. We aimed to evaluate the diagnostic accuracy of the FNAB in systematically resected ≥4 cm TN and if the risk of malignancy is higher in these patients. Subjects and methods: We retrospectively evaluated 138 patients (142 nodules) with TN with diameters ≥4 cm who underwent thyroidectomy. Results: The FNAB results were nondiagnostic/unsatisfactory (ND/UNS) in 2.1% of the cases and benign in 51.4%. They indicated atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) in 23.9% of cases, follicular neoplasia/suspicious for a follicular neoplasm (FN/SFN) in 9.2%, suspicion of malignancy (SUS) in 8.5%, and malignant in 4.9%. The histopathological analysis after thyroidectomy revealed a thyroid cancer rate of 100% in the FNABs classified as malignant, 33.3% in SUS cases, 7.7% in FN/SFN, 17.6% in AUS/FLUS, and 4.1% in benign FNABs. None of the ND/UNS FNABs were malignant. The global malignancy diagnosis was 14.8% (n = 21). However, the rate of false negatives for FNAB was low (4.1%). Conclusion: We showed that the risk of malignancy in nodules with diameters ≥4 cm was higher compared to the risk of thyroid cancer in TN in general. However, we found a low rate of false-negative cytological results; therefore, our data do not justify the orientation of routine resection for these larger nodules.

Risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy in thyroid nodules with diameters greater than 4 centimeters

ABSTRACT Objective: The risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy (FNAB) of thyroid nodules (TN) with diameters ≥ 3-4 cm remains controversial. However, some groups have indicated surgical treatment in these patients regardless of the FNAB results. We aimed to evaluate the diagnostic accuracy of the FNAB in systematically resected ≥4 cm TN and if the risk of malignancy is higher in these patients. Subjects and methods: We retrospectively evaluated 138 patients (142 nodules) with TN with diameters ≥4 cm who underwent thyroidectomy. Results: The FNAB results were nondiagnostic/unsatisfactory (ND/UNS) in 2.1% of the cases and benign in 51.4%. They indicated atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) in 23.9% of cases, follicular neoplasia/suspicious for a follicular neoplasm (FN/SFN) in 9.2%, suspicion of malignancy (SUS) in 8.5%, and malignant in 4.9%. The histopathological analysis after thyroidectomy revealed a thyroid cancer rate of 100% in the FNABs classified as malignant, 33.3% in SUS cases, 7.7% in FN/SFN, 17.6% in AUS/FLUS, and 4.1% in benign FNABs. None of the ND/UNS FNABs were malignant. The global malignancy diagnosis was 14.8% (n = 21). However, the rate of false negatives for FNAB was low (4.1%). Conclusion: We showed that the risk of malignancy in nodules with diameters ≥4 cm was higher compared to the risk of thyroid cancer in TN in general. However, we found a low rate of false-negative cytological results; therefore, our data do not justify the orientation of routine resection for these larger nodules.

Análise de Maturidade em Gestão do Conhecimento na Secretaria Municipal de Saúde da Prefeitura do município de Contagem, Minas Gerais, Brasil / Analysis of Maturity in Knowledge Management at the Municipal Health Department of the Municipality of Contagem, Minas Gerais, Brazil

O objetivo desta pesquisa foi analisar o nível de maturidade de Gestão do Conhecimento na Secretaria Municipal de Saúde da Prefeitura do município de Contagem, Minas Gerais, Brasil, aliando teoria e prática. A maturidade em Gestão do Conhecimento é estabelecida em 13 dimensões, que devem ser consideradas concomitantemente. Os métodos utilizados consistem na aplicação de um instrumento de pesquisa constituído por 39 afirmativas, dispostas em escala likert de cinco pontos, seccionadas em 13 constructos, os quais são analisados sob a ótica positivista, por meio dos critérios de Kaiser-Meyer-Olkin para dimensionalidade, Alfa de Cronbach para confiabilidade e r de Pearson junto ao p-Valor para validade, sendo adotadas Médias, Desvio Padrão e Intervalo de Confiança de 95 porcent. Os resultados indicam que a instituição se encontra no nível três de cinco, denominado Incipiente, caracterizado por buscar gerenciar o conhecimento e suas áreas críticas para seu sucesso. Para elevação ao nível quatro de cinco de maturidade, são sugeridas três ações para as dimensões, Estratégia, Liderança e suporte da Alta Administração, Equipe de Gestão do Conhecimento, Recursos (financeiro, humano, material e tempo), Processos e Atividades, Gestão de Recursos Humanos, Treinamento e Educação, Motivação, Trabalho em Equipe, Cultura, Mensuração e Projeto Piloto e duas ações para a dimensão Tecnologia da Informação, totalizando 38 ações para promoção da maturidade. Esta pesquisa contribuiu na busca por estudos empíricos sobre nível de maturidade de Gestão do Conhecimento e instiga novos estudos em diferentes instituições públicas(AU)

