Hereditary breast cancer next-generation sequencing panel evaluation in the south region of Brazil: A novel BRCA2 candidate pathogenic variant is reported.

BACKGROUND: In this article, we delineate a loosely selected cohort comprising patients with a history of early-onset breast cancer and/or a familial occurrence of cancer. The aim of this study was to gain insights into the presence of breast cancer-related gene variants in a population from a micro-region in southern Brazil, specifically the Metropolitan Region of Curitiba. This area exhibits a highly genetically mixed population, mirroring the general characteristics of the Brazilian people. METHODS: Comprehensive next-generation sequencing (NGS) multigene panel testing was conducted on 12 patients from the region, utilizing three different library preparation methods. RESULTS: Two pathogenic variants and one candidate pathogenic variant were identified: BRCA2 c.8878C>T, p.Gln2960Ter; CHEK2 c.1100del, p.Thr367Metfs15, and BRCA2 c.3482dup, p.Asp1161Glufs3. CONCLUSION: BRCA2 c.3482dup, a novel candidate pathogenic variant, previously unpublished, is reported. The prevalence of pathogenic variants in this small cohort is similar to that described in the literature. All different library preparation methods were equally proficient in enabling the detection of these variants.

Mnemotecnias para la aplicación e interpretación del electroencefalograma de amplitud integrada en recién nacidos / Mnemonics for the use and interpretation of amplitude-integrated electroencephalography in newborn infants

La electroencefalografía (EEG) siempre ha sido considerada una materia especializada, que amerita de entrenamiento para su aplicación e interpretación; esto ha provocado que el acceso a estos estudios quedara confinado a neurólogos y neurofisiólogos. El recién nacido ingresado en la unidad de cuidados intensivos neonatales (UCIN) amerita de monitorización neurológica para establecer diagnóstico y pronóstico, por lo que se necesita una herramienta sencilla y accesible para el personal de la UCIN. Estas características han sido cubiertas por el electroencefalograma de amplitud integrada (aEEG) que, a través de patrones visuales simples de la actividad cerebral, permite el abordaje de la condición neurológica. El objetivo de este ensayo se orienta al manejo de mnemotecnias que faciliten la identificación de patrones visuales normales y patológicos en el aEEG. La nomenclatura empleada, aunque puede parecer simple, pretende crear una idea fácilmente asimilable de los conceptos básicos para la aplicación e interpretación de la neuromonitorización con aEEG.

An electroencephalography (EEG) has always been considered a specialized field, whose use and interpretation requires training. For this reason, access to these monitoring studies has been restricted to neurologists and neurophysiologists. Newborn infants admitted to the neonatal intensive care unit (NICU) require neurophysiological monitoring to establish their diagnosis and prognosis, so a simple and accessible tool is required for NICU staff. Such features have been covered by amplitude-integrated electroencephalography (aEEG), which, through simple visual patterns of brain activity, allows to approach neurological conditions. The objective of this study is to help with the management of mnemonics that facilitate the identification of normal and pathological visual patterns in an aEEG. Although simple in appearance, this nomenclature is intended to create an easy-to-understand idea of basic concepts for the use and interpretation of neurophysiological monitoring with aEEG.

Significancia clínica y significancia estadística. ¿Qué es más significativo? / Clinical significance and statistical significance. What is more significant?

Una de las dificultades más comunes que enfrentan los lectores de artículos del área de la biomedicina y epidemiología es la interpretación del término "significativo". El término "estadísticamente significativo" a menudo se malinterpreta como un resultado "clínicamente significativo". La confusión surge del hecho de que muchas personas equiparan "significativo" con su significado literal de "importante", sin embargo, la significación estadística cuantifica la probabilidad de que los resultados de un estudio se deban al azar, mientras que la significancia clínica refleja la importancia práctica o relevancia en el contexto de la atención médica o práctica clínica. Este artículo aborda la diferencia entre la significación estadística y la relevancia o importancia clínica en la interpretación de los resultados de una investigación biomédica.

One of the most common difficulties faced by readers of articles in the area of biomedicine and epidemiology is the interpretation of the term "significant". The term "statistically significant" is often misinterpreted as a "clinically significant" result. Confusion arises from the fact that many people equate "significant" with its literal meaning of "important," however, statistical significance quantifies the probability that the results of a study are due to chance, while clinical significance reflects the practical importance or relevance in the context of health care or clinical practice. This article addresses the difference between statistical significance and clinical relevance or importance in the interpretation of biomedical research results.

