Extra-legal abortion and post-abortion care knowledge, attitudes, and practices among obstetrician-gynecologist clinicians and medical residents in San José, Costa Rica: a qualitative study.

BACKGROUND: Induced abortion in Costa Rica is illegal in all cases except to save the life of the pregnant person. Despite severe restrictions to legal abortion, individuals in Costa Rica still induce abortions outside of the formal healthcare system. These individuals and those with spontaneous abortions, also known as miscarriages, occasionally need medical care for complications. In Costa Rica, an estimated 41% of unintended pregnancies end in abortion, yet there is very little published literature exploring the perspectives of healthcare providers on abortion in Costa Rica. METHODS: We interviewed ten obstetrician-gynecologist clinicians and five obstetrician-gynecologist medical residents in San José, Costa Rica about their beliefs and practices related to extra-legal abortion and post-abortion care (PAC) using a Spanish language in-depth semi-structured interview guide. After transcription and translation into English, analysis team pairs used a combination of deductive and inductive coding to identify themes and sub-themes within the data. RESULTS: Obstetrician-gynecologist clinicians and medical residents were aware of the presence of extra-legal abortion, and particularly, medication abortion, in their communities, but less familiar with dosing for induction. They expressed the desire to provide non-judgmental care and support their patients through extra-legal abortion and PAC journeys. Study participants were most familiar with providing care to individuals with spontaneous abortions. When discussing PAC, they often spoke about a policy of reporting individuals who seek PAC following an extra-legal abortion, without commenting on whether or not they followed the guidance. CONCLUSIONS: This study contributes to a gap in research about the knowledge, attitudes, and practices of Costa Rican obstetrician-gynecologist clinicians and medical residents around extra-legal abortion and PAC. The results reveal an opportunity to train these healthcare providers as harm reduction experts, who are able to accurately counsel individuals who are seeking abortion services outside of the healthcare system, and to provide training to improve care for individuals needing PAC.

Analysis of microbiota-host communication mediated by butyrate in Atlantic salmon.

Butyrate is a microbiota-produced metabolite, sensed by host short-chain fatty acid receptors FFAR2 (Gpr43), FFAR3 (Gpr41), HCAR2 (Gpr109A), and Histone deacetylase (HDAC) that promotes microbiota-host crosstalk. Butyrate influences energy uptake, developmental and immune response in mammals. This microbial metabolite is produced by around 79 anaerobic genera present in the mammalian gut, yet little is known about the role of butyrate in the host-microbiota interaction in salmonid fish. To further our knowledge of this interaction, we analyzed the intestinal microbiota and genome of Atlantic salmon (Salmo salar), searching for butyrate-producing genera and host butyrate receptors. We identified Firmicutes, Proteobacteria, and Actinobacteria as the main butyrate-producing bacteria in the salmon gut microbiota. In the Atlantic salmon genome, we identified an expansion of genes orthologous to FFAR2 and HCAR2 receptors, and class I and IIa HDACs that are sensitive to butyrate. In addition, we determined the expression levels of orthologous of HCAR2 in the gut, spleen, and head-kidney, and FFAR2 in RTgutGC cells. The effect of butyrate on the Atlantic salmon immune response was evaluated by analyzing the pro and anti-inflammatory cytokines response in vitro in SHK-1 cells by RT-qPCR. Butyrate decreased the expression of the pro-inflammatory cytokine IL-1ß and increased anti-inflammatory IL-10 and TGF-ß cytokines. Butyrate also reduced the expression of interferon-alpha, Mx, and PKR, and decreased the viral load at a higher concentration (4 mM) in cells treated with this molecule before the infection with Infectious Pancreatic Necrosis Virus (IPNV) by mechanisms independent of FFAR2, FFAR3 and HCAR2 expression that probably inhibit HDAC. Moreover, butyrate modified phosphorylation of cytoplasmic proteins in RTgutGC cells. Our data allow us to infer that Atlantic salmon have the ability to sense butyrate produced by their gut microbiota via different specific targets, through which butyrate modulates the immune response of pro and anti-inflammatory cytokines and the antiviral response.

How video calls affect mimicry and trust during interactions.