El objetivo de esta investigación fue analizar el nivel de madurez de la Gestión del Conocimiento en la Secretaría Municipal de Salud del Municipio de Contagem, Minas Gerais, Brasil, combinando teoría y práctica. La madurez en Gestión del Conocimiento se establece en 13 dimensiones, las cuales deben ser consideradas concomitantemente. Los métodos utilizados consisten en la aplicación de un instrumento de investigación que consta de 39 enunciados, ordenados en una escala tipo Likert de cinco puntos, seccionados en 13 constructos, los cuales son analizados desde una perspectiva positivista, utilizando los criterios de dimensionalidad de Kaiser-Meyer-Olkin; Alfa de Cronbach para la confiabilidad y r de Pearson junto con el valor-p para validez; se adopta el análisis de la media, la desviación estándar y el intervalo de confianza del 95 por ciento. Los resultados indican que la institución se encuentra en el nivel tres de cinco, denominado incipiente, caracterizado por buscar gestionar el conocimiento y sus áreas críticas en función de su éxito. Para la elevación al nivel cuatro de cinco de madurez se sugieren tres acciones para las dimensiones: estrategia, liderazgo y apoyo a la alta dirección, equipo de gestión del conocimiento, recursos (económicos, humanos, materiales y de tiempo), procesos, actividades, recursos humanos, capacitación y educación, motivación, trabajo en equipo, cultura, medición y proyecto piloto; además dos acciones para la dimensión de Tecnologías de la Información. Se proponen 38 acciones en total para promover la madurez. Esta investigación contribuyó a la búsqueda de estudios empíricos sobre el nivel de madurez de la Gestión del Conocimiento y propone nuevos estudios en diferentes instituciones públicas(AU)

The objective of this research was to analyze the maturity level of Knowledge Management in the Municipal Health Department of the Municipality of Contagem, Minas Gerais, Brazil, combining theory and practice. Maturity in Knowledge Management is established in 13 dimensions, which must be considered concomitantly. The methods used consist of the application of a research instrument consisting of 39 statements, arranged on a five-point Likert scale, sectioned into 13 constructs, which are analyzed from a positivist perspective, using the Kaiser-Meyer-Olkin criteria for dimensionality. , Cronbach's Alpha for reliability and Pearson's r together with the p-Value for validity, adopting Means, Standard Deviation and Confidence Interval of 95percent. The results indicate that the institution is at level three out of five, called Incipient, characterized by seeking to manage knowledge and its critical areas for its success. For elevation to level four out of five of maturity, three actions are suggested for the dimensions, Strategy, Leadership and Senior Management support, Knowledge Management Team, Resources (financial, human, material and time), Processes and Activities, Human Resources, Training and Education, Motivation, Teamwork, Culture, Measurement and Pilot Project and two actions for the Information Technology dimension, totaling 38 actions to promote maturity. This research contributed to the search for empirical studies on the maturity level of Knowledge Management and instigates new studies in different public institutions(AU)

Combined larynx large cell neuroendocrine and squamous cell carcinoma: a case report

ABSTRACT Laryngeal cancer ranks third among the most common head and neck neoplasms. The most common histological subtype is squamous cell carcinoma, and neuroendocrine tumors are rare. An even rarer entity is a composite tumor with both these histologies. This case reports a metastatic combined carcinoma of squamous cells and large neuroendocrine cells, presenting favorable response to treatment with a total laryngectomy followed by adjuvant therapy including chemo-, radio-, and immunotherapy.

Ultrasound classification of thyroid nodules: does size matter?

