Land use and land cover (LULC) mapping is a powerful tool for monitoring large areas. For the Amazon rainforest, automated mapping is of critical importance, as land cover is changing rapidly due to ...forest degradation and deforestation. Several research groups have addressed this challenge by conducting local surveys and producing maps using freely available remote sensing data. However, automating the process of large-scale land cover mapping remains one of the biggest challenges in the remote sensing community. One issue when using supervised learning is the scarcity of labeled training data. One way to address this problem is to make use of already available maps produced with (semi-) automated classifiers. This is also known as weakly supervised learning. The present study aims to develop novel methods for automated LULC classification in the cloud-prone Amazon basin (Brazil) based on the labels from the MapBiomas project, which include twelve classes. We investigate different fusion techniques for multi-spectral Sentinel-2 data and synthetic aperture radar Sentinel-1 time-series from 2018. The newly designed deep learning architectures—DeepForest-1 and DeepForest-2—utilize spatiotemporal characteristics, as well as multi-scale representations of the data. In several data scenarios, the models are compared to state-of-the-art (SotA) models, such as U-Net and DeepLab. The proposed networks reach an overall accuracy of up to 75.0%, similar to the SotA models. However, the novel approaches outperform the SotA models with respect to underrepresented classes. Forest, savanna and crop were mapped best, with F1 scores up to 85.0% when combining multi-modal data, compared to 81.6% reached by DeepLab. Furthermore, in a qualitative analysis, we highlight that the classifiers sometimes outperform the inaccurate labels.
Acalculous cholecystitis etiologies while numerous, some of them are less-known such as brucellosis. In this report, we elaborate the clinical findings, investigations and management of two female ...patients presenting acalculous cholecystitis in whom diagnosis of acute brucellosis was retained. Both patients had fever, asthenia and abdominal tenderness. Laboratory results showed evidence of inflammation as well as hepatic cytolysis while cholestasis was noted in one patient. In both cases, ultrasound study and CT confirmed the presence of acalculous cholecystitis. Serology (tube agglutination test) led to the diagnosis of brucellosis. Diagnosis of brucellosis-related acute cholecystitis was established in both cases based on imaging findings as well as serology without resorting to cholecystectomy. Favourable clinical response to specific antibiotic therapy further supported our diagnosis as well as our decision to avoid surgery. Although few cases have been reported, brucellosis must be considered as a cause of acalculous cholecystitis, especially in endemic countries.
While autoimmune haemolytic anaemia (AIHA) is a well-known paraneoplastic syndrome in haematological malignancies, it has been described far less in solid tumours. We hereby report the case of a ...61-year-old male patient presenting AIHA related to pancreatic cancer. Investigations excluded infectious, autoimmune and toxic causes of AIHA. CT of the abdomen highlighted the presence of hypodense, infiltrating mass of the tail of the pancreas measuring 70×37×36 mm, compatible with pancreas neoplasm. Histological examination of two associated nodular lesions of the liver showed metastasis of pancreatic adenocarcinoma. The patient was started on corticosteroid without improvement of haemoglobin. Palliative chemotherapy was initiated; this led to significant improvement in haemoglobin comforting our diagnosis. This case illustrates the rare association between AIHA and pancreatic cancer. However, such association cannot be considered before excluding other, more frequent, aetiologies.
Introduction Les chutes chez le sujet âgé constituent un problème de santé majeur de par les complications traumatiques et psychosociales qui peuvent entrainer une perte de l'autonomie et un état de ...dépendance. L'objectif de notre travail est d'étudier les circonstances et les conséquences traumatiques et psychosociales des chutes chez les sujets âgés. Méthodes Nous avons mené une étude rétrospective réalisée entre septembre 2014 et janvier 2016 incluant 40 patients âgés de 65 ans et plus ayant fait au moins une chute l'année précédente recrutés parmi les patients hospitalisés ou suivis à la consultation externe du service de Médecine Interne B de l'hôpital Charles Nicolle. Les circonstances et les conséquences des chutes ont été recueillies par l'interrogatoire rétrospectif des patients et de leur entourage à distance de la chute. Résultats L'âge moyen des patients chuteurs était de 75,7 ans avec une prédominance féminine nette (30F/10H). Des facteurs précipitants étaient retrouvés chez 38 patients. Ils étaient de type extrinsèque dans 78,9% des cas et intrinsèques dans 50% des cas. Un séjour prolongé au sol était noté dans 10% des cas. Les fractures étaient plus fréquentes chez les femmes (12F/1H) intéressant surtout les membres supérieurs (61,5%). Les conséquences psychosociales ont été plus fréquentes chez les femmes. Un syndrome post chutes a été noté chez 5 patients. Conclusion La correction des facteurs précipitants intrinsèques et extrinsèques des chutes et l'apprentissage du relever du sol en post chutes permettra de prévenir le risque de chute ainsi que ses conséquences graves.