Comparing the Performance of ChatGPT-4 and Medical Students on MCQs at Varied Levels of Bloom's Taxonomy.

Introduction: This research investigated the capabilities of ChatGPT-4 compared to medical students in answering MCQs using the revised Bloom's Taxonomy as a benchmark. Methods: A cross-sectional study was conducted at The University of the West Indies, Barbados. ChatGPT-4 and medical students were assessed on MCQs from various medical courses using computer-based testing. Results: The study included 304 MCQs. Students demonstrated good knowledge, with 78% correctly answering at least 90% of the questions. However, ChatGPT-4 achieved a higher overall score (73.7%) compared to students (66.7%). Course type significantly affected ChatGPT-4's performance, but revised Bloom's Taxonomy levels did not. A detailed association check between program levels and Bloom's taxonomy levels for correct answers by ChatGPT-4 showed a highly significant correlation (p<0.001), reflecting a concentration of "remember-level" questions in preclinical and "evaluate-level" questions in clinical courses. Discussion: The study highlights ChatGPT-4's proficiency in standardized tests but indicates limitations in clinical reasoning and practical skills. This performance discrepancy suggests that the effectiveness of artificial intelligence (AI) varies based on course content. Conclusion: While ChatGPT-4 shows promise as an educational tool, its role should be supplementary, with strategic integration into medical education to leverage its strengths and address limitations. Further research is needed to explore AI's impact on medical education and student performance across educational levels and courses.

Mnemonics for the use and interpretation of amplitude-integrated electroencephalography in newborn infants. / Mnemotecnias para la aplicación e interpretación del electroencefalograma de amplitud integrada en recién nacidos.

An electroencephalography (EEG) has always been considered a specialized field, whose use and interpretation requires training. For this reason, access to these monitoring studies has been restricted to neurologists and neurophysiologists. Newborn infants admitted to the neonatal intensive care unit (NICU) require neurophysiological monitoring to establish their diagnosis and prognosis, so a simple and accessible tool is required for NICU staff. Such features have been covered by amplitude-integrated electroencephalography (aEEG), which, through simple visual patterns of brain activity, allows to approach neurological conditions. The objective of this study is to help with the management of mnemonics that facilitate the identification of normal and pathological visual patterns in an aEEG. Although simple in appearance, this nomenclature is intended to create an easy-to-understand idea of basic concepts for the use and interpretation of neurophysiological monitoring with aEEG.

La electroencefalografía (EEG) siempre ha sido considerada una materia especializada, que amerita de entrenamiento para su aplicación e interpretación; esto ha provocado que el acceso a estos estudios quedara confinado a neurólogos y neurofisiólogos. El recién nacido ingresado en la unidad de cuidados intensivos neonatales (UCIN) amerita de monitorización neurológica para establecer diagnóstico y pronóstico, por lo que se necesita una herramienta sencilla y accesible para el personal de la UCIN. Estas características han sido cubiertas por el electroencefalograma de amplitud integrada (aEEG) que, a través de patrones visuales simples de la actividad cerebral, permite el abordaje de la condición neurológica. El objetivo de este ensayo se orienta al manejo de mnemotecnias que faciliten la identificación de patrones visuales normales y patológicos en el aEEG. La nomenclatura empleada, aunque puede parecer simple, pretende crear una idea fácilmente asimilable de los conceptos básicos para la aplicación e interpretación de la neuromonitorización con aEEG.

A Collaborative Platform for Advancing Automatic Interpretation in ECG Signals.

Numerous papers report the efficiency of the automatic interpretation capabilities of commercial algorithms. Unfortunately, these algorithms are proprietary, and academia has no means of directly contributing to these results. In fact, nothing at the same stage of development exists in academia. Despite the extensive research in ECG signal processing, from signal conditioning to expert systems, a cohesive single application for clinical use is not ready yet. This is due to a serious lack of coordination in the academic efforts, which involve not only algorithms for signal processing, but also the signal acquisition equipment itself. For instance, the different sampling rates and the different noise levels frequently found in the available signal databases can cause severe incompatibility problems when the integration of different algorithms is desired. Therefore, this work aims to solve this incompatibility problem by providing the academic community with a diagnostic-grade electrocardiograph. The intention is to create a new standardized ECG signals database in order to address the automatic interpretation problem and create an electrocardiography system that can fully assist clinical practitioners, as the proprietary systems do. Achieving this objective is expected through an open and coordinated collaboration platform for which a webpage has already been created.