OBJECTIVE: To determine whether the size of thyroid nodules in ACR-TIRADS ultrasound categories 3 and 4 is correlated with the Bethesda cytopathology classification. METHODS: Thyroid nodules (566) subclassified as ACR-TIRADS 3 or 4 were divided into three size categories according to American Thyroid Association guidelines. The frequency of different Bethesda categories in each size range within ACR-TIRADS 3 and 4 classifications was analyzed. RESULTS: Most nodules in both ACR-TIRADS classifications fell in the Bethesda 2 category, regardless of size (90.8% and 68.6%, ACR-TIRADS 3 and 4 respectively). The prevalence of Bethesda 6 nodules in the ACR-TIRADS 4 group was 14 times higher than in the ACR-TIRADS 3 group. There were no significant differences between nodule size and fine needle aspiration biopsy classification in any of the ACR-TIRADS categories. CONCLUSION: Size does not appear to be an important criterion for indication of fine needle aspiration biopsy in thyroid nodules with a high suspicion of malignancy on ultrasound examination.

Cryodehydration protocol to obtain high-quality permanent anatomical material.

The study of anatomy is largely dependent on cadaveric specimens to fulfill the tridimensional comprehension of each structure as well as the relationship between organs. Given the difficult access to fresh anatomical specimens, the constant renovation of samples for research and educational purposes is unsustainable, beyond the ethical issues involved. The standard technique for preserving specimens involves fixation and later immersion in formaldehyde, which enables a good result, but also presents elevated carcinogenic potential. Therefore, safe and efficient preservation methods are mandatory for anatomical practices and investigations. An accessible and inexpensive alternative for specimen preservation is cryodehydration. Cryodehydrated specimens can be kept dry, with no final odor, reducing the use and exposure to formaldehyde. The objective of this study was to propose a simplified step-by-step cryodehydration protocol to obtain high-quality anatomical specimens. Through consecutive freezing and thawing cycles, cryodehydration caused a weight reduction of 60%-70% and allowed anatomical preservation, while maintaining the main morphological aspects of cavitary and parenchymatous organs, muscles, or even full-body sections. The final specimens presented high durability and can be maintained for decades, preserving all relevant anatomical features.

Validation of the brazilian version of the oral health impact profile - Aesthetic questionnaire.

The aim of the study was to develop the Brazilian version of the Oral Health Impact Profile - Aesthetic Questionnaire (OHIP-Aes-Braz) and test its psychometric properties. The questionnaire test versions were developed by a panel of experts and a pre-test was conducted in a focus group. Data used for testing its psychometric properties were obtained from a randomized controlled clinical trial on tooth bleaching. Seventy-nine Brazilian adults were included. The questionnaires were applied before tooth bleaching treatment (baseline), one week (T1), and one month after the intervention (T2). Reliability was assessed in terms of internal consistency and stability, while validity was ascertained by criterion and construct validity. The sensitivity to change was assessed comparing the total scores at baseline and T2, using the Wilcoxon test (α = 0.05). Both stability and internal consistency (intra-class correlation coefficient=0.95, Cronbach's α = 0.92) proved to be adequate. Construct validity was confirmed as the correlation between OHIP-Aes-Braz scores with tooth color satisfaction and self-perceived oral health were in the expected direction. A positive correlation between OHIP-Aes-Braz and OHIP-14 (rs=0.63) and OIDP (rs=0.77) was observed. The instrument was responsive once differences in total scores before and after treatment were statistically significant (p<0.001). The OHIP-Aes-Braz presented good psychometric properties and showed sensitivity to change regarding aesthetics evaluation in Brazilian adults treated with tooth bleaching. A valid and reliable instrument allows a suitable assessment of oral health-related quality of life in Brazilian patients submitted to aesthetics dental interventions.

