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Training machine learning models for artificial intelligence (AI) applications in pathology often requires extensive annotation by human experts, but there is little guidance on the subject. In this work, we aimed to describe our experience and provide a simple, useful, and practical guide addressing annotation strategies for AI development in computational pathology. Annotation methodology will vary significantly depending on the specific study's objectives, but common difficulties will be present across different settings. We summarize key aspects and issue guiding principles regarding team interaction, ground-truth quality assessment, different annotation types, and available software and hardware options and address common difficulties while annotating. This guide was specifically designed for pathology annotation, intending to help pathologists, other researchers, and AI developers with this process.
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Inteligência Artificial , Patologistas , Humanos , Software , Aprendizado de MáquinaRESUMO
BACKGROUND: Oxaliplatin based chemotherapy is often used as adjuvant therapy in colon and rectal cancer. A reported side effect is Sinusoidal Obstruction Syndrome which is characterized by a spectrum of pathologic changes, from sinusoidal dilation, peri-sinusoidal haemorrhage, peliosis and nodular regenerative hyperplasia. Very rarely it can cause the development of liver nodules mimicking liver metastases. Herein, we report a case of Sinusoidal Obstruction Syndrome causing a liver nodule suspicious of liver metastasis on imaging. This is the third reported case of this complication of oxaliplatin toxicity, in which resection was performed and pathological diagnosis confirmed. CASE PRESENTATION: We report the case of a 59 year old man with stage III colon cancer who underwent sigmoidectomy followed by adjuvant chemotherapy with oxaliplatin. One year after surgery a liver nodule was detected and the patient underwent right hepatectomy. Pathology showed no liver nodule and diagnosed sinusoidal obstruction syndrome. CONCLUSION: We describe the third reported case of a liver lesion mimicking a liver metastasis after oxaliplatin-based chemotherapy for colon cancer. We suggest that in patients heavily treated with oxaliplatin with de novo liver nodules, this differential diagnosis should be considered. In particular, in this population of patients an intense imagiologic evaluation and even a preoperative biopsy should be pursued to confirm the diagnosis of malignancy and avoid overtreatment.
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Antineoplásicos/efeitos adversos , Neoplasias Colorretais/complicações , Hepatopatia Veno-Oclusiva/diagnóstico , Hepatopatia Veno-Oclusiva/etiologia , Fígado/efeitos dos fármacos , Fígado/patologia , Compostos Organoplatínicos/efeitos adversos , Antineoplásicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Quimioterapia Adjuvante/efeitos adversos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/tratamento farmacológico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Organoplatínicos/administração & dosagem , Oxaliplatina , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: The lactulose:mannitol (L:M) diagnostic test is frequently used in field studies of environmental enteropathy (EE); however, heterogeneity in test administration and disaccharide measurement has limited the comparison of results between studies and populations. We aim to assess the agreement between L:M measurement between high-performance liquid chromatography with pulsed amperometric detection (HPLC-PAD) and liquid chromatography-tandem mass spectrometry (LC-MSMS) platforms. METHODS: The L:M test was administered in a cohort of Peruvian infants considered at risk for EE. A total of 100 samples were tested for lactulose and mannitol at 3 independent laboratories: 1 running an HPLC-PAD platform and 2 running LC-MSMS platforms. Agreement between the platforms was estimated. RESULTS: The Spearman correlation between the 2 LC-MSMS platforms was high (ρ ≥ 0.89) for mannitol, lactulose, and the L:M ratio. The correlation between the HPLC-PAD platform and LC-MSMS platform was ρ = 0.95 for mannitol, ρ = 0.70 for lactulose, and ρ = 0.43 for the L:M ratio. In addition, the HPLC-PAD platform overestimated the lowest disaccharide concentrations to the greatest degree. CONCLUSIONS: Given the large analyte concentration range, the improved accuracy of LC-MSMS has important consequences for the assessment of lactulose and mannitol following oral administration in populations at risk for EE. We recommend that researchers wishing to implement a dual-sugar test as part of a study of EE use an LC-MSMS platform to optimize the accuracy of results and increase comparability between studies.