Cone-beam computed tomography in endodontics: from the specific technical considerations of acquisition parameters and interpretation to advanced clinical applications.

The implementation of imaging methods that enable sensitive and specific observation of anatomical structures has been a constant in the evolution of endodontic therapy. Cone-beam computed tomography (CBCT) enables 3-dimensional (3D) spatial anatomical navigation in the 3 volumetric planes (sagittal, coronal and axial) which translates into great accuracy for the identification of endodontic pathologies/conditions. CBCT interpretation consists of 2 main components: (i) the generation of specific tasks of the image and (ii) the subsequent interpretation report. A systematic and reproducible method to review CBCT scans can improve the accuracy of the interpretation process, translating into greater precision in terms of diagnosis and planning of endodontic clinical procedures. MEDLINE (PubMed), Web of Science, Google Scholar, Embase and Scopus were searched from inception to March 2023. This narrative review addresses the theoretical concepts, elements of interpretation and applications of the CBCT scan in endodontics. In addition, the contents and rationale for reporting 3D endodontic imaging are discussed.

Randomized trial of dentists' understanding: treatment benefit in absolute numbers vs relative risk reduction

Abstract This study aimed to assess whether dentists correctly understand the benefit of a dental treatment when it is presented using absolute numbers or relative risk reduction (RRR). This parallel-group randomized controlled trial recruited dentists from 3 postgraduate courses in Rio de Janeiro, Brazil. Participants received, in sequentially numbered sealed opaque envelopes, the description of a hypothetical scenario of the benefit (avoidance of multiple tooth loss) of nonsurgical periodontal treatment without or with antibiotics. Treatment benefit was presented in 2 different formats: absolute numbers or RRR. Dentists were given 10 minutes to read the treatment scenario and answer 5 questions. The final sample for analysis included 101 dentists. When asked to estimate the number of patients out of 100 who would avoid multiple tooth loss without antibiotics, 17 dentists (33%) in the absolute numbers group and 12 (25%) in the RRR group provided the correct response (p = 0.39). Regarding treatment with antibiotics, 26 dentists (50%) in the absolute numbers group and 14 (29%) in the RRR group provided the correct response (p = 0.04). Only 16 dentists (31%) in the absolute numbers group and 12 (25%) in the RRR group gave correct answers for both questions (p = 0.51). Most dentists did not correctly understand the benefit of the treatment, irrespective of the format it was presented. Slightly more dentists correctly understood the benefit of the treatment when it was presented as absolute numbers than as RRR.

Is the Bland-Altman plot method useful without inferences for accuracy, precision, and agreement?

ABSTRACT OBJECTIVE This study aims to propose a comprehensive alternative to the Bland-Altman plot method, addressing its limitations and providing a statistical framework for evaluating the equivalences of measurement techniques. This involves introducing an innovative three-step approach for assessing accuracy, precision, and agreement between techniques, which enhances objectivity in equivalence assessment. Additionally, the development of an R package that is easy to use enables researchers to efficiently analyze and interpret technique equivalences. METHODS Inferential statistics support for equivalence between measurement techniques was proposed in three nested tests. These were based on structural regressions with the goal to assess the equivalence of structural means (accuracy), the equivalence of structural variances (precision), and concordance with the structural bisector line (agreement in measurements obtained from the same subject), using analytical methods and robust approach by bootstrapping. To promote better understanding, graphical outputs following Bland and Altman's principles were also implemented. RESULTS The performance of this method was shown and confronted by five data sets from previously published articles that used Bland and Altman's method. One case demonstrated strict equivalence, three cases showed partial equivalence, and one showed poor equivalence. The developed R package containing open codes and data are available for free and with installation instructions at Harvard Dataverse at https://doi.org/10.7910/DVN/AGJPZH. CONCLUSION Although easy to communicate, the widely cited and applied Bland and Altman plot method is often misinterpreted, since it lacks suitable inferential statistical support. Common alternatives, such as Pearson's correlation or ordinal least-square linear regression, also fail to locate the weakness of each measurement technique. It may be possible to test whether two techniques have full equivalence by preserving graphical communication, in accordance with Bland and Altman's principles, but also adding robust and suitable inferential statistics. Decomposing equivalence into three features (accuracy, precision, and agreement) helps to locate the sources of the problem when fixing a new technique.