Validation of the brazilian version of the oral health impact profile - Aesthetic questionnaire

Abstract The aim of the study was to develop the Brazilian version of the Oral Health Impact Profile - Aesthetic Questionnaire (OHIP-Aes-Braz) and test its psychometric properties. The questionnaire test versions were developed by a panel of experts and a pre-test was conducted in a focus group. Data used for testing its psychometric properties were obtained from a randomized controlled clinical trial on tooth bleaching. Seventy-nine Brazilian adults were included. The questionnaires were applied before tooth bleaching treatment (baseline), one week (T1), and one month after the intervention (T2). Reliability was assessed in terms of internal consistency and stability, while validity was ascertained by criterion and construct validity. The sensitivity to change was assessed comparing the total scores at baseline and T2, using the Wilcoxon test (α = 0.05). Both stability and internal consistency (intra-class correlation coefficient=0.95, Cronbach's α = 0.92) proved to be adequate. Construct validity was confirmed as the correlation between OHIP-Aes-Braz scores with tooth color satisfaction and self-perceived oral health were in the expected direction. A positive correlation between OHIP-Aes-Braz and OHIP-14 (rs=0.63) and OIDP (rs=0.77) was observed. The instrument was responsive once differences in total scores before and after treatment were statistically significant (p<0.001). The OHIP-Aes-Braz presented good psychometric properties and showed sensitivity to change regarding aesthetics evaluation in Brazilian adults treated with tooth bleaching. A valid and reliable instrument allows a suitable assessment of oral health-related quality of life in Brazilian patients submitted to aesthetics dental interventions.

Resumo O objetivo do estudo foi desenvolver a versão brasileira do Oral Health Impact Profile - Aesthetic Questionnaire (OHIP-Aes-Braz) e testar suas propriedades psicométricas. As versões de teste do questionário foram desenvolvidas por um painel de especialistas e um pré-teste foi realizado em um grupo focal. Os dados usados para testar suas propriedades psicométricas foram obtidos a partir de um ensaio clínico randomizado controlado de clareamento dental. Setenta e nove brasileiros adultos foram incluídos. Os questionários foram aplicados antes do tratamento clareador (baseline), uma semana (T1) e um mês após a intervenção (T2). A confiabilidade foi avaliada em termos de consistência interna e estabilidade, enquanto a validade foi avaliada pela validade de critério e de construto. A sensibilidade à mudança foi avaliada pela comparação entre os escores totais no baseline e T2, usando o teste de Wilcoxon ((=0,05). Tanto a estabilidade quanto a consistência interna (coeficiente de correlação intraclasse=0,95, alfa de Cronbach=0,92) mostraram-se adequadas. A validade de construto foi confirmada uma vez que a correlação dos escores do OHIP-Aes-Braz com a satisfação com a cor dos dentes e a autopercepção da saúde bucal foram na direção esperada. Uma correlação positiva entre OHIP-Aes-Braz e OHIP-14 (r s =0,63) e OIDP (r s =0,77) foi observada. O instrumento foi responsivo uma vez que as diferenças nos escores totais antes e depois do tratamento foram estatisticamente significantes (p<0,001). O OHIP-Aes-Braz apresentou boas propriedades psicométricas e mostrou sensibilidade a mudanças na avaliação estética em adultos brasileiros submetidos ao clareamento dental. Um instrumento válido e confiável permite uma avaliação adequada da qualidade de vida relacionada à saúde bucal em pacientes brasileiros submetidos a intervenções odontológicas estéticas.

The influence of final endodontic irrigation techniques and irrigants on the push-out resistance of glass fiber posts.

This study evaluated the influence of different combinations of 3 final endodontic irrigation techniques (positive-pressure irrigation [PPI], passive ultrasonic irrigation [PUI], and continuous ultrasonic irrigation [CUI]) and 2 irrigants (5.25% sodium hypochlorite [NaOCl] and 2% chlorhexidine [CHX]) on the push-out resistance of glass fiber posts. Ninety bovine roots were prepared and divided into 6 groups (n = 15): PPIN, PPI with 5.25% NaOCl; PUIN, PUI with 5.25% NaOCl; CUIN, CUI with 5.25% NaOCl; PPIC, PPI with 2% CHX; PUIC, PUI with 2% CHX; and CUIC, CUI with 2% CHX. In the PPI groups, a 30-gauge needle was used to deliver the irrigating solution. In the PUI groups, a 30-gauge needle was used to deliver the irrigating solution, which was activated for 10 seconds by means of a stainless steel file mounted on an ultrasonic unit. In the CUI groups, delivery and continuous agitation of the irrigating solution for 10 seconds were performed using a stainless steel file mounted on the ultrasonic unit. After canal preparation was completed, glass fiber posts were cemented with a dual-cure resin cement. The roots were sectioned into 1-mm-thick slices (coronal, middle, and apical thirds). After 7 days' storage in distilled water, the slices were submitted to a push-out test. The mean bond strength values were compared using 2-way analysis of variance and Tukey post hoc test (P < 0.05). The mean (SD) overall bond strength values of the specimens were as follows: PPIN, 4.46 (1.43) MPa; PUIN, 6.13 (2.35) MPa; CUIN, 7.41 (1.83) MPa; PPIC, 3.59 (1.70) MPa; PUIC, 5.49 (1.41) MPa; and CUIC, 6.0 (1.63) MPa. Irrespective of the irrigating solution, continuous ultrasonic irrigation achieved significantly greater push-out bond strengths for glass fiber posts, mainly at the apical third of the root specimens (P < 0.05).

