In recent years, employment in sedentary occupations has continuously risen. Office workers are more prone to prolonged static sitting, spending 65−80% of work hours sitting, increasing risks for ...multiple health problems, including cardiovascular diseases and musculoskeletal disorders. These adverse health effects lead to decreased productivity, increased absenteeism and health care costs. However, lack of regulation targeting these issues has oftentimes left them unattended. This article proposes a smart chair system, with posture and electrocardiography (ECG) monitoring modules, using an “invisible” sensing approach, to optimize working conditions, without hindering everyday tasks. For posture classification, machine learning models were trained and tested with datasets composed by center of mass coordinates in the seat plane, computed from the weight measured by load cells fixed under the seat. Models were trained and evaluated in the classification of five and seven sitting positions, achieving high accuracy results for all five-class models (>97.4%), and good results for some seven-class models, particularly the best performing k-NN model (87.5%). For ECG monitoring, signals were acquired at the armrests covered with conductive nappa, connected to a single-lead sensor. Following signal filtering and segmentation, several outlier detection methods were applied to remove extremely noisy segments with mislabeled R-peaks, but only DBSCAN showed satisfactory results for the ECG segmentation performance (88.21%) and accuracy (90.50%).
Background
Prebiopsy magnetic resonance imaging (MRI) increases the detection rate of clinically significant prostate cancer (csPCa). Prostate‐specific membrane antigen‐positron emission ...tomography/computed tomography (PSMA PET/CT) maximum standardized uptake value (SUVmax) of the prostate may offer additional value in predicting the likelihood of csPCa in biopsy.
Methods
A single‐center cohort study involving patients with biopsy‐proven PCa who underwent both MRI and PSMA PET/CT between 2020 and 2021. Logistic regression models were developed for International Society of Urological Pathology (ISUP) Grade Group (GG) ≥ 2 and GG ≥ 3 using noninvasive prebiopsy parameters: age, (log‐)prostate‐specific antigen (PSA) density, PI‐RADS 5 lesion presence, extraprostatic extension (EPE) on MRI, and SUVmax of the prostate. Models with and without SUVmax were compared using Likelihood ratio tests and area under the curve (AUC). DeLong's test was used to compare the AUCs.
Results
The study included 386 patients, with 262 (68%) having ISUP GG ≥ 2 and 180 (47%) having ISUP GG ≥ 3. Including SUVmax significantly improved both models' goodness of fit (p < 0.001). The GG ≥ 2 model had a higher AUC with SUVmax 89.16% (95% confidence interval CI: 86.06%–92.26%) than without 87.34% (95% CI: 83.93%–90.76%) (p = 0.026). Similarly, the GG ≥ 3 model had a higher AUC with SUVmax 82.51% (95% CI: 78.41%–86.6%) than without 79.33% (95% CI: 74.84%–83.83%) (p = 0.003). The SUVmax inclusion improved the GG ≥ 3 model's calibration at higher probabilities.
Conclusion
SUVmax of the prostate on PSMA PET/CT potentially improves diagnostic accuracy in predicting the likelihood of csPCa in prostate biopsy.
History of depression symptoms, including before and during pregnancy, has been identified as an important risk factor for postpartum depression (PPD) symptoms. This condition has also been ...associated with diverse implications, namely, on the quality of mother-infant bonding. Moreover, the role of self-criticism on PPD has been recently found in several studies. However, the link between these factors has not been explored yet. Furthermore, anxiety symptoms in postpartum has been less studied.
This study analyzed whether the history of depression symptoms predicted mother-infant bonding,
self-criticism and PPD symptoms. The same model was repeated with a history of anxiety and postpartum anxiety symptoms. A total of 550 mothers of infants <24 months old participated in this cross-sectional study and answered an online survey.
Through a parallel-serial mediation model, the results show that in a first step, self-criticism dimensions of inadequate-self, hated-self, and reassuring-self, and in a second step, PPD symptoms, mediate the relationship between the history of depression symptoms and mother-infant bonding. However, the relationship between the history of anxiety symptoms and bonding is not mediated by all the considered chain of mediators, being only mediated by one of the self-criticism dimensions, inadequate self.
The current study confirmed the association of history of both depression and anxiety with mother-infant bonding. While in the case of history of anxiety symptoms, the relation was only mediated by inadequate self-dimension of self-criticism, in the case of history of depression symptoms, the relation was mediated by self-criticism and postpartum depressive symptoms. The buffering effect of reassuring-self on bonding and negative affect was also evidenced. Psychological and preventive interventions should address this evidence to target interventions for mother-infant bonding problems in accordance with previous and actual current maternal risk factors.
Objective
To evaluate the proportions of detected prostate cancer (PCa) and clinically significant PCa (csPCa), as well as identify clinical predictors of PCa, in patients with PI-RADS > = 3 lesion ...at mpMRI and initial negative targeted and systematic biopsy (initial biopsy) who underwent a second MRI and a re-biopsy.