Many social species, humans included, mimic emotional expressions, with important consequences for social bonding. Although humans increasingly interact via video calls, little is known about the effect of these online interactions on the mimicry of scratching and yawning, and their linkage with trust. The current study investigated whether mimicry and trust are affected by these new communication media. Using participant-confederate dyads (n = 27), we tested the mimicry of four behaviours across three different conditions: watching a pre-recorded video, online video call, and face-to-face. We measured mimicry of target behaviours frequently observed in emotional situations, yawn and scratch and control behaviours, lip-bite and face-touch. In addition, trust in the confederate was assessed via a trust game. Our study revealed that (i) mimicry and trust did not differ between face-to-face and video calls, but were significantly lower in the pre-recorded condition; and (ii) target behaviours were significantly more mimicked than the control behaviours. This negative relationship can possibly be explained by the negative connotation usually associated with the behaviours included in this study. Overall, this study showed that video calls might provide enough interaction cues for mimicry to occur in our student population and during interactions between strangers. This article is part of a discussion meeting issue 'Face2face: advancing the science of social interaction'.

Epidemiologic characteristics and burden of psoriasis: A multicenter, cross-sectional study.

Background: Although psoriasis burden and treatment have been well characterized in developed countries, there are scarce in-depth epidemiological studies in Latin American countries. Objectives: To describe the sociodemographic and clinical features and the economic burden of psoriasis among children and adult patients from Colombia. Methods: This cross-sectional study included patients from dermatology private practice offices, health provider institutions and hospitals in seven Colombian cities. We collected data on disease distribution, weight, height, body mass index, waist-hip ratio, disease severity, therapy, personal history of comorbidities, and direct costs. Multiple logistic regression analyses were conducted to assess the associations between severity scales and sociodemographic and clinical variables. Results: Two-hundred-three patients (43.8% women, 56.2% men) with an age range between 7 to 89 years old were included. The main subtype was psoriasis vulgaris and mean age of diagnosis was 37.1 years. The most common comorbidities were obesity, hypertension, psoriatic arthritis, dyslipidemia and diabetes. Women had a significant increased odds of presenting with psoriatic arthritis. Body-mass-index and hypertension were significantly associated with a higher psoriasis severity, whereas being female and non-obese was associated with a lower risk. A third of the patients had a family history of psoriasis and sleeping disorders. Forty-one percent of participants either had no income or had an income below 224 US dollars per month and >20% of their income was spent on their disease. Conclusions: This study is supported by robust scientific data and contributes to understanding the burden of psoriasis in Latin America. This study adds well-supported data through an in-depth clinical and economical characterization of Colombian children and adult patients with psoriasis and shows the high impact and burden of the disease on patients and their families.

CatLC: Catalonia Multiresolution Land Cover Dataset.

The availability of large annotated image datasets represented one of the tipping points in the progress of object recognition in the realm of natural images, but other important visual spaces are still lacking this asset. In the case of remote sensing, only a few richly annotated datasets covering small areas are available. In this paper, we present the Catalonia Multiresolution Land Cover Dataset (CatLC), a remote sensing dataset corresponding to a mid-size geographical area which has been carefully annotated with a large variety of land cover classes. The dataset includes pre-processed images from the Cartographic and Geological Institute of Catalonia (ICGC) ( https://www.icgc.cat/en/Downloads ) and the European Space Agency (ESA) ( https://scihub.copernicus.eu ) catalogs, captured from both aircraft and satellites. Detailed topographic layers inferred from other sensors are also included. CatLC is a multiresolution, multimodal, multitemporal dataset, that can be readily used by the machine learning community to explore new classification techniques for land cover mapping in different scenarios such as area estimation in forest inventories, hydrologic studies involving microclimatic variables or geologic hazards identification and assessment. Moreover, remote sensing data present some specific characteristics that are not shared by natural images and that have been seldom explored. In this vein, CatLC dataset aims to engage with computer vision experts interested in remote sensing and also stimulate new research and development in the field of machine learning.