Susceptibility Profile and Epidemiological Cut-Off Values Are Influenced by Serotype in Fish Pathogenic Streptococcus agalactiae.

Streptococcus agalactiae is a major health concern in tilapia farming worldwide. In contrast to the availability of susceptibility profile results, interpretative criteria for disk diffusion assays and the influence of serotypes on resistance profiles are not available. To address this, sixty isolates (thirty of each serotype, Ib and III) were evaluated using the disk diffusion assay against six antibiotics, and the epidemiological cut-off value (ECV) was calculated. All the isolates were classified as non-wild type (NWT) for sulfamethoxazole (SUT) and norfloxacin (NOR). The inhibition zones for oxytetracycline (OXY) and doxycycline (DOX) were largely distinct; all serotype Ib and III isolates were classified as wild-type (WT) and NWT, respectively. The results for serotype III of fish group B Streptococcus (GBS) were comparable to the NWT tetracycline profile of human GBS available in EUCAST, suggesting the presence of resistance mechanisms in these fish isolates. The calculation of the cut-off wild type (COWT) values for OXY and DOX was appropriate for both serotypes. Differences between the distribution of florfenicol (FLO) and amoxicillin (AMO) were found, and we attribute this to the faster growth rate of serotype III, which promotes smaller inhibition zones. Therefore, using separate COWT for each serotype is necessary. In conclusion, the serotype of fish GBS affects its susceptibility profile, and it is recommended to use serotype-specific COWT values as interpretative criteria for disk diffusion assays against FLO and AMO.

Validez de apariencia y racionalidad de una metodología para estudiar la causalidad en salud / Appearance and rational validity of a methodology to study causality in health

Introducción: Es objetivo fundamental de la medicina, determinar las causas que producen las enfermedades; para llevar a cabo este estudio, a finales del siglo XX se emplearon técnicas estadísticas multivariadas confiables en el análisis simultáneo de diferentes variables independientes sobre un desenlace. Objetivo: Determinar la aplicación de la validez racional y de apariencia en la metodología empleada para el estudio de la causalidad en salud. Métodos: Para evaluar si la metodología se correspondía con los requerimientos de la investigación, se aplicó la validez de apariencia para valorar los resultados obtenidos en su aplicación, específicamente, si las reglas reflejan verazmente, lo que ocurre en la práctica médica, mediante el empleo de la validez racional. Resultados: Los usuarios potenciales de la metodología la consideraron aceptable en los aspectos medidos sobre la regresión logística binaria. El mayor porcentaje de las reglas analizadas está en correspondencia con lo planteado en la literatura, pocas plantean aspectos que no se dan necesariamente en la práctica médica, pero tampoco se contradicen con la literatura. Los resultados de la validez de apariencia no fueron favorables, pues la metodología no había sido empleada antes en el contexto. En cuanto a la validez racional, se verificó un alto porcentaje de correspondencia entre lo planteado por las reglas y la literatura. Es importante tener en cuenta, que el hallazgo de algo conocido reafirma la validez de esa regla. Conclusiones: Las reglas obtenidas de la aplicación de la metodología reflejan, en general, lo que ocurre en la práctica médica.

Introduction: the fundamental objective of medicine is to determine the causes that produce diseases. At the end of the 20th century, multivariate statistical techniques were used as reliable in the simultaneous analysis of different independent variables on an outcome. Objective: to determine the application of appearance and rational validity of a methodology to study causality in health. Methods: to evaluate whether the methodology corresponded to the research requirements, appearance validity was applied to assess the results obtained in its application, specifically, if the rules accurately reflect what happens in medical practice, through the use of rational validity. Results: the potential users of the methodology considered it acceptable in the measured aspects of the binary logistic regression. The highest percentage of the rules analyzed is in correspondence with what is stated in the literature; few raise aspects that do not necessarily occur in medical practice, but they do not contradict the literature either. The results of face validity were not favourable, since the methodology had not been used before in the context. A high percentage of correspondence regarding rational validity was verified between what was stated by the rules and the literature. It is important to note that finding something known reaffirms the validity of that rule. Conclusions: the rules obtained from the application of the methodology reflect, in general, what happens in medical practice.