Methods
A total of 290 patients from 10 tertiary referral centers were included. The primary outcome measures were the presence of PCa and csPCa at re-biopsy. Logistic regression analyses were performed to evaluate predictors of PCa and csPCa, adjusting for relevant covariates.
Results
Forty-two percentage of patients exhibited the presence of a new lesion. Furthermore, at the second MRI, patients showed stable, upgrading, and downgrading PI-RADS lesions in 42%, 39%, and 19%, respectively. The interval from the initial to repeated mpMRI and from the initial to repeated biopsy was 16 mo (IQR 12–20) and 18 mo (IQR 12–21), respectively. One hundred and eight patients (37.2%) were diagnosed with PCa and 74 (25.5%) with csPCa at re-biopsy. The presence of ASAP on the initial biopsy strongly predicted the presence of PCa and csPCa at re-biopsy. Furthermore, PI-RADS scores at the first and second MRI and a higher number of systematic biopsy cores at first and second biopsy were independent predictors of the presence of PCa and csPCa. Selection bias cannot be ruled out.
Conclusions
Persistent PI-RADS ≥ 3 at the second MRI is suggestive of the presence of a not negligible proportion of csPca. These findings contribute to the refinement of risk stratification for men with initial negative MRI-TBx.
Magnetic resonance imaging (MRI) has resulted in a reduction in the number of patients indicated for prostate biopsy. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed ...tomography (PET/CT) has recently shown additional value in detecting clinically significant prostate cancer (csPCa). Combining these imaging modalities allows such specific prediction of the presence of csPCa that the need for histological confirmation may be obsolete. We retrospectively analyzed PSMA PET/CT scans performed in the primary staging of PCa in the past 2 yr in our center (n = 451). All 74 patients with a PSMA ligand maximum standardized uptake value (SUVmax) of ≥16 had csPCa (grade group ≥2). Of the 185 patients with a combination of a Prostate Imaging-Reporting and Data System score ≥4 and SUVmax ≥8, 98% had csPCa. A nomogram combining predictive factors should be developed to identify patients in whom biopsy could theoretically be avoided. Nevertheless, biopsy will remain indispensable in patients with indefinite risk of csPCa and can provide important additional information.
Using patient data from our center, we found that addition of a special type of scan based on prostate-specific membrane antigen could help in the diagnosis of clinically significant prostate cancer without the need for prostate biopsy. Direct therapy without biopsy confirmation of cancer might be possible for a highly select group of patients.
Background: Diagnostic pathways for prostate cancer (PCa) balance detection rates and burden. MRI impacts biopsy indication and strategy. Methods: A prospectively collected cohort database (N = 496) ...of men referred for elevated PSA and/or abnormal DRE was analyzed. All underwent biparametric MRI (3 Tesla scanner) and ERSPC prostate risk-calculator. Indication for biopsy was PIRADS ≥ 3 or risk-calculator ≥ 20%. Both targeted (cognitive-fusion) and systematic cores were combined. A hypothetical full-MRI-based pathway was retrospectively studied, omitting systematic biopsies in: (1) PIRADS 1–2 but risk-calculator ≥ 20%, (2) PIRADS ≥ 3, receiving targeted biopsy-cores only. Results: Significant PCa (GG ≥ 2) was detected in 120 (24%) men. Omission of systematic cores in cases with PIRADS 1–2 but risk-calculator ≥ 20%, would result in 34% less biopsy indication, not-detecting 7% significant tumors. Omission of systematic cores in PIRADS ≥ 3, only performing targeted biopsies, would result in a decrease of 75% cores per procedure, not detecting 9% significant tumors. Diagnosis of insignificant PCa dropped by 52%. PCa undetected by targeted cores only, were ipsilateral to MRI-index lesions in 67%. Conclusions: A biparametric MRI-guided PCa diagnostic pathway would have missed one out of six cases with significant PCa, but would have considerably reduced the number of biopsy procedures, cores, and insignificant PCa. Further refinement or follow-up may identify initially undetected cases. Center-specific data on the performance of the diagnostic pathway is required.
Prebiopsy magnetic resonance imaging (MRI) increases the detection rate of clinically significant prostate cancer (csPCa). Prostate-specific membrane antigen-positron emission tomography/computed ...tomography (PSMA PET/CT) maximum standardized uptake value (SUVmax) of the prostate may offer additional value in predicting the likelihood of csPCa in biopsy.
A single-center cohort study involving patients with biopsy-proven PCa who underwent both MRI and PSMA PET/CT between 2020 and 2021. Logistic regression models were developed for International Society of Urological Pathology (ISUP) Grade Group (GG) ≥ 2 and GG ≥ 3 using noninvasive prebiopsy parameters: age, (log-)prostate-specific antigen (PSA) density, PI-RADS 5 lesion presence, extraprostatic extension (EPE) on MRI, and SUVmax of the prostate. Models with and without SUVmax were compared using Likelihood ratio tests and area under the curve (AUC). DeLong's test was used to compare the AUCs.