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Cromatografia Líquida de Alta Pressão/métodos , Técnicas de Diagnóstico do Sistema Digestório/normas , Absorção Intestinal , Enteropatias/diagnóstico , Lactulose/metabolismo , Manitol/metabolismo , Espectrometria de Massas em Tandem/métodos , Administração Oral , Feminino , Humanos , Lactente , Enteropatias/metabolismo , Masculino , Peru , Estatísticas não ParamétricasRESUMO
BACKGROUND: The magnetic resonance imaging-guided focused ultrasound (MRgFUS) has emerged as an innovative treatment for patients with medically refractory essential tremor (ET). OBJECTIVE: This retrospective observational study aims to present the results of the first five patients with medically refractory ET who underwent MRgFUS treatment at this pioneering medical unit in Portugal. METHODS: We conducted a retrospective chart review for the first five patients who underwent unilateral MRgFUS thalamotomy of the ventral intermediate (Vim) nucleus to treat medically refractory ET at our medical unit. RESULTS: The mean patient age was 65.4 (26-84) years, and 60% were male. All patients had a family history of ET. The mean duration of disease was 17.4 years (range 10-24 years), and their dominant hand was the right. According to personal preference, the thalamotomy was performed on the left side in four patients, and on the right side in one. The MRgFUS thalamotomy led to significant improvements in both the clinical rating scale for tremor (CRST) score, by 62%, and the CRST composite score for the treated hand, by 73%. All patients experienced improvements in functionality and quality of life, by 52%. No severe adverse events were observed, and those that did occur during and following the procedure were mild and transient. CONCLUSION: The initial results from Portugal's first MRgFUS medical unit indicate promising outcomes, with improvement in quality of life, as well as mild and temporary adverse events These findings contribute to the growing body of literature supporting the efficacy and safety of MRgFUS as a viable treatment option for patients with medication-resistant ET.
ANTECEDENTES: A talomotomia por ultrassons focados - guiada por imagem de ressonância magnética (MRgFUS) surgiu recentemente como um tratamento inovador para pacientes com tremor essencial (TE) refratário ao tratamento médico. OBJETIVO: Este estudo observacional retrospectivo tem como objetivo apresentar os resultados dos primeiros cinco pacientes com TE refratário à medicação submetidos ao tratamento com MRgFUS numa unidade médica pioneira em Portugal. MéTODOS: Realizamos uma revisão retrospectiva dos dados clínicos dos cinco primeiros pacientes submetidos a talamotomia MRgFUS unilateral do núcleo ventral intermédio (Vim) para tratamento do TE medicamente refratário em nossa unidade médica. RESULTADOS: A idade média dos pacientes era de 65,4 (2684) anos, e 60% eram do sexo masculino. Todos os pacientes tinham história familiar de TE. A duração média da doença foi de 17,4 anos, e todos eram destros. De acordo com a preferência individual, em 4 pacientes, a talamotomia foi realizada no lado esquerdo, e em um, no lado direito. A talamotomia por MRgFUS levou a melhorias significativas tanto na pontuação da escala de classificação clínica para tremor (CRST), de 62%, e na pontuação composta da CRST para a mão tratada, de 73%. Todos os pacientes apresentaram melhorias na funcionalidade e na qualidade de vida, de 52%. Não foram observados efeitos adversos graves e os que ocorreram durante e após o procedimento foram ligeiros e transitórios. CONCLUSãO: Os resultados iniciais da primeira unidade médica MRgFUS de Portugal indicam melhorias na qualidade de vida dos pacientes, com efeitos adversos ligeiros e transitórios. Estes dados reforçam a evidência crescente sobre a eficácia e segurança da talamotomia por MRgFUS como opção viável para pacientes com TE resistente à medicação.
