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The finding of increased T2 with liver fibrosis may relate to inflammation that may be an alternative or adjunct to other noninvasive MR imaging based approaches for assessing liver fibrosis.

The role of chemotherapy in well differentiated neuroendocrine tumors (NET) has been questioned. It was recently demonstrated that everolimus and sunitinib have activity in low and intermediate grade pancreatic NET. The aim of this study was to evaluate the activity of capecitabine and oxaliplatin (CapOx) combination in treating NET in an unselected population. In this regard, we retrospectively evaluated 24 patients diagnosed with metastatic NET treated with CapOx at two Brazilian institutes that are reference centers in cancer care. Tumor response was measured by RECIST criteria. Median age at diagnosis was 56 years, 71% had ECOG 0 or 1, the majority of tumors were primary from pancreas (67%) followed by lung (17%), and 29% were functional. According to WHO classification criteria, 25% were grade 1, 37.5% grade 2 and 37.5% grade 3. Most patients received CapOx as second-line therapy, with a median of 6 cycles. Twenty-nine percent of patients had partial response by RECIST criteria. No association was observed between response rate and tumor grade, primary site or line of CapOx. The median time to progression was 9.8 months and median time to treatment failure was 12.1 months. Seventy-five percent of patients are alive at the time of this analysis; therefore, median overall survival was not reached. The CapOx combination was shown to be active in an unselected population with metastatic NET and may be a good platform for the incorporation of the newer molecular targeted agents being investigated for the treatment of this entity.

Rationale:In the setting of metastatic or locally advanced adrenocortical carcinoma, a limited number of therapies are available and their efficacy is generally below modest. The backbone of treatment remains surgery, even for metastatic disease, whenever it is possible, and mitotane. Chemotherapy can be used with limited results. A small subset of patients with adrenocortical carcinoma may have high mutational burden and harbor mutations in mismatch-repair genes.Patient concerns:We report a 40-year old and a 28-year-old female patients with metastatic adrenocortical carcinoma refractory to multiple treatments.Diagnosis:Next-generation sequencing detected high mutational burden (>10 mutations/megabase) in both patients, one of them with MSH2 mutation.Interventions:They were treated with pembrolizumab (100 to 200 mg every 3 weeks).Outcomes:The patient harboring a MSH2 mutation experienced a long-term complete response after pembrolizumab, while the patient with high mutational burden and absence of mismatch repair deficiency did not have any response.Lessons:To the best of our knowledge, this is the first report in the literature of a durable complete response after pembrolizumab in a patient with metastatic adrenocortical carcinoma. Differences in therapy sequencing, possibly abscopal effect related to multiple previous radiotherapy exposition, predictive values of high mutational burden and mutations in mismatch-repair genes are discussed.

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RESUMO -(Variação da biomassa e necromassa aérea de duas espécies invasoras na Floresta Atlântica, sudeste do Brasil). Este trabalho descreve a variação da biomassa e necromassa aérea, e da produção primária líquida (NAGPP) de duas espécies invasoras Panicum maximum Jacquin (Poaceae) e Pteridium arachnoideum (Kaulf.) Maxon. (Dennstaedtiaceae) em duas áreas da Reserva Biológica de Poço das Antas, no sudeste brasileiro. As duas espécies eram mono-dominantes nestas áreas, ambas localizadas na matriz entre fragmentos florestais. A matéria orgânica foi amostrada mensalmente durante dois anos, separada em biomassa e necromassa e a produção aérea primária líquida (NAGPP) foi calculada. Houve variação intra-sazonal bem marcada, para ambas as espécies; Pa. maximum geralmente apresentou os maiores valores para biomassa, necromassa, massa total e NAGPP (NAGPP, Pa. maximum = 3953 g m -2 ano -1 , Pt. arachnoideum = 2667 g m -2 ano -1 ). A NAGPP não variou entre as duas estações de crescimento para Pa. maximum, porém estas diferenças foram acentuadas para Pt. arachnoideum (2% comparados aos 44% de variação em relação a média). A segunda estação de crescimento foi mais seca e Pa. maximum produziu maior quantidade de necromassa do que na primeira estação de crescimento; Pteridium mostrou pouca variação sazonal de biomassa, mas uma maior produtividade na segunda estação de crescimento. Pteridium arachnoideum é aparentemente mais sensível ao clima, especialmente em relação à pluviosidade. Palavras-chave: fogo, Panicum maximum, plantas invasoras, Pteridium arachnoideumABSTRACT -(Variation in aboveground biomass and necromass of two invasive species in the Atlantic Rain Forest, Southeast Brazil). This paper describes the variation of the above-ground biomass, necromass, and net above-ground primary production (NAGPP) of two weed species, Panicum maximum Jacquin (Poaceae) and Pteridium arachnoideum (Kaulf.) Maxon. (Dennstaedtiaceae), at two sites in the Poço das Antas Biological Reserve, southeast Brazil. Both species form mono-dominant stands in the matrix surrounding forest fragments. The organic matter was sampled monthly from each site, separated into biomass and necromass, and net above-ground primary production (NAGPP) was calculated. There was marked intra-seasonal fluctuation for both species; Pa. maximum generally had the largest values for necromass, total mass and NAGPP (NAGPP, Pa. maximum = 3953 g.m -2 .y -1 , Pt. arachnoideum = 2667 g.m -2 .y -1 ). NAGPP did not vary between the two growth periods for Pa. maximum, but marked differences were found for Pt. arachnoideum (2% compared to 44% variation around the mean). The second growth year was drier and Pa. maximum produced much greater necromass in that year; Pt. arachnoideum showed little variation in biomass but much greater productivity in the drier second season. Pteridium arachnoideum appears to be more sensitive to climate, and especially rainfall.

Promoting diversity is core for ecological restoration. Restoration projects often quantify biological diversity as a measure of success, but generally overlook human diversity, including gender issues, which have not been sufficiently considered in restoration planning, implementation, and monitoring. Here, we justify the need to consider gender equality in ecological restoration and offer guidance on adopting gender‐responsive approaches. Gender equality should be considered both a driver and a measure of success and will play a central role to leverage the contributions of restoration to the United Nations' Sustainable Development Goals and of women to its Decade on Ecosystem Restoration. We finally recommend that the International Principles and Standards for the Practice of Ecological Restoration are amended to include a gender‐responsive perspective in its recommendations.

Paracoccidioidomycosis is a granulomatous systemic mycosis that is endemic in Latin America; it is an extremely rare infection following solid organ transplantation. In this study, we describe the first report of disseminated paracoccidioidomycosis in a 3-year-old girl who underwent liver transplantation 2 years previously. The radiologic diagnosis and patient follow-up are described. In addition, we review the clinical evolution and treatment regimens for this infection.