The study included 386 patients, with 262 (68%) having ISUP GG ≥ 2 and 180 (47%) having ISUP GG ≥ 3. Including SUVmax significantly improved both models' goodness of fit (p < 0.001). The GG ≥ 2 model had a higher AUC with SUVmax 89.16% (95% confidence interval CI: 86.06%-92.26%) than without 87.34% (95% CI: 83.93%-90.76%) (p = 0.026). Similarly, the GG ≥ 3 model had a higher AUC with SUVmax 82.51% (95% CI: 78.41%-86.6%) than without 79.33% (95% CI: 74.84%-83.83%) (p = 0.003). The SUVmax inclusion improved the GG ≥ 3 model's calibration at higher probabilities.
SUVmax of the prostate on PSMA PET/CT potentially improves diagnostic accuracy in predicting the likelihood of csPCa in prostate biopsy.
People's explanations for why some individuals are poor are of great importance to a comprehensive study of poverty. This cross-cultural study aims to profile differences and similarities in ...perceptions of the causes of poverty within and between 28 European Union countries. Multilevel models were estimated to allow two levels of analysis to be studied simultaneously, namely the individual and the country, and a multilevel latent class model was selected with six classes of countries and seven classes of individuals. Despite the generalization of the social explanations of poverty at the individual level, some groups also blame the poor for their situation. Individuals in greater economic difficulty attributed more social causes to poverty than those who were better off financially and socially. At the country level, the most developed countries believe poverty has individualistic and fatalistic causes, whereas the least developed countries explain poverty based on the injustices of society. We found that this methodology permits a deeper and richer analysis than traditional clustering methods as it accounts for different nested levels of analysis simultaneously.
The use of clinical parameters, including prebiopsy magnetic resonance imaging (MRI), to decide between active surveillance (AS) and active therapy for prostate cancer (PCa) leads to imperfect ...selection. Additional prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) imaging may improve risk stratification.
To study risk stratification and patient selection for AS with the addition of PSMA PET/CT to standard practice.
A single-centre prospective cohort study (NL69880.100.19) enrolled patients recently diagnosed with PCa who started AS. At diagnosis, all participants had undergone prebiopsy MRI and targeted biopsy for visualised lesions. Patients underwent an additional 68Ga-PSMA PET/CT and targeted biopsy of all PSMA lesions with a maximum standardised uptake value (SUVmax) of ≥4 not covered by previous biopsies.
The primary outcome was the number needed to scan (NNS) to detect one patient with upgrading. The study was powered to detect an NNS of 10. Regarding secondary outcomes, univariate logistic regressions analyses were performed on all patients and on the patients who received additional PSMA targeted biopsies on the likelihood of upgrading.
A total of 141 patients were included. Additional PSMA targeted biopsies were performed in 45 (32%) patients. In 13 (9%) patients, upgrading was detected: nine grade group (GG) 2, two GG 3, one GG 4, and one GG 5. The NNS was 11 (95% confidence interval 6-18). Of all participants, PSMA PET/CT and targeted biopsies yielded upgrading most frequently in patients with negative MRI (Prostate Imaging Reporting and Data System PI-RADS 1-2). Of patients who received additional PSMA targeted biopsies, upgrading was most frequently found in those with higher prostate-specific antigen density and negative MRI. Limitations included the lack of comparison with standard repeat biopsy, no central review of MRI, and possibility of biopsy sampling error.
PSMA PET/CT can further improve PCa risk stratification and selection for AS patients diagnosed after MRI and targeted biopsies.
Prostate-specific membrane antigen positron emission tomography/computed tomography and additional targeted prostate biopsies can identify more aggressive prostate cancer cases previously missed in patients recently started with expectant management for favourable-risk prostate cancer.
Universities are today seen as living labs for the creation of knowledge with the aim of transferring it to society. The integration of sustainability is a critical point in this context, as ...solutions for problems experienced in society can be experimented with regarding physical aspects, such as Solid Waste Management (SWM), and efficiency in energy and water use, but also social aspects such as accessibility, equality, and inclusion. This paper explores the implementation of similar SWM projects in two European universities, Milan-Bicocca University and Instituto Superior Técnico from Lisbon University. Milan-Bicocca was the pioneer project that followed an ambitious model that demanded the removal of all isolated waste bins from inside the offices and rooms, replacing them with waste collection islands in the public spaces. This meant a very coordinated procedure and communication plan, and inspired the pilot project in Instituto Superior Técnico, currently in the expansion phase. This paper describes the implementation of each model and their specificities, and a roadmap is proposed that resulted from the interactions, meetings, and discussions between the two teams, Italian and Portuguese.