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Tremor Essencial , Humanos , Masculino , Tremor Essencial/cirurgia , Tremor Essencial/diagnóstico por imagem , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Feminino , Adulto , Idoso de 80 Anos ou mais , Resultado do Tratamento , Portugal , Tálamo/cirurgia , Tálamo/diagnóstico por imagem , Imagem por Ressonância Magnética Intervencionista , Imageamento por Ressonância Magnética , Reprodutibilidade dos Testes , Ultrassonografia de Intervenção/métodosRESUMO
Considering the profound transformation affecting pathology practice, we aimed to develop a scalable artificial intelligence (AI) system to diagnose colorectal cancer from whole-slide images (WSI). For this, we propose a deep learning (DL) system that learns from weak labels, a sampling strategy that reduces the number of training samples by a factor of six without compromising performance, an approach to leverage a small subset of fully annotated samples, and a prototype with explainable predictions, active learning features and parallelisation. Noting some problems in the literature, this study is conducted with one of the largest WSI colorectal samples dataset with approximately 10,500 WSIs. Of these samples, 900 are testing samples. Furthermore, the robustness of the proposed method is assessed with two additional external datasets (TCGA and PAIP) and a dataset of samples collected directly from the proposed prototype. Our proposed method predicts, for the patch-based tiles, a class based on the severity of the dysplasia and uses that information to classify the whole slide. It is trained with an interpretable mixed-supervision scheme to leverage the domain knowledge introduced by pathologists through spatial annotations. The mixed-supervision scheme allowed for an intelligent sampling strategy effectively evaluated in several different scenarios without compromising the performance. On the internal dataset, the method shows an accuracy of 93.44% and a sensitivity between positive (low-grade and high-grade dysplasia) and non-neoplastic samples of 0.996. On the external test samples varied with TCGA being the most challenging dataset with an overall accuracy of 84.91% and a sensitivity of 0.996.
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Cervical cancer is the fourth most common female cancer worldwide and the fourth leading cause of cancer-related death in women. Nonetheless, it is also among the most successfully preventable and treatable types of cancer, provided it is early identified and properly managed. As such, the detection of pre-cancerous lesions is crucial. These lesions are detected in the squamous epithelium of the uterine cervix and are graded as low- or high-grade intraepithelial squamous lesions, known as LSIL and HSIL, respectively. Due to their complex nature, this classification can become very subjective. Therefore, the development of machine learning models, particularly directly on whole-slide images (WSI), can assist pathologists in this task. In this work, we propose a weakly-supervised methodology for grading cervical dysplasia, using different levels of training supervision, in an effort to gather a bigger dataset without the need of having all samples fully annotated. The framework comprises an epithelium segmentation step followed by a dysplasia classifier (non-neoplastic, LSIL, HSIL), making the slide assessment completely automatic, without the need for manual identification of epithelial areas. The proposed classification approach achieved a balanced accuracy of 71.07% and sensitivity of 72.18%, at the slide-level testing on 600 independent samples, which are publicly available upon reasonable request.
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Carcinoma de Células Escamosas , Lesões Intraepiteliais Escamosas , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Feminino , Humanos , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/diagnóstico , Hiperplasia/patologia , Lesões Intraepiteliais Escamosas/patologia , Carcinoma de Células Escamosas/patologia , Gradação de TumoresRESUMO
Metaplastic breast cancer (MBC) comprises less than 1% of all breast cancers, and it is defined by a mixture of adenocarcinoma plus mesenchymal and epithelial components. It is more common in older and black female patients. It has a larger size and faster growth, and it is frequently node-negative and triple-negative when compared with invasive ductal carcinoma. The authors report the case of a 72-year-old female patient, presenting with a breast lump, whose biopsy revealed a probable MBC with chondroid differentiation. She underwent a breast conservative surgery (BCS) and axillary sentinel lymph node dissection (SLND). The pathological report was concordant with the biopsy, and the patient was proposed to chemoradiotherapy. Despite its rarity and more severe features at diagnosis, BCS plus SLND plus radiotherapy should be offered to these patients, associated with chemotherapy. Chondroid differentiation is the rarest of all histological subtypes.
