Comparing operative techniques for non-palpable breast tumours: Wire-guided localisation vs LOCaliser

Introduction: Wire-guided localisation (WGL) has been the standard operative technique for non-palpable breast tumours. LOCaliser is an alternative method, with a clinical effectiveness that may be equal to the standard while providing additional benefits regarding the patient experience. Method(s): A single-centre, retrospective study of WGL vs LOCaliser from January 2020 to December 2021. We collected demographic and outcome data from electronic records. The primary outcome was rates of complications, this included seromas, haematomas, pain and re-excisions. Secondary outcomes included operative time. Result(s): 21 WGL and 16 LOCaliser patients were identified. The average age was similar between the two groups (62 vs 61;P=0.291). There were fewer complications in the LOCaliser group, however without statistical significance (1 vs 5;P=0.206). The LOCaliser group had less re-excisions (1 vs 5;P=0.206), with 3 of 5 patients requiring 2 margins to be re-excised in the WGL group. There was no difference in the operative time between the two groups (107 minutes vs 104 minutes;P=0.070), sub-group analysis was not done to compare axillary node clearances and sentinel lymph node biopsies. Conclusion(s): LOCaliser is as effective if not superior to WGL when measuring clinical outcomes. The data did not demonstrate statistical significance, however demonstrated differences which could become significant with larger patient cohorts. LOCaliser prevented the need for pre-operative procedures, which was particularly important during the COVID-19 pandemic as it reduced patient exposure and hospital attendances prior to surgery. A larger scale audit and assessing patients' experiences by collection patient reported outcomes measures (PROM) would be beneficial. Copyright © 2022

Machine Learning approach for detecting mental health on Twitter using chrome extension

Social media is used by people to communicate with friends and to share information, such as their feelings and moods. This enables companies to better understand how people think, feel, and act when communicating on various online platforms by analysing emotional data from social networks. People don't seek expert assistance because they are unwilling to do so. Additionally, many people who were kept inside their houses due of the Covid 19 pandemic decided to vent themselves on social media. We intend to create and develop a Chrome plugin that will instantly evaluate the user's tweet in order to solve this issue. Our technology would assess their posts using a machine learning model, then query them. The system will decide whether a user needs professional help based on how they respond to the questions. © 2022 IEEE.

EATING BEHAVIORS IN CHILDREN AND ADOLESCENTS DURING THE COVID-19 PANDEMIC: THE IMPORTANCE OF FAMILY CONTEXT

A healthy and balanced diet has been identified as a primary factor for good health across the entire lifespan. Early in 2020, the Coronavirus disease (COVID-19) spread very quickly worldwide and was classified by the World Health Organization (WHO) as a pandemic. Preliminary reports indicate that the COVID-19 pandemic has increased unhealthy eating patterns, especially in at-risk populations and in children and adolescents (e.g., increased snack intake). The evolution of the pandemic and, consequently, the tightening of social restrictions (e.g., social distancing, isolation, mandatory lockdowns) led families to spend more time together in close quarters. Accordingly, the routine of families eating meals together increased, allowing for more opportunities to instill parental food practices. Furthermore, as a consequence of this health crisis, food insecurity may have increased, impacting parental feeding practices and family food consumption. Overall, current findings within the family context indicate potential impacts on child and adult obesity risk, indicating several modifiable points of intervention in this context. For this reason, exploring the recent data and the impact of COVID- 19 on children and adolescents' eating behaviors is crucial to deepen our understanding of the phenomenon. Analysis of current literature findings is expected to prompt reflection on the role of the family and generate discussion and suggestions for best practices to follow in future crises. Additionally, this analysis is expected to elicit thinking on future policy guidelines. Hopefully, the discussion on prior findings will provide: i) a deepened foresight into the impact of the current pandemic on eating behaviors in children and adolescents, and ii) support to practitioners, researchers, and policymakers efforts in mitigating long-term negative consequences through educational tools aimed to promote healthy eating in the younger population, with particular emphasis on the family context. © 2022 by Nova Science Publishers, Inc. All rights reserved.