Effect of luting cement thickness on the bond strength of glass fiber posts to dentin.

The objective of this study was to evaluate the effect of cement thickness and luting cement type on the push-out bond strength of glass fiber posts (GFPs) to root dentin. Sixty human maxillary root-filled canines or premolars with single straight roots were randomly divided into 6 groups (n = 10) according to the GFP configuration (conventional or relined with composite resin) and the cement used (RelyX U200, Ketac Cem, or Allcem Core). After endodontic treatment and GFP cementation, all of the roots were sectioned perpendicular to their long axis to obtain 1.0-mm-thick slices (n = 6 per group), which were mounted on a universal testing machine and submitted to a push-out test. The data (n = 45 to 51 specimens per group because of pretest failures) were analyzed by means of 2-way analysis of variance (ANOVA) and Tukey tests (α = 0.05). The type of failure was determined under a stereomicroscope, and representative specimens were observed with scanning electron microscopy. Significant interactions between the cements and GFP configurations were detected in the coronal and apical thirds (P < 0.05; 2-way ANOVA). For the coronal third, both RelyX U200 cement groups exhibited the greatest push-out bond strengths but were not significantly different from the Allcem Core relined group. For the middle third, no statistically significant interactions were observed between the cements and GFP configurations (P = 0.232; 2-way ANOVA). Adhesive failure between the dentin and cement layer was the most frequently observed failure mode. As expected, because of the composite resin added to relined GFPs, the cement layer was thinner in those groups. The type of cement used played an important role in the push-out bond strength.

Is the at-home bleaching treatment applied only on the lingual surface as effective as that on the buccal surface? A randomized clinical trial.

OBJECTIVES: This double-blind randomized clinical trial compared the effectiveness and bleaching sensitivity (BS) of at-home dental bleaching performed on the buccal surface and on the lingual surface. METHODS: Using a split-mouth design, 25 patients were assigned to two bleaching groups: 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the buccal surface (BSB) and 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the lingual surface (LSB), both for 14 days. The color was evaluated before bleaching, after the first and second weeks, and 1 month after the bleaching using Vita Classical and Vita Bleachedguide scales and a Vita Easyshade spectrophotometer. BS was recorded daily using a 0-4 numerical rating scale and a 0-10 visual analogue scale. The following statistical tests were used: color changes (Mann-Whitney), absolute risk of BS (McNemar's exact), and the intensity of BS (Mann-Whitney). In all statistical tests, the significance level was 5%. RESULTS: Significant bleaching was observed after the end of bleaching in both groups, with higher bleaching effectiveness for BSB when compared to LSB (p < 0.05). Regarding BS, no significant difference was observed between groups (p = 1.00). CONCLUSIONS: The 10% hydrogen peroxide (White Class 10%, FGM) applied in at-home bleaching performed on the lingual surface did not promote a similar result of color change compared to on the buccal surface. Regarding BS, there was no significant difference between the groups. CLINICAL RELEVANCE: The at-home bleaching performed on the lingual surface promotes a lower result in the color change. BS is similar between the groups. CLINICAL TRIAL REGISTRATION NUMBER: RBR-283byt.

The effectiveness of in-office dental bleaching with and without sonic activation: A randomized, split-mouth, double-blind clinical trial.