Epidemiologic characteristics and burden of psoriasis: A multicenter, cross-sectional study

Antecedentes La carga de enfermedad y el tratamiento de la psoriasis han sido bien caracterizados en los países desarrollados, pero los estudios epidemiológicos realizados en America Latina son escasos. Objetivos Describir las características sociodemográficas, clínicas y económicas de la psoriasis en pacientes pediátricos y adultos de Colombia. Métodos Este fue un estudio observacional transversal que incluyó pacientes recolectados en consultorios privados de dermatología, instituciones prestadoras de salud y hospitales de siete ciudades de Colombia. Se incluyeron datos relacionados con la distribución de la enfermedad, peso, altura, índice de masa corporal, medición de la cintura/cadera, severidad de la enfermedad, tratamiento, antecedentes de comorbilidades y costos directos para el paciente o la familia. Se realizó un análisis de regresión logística múltiple para evaluar las asociaciones entre la severidad de la psoriasis y las variables sociodemográficas y clínicas. Resultados Se incluyeron 203 pacientes (43.8% mujeres y 56.2% hombres) con un rango de edad entre 7 a 89 años. El subtipo principal fue la psoriasis vulgar y la edad media de diagnóstico fue de 37,1 años. Las comorbilidades más frecuentes fueron la obesidad, la hipertensión arterial, la artritis psoriásica, la dislipidemia y la diabetes. Las mujeres tuvieron un mayor riesgo de presentar artritis psoriásica. El índice de masa corporal y la hipertensión se asociaron significativamente con la severidad de la psoriasis, mientras que ser mujer y no obeso se relacionó con un menor riesgo, respectivamente. Un tercio de los pacientes tenía antecedentes familiares de psoriasis y trastornos del sueño. Cuarenta y uno por ciento de los participantes no tenían ingresos o tenían ingresos inferiores a 224 dólares estadounidenses por mes y >20% de sus ingresos los gastaron en la enfermedad. Conclusiones Este estudio muestra un gran impacto de la psoriasis en los pacientes afectados y contribuye a comprender la carga de la psoriasis en América Latina aportando datos científicos sólidos a la comunidad dermatológica y a las autoridades sanitarias colombianas con respecto a los estándares de atención médica. También crea conciencia sobre la carga económica de la enfermedad y también enfatiza la necesidad de un seguimiento estrecho de los pacientes con psoriasis para prevenir, identificar y manejar sus comorbilidades.

Background Although psoriasis burden and treatment have been well characterized in developed countries, there are scarce in-depth epidemiological studies in Latin American countries. Objectives To describe the sociodemographic and clinical features and the economic burden of psoriasis among children and adult patients from Colombia. Methods This cross-sectional study included patients from dermatology private practice offices, health provider institutions and hospitals in seven Colombian cities. We collected data on disease distribution, weight, height, body mass index, waist-hip ratio, disease severity, therapy, personal history of comorbidities, and direct costs. Multiple logistic regression analyses were conducted to assess the associations between severity scales and sociodemographic and clinical variables. Results Two-hundred-three patients (43.8% women, 56.2% men) with an age range between 7 to 89 years old were included. The main subtype was psoriasis vulgaris and mean age of diagnosis was 37.1 years. The most common comorbidities were obesity, hypertension, psoriatic arthritis, dyslipidemia and diabetes. Women had a significant increased odds of presenting with psoriatic arthritis. Body-mass-index and hypertension were significantly associated with a higher psoriasis severity, whereas being female and non-obese was associated with a lower risk. A third of the patients had a family history of psoriasis and sleeping disorders. Forty-one percent of participants either had no income or had an income below 224 US dollars per month and >20% of their income was spent on their disease. Conclusions This study is supported by robust scientific data and contributes to understanding the burden of psoriasis in Latin America. This study adds well-supported data through an in-depth clinical and economical characterization of Colombian children and adult patients with psoriasis and shows the high impact and burden of the disease on patients and their families.