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Many studies have linked the antimicrobial properties of kefir with the presence of bacteriocins and organic acids. In the present work, results obtained from bacteriostatic and bactericidal studies, and from RP-HPLC, Mass Spectrometry and proton NMR analysis, show that a sample of milk kefir grains is able to produce an antimicrobial fraction, denoted FK-1000, composed of sugars and amino acids, predominantly polymers of alanine, doublets of tyrosine and phenylalanine. Since this fraction is a lyophilized product whose molecular profile is different from bacteriocins and simple carboxylic acids, its antimicrobial effect cannot be attributed to these molecules, or to alcohols or hydrogen peroxide. The fraction is bactericidal against weak-acid-resistant MRSA and weak-acid resistant P. aeruginosa at pH 5, and is bacteriostatic against both pathogens at pH 7. In combination formulation, the FK-1000 fraction is able to increase fivefold the effect of streptomycin against P. aeruginosa and it is not toxic to human epithelial cells at antimicrobial concentrations. 16 S rRNA microbiota analysis of antimicrobial-producing and non-producing kefir grains demonstrated that they are distinct. In summary, the results indicate that milk kefir grains can produce different classes of molecules with potent antibiotic activity against resistant bacteria.
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Antibacterianos/farmacologia , Kefir , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Humanos , Kefir/microbiologia , Espectroscopia de Ressonância Magnética , Testes de Sensibilidade Microbiana , MicrobiotaRESUMO
BACKGROUND: Diarrheal diseases are an important cause of morbidity and mortality among children in developing countries. We aimed to study the etiology and severity of diarrhea in children living in the low-income semiarid region of Brazil. METHODOLOGY: This is a cross-sectional, age-matched case-control study of diarrhea in children aged 2-36 months from six cities in Brazil's semiarid region. Clinical, epidemiological, and anthropometric data were matched with fecal samples collected for the identification of enteropathogens. RESULTS: We enrolled 1,200 children, 596 cases and 604 controls. By univariate analysis, eight enteropathogens were associated with diarrhea: Norovirus GII (OR 5.08, 95% CI 2.10, 12.30), Adenovirus (OR 3.79, 95% CI 1.41, 10.23), typical enteropathogenic Escherichia coli (tEPEC), (OR 3.28, 95% CI 1.39, 7.73), enterotoxigenic E. coli (ETEC LT and ST producing toxins), (OR 2.58, 95% CI 0.99, 6.69), rotavirus (OR 1.91, 95% CI 1.20, 3.02), shiga toxin-producing E. coli (STEC; OR 1.77, 95% CI 1.16, 2.69), enteroaggregative E. coli (EAEC), (OR 1.45, 95% CI 1.16, 1.83) and Giardia spp. (OR 1.39, 95% CI 1.05, 1.84). By logistic regression of all enteropathogens, the best predictors of diarrhea were norovirus, adenovirus, rotavirus, STEC, Giardia spp. and EAEC. A high diarrhea severity score was associated with EAEC. CONCLUSIONS: Six enteropathogens: Norovirus, Adenovirus, Rotavirus, STEC, Giardia spp., and EAEC were associated with diarrhea in children from Brazil's semiarid region. EAEC was associated with increased diarrhea severity.
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Diarreia/epidemiologia , Diarreia/etiologia , Infecções por Escherichia coli/epidemiologia , Giardíase/epidemiologia , Viroses/epidemiologia , Brasil/epidemiologia , Estudos de Casos e Controles , Diarreia/patologia , Infecções por Escherichia coli/patologia , Giardíase/patologia , Humanos , Lactente , Razão de Chances , Viroses/patologiaRESUMO
Loxosceles venom is a potential source of bioactive molecules which may be transformed into antimicrobial products against multi-resistant bacteria. Here, it was investigated whether Loxosceles gaucho spider had any influence on the proliferation, enzyme release and biofilm formation of a Pseudomonas aeruginosa strain resistant to two different classes of antibiotic. The results demonstrated that L. gaucho whole venom has no influence on P. aeruginosa proliferation. However, it increases P. aeruginosa production of gelatinase, caseinase and biofilm formation. The same effects were noted when P. aeruginosa was exposed to a L. gaucho venom molecular fraction with mass lower than 1â¯kDa. Separation of this molecular fraction into different subsets by RP-HPLC demonstrated that, among the molecules with the ability to increase the production of enzymes and biofilm formation, there are some with antimicrobial activities whose effects are not observed in the whole venom. In summary, the results obtained herein indicate that L. gaucho venom has a variety of low molecular mass bioactive components that influence the mechanisms of virulence of P. aeruginosa in different ways.