OBJECTIVE: This study was aimed at comparing the bleaching efficacy and bleaching sensitivity (BS) of two higher-concentration in-office bleaching gels (37% carbamide peroxide [CP] and 38% hydrogen peroxide [HP]) applied under two conditions: alone or in association with sonic activation. METHODS: Fifty-six volunteers were randomly assigned in the split-mouth design into the following groups: CP, CP with sonic activation (CPS), HP, and HP with sonic activation (HPS). Two in-office bleaching sessions were performed. Color was evaluated using Vita Classical, Vita Bleachedguide, and digital spectrophotometer at baseline and at 30 days post-bleaching. Absolute risk and intensity of BS were recorded using two pain scales. All data were evaluated statistically (color changes [t test], BS [Chi-square and McNemar test], and BS intensity [VAS; t test; NRS; Wilcoxon; α = 0.05]). RESULTS: Significant and higher whitening was observed for HP when compared with CP (p < 0.04). However, higher BS intensity was observed in the former (p < 0.001). No significant difference was observed in whitening effect or BS when the HP or CP bleaching gels were agitated (sonic application) compared with when they were not (p > 0.05). CONCLUSION: The 37% CP gel demonstrated lower bleaching efficacy and lower BS compared with the 38% HP bleaching gel. The whitening effect was not influenced by the use of sonic activation. CLINICAL SIGNIFICANCE: The use of 37% CP gel did not achieve the same whitening effect when compared to 38% HP gel used for in-office bleaching. The use of sonic activation offers no benefit for in-office bleaching.

Ultrasound classification of thyroid nodules: does size matter?

ABSTRACT Objective To determine whether the size of thyroid nodules in ACR-TIRADS ultrasound categories 3 and 4 is correlated with the Bethesda cytopathology classification. Methods Thyroid nodules (566) subclassified as ACR-TIRADS 3 or 4 were divided into three size categories according to American Thyroid Association guidelines. The frequency of different Bethesda categories in each size range within ACR-TIRADS 3 and 4 classifications was analyzed. Results Most nodules in both ACR-TIRADS classifications fell in the Bethesda 2 category, regardless of size (90.8% and 68.6%, ACR-TIRADS 3 and 4 respectively). The prevalence of Bethesda 6 nodules in the ACR-TIRADS 4 group was 14 times higher than in the ACR-TIRADS 3 group. There were no significant differences between nodule size and fine needle aspiration biopsy classification in any of the ACR-TIRADS categories. Conclusion Size does not appear to be an important criterion for indication of fine needle aspiration biopsy in thyroid nodules with a high suspicion of malignancy on ultrasound examination.

Peritoneal Chlamydia trachomatis Infection as a Cause of Ascites: A Diagnosis Not to Be Missed.

Ascites is a common complication of several conditions, but it is rare in cases of Chlamydia trachomatis infection. We report a 36-year-old patient presenting with abdominal swelling for a week prior to hospitalization. An extensive workup excluded liver or heart disease and malignancy. A computed tomography scan demonstrated massive ascites and severe thickening of peritoneal reflections. Laboratory tests showed low serum-ascites albumin gradient, high total protein, and low adenosine. Diagnostic laparoscopy revealed inflammatory signs of both fallopian tubes. The histopathological results from peritoneal biopsy were consistent with lymphoid proliferation with reactive lymphoplasmacytic infiltrate. A gynecological investigation showed a positive DNA for C. trachomatis in the cervical swab. After treatment with doxycycline, there was a complete resolution of ascites.

Morphology and immunolocalization of aquaporins 1 and 9 in the agouti (Dasyprocta azarae) testis excurrent ducts.

This study investigated the morphology and immunoexpression of aquaporins (AQPs) 1 and 9 in the rete testis, efferent ducts, epididymis, and vas deferens in the Azara's agouti (Dasyprocta azarae). For this purpose, ten adult sexually mature animals were used in histologic and immunohistochemical analyses. The Azara's agouti rete testis was labyrinthine and lined with simple cubic epithelium. Ciliated and non-ciliated cells were observed in the epithelium of the efferent ducts. The epididymal cellular population was composed of principal, basal, apical, clear, narrow, and halo cells. The epithelium lining of vas deferens was composed of the principal and basal cells. AQPs 1 and 9 were not expressed in the rete testis. Positive reaction to AQP1 was observed at the luminal border of non-ciliated cells of the efferent ducts, and in the peritubular stroma and blood vessels in the epididymis, and vas deferens. AQP9 was immunolocalized in the epithelial cells in the efferent ducts, epididymis and vas deferens. The morphology of Azara's agouti testis excurrent ducts is similar to that reported for other rodents such as Cuniculus paca. The immunolocalization results of the AQPs suggest that the expression of AQPs is species-specific due to differences in localization and expression when compared to studies in other mammals species. The knowledge about the expression of AQPs in Azara's agouti testis excurrent ducts is essential to support future reproductive studies on this animal, since previous studies show that AQPs may be biomarkers of male fertility and infertility.