Eficacia del «Programa de tamizaje auditivo neonatal universal¼ de la Caja Costarricense del Seguro Social en la detección de sordera en niñas y niños, entre 2016 y 2018 / Effectiveness of «Universal Newborn Hearing Screening program¼ of Caja Costarricense del Seguro Social, in detecting deafness in children, from 2016 to 2018

Resumen Introducción: el tamizaje auditivo es un método de detección y su propósito es intervenir de forma temprana para reducir las consecuencias negativas de una eventual afección auditiva en el desarrollo integral del infante. Costa Rica ha implementado en el sistema de salud público un programa de tamizaje auditivo neonatal universal, donde se examina todo niño o niña antes del primer mes de vida. Aunque se han percibido múltiples beneficios, es importante demostrar con evidencia científica si cumple sus objetivos. Metodología: se analizó la eficacia del «Programa de tamizaje auditivo neonatal universal» (TANU) de la Caja Costarricense de Seguro Social, a partir de la información registrada de 37 656 infantes evaluados entre los años 2016 y 2018, mediante el contraste empírico con las técnicas descriptivas de distribución de frecuencias de variables, y las pruebas inferenciales chi cuadrado y análisis de varianza (ANOVA). Resultados: en cuanto a la edad al momento del examen, el 71 % de la muestra tenía entre 0 y 3 días. Su desempeño a través del tiempo y la extensión a distintos centros de salud ha sido satisfactorio, así mismo, la cantidad de infantes valorados ha sido hasta del 98 % de la población. Conclusiones: el programa TANU es eficaz en la mayoría de aspectos analizados, destaca la identificación de factores de riesgo y la detección temprana de afecciones auditivas, sin embargo, se proponen mejoras en relación con el manejo de la información.

Abstract Introduction: Hearing screening is a detection method, its objective is to provide an early intervention that allows reducing the negative consequences of an eventual hearing impairment, in the integral development of the infant. Costa Rica has implemented a universal neonatal hearing screening program in the public health system, where the hearing of every child born in the country is examined before the first month of life. Although multiple benefits have been perceived, it is important to demonstrate with scientific evidence if it accomplishes its objectives. Methodology: the effectiveness of the Universal Newborn Hearing Screening Program in Costa Rica was analyzed, based on the information recorded from 37,656 children evaluated since 2016 to 2018, through empirical contrast using both descriptive techniques: frequency distribution of variables, as well as the use of inferential tests: chi square and analysis of variance (ANOVA). Results: 71 % of the sample was between 0 and 3 days old at the moment of being examined. Its performance over time and extension to different health centers has been satisfactory, likewise, the number of infants evaluated has been up to 98 % of the population. Conclusions: the TANU program is effective in most of the aspects analyzed, the identification of risk factors and the early detection of hearing disorders are outstanding, however, improvements are proposed in relation to the handling of information.

Seroconversion panels demonstrate anti-SARS-CoV-2 antibody development after administration of the mRNA-1273 vaccine.

Seroconversion panels are an important tool for investigating antibody responses in acute and chronic phases of disease and development of serological assays for viral diseases including COVID-19. Globally it is anticipated that vaccines against SARS-CoV-2 will facilitate control of the current pandemic. The two COVID-19 seroconversion panels analyzed in this study were obtained from healthcare workers with samples collected before vaccination with the mRNA-1273 vaccine (Moderna) and after the first and second doses of the vaccine. Panel samples were tested for antibodies to SARS-CoV-2 (IgG). Individual subjects with a positive response for anti-SARS-CoV2 IgG in their pre-vaccination samples showed a significantly enhanced response to the first vaccination. In older subjects, lower immunological responses to the first injection were observed, which were overcome by the second injection. All subjects in the study were positive for anti-SARS-CoV-2 IgG after the second dose of vaccine.

Distortion and instability compensation with deep learning for rotational scanning endoscopic optical coherence tomography.

Optical Coherence Tomography (OCT) is increasingly used in endoluminal procedures since it provides high-speed and high resolution imaging. Distortion and instability of images obtained with a proximal scanning endoscopic OCT system are significant due to the motor rotation irregularity, the friction between the rotating probe and outer sheath and synchronization issues. On-line compensation of artefacts is essential to ensure image quality suitable for real-time assistance during diagnosis or minimally invasive treatment. In this paper, we propose a new online correction method to tackle both B-scan distortion, video stream shaking and drift problem of endoscopic OCT linked to A-line level image shifting. The proposed computational approach for OCT scanning video correction integrates a Convolutional Neural Network (CNN) to improve the estimation of azimuthal shifting of each A-line. To suppress the accumulative error of integral estimation we also introduce another CNN branch to estimate a dynamic overall orientation angle. We train the network with semi-synthetic OCT videos by intentionally adding rotational distortion into real OCT scanning images. The results show that networks trained on this semi-synthetic data generalize to stabilize real OCT videos, and the algorithm efficacy is demonstrated on both ex vivo and in vivo data, where strong scanning artifacts are successfully corrected.