Use of Research in the Nursing Practice: from Statistical Significance to Clinical Significance / Uso de la investigación en la práctica de enfermería: de la significancia estadística a la significancia clínica / Utilização da pesquisa na prática de enfermagem: da significância estatística à significância clínica

Objective. Within the context of evidence-based practice, this article exposes the reflection on the understanding and usefulness of the information provided by the research findings shared in reports and research publications, exposing differences based on the interpretation of statistical significance and clinical significance. Content synthesis. Basic aspects of the meaning and use of the information reported by research on p value (statistical significance) and the value and usefulness of these results are analyzed and exemplified, contrasting the value for the practice of an additional judgment on clinical significance. In addition to establishing conceptual differences, the need is highlighted for nurses to have the competencies to differentiate and apply each of them according to the clinical contexts of their potential implementation. Conclusion. The real usefulness of research about interventions within the context of nursing care is given by its real application and reach for the practice and benefit for patients. For this to occur, nurses must interpret adequately the information provided by scientific publications and other research reports.

Objetivo. En el contexto de una práctica basada en evidencia, este artículo expone la reflexión sobre la comprensión y utilidad de la información que proveen los hallazgos de investigación reportados en informes y publicaciones de investigación, exponiendo las diferencias a partir de la interpretación de la significancia estadística y significancia clínica. Síntesis del contenido. Se analizan y ejemplifican aspectos básicos sobre el significado y uso de la información que reportan las investigaciones sobre valor p (significancia estadística) y el valor y utilidad de estos resultados contrastando el valor para la práctica de un juicio adicional sobre significancia clínica. Además de establecer diferencias conceptuales, se resalta la necesidad de que las enfermeras tengan las competencias para diferenciar y aplicar cada uno de ellos según los contextos clínicos de su potencial implementación. Conclusión. La real utilidad de la investigación sobre intervenciones en el contexto del cuidado de enfermería está dada por su real aplicación y alcance para la práctica y el beneficio para los pacientes. Para que ello ocurra, las enfermeras deben interpretar adecuadamente la información que proveen las publicaciones científicas y otros reportes de investigación.

Objetivo. No contexto de uma prática baseada em evidências, este artigo apresenta a reflexão sobre a compreensão e utilidade da informação fornecida pelos resultados da investigação relatados em relatórios de investigação e publicações, expondo as diferenças com base na interpretação da significância estatística e da significância clínica. Síntese de conteúdo. Aspectos básicos sobre o significado e uso das informações relatadas pelas pesquisas sobre valor p (significância estatística) e o valor e utilidade desses resultados são analisados e exemplificados, contrastando o valor para a prática de um julgamento adicional sobre significância clínica. Além de estabelecer diferenças conceituais, destaca-se a necessidade de o enfermeiro ter competências para diferenciar e aplicar cada uma delas de acordo com os contextos clínicos de seu potencial implementação. Conclusão. A real utilidade da investigação sobre intervenções no contexto dos cuidados de enfermagem é dada pela sua real aplicação e âmbito de prática e benefício para os pacientes. Para que isso ocorra, os enfermeiros devem interpretar adequadamente as informações fornecidas pelas publicações científicas e outros relatórios de pesquisa.

Shear wave elastography for extracranial carotid atherosclerotic plaques: technical principles and how to do it.

In the wake of studies targeting atherosclerotic plaques and searching for quantifiable variables that contribute additional information to therapeutic decision-making, plaque assessment using Shear Wave Elastography (SWE) is emerging as a reproducible and promising alternative. We used a single Logiq S8 device (General Electric, Boston, Massachusetts, United States) with an 8.5-11MHz multifrequency linear transducer at 10MHz in longitudinal section. We considered relevant criteria for image acquisition: adequate longitudinal insonation, differentiation of the intima-media complex, delineation of proximal and distal tunica adventitia and the vascular lumen, good visualization of the atherosclerotic plaque, cardiac cycle in ventricular diastole, and absence of incongruous changes. SWE is an emerging and extremely promising method for assessment of carotid plaques that may contribute to therapeutic decision-making based on characteristics related to the atherosclerotic plaque, with inter-device and inter-examiner reproducibility.