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Diester Fosfórico Hidrolases/química , Diester Fosfórico Hidrolases/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Venenos de Aranha/química , Venenos de Aranha/farmacologia , Virulência/efeitos dos fármacos , Animais , Biofilmes/efeitos dos fármacos , Gelatinases/metabolismo , Metaloendopeptidases/metabolismo , Pseudomonas aeruginosa/enzimologia , Pseudomonas aeruginosa/crescimento & desenvolvimento , AranhasRESUMO
OBJECTIVE: The purpose of the study was to determine whether children are more negatively perceived because of a lip incompetence. STUDY DESIGN: A sample survey study. METHODS: Two sets of colored pictures (1 set with the mouth open and 1 set with the mouth closed) were taken of four children with lip incompetence and mouth breathing and four children with normal lip closure and breathing patterns. These pictures were presented to a group of judges in Belgium and Brazil. Judges were presented either pictures of the closed mouth sets or pictures of the open mouth sets and were asked to rate on a 10-point scale the chance that the child was shy, had few friends, belonged to a lower socioeconomic class, had problems with reading, writing, or arithmetic, had ever manifested thumb-sucking, and had difficulties breathing through the nose. In each child, scores obtained for the open mouth set were compared with those obtained for the closed mouth set. RESULTS: There was no consistent pattern of higher scores being assigned to the pictures of the open mouth set, neither in the Belgian survey nor in the Brazilian survey. CONCLUSION: Contrary with past and present claims, results suggest that children with a lip incompetence are not necessarily perceived negatively.
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Lábio/anormalidades , Atitude , Criança , Feminino , Humanos , Masculino , Respiração Bucal/epidemiologia , Projetos Piloto , Postura , Psicologia , Desejabilidade Social , Inquéritos e Questionários , Percepção VisualRESUMO
The lactulose mannitol (LM) dual sugar permeability test is the most commonly used test of environmental enteropathy in developing countries. However, there is a large but conflicting literature on its association with enteric infection and host nutritional status. We conducted a longitudinal cohort using a single field protocol and comparable laboratory procedures to examine intestinal permeability in multiple, geographically diverse pediatric populations. Using a previously published systematic review to guide the selection of factors potentially associated with LM test results, we examined the relationships between these factors and mucosal breach, represented by percent lactulose excretion; absorptive area, represented by percent mannitol excretion; and gut barrier function, represented by the L/M ratio. A total of 6,602 LM tests were conducted in 1,980 children at 3, 6, 9, and 15 months old; percent lactulose excretion, percent mannitol excretion, and the L/M ratio were expressed as age- and sex-specific normalized values using the Brazil cohort as the reference population. Among the factors considered, recent severe diarrhea, lower socioeconomic status, and recent asymptomatic enteropathogen infections were associated with decreased percent mannitol excretion and higher L/M ratios. Poorer concurrent weight-for-age, infection, and recent breastfeeding were associated with increased percent lactulose excretion and increased L/M ratios. Our results support previously reported associations between the L/M ratio and factors related to child nutritional status and enteropathogen exposure. These results were remarkably consistent across sites and support the hypothesis that the frequency of these exposures in communities living in poverty leads to alterations in gut barrier function.
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Trato Gastrointestinal/fisiologia , Fenômenos Fisiológicos da Nutrição do Lactente , Lactulose/metabolismo , Manitol/metabolismo , Estado Nutricional , Envelhecimento , Feminino , Humanos , Lactente , Alimentos Infantis , Masculino , Fatores SocioeconômicosRESUMO
Here, we evaluate the potential of the bumble bee Bombus impatiens Cresson, obtained from commercial colonies, as a pollen vector for lowbush blueberry, Vaccinium augustifolium Aiton. We wanted to gain insight into the relationships between pollination by introduced bumble bees, the categories of seeds produced, and the weight and the maturity of the blueberries. The effect of B. impatiens foraging in blueberry stands was measured quantitatively through fruit set and seed set analysis. We created a density gradient of B. impatiens by clustering 72 small hives at the southern extremity of blueberry fields located in Girardville (49 degrees 00' N, 72 degrees 33' W), Quebec, Canada. Observers recorded plant and insect data in 52 plots of 1 by 10 m, distributed at distances ranging from 25 to 1,500 m from the hives. From these data, we evaluated the fruit set rate, the weight and maturity of the berries, and the number of seed structures per berry, including true seeds of large, medium, and small size, pseudo-seeds, and ovules. Positive correlations were found between the density of B. impatiens and fruit set as well as the number of large seeds per berry. Large seeds influenced the weight and maturity of berries. B. impatiens acted as a "near-nest central forager" and increased fruit set and seed production up to 100 and 150 m respectively, from the hives.