Experimental evidence for yawn contagion in orangutans (Pongo pygmaeus).

Yawning is highly contagious, yet both its proximate mechanism(s) and its ultimate causation remain poorly understood. Scholars have suggested a link between contagious yawning (CY) and sociality due to its appearance in mostly social species. Nevertheless, as findings are inconsistent, CY's function and evolution remains heavily debated. One way to understand the evolution of CY is by studying it in hominids. Although CY has been found in chimpanzees and bonobos, but is absent in gorillas, data on orangutans are missing despite them being the least social hominid. Orangutans are thus interesting for understanding CY's phylogeny. Here, we experimentally tested whether orangutans yawn contagiously in response to videos of conspecifics yawning. Furthermore, we investigated whether CY was affected by familiarity with the yawning individual (i.e. a familiar or unfamiliar conspecific and a 3D orangutan avatar). In 700 trials across 8 individuals, we found that orangutans are more likely to yawn in response to yawn videos compared to control videos of conspecifics, but not to yawn videos of the avatar. Interestingly, CY occurred regardless of whether a conspecific was familiar or unfamiliar. We conclude that CY was likely already present in the last common ancestor of humans and great apes, though more converging evidence is needed.

Steerable OCT catheter for real-time assistance during teleoperated endoscopic treatment of colorectal cancer.

When detected early, colorectal cancer can be treated with minimally invasive flexible endoscopy. However, since only specialized experts can delineate margins and perform endoscopic resections of lesions, patients still often undergo colon resections. To better assist in the performance of surgical tasks, a robotized flexible interventional endoscope was previously developed, having two additional side channels for surgical instrument. We propose to enhance the imaging capabilities of this device by combining it with optical coherence tomography (OCT). For this purpose, we have developed a new steerable OCT instrument with an outer diameter of 3.5 mm. The steerable instrument is terminated with a 2 cm long transparent sheath to allow three-dimensional OCT imaging using a side-focusing optical probe with two external scanning actuators. The instrument is connected to an OCT imaging system built around the OCT Axsun engine, with a 1310 nm center wavelength swept source laser and 100 kHz A-line rate. Once inserted in one of the side channels of the robotized endoscope, bending, rotation and translation of the steerable OCT instrument can be controlled by a physician using a joystick. Ex vivo and in vivo tests show that the novel, steerable and teleoperated OCT device enhances dexterity, allowing for inspection of the surgical field without the need for changing the position of the main endoscope.

A Laboratory Method to Measure Contagious Yawning in Rats.

Communication is an essential aspect of animal social life. Animals may influence one another and come together in schools, flocks, and herds. Communication is also the way sexes interact during courtship and how rivals settle disputes without fighting. However, there are some behavioral patterns for which it is difficult to test the existence of a communicatory function, because several types of sensory modalities are likely involved. For example, contagious yawning is a communicatory act in mammals that potentially occurs through sight, hearing, smell, or a combination of these senses depending on whether the animals are familiar to one another. Therefore, to test hypotheses about the possible communicatory role of such behaviors, a suitable method is necessary to identify the participating sensory modalities. The method proposed here aims to obtain yawn contagion curves for familiar and unfamiliar rats and evaluate the relative participation of visual and olfactory sensory modalities. The method uses inexpensive materials, and with some minor changes, it can also be used with other rodent species such as mice. Overall, the method involves the substitution of clear dividers (with or without holes) with opaque dividers (with or without holes) that either allow or prevent communication between rats placed in adjacent cages with holes in adjoining sides. Accordingly, four conditions can be tested: olfactory communication, visual communication, both visual and olfactory communication, and neither visual nor olfactory communication. As social interaction occurs between the rats, these test conditions simulate what may occur in a natural environment. In this respect, the method proposed here is more effective than traditional methods that rely on video presentations whose biological validity can raise concerns. Nonetheless, it does not discriminate between the potential role of hearing and roles of smell and vision in yawn contagion.

Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation - A first step to create reliable customized simulators.

INTRODUCTION: Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training. METHODS: Four 3D-printed consumer-grade materials were compared to human cadaver bone: calcium sulfate hemihydrate (named Multicolor), polyamide, resin and polycarbonate. We compared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling. RESULTS: All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error). Local accuracy was better in polycarbonate (0.09mm) and polyamide (0.15mm) than in Multicolor (0.90mm) and resin (0.86mm). Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6-3.5 times higher than in bone. For polycarbonate, forces applied were 1.6-2.5 times higher. Polycarbonate had a mode of fracture similar to the cadaver bone. Forces applied on materials during drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor. CONCLUSION: Polycarbonate is a good substitute of human cadaver bone for skull base surgery simulation. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety.

A novel QSAR model of Salmonella mutagenicity and its application in the safety assessment of drug impurities.

As indicated in ICH M7 draft guidance, in silico predictive tools including statistically-based QSARs and expert analysis may be used as a computational assessment for bacterial mutagenicity for the qualification of impurities in pharmaceuticals. To address this need, we developed and validated a QSAR model to predict Salmonella t. mutagenicity (Ames assay outcome) of pharmaceutical impurities using Prous Institute's Symmetry(SM), a new in silico solution for drug discovery and toxicity screening, and the Mold2 molecular descriptor package (FDA/NCTR). Data was sourced from public benchmark databases with known Ames assay mutagenicity outcomes for 7300 chemicals (57% mutagens). Of these data, 90% was used to train the model and the remaining 10% was set aside as a holdout set for validation. The model's applicability to drug impurities was tested using a FDA/CDER database of 951 structures, of which 94% were found within the model's applicability domain. The predictive performance of the model is acceptable for supporting regulatory decision-making with 84±1% sensitivity, 81±1% specificity, 83±1% concordance and 79±1% negative predictivity based on internal cross-validation, while the holdout dataset yielded 83% sensitivity, 77% specificity, 80% concordance and 78% negative predictivity. Given the importance of having confidence in negative predictions, an additional external validation of the model was also carried out, using marketed drugs known to be Ames-negative, and obtained 98% coverage and 81% specificity. Additionally, Ames mutagenicity data from FDA/CFSAN was used to create another data set of 1535 chemicals for external validation of the model, yielding 98% coverage, 73% sensitivity, 86% specificity, 81% concordance and 84% negative predictivity.

Manejo Quirúrgico del cáncer de piel. Servicio de dermatología, Hospital de San José, Bogotá DC, Colombia / Surgical management of skin cancer, dermatology departament, Hospital de San José, Bogotá DC, ColombiA

El cáncer de piel representa un problema de salud pública que se puede prevenir y manejar con éxito ante el diagnóstico temprano. Objetivo: describir las características clínicas, histopatológicas, poblacionales y quirúrgicas del cáncer de piel tratado mediante cirugía en el Hospital de San José de Bogotá DC, de enero 2009 a diciembre 2010. Material y métodos: estudio descriptivo y retrospectivo de dos años de los casos confirmados de carcinoma basocelular, escamocelular y melanoma in situ. Resultados: de 294 historias clínicas revisadas se tomaron cien con diagnóstico de cáncer cutáneo que cumplieron con los criterios de inclusión: 84 pacientes (84%) con carcinoma basocelular, trece (13%) con carcinoma escamocelular y tres (3%) con melanoma in situ. Conclusión: con el presente trabajo presentamos las normas del manejo quirúrgico de los pacientes con cáncer de piel en un hospital general...

