Melanoma is the most fatal form of skin cancer, making its research a hot topic worldwide. Despite the promising results achieved by recent methods, they often disregard one of the most important ...criteria considered by dermatologists: the intrapatient lesion context. In this work we address this limitation, leveraging the medical concept of the ugly duckling (UD) lesion, and translating it to both the deep learning and the anomaly detection fields. Considering this, we propose an integrated diagnosis at the image and patient levels. Our results strongly support the hypothesis that the intrapatient context can enhance the diagnosis. The detection of melanoma at the image level improved by 7%, while the patient diagnosis improved by over 10% when compared with models that did not incorporate the patient context.
Falls and violence against older people might represent a joint public health problem, as both may result in injury, fear, social isolation, sedentary behavior and dependence or even death. The ESACA ...project "Aging safely in Alentejo - Understanding for action" was designed to promote the healthy aging of older people in Alentejo by preventing the occurrence of falls and violence. This study aimed to report the ESACA protocol and the preliminary outcomes.
The ESACA study has a twofold design as a cross-sectional study that included retrospective and prospective surveys. The participants were 508 community-dwelling older people. Assessments included falls, the risk of violence against older people, sociodemographic characteristics, health-related measurements, fear of falling, anthropometric measures and body composition, functional physical fitness, physical activity, and environmental hazards.
Among the participants, 43% were fallers, 21% were recurrent fallers, and 22% were victims of one or more kinds of violence (psychological: 17.1%, physical: 5.6%, and patrimonial: 3.0%). Moreover, the cumulative results suggested high risk on several risk factors for falling (7 factors: 0.6% to 2 factors: 17.4%) and of violence (26.7%).
In the ESACA project, a wide range of potential influencing factors on falls and violence risk factors were measured, and comprehensive quality control measures were applied. Overall, the results suggest that for falls and violence prevention strategies to be effective, it is essential to evaluate, diagnose, and inform all stakeholders in a directed and useful way. Moreover, we believe that our project outcomes may help change mindsets and behaviors by involving people in active aging and well-being programs that promote exercise and avoid isolation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Empirical evidence has previously shown the impact of shame and insecure striving on the emergence of eating psychopathology. However, interactions between these variables and the ...development of pathological eating remain unclear.
Objective
The present study aimed at exploring the moderator effect of insecure striving on the relationship between shame and disordered eating, while controlling for BMI effects.
Methods
Participants of this study were 458 women from the general population, with a mean age of 30.74 (SD = 12.15) and a mean BMI of 23.14 kg/m
2
(SD = 3.99), who completed an online investigation protocol. Out of these participants, 7.0% were underweight, 67.9% had a normal weight, 18.8% were overweight and 6.3% were obese.
Results
Results showed that the study variables were positive and significantly intercorrelated. A multiple regression analysis revealed that insecure striving and shame explained 20.5% of disordered eating. The exacerbating role of insecure striving on the relationship between shame and disordered eating was further confirmed through path analysis. The model explained 38% of disordered eating and the plotted graph revealed that, for any level of shame, women who manifested a greater need to strive to avoid inferiority, expressed higher levels of disordered eating, in comparison to those who felt a lower pressure to prove others that they are attractive through the achievement of excellence goals.
Conclusions
These results support the notion that eating psychopathology may be regarded as a striving to avoid inferiority strategy, establishing an important avenue for disordered eating-related investigation and clinical practice.
Level of evidence
Level V, cross-sectional descriptive study.