In-office bleaching with complete cervical third protection protocol: A split-mouth, double-blind, randomized clinical trial.

PURPOSE: To evaluate the bleaching sensitivity and the bleaching effectiveness of in-office bleaching, following a protocol of complete cervical third protection with gingival dam in comparison with a traditional manner of applying gingival dam (used only in the gingival sulcus area). METHODS: 35 participants were selected for this double-blind split-mouth randomized clinical trial. The control group received the gingival barrier in the traditional manner, and in the experimental group the barrier was extended by about 3 mm to include the cervical region. The bleaching agent was applied in two sessions. The risk and intensity of bleaching sensitivity were assessed using two scales. The bleaching effectiveness was evaluated with a digital spectrophotometer with the tip placed in the cervical area. The absolute risk of bleaching sensitivity was compared by the McNemar's test and bleaching effectiveness (ΔEab, ΔE00 and ΔWi) and intensity of bleaching sensitivity was evaluated by Wilcoxon-paired test (α= 0.05). RESULTS: No significant difference at risk (P= 1.0) and intensity of bleaching sensitivity (P> 0.45) was seen between groups. After 30 days, bleaching effectiveness had no statistical difference between the groups (P> 0.09). CLINICAL SIGNIFICANCE: Extending the barrier in the cervical region of teeth did not reduce the risk and intensity of bleaching sensitivity, nor jeopardize the bleaching effectiveness.

Non-volatile artificial synapse based on a vortex nano-oscillator.

In this work, a new mechanism to combine a non-volatile behaviour with the spin diode detection of a vortex-based spin torque nano-oscillator (STVO) is presented. Experimentally, it is observed that the spin diode response of the oscillator depends on the vortex chirality. Consequently, fixing the frequency of the incoming signal and switching the vortex chirality results in a different rectified voltage. In this way, the chirality can be deterministically controlled via the application of electrical signals injected locally in the device, resulting in a non-volatile control of the output voltage for a given input frequency. Micromagnetic simulations corroborate the experimental results and show the main contribution of the Oersted field created by the input RF current density in defining two distinct spin diode detections for different chiralities. By using two non-identical STVOs, we show how these devices can be used as programmable non-volatile synapses in artificial neural networks.

Insights into the Preparation of Copper Catalysts Supported on Layered Double Hydroxide Derived Mixed Oxides for Ethanol Dehydrogenation.

Acetaldehyde is an important chemical commodity and a building block for producing several other high-value products in the chemical industry. This has motivated the search for suitable, efficient, stable, and selective catalysts, as well as renewable raw materials such as ethanol. In this work, supported copper catalysts were prepared from CuZnAl layered double hydroxides (LDHs) with different copper contents (5, 10, and 20 wt %) for application in the ethanol dehydrogenation reaction (EDR). The samples were thoroughly characterized by a series of techniques, which allowed for analysis of all of the copper and zinc species involved in the different catalyst preparation steps and during the EDR. The results obtained by in situ quick extended X-ray absorption fine structure (EXAFS) measurements, combined with multivariate data analysis, showed that the copper content in the pristine LDH influenced the phase composition of the mixed oxide support, which consequently affected the dispersion of copper nanoparticles. The higher the copper content, the higher are the ZnAl2O4 and zinc tetrahedral prenuclei (TPN) contents, to the detriment of the ZnO content. All the samples showed high selectivity (>97%) and stability in the catalytic reactions at 300 and 350 °C, with no observed deactivation during 6 h on-stream. Although the samples with lower copper content presented higher copper dispersion and reactivity, the sample containing 20 wt % of copper outperformed the others, with greater conversion and higher activity toward acetaldehyde.