Skin cancer is a public health problem which may be prevented and treated successfully if diagnosed early. Objective: to describe the clinical, hystopathologic, demographic and surgical characteristics of surgically treated cases of skin cancer at Hospital de San José, Bogotá DC, from January 2009 to December 2010. Material and Methods: a two-year descriptive retrospective study of confirmed cases of basal cell carcinoma, squamous cell carcinoma and melanoma in situ. Results: one hundred cases of diagnosed skin cancer which met inclusion criteria were selected from 294 clinical records reviewed: 84 patients (84%) had basal cell carcinoma (BCC), thirteen (13%) had squamous cell carcinoma (SCC) and three (3%) had melanoma in situ. Conclusion: we hereby present surgical management guidelines for patients with skin cancer at a general hospital...

A service-oriented distributed semantic mediator: integrating multiscale biomedical information.

Biomedical research continuously generates large amounts of heterogeneous and multimodal data spread over multiple data sources. These data, if appropriately shared and exploited, could dramatically improve the research practice itself, and ultimately the quality of health care delivered. This paper presents DISMED (DIstributed Semantic MEDiator), an open source semantic mediator that provides a unified view of a federated environment of multiscale biomedical data sources. DISMED is a Web-based software application to query and retrieve information distributed over a set of registered data sources, using semantic technologies. It also offers a userfriendly interface specifically designed to simplify the usage of these technologies by non-expert users. Although the architecture of the software mediator is generic and domain independent, in the context of this paper, DISMED has been evaluated for managing biomedical environments and facilitating research with respect to the handling of scientific data distributed in multiple heterogeneous data sources. As part of this contribution, a quantitative evaluation framework has been developed. It consist of a benchmarking scenario and the definition of five realistic use-cases. This framework, created entirely with public datasets, has been used to compare the performance of DISMED against other available mediators. It is also available to the scientific community in order to evaluate progress in the domain of semantic mediation, in a systematic and comparable manner. The results show an average improvement in the execution time by DISMED of 55% compared to the second best alternative in four out of the five use-cases of the experimental evaluation.

Acuerdo entre el examen dermatológico directo y teledermatología asincrónica prueba piloto, Hospital de San José, Bogotá DC, Colombia / Diagnostic agreement between face-toface dermatologic exam and asynchronious teledermatology evaluations - a pilot study - Hospital de San José, Bogotá DC

la patología dermatológica es frecuente y el acceso a especialistas está limitado tanto en lugares remotos como en las grandes ciudades. El empleo de teledermatología permite el diagnóstico y el tratamiento oportuno. Objetivo: describir la frecuencia de acuerdo intra e interobservador entre la valoración dermatológica de rutina (examen físico directo) y la de teledermatología asincrónica. Métodos: se realizó una prueba piloto previa implementación de la plataforma de teledermatología. Dos dermatólogos expertos valoraron 39 pacientes que consultaron por primera vez al servicio de dermatología del Hospital de San José, Bogotá DC. Emitieron su diagnóstico independiente para evaluar el acuerdo interobservador. La plataforma de telemedicina asincrónica se utilizó para presentar las fotografías de las lesiones dos meses después de la valoración clínica directa. En esta fase se describe el acuerdo intra e interobservador y el grado de satisfacción de los dermatólogos con la plataforma. Resultados: el acuerdo intraobservador del examen físico directo y el teledermatológico fue 51 y 59% (evaluadores 1 y 2), siendo mayor ante patología tumoral (68 y 74%). En el examen físico directo el acuerdo interobservador fue 64% y se reduce a 46% con telemedicina. Conclusiones: la frecuencia de acuerdo entre el examen dermatológico directo y el teledermatológico fue aceptable y mejora ante patología tumoral. Estos resultados coinciden con lo descrito en la literatura en series mayores.

Skin diseases are common and access to specialists is limited in remote locations as well as in large cities. The use of teledermatology allows a prompt diagnosis and treatment. Objective: to determine the intra and interobserver diagnostic agreement between traditional dermatologic examination (face-to-face physical exam) and asynchronous teledermatology evaluations. Methods: a pilot study was conducted prior to the teledermatology platform implementation. Two expert dermatologists examined 39 first-time patients attended at Hospital de San José, Bogotá DC dermatology service. They provided their own independent diagnosis in order to conduct the interobserver diagnostic correlation evaluation. The asynchronous teledermatology platform was used to show photographs of the lesions two months later. This phase describes the intra and interobserver agreement and satisfaction among dermatologists regarding the platform. Results: the rate of intraobserver agreement between face-to-face physical exam and teledermatology evaluations was 51 and 59% (examiners 1 and 2) and greater for tumoral lesions (68% and 74%). The rate of interobserver agreement was 64% for direct physical exam and declined to 46% when using telemedicine. Conclusions: the correlation rate between direct dermatologic exam and teledermatology evaluations was acceptable and improves in tumoral pathology. These results match those reported in the literature regarding greater series.