Hypercalcemia caused by tumor production of PTH-rp occurs most often in cases of squamous cell carcinoma of the lung, aerodigestive tract cancer, gynecological cancer and lymphoma. We report an ...exceptional case of PTH-rp related to a hepatic hemangioendothelioma. A 70 years-old male admitted for deterioration of the general state. The laboratory investigations revealed hypercalcemia, related to tumor production of PTH-rp. Imaging revealed tumoral hepatic lesions. Histopathological study and immunohistochemistry showed diffuse response for CD31 marker, CK20 (+) with CK7 (-) and hepatocyt antigen (-). The diagnosis of PTH-rp related to hepatic hemangioendothelioma was make. The patient died with recurrence of fatal hypercalcemia. Management of patients presenting with humoral hypercalcemia includes a vigorous search for tumor lesions. Elevated PTH-rp can be a bad prognostic factor. In front of tumoral liver lesions, a hepatic epithelioid hemangioendothelioma must be considered. Immunohistochemistry is necessary to make diagnosis.
Large-scale information on several vegetation properties (‘plant traits’) is critical to assess ecosystem functioning, functional diversity and their role in the Earth system. Hyperspectral remote ...sensing of plant canopies offers a key tool to map multiple plant traits. However, we are still lacking generalized methods to translate hyperspectral reflectance into a suite of relevant plant traits across biomes, land cover and sensor types. The absence of globally representative data sets and the gap between the available reflectance data with corresponding in-situ measurements have hampered such approaches. In recent years, the scientific community acquired multiple data sets encompassing canopy hyperspectral reflectance and plant traits from different plant types and sensors. To combine these heterogeneous data sets, we propose three multi-trait modeling approaches based on Convolutional Neural Networks (CNNs) to simultaneously infer a broad set of 20 structural and chemical traits (e.g. leaf mass per area, leaf area index, pigments, nitrogen). The performance of these multi-trait CNN models predicting these traits was compared against single-trait CNN as well as single-trait partial least squares regression (PLSR). We found that the multi-trait CNNs performances significantly increased from single-trait CNNs (nRMSE = 0.027–19.61%) and the state-of-the-art PLSR models (nRMSE = 1.94–40.07%) across a broad range of vegetation types (crops, forest, tundra, grassland, shrubland) and sensor types. Thus, providing a single model for multiple traits not only proved to be computationally more efficient, but also more accurate, since it enabled the model to incorporate traits' co-variation. Despite the data heterogeneity of the merged data set, our models performances' were comparable or exceeded those of previous studies. Overall, this study highlights the potential of weakly supervised approaches to overcome the scarcity of in-situ measurements and take a step forward in creating efficient predictive models of multiple biochemical and biophysical vegetation properties.
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•We retrieve a set of 20 plant traits with a CNN model from canopy spectra.•The multi-trait model covers various ecosystems, vegetation types and sensors.•The multi-trait model outperforms partial least squares regression approaches.•Despite sparsity, data heterogeneity facilitated high retrieval performance.•Data sharing and collaboration advances the development of transferable models.
Les phéochromocytomes de localisation bilatérale sont rares. Ils s'intègrent le plus souvent dans le cadre d'une maladie familiale. Néanmoins des formes bilatérales sporadiques peuvent être ...observées. Ainsi, chez tout patient présentant des masses surrénaliennes bilatérales, un phéochromocytome bilatéral doit être suspecté et son caractère familial ou sporadique doit être déterminé devant le risque de récidive tumorale. A ce propos, nous rapportons l'observation d'une patiente âgée de 22 ans qui a été hospitalisée pour exploration d'une hypertension artérielle de découverte récente. L'association à des céphalées, sueurs et palpitations a orienté vers le diagnostic de phéochromocytome. Les taux urinaires des dérivés méthoxylés étaient très élevés. L’échographie et l'IRM abdominales ont noté la présence de deux masses surrénaliennes bilatérales. La scintigraphie au MIBG a montré une hyperfixation au niveau des deux surrénales, sans autres localisations. L'enquête à la recherche d'une néoplasie endocrinienne multiple ou d'une phacomatose était négative. Le traitement a consisté en une surrénalectomie bilatérale par voie cœlioscopique. L’évolution sous traitement substitutif par hydrocortisone était favorable avec une normalisation des chiffres tensionnels.
Since its occurrence, the coronavirus disease 2019 (COVID-19) pandemic has been responsible for a substantial rate of morbidity and mortality. The quick development of an effective and safe vaccine ...was essential in order to control the ongoing pandemic. However, given the severity of the situation, mass-scale vaccination had to be undertaken without much hindsight. Subsequently, side effects of the anti-COVID-19 vaccine, such as autoimmune diseases, have been reported. Cryoglobulinemic vasculitis (CryoVas) is a rare auto-immune disease, caused by the presence in the serum of abnormal immunoglobulins (cryoglobulins) able to precipitate at temperatures below 37°C. CryoVas can be either essential or, more frequently, secondary to other diseases such as infections, malignancies and auto-immune diseases. In some cases, CryoVas can be vaccine-induced. We describe an original case of a 57-year-old woman with no medical history who presented with purpura of the lower limbs that appeared 5 days after receiving her first COVID-19 vaccine. Skin biopsy and immunological work out were consistent with CryoVas.
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