Machine Learning in Melanoma Diagnosis. Limitations About to be Overcome. / Uso del aprendizaje automático en el diagnóstico del melanoma. Limitaciones por superar.

BACKGROUND: Automated image classification is a promising branch of machine learning (ML) useful for skin cancer diagnosis, but little has been determined about its limitations for general usability in current clinical practice. OBJECTIVE: To determine limitations in the selection of skin cancer images for ML analysis, particularly in melanoma. METHODS: Retrospective cohort study design, including 2,849 consecutive high-quality dermoscopy images of skin tumors from 2010 to 2014, for evaluation by a ML system. Each dermoscopy image was assorted according to its eligibility for ML analysis. RESULTS: Of the 2,849 images chosen from our database, 968 (34%) met the inclusion criteria for analysis by the ML system. Only 64.7% of nevi and 36.6% of melanoma met the inclusion criteria. Of the 528 melanomas, 335 (63.4%) were excluded. An absence of normal surrounding skin (40.5% of all melanomas from our database) and absence of pigmentation (14.2%) were the most common reasons for exclusion from ML analysis. DISCUSSION: Only 36.6% of our melanomas were admissible for analysis by state-of-the-art ML systems. We conclude that future ML systems should be trained on larger datasets which include relevant non-ideal images from lesions evaluated in real clinical practice. Fortunately, many of these limitations are being overcome by the scientific community as recent works show.

Comunicación intercultural como medio para favorecer el cuidado culturalmente aceptable / Intercultural communication as a means to promote culturally appropriate care

Introducción: Un elemento central para el cumplimiento de la competencia cultural, que nos permita entender y desarrollar habilidades de comunicación con grupos culturales diversos, es ampliar nuestras habilidades en la comunicación intercultural. La comunicación intercultural favorece la calidad de atención de los servicios de salud. El objetivo del documento es describir la importancia de mantener una comunicación intercultural como medio para favorecer las prácticas de cuidado culturalmente competentes. Desarrollo: La cultura proporciona un significado heterogéneo al lenguaje de cada persona y grupo social. Es necesaria una cierta competencia comunicativa y no sólo una competencia lingüística. Es a través de la cultura donde se enseña a los individuos cómo comunicar a través del lenguaje, los gestos, los vestidos, la comida, la forma de utilizar el espacio, etc.. El etnocentrismo y el choque cultural, podría aflorar emociones negativas, por lo que se requiere de hacer un esfuerzo no solo de aproximarse a otras culturas sino repensar la cultura propia. Conclusiones: Evidentemente es necesario para proporcionar un cuidado culturalmente aceptable, estar interesado por conocer e integrarse a otras culturas, se proponen algunas estrategias como: la relación de ayuda, así como la participación de mediadores interculturales para lograr una mejor comprensión de los cuidados y tratamientos aplicados por el personal sanitario.

Introduction: A central element for the implementation of cultural competence that allows us to understand and develop communication skills with diverse cultural groups, is to expand our skills in intercultural communication. Intercultural communication improves the quality of care health services. The document aims to describe the importance of intercultural communication as a means to encourage culturally competent care practices. Development: Culture provides a heterogeneous meaning to the language of every person and social group. We need a certain communicative competence and not only linguistic competence. It is through culture that teaches individuals how to communicate through language, gestures, clothing, food, how to use the space, etc. Ethnocentrism and culture shock, negative emotions could surface, for what it takes to make an effort not only to approach other cultures but to rethink the culture. Conclusions: obviously it is necessary to provide culturally acceptable care, be interested to know and integrate other cultures, suggests some strategies, like the aid relationship, as well as the participation of intercultural mediators to achieve a better understanding of the care and treatment applied by health personnel.

Determination of fumonisins B1 and B2 in Portuguese maize and maize-based samples by HPLC with fluorescence detection.

Fumonisins B(1) (FB1) and fumonisin B2 (FB2) are the main members of a family of mycotoxins produced by Fusarium verticillioides, Fusarium proliferatum, and other fungi species of the section Liseola. The present work shows the results of comparative studies using two different procedures for the analysis of fumonisins in maize and maize-based samples. The studied analytical methods involve extraction with methanol/water, dilution with PBS, and clean-up through immunoaffinity columns. Two reagents (o-phthaldialdehyde and naphthalene-2,3-dicarboxaldehyde) were studied for formation of fluorescent derivatives. The separation and identification were carried out by high-performance liquid chromatography with fluorescence detection. The optimized method for analysis of fumonisins in maize involved extraction with methanol/water (80:20), clean-up with an immunoaffinity column, and derivatization with naphthalene-2,3-dicarboxaldehyde (NDA). The limit of detection was 20 microg kg(-1) for FB1 and 15 microg kg(-1) for FB2. Recoveries of FB1 and FB2 ranged from 79% to 99.6% for maize fortified at 150 microg kg(-1) and 200 microg kg(-1), respectively, with within-day RSDs of 3.0 and 2.7%. The proposed method was applied to 31 samples, and the presence of fumonisins was found in 14 samples at concentrations ranging from 113 to 2,026 microg kg(-1). The estimated daily intake of fumonisins was 0.14 microg kg(-1) body weight per day.

Determination of oxytetracycline, tetracycline, and chlortetracycline in milk by liquid chromatography with postcolumn derivatization and fluorescence detection.

A multiresidue method for isolation and liquid chromatographic determination of oxytetracycline (OTC), tetracycline (TC), and chlortetracycline (CTC) in milk is presented. The sensitivity of the method is adequate to meet the needs of regulatory agencies. The European Community established 100 micrograms/kg as the maximum residue limit (MRL) in milk for TC, CTC, and OTC. Recoveries exceeded 80% for all tetracyclines at all levels, with good precision. Correlation coefficients of standards curves for individual tetracyclines isolated from fortified samples ranged from 0.991 for CTC to 0.998 for OTC. Other antibiotics that might interfere with analysis did not interfere with elution times of OTC, TC, and CTC. The procedure is rapid, precise, and quantitative and requires minimal preparation and minimal use of organic solvents. It can be applied to routine surveillance programs. We can prepare 10 samples for analysis in about 1.45 h.

[Changes in the aortic arch in chick embryos resulting from modified hemodynamic factors]. / Alteración de los arcos aórticos en embriones de pollo como consecuencia de factores hemodinámicos modificados.

Hemodynamic factors acting as modelator agents in the outflow region of great vessels and aortic arches have been studied by many authors. In our study, we have tried to analyse the influence which a modification of some of these factors, as it is an increased blood volume, could cause on truncus and aortic arches, by means of the perfusion of blood from chick embryos of 12-15 days of incubation to receptor embryos between stages 22-29 of HH. We have obtained a malformation percentage smaller than expected, on the basis of bibliographic data, so we now believe that hemodynamic factors, by themselves, don't play a role in the definitive morphogenesis and septation of great vessels and its main branches as important as believed until present time.