Different Clinical Uses and Advantages of Melatonin

Introduction: Melatonin (N-acetyl-5-methoxytryptamine), an endogenous hormone produced by the pineal gland and released exclusively at night, is known to influence many biological processes in the body, including circadian rhythms, the immune system, and neuroendocrine and cardiovascular functions, due to its great therapeutic potential and safety for application. This molecule is being widely studied in order to establish safe and effective therapeutic protocols for the treatment of several disorders, such as sleep disorders, cardiovascular diseases, metabolic bone diseases, covid-19, schizophrenia, neurofetal protection, among others. In view of this, the present article aims to demonstrate the numerous possible applications and their respective benefits of melatonin use. © 2022 Thieme Medical Publishers, Inc.. All rights reserved.

1-year mortality after myocardial injury in COVID-19 patients

Background: Myocardial injury is a known complication of COVID-19 and is related to a worse prognosis on admission. However, its impact on 1-year mortality is unknown. Methods: Retrospective cohort study with patients admitted to intensive care and confirmed diagnosis of COVID-19 by RT-PCR and with at least one measurement of troponin during hospitalization. The study period was from March/2020 to June/2021. Clinical characteristics and the occurrence of myocardial were assessed between deaths and survivors using the chi-square test and Student's t-test. Variables with p<0.01 in the univariate analysis were included in the Cox regression model to identify predictor variables of 1-year mortality. Results: 1037 patients were included, with a mean follow-up of 1.06±0.58 years, mean age = 59.9±16.2 years, and 62.7% men. The prevalence of myocardial injury was 42.8% and occurred 204 deaths (19.7%). In the univariate analysis, the variables associated with 1-year mortality were: myocardial injury (OR 7.5;CI95% 5.2–10.9), age >60 years (OR 5.65;CI95% 3.9–8.2), arterial hypertension (OR 2.8;CI95% 2.0–3.9), diabetes (OR 2.3;CI95% 1.6–3.1), chronic kidney failure (OR 3.9;CI95% 2.2–6.8), dementia (OR 1.8;CI95% 1.2–2.6) and mechanical ventilation (OR 50.5;CI95% 33.9–77.3). In Cox regression, the predictor variables were: myocardial injury (HR 2.4;CI95% 1.7–3.5), age >60 years (HR 2.5;CI95% 1.8–3.6), chronic kidney disease (HR 1.9;CI95% 1.2–2.9), dementia (HR 3.2;CI95% 2.1–5.0) and mechanical ventilation (HR 17.5;CI95% 12.2–25.2). Conclusion: In patients admitted to intensive care by COVID-19, the detection of myocardial injury more than doubled the risk of death in 1 year. Funding Acknowledgement: Type of funding sources: None.Figure 1

Has online betting come to conquer casinos? A comparison between the experience and emotions of online betting vs casinos

Undoubtedly, the online market has grown exponentially over the last decade, allowing several activities that were carried out in person to be carried out virtually. Has technology reached the point of perfection, when it comes to replicating face-to-face activities? This article focuses on the analysis of factors that may influence the experience of playing in physical casinos vs. betting on online casinos. The goal is to understand the extent to which technology was able to reproduce this activity and concerning which points does it fail. We also assess which of the two activities players feel most comfortable with, where they spend more money, where they feel like betting more often, among others. To this end, we performed an analysis of articles, a survey (with 100 responses), and seven interviews with regular casino gamblers, which allowed conclusions to be drawn on the theme. Chi-square tests were performed on the survey data, but no statistically significant associations were found. The results of our survey show a slight increase in the need to gamble due to the pandemic, which is in line with previous research. Despite the accessibility of online games, there are factors that lag behind, such as the fact that people have more fun in physical casinos. However, online casinos make people bet more money because they are not so aware of the money they are spending and because they are in the comfort of their home, away from negative looks.