The tumour microenvironment plays a critical role in tumour progression and drug resistance processes. Non-malignant cell players, such as fibroblasts, endothelial cells, immune cells and others, ...interact with each other and with the tumour cells, shaping the disease. Though the role of each cell type and cell communication mechanisms have been progressively studied, the complexity of this cellular network and its role in disease mechanism and therapeutic response are still being unveiled. Animal models have been mainly used, as they can represent systemic interactions and conditions, though they face recognized limitations in translational potential due to interspecies differences. In vitro 3D cancer models can surpass these limitations, by incorporating human cells, including patient-derived ones, and allowing a range of experimental designs with precise control of each tumour microenvironment element. We summarize the role of each tumour microenvironment component and review studies proposing 3D co-culture strategies of tumour cells and non-malignant cell components. Moreover, we discuss the potential of these modelling approaches to uncover potential therapeutic targets in the tumour microenvironment and assess therapeutic efficacy, current bottlenecks and perspectives.
Mental disorders are highly prevalent in older people, being depression a predominant disorder. Evidence points to a possible relationship between depression and violence against older people. ...Nonetheless, the role of the depressive symptomology severity in the risk of violence against older people remains unclear. Thus, this study's main objective was to analyze the relationship between geriatric depressive symptomatology and the risk of violence against older people.
This exploratory study involved 502 community-dwelling older persons aged 65 to 96 years (73.3 ± 6.5). Measures were performed using the Geriatric Depression Scale and the Risk Assessment of Violence against the Non-Institutionalized Elderly scale.
One hundred nineteen older people (23.7%) had mild/moderate depressive symptomology, and twenty-six (5.2%) had severe depressive symptomology. There were significant relationships between the severity of depressive symptomatology and the risk of violence (p < 0.05). The presence of depressive symptomatology increased the likelihood of being victims of violence, particularly among women (odds ratio: 2-8, p < 0.05).
The severity of depressive symptomatology plays an essential role in the risk of violence against community-dwelling older people. Moreover, it was found that older persons with depression symptomatology were at higher risk of being victims of violence. Our study findings support the need for protective measures within mental health national or regional policies to prevent depression and violence against community-dwelling older people.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
is a common skin commensal that has emerged as a pathogen in hospitals, mainly related to medical devices-associated infections. Noteworthy, infection rates by
have the tendency to rise steeply in ...next decades together with medical devices use and immunocompromized population growth.
population structure includes two major clonal lineages (A/C and B) that present contrasting pathogenic potentials. To address this distinction and explore the basis of increased pathogenicity of A/C lineage, we performed a detailed comparative analysis using phylogenetic and integrated pangenome-wide-association study (panGWAS) approaches and compared the lineages's phenotypes in
conditions mimicking carriage and infection.
Each
lineage had distinct phenotypic signatures in skin and infection conditions and differed in genomic content. Combination of phenotypic and genotypic data revealed that both lineages were well adapted to skin environmental cues. However, they appear to occupy different skin niches, perform distinct biological functions in the skin and use different mechanisms to complete the same function: lineage B strains showed evidence of specialization to survival in microaerobic and lipid rich environment, characteristic of hair follicle and sebaceous glands; lineage A/C strains showed evidence for adaption to diverse osmotic and pH conditions, potentially allowing them to occupy a broader and more superficial skin niche. In infection conditions, A/C strains had an advantage, having the potential to bind blood-associated host matrix proteins, form biofilms at blood pH, resist antibiotics and macrophage acidity and to produce proteases. These features were observed to be rare in the lineage B strains. PanGWAS analysis produced a catalog of putative
virulence factors and identified an epidemiological molecular marker for the more pathogenic lineage.
The prevalence of A/C lineage in infection is probably related to a higher metabolic and genomic versatility that allows rapid adaptation during transition from a commensal to a pathogenic lifestyle. The putative virulence and phenotypic factors associated to A/C lineage constitute a reliable framework for future studies on
pathogenesis and the finding of an epidemiological marker for the more pathogenic lineage is an asset for the management of
infections.
To determine the clinical outcomes of arthroscopic superior capsular reconstruction (ASCR) using either fascia lata autograft or human dermal allograft for irreparable rotator cuff tears (IRCTs).