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Abelhas/fisiologia , Ericaceae/fisiologia , Pólen/fisiologia , Animais , Comportamento Alimentar , Densidade Demográfica , SementesRESUMO
Pollination is an essential step in the seed production of canola, Brassica napus L. It is achieved with the assistance of various pollen vectors, but particularly by the honey bee, Apis mellifera L. Although the importance of pollination has been shown for the production of seed crops, the need to introduce bee hives in canola fields during flowering to increase oil seed yield has not yet been proven. With the purpose of showing this, hives of A. mellifera were grouped and placed in various canola fields in the Chaudière-Appalaches and Capitale-Nationale regions (nine fields; three blocks with three treatments; 0, 1.5, and 3 hives per hectare). A cage was used to exclude pollinators and bee visitations were observed in each field. After the harvest, yield analyses were done in relation to the bee density gradient created, by using pod set, number of seeds per plant, and weight of 1000 seeds. Results showed an improvement in seed yield of 46% in the presence of three honey bee hives per hectare, compared with the absence of hives. The introduction of honey bees contributed to production and consequently, these pollinators represented a beneficial and important pollen vector for the optimal yield of canola.
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Abelhas/fisiologia , Brassica napus/crescimento & desenvolvimento , Animais , Ácidos Graxos Monoinsaturados , Pólen/fisiologia , Densidade Demográfica , Óleo de Brassica napus , SementesRESUMO
Resumo Este estudo visa evidenciar os esforços empreendidos pelos Tribunais de Contas (TCs) brasileiros no período de pandemia do coronavírus a fim de colaborar com seus jurisdicionados, seus servidores e a sociedade para o enfrentamento de seus efeitos. Realizou-se pesquisa descritiva, com abordagem qualitativa, por meio de análise das legislações emitidas pelos TCs, para avaliação das ações tomadas por eles. Entre os achados, destacam-se as ações de âmbito interno e pedagógicas empreendidas na forma de medidas destinadas ao público externo (como a limitação no atendimento presencial), à suspensão de eventos coletivos, de reuniões presenciais e viagens, à adoção de teletrabalho, ao contingenciamento de despesas, cursos à distância etc. Entre as ações processuais, destacam-se as suspensões de Sessões Plenárias ou das Câmaras, dos prazos processuais e da remessa das prestações de contas. Por fim, no tocante às ações orientativas e de monitoramento empreendidas pelos TCs, constatou-se que foi elaborada uma série de diretrizes e recomendações em relação às práticas adotadas pelos órgãos de controle externo de modo colaborativo aos demais poderes, de modo orientar os gastos públicos, a aquisição e a contratação de serviços com dispensa de licitação, entre outros riscos. Conclui-se que o conjunto de medidas implementadas pelos TCs demonstra mudança no status tradicional de controle posterior das contas públicas, que enseja uma atuação punitiva para um controle prévio e concomitante, por meio de recomendações, fiscalizações e monitoramento, quando o gestor ainda dispõe de instrumentos para corrigir eventuais erros e evitar o desperdício e a má aplicação do recurso público.