Physiological Effects and Safety of Bed Verticalization in Patients with Acute Respiratory Distress Syndrome

BACKGROUND : Prone positioning has been proposed as a key aspect of care in acute respiratory distress syndrome (ARDS), more than ever with emergence of COVID-19 pandemic, but sometimes at the cost of burdensome procedure and serious adverse events. Bed verticalization (standing upright) could be an efficient alternative to prone position. Semi-seated position (45-degree head-up, 45-degree legs-down) have already been studied and shew promising results, but to our knowledge no study has evaluated the mechanical and physiological impacts of complete patient verticalization during ARDS. The objective was to evaluate the safety and physiological effects of bed verticalization of sedated and ventilated patients with ARDS. METHODS : Patients were gradually verticalized, using a dedicated bed, at 0°, 30°, 60° and 90° by steps of 30 minutes. At each position step, multiparametric measurements were performed, including hemodynamic data with pulmonary artery catheter, ventilatory parameters, arterial and central veinous gasometry, end-expiratory lung volume, esophageal pressures, and electrical impedance tomography. All these measurements were set to assess effects of verticalization on hemodynamics, ventilatory mechanics and hematosis.

SCIENTIFIC COMMUNICATION AND TEACHER EDUCATION Extensionist possibilities in the COVID-19 pandemic

This paper presents an experience of extensionist scientific dissemination, linked to the curriculum of a science undergraduate course, called Scientist for a day, during the Covid-19 pandemic. The proposal was characterized by synchronous meetings with basic education students to carry out investigative experimental activities that dialogued with current scientific issues. During the years 2020 and 2021, about 290 students from 13 public and private schools participated in the activities, monitored by extension fellows. The results indicate that, despite the remote environment hindering the interactions between the participating students, they were able to express their doubts and opinions throughout the meetings. The activity is an important formative component for future teachers, who were able to learn about the reality of remote teaching in basic education and the difficulties faced by teachers during the pandemic. In addition, the experience enabled a dialogical relationship between the university and the schools, professional interaction, and the strengthening of the teaching-research- extension triad.

Thoracic sarcopenia as a predictive factor of SARS-COV2 evolution.

PURPOSE: Evaluation of CT sarcopenia as a predictor of intensive care hospitalization during SARS-COV2 infection. MATERIALS AND METHODS: Single-center retrospective study of patients admitted to hospital with SARS-COV2 infection. The estimation of muscle mass (skeletal muscle index (SMI)) for sarcopenia, measurement of muscle density for muscle quality and body adiposity, were based on CT views on the T4 and L3 levels measured at admission. Demographic data, percentage of pulmonary parenchymal involvement as well as the orientation of patients during hospitalization and the risk of hospitalization in intensive care were collected. RESULTS: A total of 162 patients hospitalized for SARS-COV2 infection were included (92 men and 70 women, with an average age of 64.6 years and an average BMI of 27.4). The muscle area measured at the level of L3 was significantly associated with the patient's unfavorable evolution (124.4cm2 [97; 147] vs 141.5 cm2 [108; 173]) (p = 0.007), as was a lowered SMI (p < 0.001) and the muscle area measured in T4 (OR = 0.98 [0.97; 0.99]), (p = 0.026). Finally, an abdominal visceral fat area measured at the level of L3 was also associated with a risk of hospitalization in intensive care (249.4cm2 [173; 313] vs 147.5cm2 [93.1; 228] (p < 0.001). CONCLUSION: This study demonstrates that thoracic and abdominal sarcopenia are independently associated with an increased risk of hospitalization in an intensive care unit, suggesting the need to assess sarcopenia on admission during SARS-COV2 infection.