A ...systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines by searching the MEDLINE, Embase, and Cochrane Library databases through January 31, 2019. The inclusion criteria were as follows: 5 or more consecutive patients who underwent ASCR for IRCTs; clinical outcome measures reported at a minimum follow-up of 12 months; and magnetic resonance imaging assessment at a minimum follow-up of 6 months. The methodologic quality was evaluated using the Methodological Index for Non-randomized Studies (MINORS). A narrative synthesis of data was performed. Mean outcome improvements were compared with minimal clinically important differences.
We identified 7 eligible studies that included 344 shoulders in 338 patients who underwent ASCR for IRCTs (all Level IV studies). The mean MINORS score was 12.3 ± 1.60. Of the 7 studies, 5 had a high risk of bias (MINORS score ≤12): 2 studies using only fascia lata autograft and 3 studies using only human dermal allograft. The mean age of patients ranged from 59.4 to 66.9 years. The mean follow-up time ranged from 12 to 48 months. All studies reported statistically significant and clinically important mean improvements in active elevation (range of means, 28°-56°), the Constant score (range of means, 12-47.1 points), or the American Shoulder and Elbow Surgeons score (range of means, 29.3-56 points). In total, 218 shoulders underwent postoperative magnetic resonance imaging. The graft tear rate reported in studies using fascia lata autograft (181 shoulders) ranged from 5% to 32%, whereas the values reported in studies using human dermal allograft (37 shoulders) ranged from 20% to 75%.
ASCR using either fascia lata autograft or human dermal allograft leads to significant and clinically important improvements in clinical outcomes in IRCT patients at 12 months or later.
Level IV, systematic review of Level IV studies.
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•Modelling of methanol oxidation in a packed bed reactor.•Estimation of the kinetic and deactivation parameters.•Deactivation equation as a function of total product consumption ...instead of time.•Good model performance till 80% of the catalyst lifetime.
In the present work, a first-principles model of methanol partial oxidation to formaldehyde in an industrial reactor was developed and the reaction kinetic and deactivation parameters estimated, taking advantage of the temperature profile established by the exothermic reaction. The catalyst deactivation was assigned primarily to hot-spot regions in the oxidation reactor. The exposure to high temperatures enhances solid-state reactions that produce volatile compounds and a consequential loss of catalyst active compounds that migrate downstream from the hot-spot. This phenomenon was modelled implementing a new method where, instead of time, the deactivation was integrated as a function of the total consumed reagent until the instant of interest. This approach allowed computing the activity of the catalyst at any instant without needing to solve the model for the whole operating history until the pertinent instant; for simulating industrial reactors, where the operating conditions are changing frequently, this feature is quite relevant.
Previous studies have identified social jetlag (SJL) as a risk factor for non-communicable chronic diseases (NCCDs), but its association with metabolic control over time is unclear in the literature. ...Therefore, we examined the influence of SJL on metabolic parameters and blood pressure (BP) in patients with NCCDs over a 1-year follow-up. This retrospective, longitudinal study included 625 individuals (age: 56.0
+
12.0 years; 76% female) with NCCDs type 2 diabetes mellitus (TD2), systemic arterial hypertension (SHA), obesity, or dyslipidemia. SJL was calculated based on the absolute difference between mid-sleep time on weekends and weekdays. Current metabolic parameters and BP of the patients were compared with data from a year prior. Generalized estimating equations (GEE) and multiple linear regression analyses were used to examine the association among SJL, metabolic parameters, and BP. Multiple linear regression analyses adjusted for confounders showed that SJL was positively associated with the delta difference of fasting glucose (β = 0.11,
p
= 0.02) and triglyceride levels (β = 0.09,
p
= 0.04) among all subjects with NCCDs, and with fasting glucose (β = 0.30,
p
= 0.0001) and triglyceride levels (β = 0.22,
p
= 0.01) in the TD2 group. GEE analysis demonstrated an isolated effect of SJL on diastolic BP. High SJL impaired clinical and metabolic control in individuals with NCCDs, leading to a worse profile after a 1-year follow-up, particularly among type II diabetics.
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