Resumen Este estudio tiene como objetivo evidenciar los esfuerzos realizados por los Tribunales de Cuentas (TC) brasileños en el período de la pandemia de coronavirus para colaborar con sus jurisdiccionales, funcionarios y la sociedad para enfrentar sus efectos. Se realizó una investigación descriptiva con enfoque cualitativo mediante el análisis de la legislación emitida por los TC para evaluar las acciones tomadas por los estos. Entre los resultados, se destacan las acciones administrativas y pedagógicas emprendidas en forma de medidas dirigidas al público externo, como la limitación en el servicio presencial, la suspensión de eventos colectivos, de reuniones presenciales y viajes; la adopción del teletrabajo, la restricción de gastos, y cursos de aprendizaje a distancia. Entre las acciones procesales están las suspensiones de sesiones plenarias o cámaras, de plazos procesales y de envío de las prestaciones de cuentas. Finalmente, con respecto a las acciones de orientación y supervisión emprendidas por los TC, se constató la elaboración de una serie de directrices y recomendaciones con relación a las prácticas adoptadas por los organismos de control externo de manera colaborativa con los otros poderes, a los efectos de orientar el gasto público, la adquisición y contratación de servicios sin licitación, entre otros riesgos. Se concluye que el conjunto de medidas implementadas por los TC muestra un cambio en el estatus tradicional: del control posterior de las cuentas públicas ‒ que da lugar a acciones punitivas ‒ hacia el control previo y concomitante, a través de recomendaciones, inspecciones y monitoreo, cuando el administrador tiene los instrumentos para corregir eventuales errores y evitar el desperdicio y la mala utilización de los recursos públicos.
Abstract This study aims to highlight the efforts made by the Brazilian Courts of Accounts (CAs) during the COVID-19 pandemic to collaborate with its jurisdictional authorities, civil servants, and society to face its effects. Descriptive and qualitative research was carried out, analyzing the legislation issued by the CAs to evaluate their actions. Among the findings, it was observed that the CAs took administrative and pedagogical measures to protect the public, such as the suspension or restriction of face-to-face service. Also, the courts suspended collective events, face-to-face meetings, and travel, adopted telework, limited expenditures and distance learning courses. Among the procedural measures, Plenary Sessions or Chambers, procedural deadlines, and remittance of accounts were suspended. Finally, the activities of guidance and monitoring were conducted under a series of guidelines and recommendations created collaboratively with other agencies and branches of government, guiding public spending, the acquisition and contracting of services with no bidding requirements, among other procedures. It is concluded that the set of measures implemented by the CAs shows a change in the traditional status of subsequent control of public accounts - which gives rise to punitive action - for prior and concurrent control, with recommendations, inspections, and monitoring, when the manager still has instruments to amend errors and avoid waste and misapplication of public resources.
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Infecções por Coronavirus , Gestão em Saúde , Normas Jurídicas , Poder Legislativo , Pesquisa Qualitativa , Pandemias/prevenção & controle , Gastos Públicos com SaúdeRESUMO
The efficacy of a vacuuming device to reduce Lygus lineolaris (Palisot de Beauvois) populations was evaluated over 3 yr in a day-neutral strawberry field. Immediately after treatments, a significant reduction of population estimates (by tapping of flower clusters) was observed for adults (75% of the time) and nymphs (50% of the time). Under the same conditions, control (i.e., vacuum turbine off) treatments significantly reduced adult population estimates 25% of the time. Lygus lineolaris tapping samples taken from strawberry plants adjacent to the treated zone did not show significant variations over sampling time, suggesting that no escape behavior occurred. This was supported by adult catches on sticky traps located in zones adjacent to the treated one. Our results suggest that vacuuming had inconsistent effect on tarnished plant bug populations and that L. lineolaris mobility plays a marginal role in the use of this control method.
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Fragaria , Hemípteros , Controle de Insetos/instrumentação , Animais , Densidade Demográfica , Estações do Ano , VácuoRESUMO
The prevalence of congenital cardiac disease in cats varies from 0.2 to 1 per cent, with males being more affected than females. This is probably an underestimate due to the fact that not all affected kittens are presented. Discordant atrioventricular connection (where the morphological right atrium connects to the morphological left ventricle, and the morphological left atrium connects to the morphological right ventricle) is an uncommon condition in humans and, to the authors' knowledge, has not to date been described in animals. The association between this anomaly and the double-outlet right ventricle (where both great arteries arise entirely or partially from the morphological right ventricle) is extremely rare in children. This report describes a case of a cat which presented with this association of cardiac defects.