TerraSAR-X high-resolution radar remote sensing: an operational warning system for Rift Valley fever risk.

In the vicinity of the Barkedji village (in the Ferlo region of Senegal), the abundance and aggressiveness of the vector mosquitoes for Rift Valley fever (RVF) are strongly linked to rainfall events and associated ponds dynamics. Initially, these results were obtained from spectral analysis of high-resolution (~10 m) Spot-5 images, but, as a part of the French AdaptFVR project, identification of the free water dynamics within ponds was made with the new high-resolution (down to 3-meter pixels), Synthetic Aperture Radar satellite (TerraSAR-X) produced by Infoterra GmbH, Friedrichshafen/Potsdam, Germany. During summer 2008, within a 30 x 50 km radar image, it was found that identified free water fell well within the footprints of ponds localized by optical data (i.e. Spot-5 images), which increased the confidence in this new and complementary remote sensing technique. Moreover, by using near real-time rainfall data from the Tropical Rainfall Measuring Mission (TRMM), NASA/JAXA joint mission, the filling-up and flushing-out rates of the ponds can be accurately determined. The latter allows for a precise, spatio-temporal mapping of the zones potentially occupied by mosquitoes capable of revealing the variability of pond surfaces. The risk for RVF infection of gathered bovines and small ruminants (~1 park/km(2)) can thus be assessed. This new operational approach (which is independent of weather conditions) is an important development in the mapping of risk components (i.e. hazards plus vulnerability) related to RVF transmission during the summer monsoon, thus contributing to a RVF early warning system.

Algo sobre la propagación de la lepra / Something about the spread of leprosy

Bogotá·Hasta hace pocos años se discutía con ardor en el campo científico la cuestión importantísima de la propagación de la lepra. Dos escuelas se disputaban el campo; la de los partidarios de la herencia y la de los contagionistas. Muchos hombres de ciencia, encanecidos en el estudio de la terrible enfermedad, sostenían que Ésta solo se propaga por herencia. Entre Éstos debe citarse, en primer término a Dannielsen, el sabio venerable que, en su ardiente deseo de aportar alguna luz a este problema en beneficio de la humanidad, no vacila en colocar bajo su piel, linfa y productos leprosos. Al lado de Dannielsen debe citarse a Profita, quien también se inocula la lepra sin resultado alguno, a Hansenen su primera Época, a Zambaco Pacha y a un centenar de esclarecidos sabios. Indudablemente ellos emitieron esta opinión sin ánimo preconcebido, porque solo anhelaban la investigación de la verdad, y como resultado de sus observaciones sobre esta enfermedad a cuyo estudio dedicaron la totalidad de su vida científica.

Manifestaciones cutáneas en cuidado intensivo neonatal: Hospital de San José, Bogotá DC, Colombia / Cutaneous manifestations in neonatal intensive care: Hospital de San José, Bogotá DC, Colombia

La identificación temprana de patologías cutáneas en el neonato es de suma importancia. Su manejo oportuno determina la morbi-mortalidad y asegura un mejor pronóstico funcional y vital. Realizamos un estudio descriptivo de corte transversal en el que se incluyeron 24 neonatos hospitalizados en cuidado intensivo del Hospital de San José. A las 72 horas de estancia se realizó una valoración por dermatología y pediatría para establecer el tipo de afección de la piel presente en ese momento. Se encontró en promedio una edad de 4.5 días, edad gestacional 32.3 semanas y peso de 1.596 gramos. Se identificaron 75% de manifestaciones dermatológicas primarias y secundarias, y un 4% de terciarias. Cada variable incluida en nuestro estudio se relacionó con las manifestaciones dermatológicas presentes.