Mortality and social vulnerability in the covid 19 pandemic

Introduction: A disastrous disease, the COVID-19, continues its spread, this, coupled with its severity, led to a initial global lockdown. Early evidence identified Black counties where mortality risk was higher than in white counties, even more evident in Latin America. In Brazil, with multiple forms of social inequalities, where color/race takes high relevance in this debate, it is even more relevant in Rio de Janeiro. We aimed to analyze these socio economic factors and its correlation with COVID 19 mortality. Hypothesis: Patients hospitalized with COVID 19 with a high social vulnerable background would had greater in-hospital mortality Methods: Prospective study of 274 confirmed adult COVID 19 hospitalized patients in the UHCFF. Clinical features/blood chemistry information were obtained from the clinical record. Using the individual address, we correlated it with the Census Code Area (CCA), using a novel methodology, we geoprocessed each home on the Division map. Giving a high relevance to the socio-economic variables for inequity and vulnerability markers, also analyzing the fact to be transferred from another primary care institution, for its delay potential of advanced medical care. We performed a logistic regression, with in-hospital mortality as our primary outcomeResults: Patients living in low adequacy households(p=0.030) with high in-house individual agglomeration markers (p=0.017), and the fact to have been transferred from another primary care institution (p=0.047) presented high in-hospital mortality, with high ICU admission and Mechanical Ventilation rates. Conclusions: In hospital mortality due to COVID 19 was influenced by social individual background characteristics of vulnerability. Among other clinical parameters, these markers should be taken into account to predict the individual likelihood of complications related to the pandemic, prioritizing the attention and vaccination for those at higher risk should be paramount.

‘Nenhum passo atrás’ (Not a step back): Brazilian Black women’s resistance in the era of Bolsonaro’s far-right government

Since 2010, the far-right in Brazil has led the backlash to feminism, sexual and gender diversity, racial equality, and other human rights agendas. In this article, we shed light on the devastating impact of the comeback of conservatism and Jair Bolsonaro’s presidency on the lives of Black women. Next, we draw from the interviews conducted with a wide range of activists to unveil how Black women have been energised to resist the backlash. We argue that the Black women’s movement has employed grassroots organising, institutional politics, counter narratives, and the Black culture, in complementary and interconnected ways, to resist the resurgence of the far-right. Moreover, we suggest that the ability to engage with different forms of activism and strategies of resistance is a key strength of the Black women’s movement in Brazil and has placed it at the forefront of the resistance against the far-right. © 2021 Oxfam GB.

Scarcity in COVID-19 vaccine supplies reduces perceived vaccination priority and increases vaccine hesitancy

In two experimental studies, we tested the effect of COVID-19 vaccine scarcity on vaccine hesitancy. Based on extensive scarcity literature, we initially predicted that high (vs. low) scarcity would increase demand for vaccines, operationalized as one's willingness to receive a vaccine. Contrary to this prediction, Study 1 showed that scarcity of vaccines reduced participants' sense of priority which, in turn, also reduced their vaccination intentions. Trust in doctors moderated the effect of perceived vaccination priority on vaccination intentions such that for individuals with high trust in doctors, reduced perceived priority did not reduce their vaccination intentions as much. Study 2 replicated these effects with a more general population sample, which included at-risk individuals for COVID-19 complications. At-risk participants (vs. low-risk) had higher perceived vaccination priority, but describing vaccine doses as scarce reduced vaccination intentions similarly across both groups. Moreover, Study 2 demonstrated that compassion for others is a boundary condition of the effect of vaccine scarcity on vaccination intentions. For participants with high compassion, scarcity reduces willingness to receive a vaccine;for participants with low compassion, scarcity increases their willingness to be vaccinated. Our results suggest that health policymakers need to deemphasize the scarcity of vaccines to increase vaccine acceptance.

An association of psychotherapists founded during lockdown

We describe the organizing of a psychological consultation group made up of volunteers, formed at the beginning of the first lockdown implemented by the Belgian government to manage the COVID-19 pandemic in March 2020. Nine psychologists and psychotherapists, most of whom did not know each other, set up a system active between March and June 2020. The idea was to offer a temporary space from which to address mental health issues while the existing network adapted to the new constraints imposed by the lockdown. We would like to share our experiences, conclusions, and lessons learned, both personal and professional. © 2021 Boeck Universite. All rights reserved.