Assuntos
Doenças do Gato/congênito , Dextrocardia/veterinária , Átrios do Coração/anormalidades , Ventrículos do Coração/anormalidades , Animais , Autopsia/veterinária , Doenças do Gato/patologia , Gatos , Dextrocardia/patologia , Átrios do Coração/patologia , Ventrículos do Coração/patologiaRESUMO
PURPOSE: To present a literature review about the Brazilian scientific production in Speech-Language Pathology and Audiology regarding voice in popular singing in the last decade, as for number of publications, musical styles studied, focus of the researches, and instruments used for data collection. RESEARCH STRATEGY: Cross-sectional descriptive study carried out in two stages: search in databases and publications encompassing the last decade of researches in this area in Brazil, and reading of the material obtained for posterior categorization. SELECTION CRITERIA: The databases LILACS and SciELO, the Databasis of Dissertations and Theses organized by CAPES, the online version of Acta ORL, and the online version of OPUS were searched, using the following uniterms: voice, professional voice, singing voice, dysphonia, voice disorders, voice training, music, dysodia. Articles published between the years 2000 and 2010 were selected. DATA ANALYSIS: The researches found were classified and categorized after reading their abstracts and, when necessary, the whole study. RESULTS: Twenty researches within the proposed theme were selected, all of which were descriptive, involving several musical styles. Twelve studies focused on the evaluation of the popular singer's voice, and the most frequently used data collection instrument was the auditory-perceptual evaluation. The results of the publications found corroborate the objectives proposed by the authors and the different methodologies. CONCLUSION: The number of studies published is still restricted when compared to the diversity of musical genres and the uniqueness of popular singer.
Assuntos
Bibliometria , Música , Fonação/fisiologia , Patologia da Fala e Linguagem , Qualidade da Voz , Brasil , Humanos , Publicações Periódicas como Assunto , Qualidade da Voz/fisiologiaRESUMO
The aim this work was to evaluate the genetic variability within and among populations grown on sisal region of Bahia. The genetic diversity of 140 population of sisal was analyzed using ISSR molecular markers. Samples were collected in six counties in Bahia. Eighteen primers of ISSR were used, in which nine of them were effective in the amplification of DNA samples to yield 143 polymorphic loci. The average percentage of polymorphism found in the population was 64%. The average heterozygosis (He) and Shannon-Wiener index (I) were 0.180 and 0.279, respectively. 73% of the molecular variance can be due to intrapopulation differences. The populations were divided into two groups according to their geographical location, showing a structure of genetic variability in space. The GST 0.235, enough to avoid that there is a strong population differentiation. The genetic structure of sisal can be exploited for the creation of gene banks for conservation in situ and ex situ to obtain individuals of good commercial quality. There is genetic variability among sisal genotypes. ISSR molecular markers are efficient to analyze the divergence between sisal genotypes, assisting improvement work.
O objetivo deste trabalho foi avaliar a variabilidade genética existente entre e dentro das populações cultivadas na região sisaleira baiana. A diversidade genética de 140 indivíduos de sisal foi analisada por meio de marcadores moleculares ISSR. As amostras foram coletadas em seis municípios baianos. Utilizando-se dezoito primers de ISSR, dos quais, nove foram eficientes na amplificação do DNA das amostras analisadas, obtendo-se 143 locos polimórficos. O percentual médio de polimorfismo encontrado nas populações foi de 64%. A média de heterozigosidade (He) e do índice de Shannon-Wiener (I) foram de 0,180 e 0,279, respectivamente. 73% da variância molecular pode ser atribuída às diferenças intrapopulacionais. As populações foram divididas em dois grupos, de acordo com sua localização geográfica, evidenciando uma estruturação da variabilidade genética no espaço. O GST de 0,235 foi suficiente para evitar que exista uma forte diferenciação populacional. A estruturação genética do sisal pode ser explorada para a criação de bancos de germoplasma, visando à conservação in situ e ex situ, para a obtenção de indivíduos de boa qualidade comercial. Há presença de variabilidade genética entre os genótipos de sisal. Marcadores moleculares ISSR são eficientes para analisar a divergência entre os acessos de sisal, auxiliando trabalhos de melhoramento.