Making Sense of Composite Endpoints in Clinical Research.

Multiple drugs currently used in clinical practice have been approved by regulatory agencies based on studies that utilize composite endpoints. Composite endpoints are appealing because they reduce sample size requirements, follow-up periods, and costs. However, interpreting composite endpoints can be challenging, and their misuse is not uncommon. Incorrect interpretation of composite outcomes can lead to misleading conclusions that impact patient care. To correctly interpret composite outcomes, several important questions should be considered. Are the individual components of the composite outcome equally important to patients? Did the more and less important endpoints occur with similar frequency? Do the component endpoints exhibit similar relative risk reductions? If these questions receive affirmative answers, the use and interpretation of the composite endpoint would be appropriate. However, if any component of the composite endpoint fails to satisfy the aforementioned criteria, interpretation can become difficult, necessitating additional steps. Regulatory agencies acknowledge these challenges and have specific considerations when approving drugs based on studies employing composite endpoints. In conclusion, composite endpoints are valuable tools for evaluating the efficacy and net clinical benefit of interventions; however, cautious interpretation is advised.

Guía metodológica: Pertinencia de Datos Poblacionales sobre Discapacidad para la Kinesiología / Methodological Guide: Relevance of Population-based Data on Disability for Physical Therapy

Introducción. El Estudio Nacional de la Discapacidad y Dependencia (ENDIDE) y el III Estudio Nacional de la Discapacidad (ENDISC) son investigaciones de relevancia en Chile que utilizan la estadística para comprender la situación de las personas con discapacidad en el país. Estos estudios recopilan datos cuantitativos y cualitativos sobre la discapacidad, permitiendo obtener información actualizada sobre su prevalencia, tipos de discapacidad, acceso a servicios y barreras enfrentadas. La utilización de la estadística en estos estudios es crucial para identificar necesidades, diseñar políticas inclusivas y evaluar el impacto de las intervenciones en la calidad de vida de las personas con discapacidad en Chile. Es relevante comprender las metodologías y pertinencia de estos datos para el desarrollo de la kinesiología, según indica la Convención sobre los Derechos de las Personas con discapacidad.

Background. The National Study on Disability and Dependency (ENDIDE) and the III National Study on Disability (ENDISC) are relevant investigations in Chile that use statistics to understand the situation of people with disabilities in the country. These studies collect quantitative and qualitative data on disability, allowing to obtain updated information on its prevalence, types of disability, access to services and barriers faced. The use of statistics in these studies is crucial to identify needs, design inclusive policies and assess the impact of explosions on the quality of life of people with disabilities in Chile. It is important to understand the methodologies and relevance of these data for the development of kinesiology, as indicated by the Convention on the Rights of Persons with Disabilities.

La interpretación del sueño y sus similitudes con el juego: una técnica para aplicar en un dispositivo clínico de Françoise Dolto / Les similitudes dans l'interpretation du reve et du jeu: une technique applicable dans un lieu d'accueil enfant-parent / Dream interpretation ant its similarities with the play: a method to apply ina Dolto's maison verte project / A interpretação do sonho e suas semelhanças com a brincadeira: uma técnica para aplicar em um dispositivo clínico de Françoise Dolto

¿Cómo nos puede ayudar el método de la interpretación de los sueños a entender los elementos arcaicos presentes en el juego del niño de 0 a 4 años, en un dispositivo clínico inspirado en la Maison Verte creada por Françoise Dolto? En este artículo describiremos las similitudes entre el sueño y el juego del niño, particularmente con respecto al trabajo del sueño. Propondremos que los mismos mecanismos del sueño están presentes en el juego del niño como parte de un contenido manifiesto. Enseguida propondremos que es posible interpretar el contenido latente del juego trasponiendo el método de la interpretación de los sueños gracias a la información aportada por los padres que acompañen al niño. Para explicar esta técnica, examinaremos el ejemplo de juego de unos niños, tomado de un Lugar de Acogida de Niños y Padres que se adhiere a los principios de la Maison Verte AU

Comment la méthode d'interprétation des rêves peut-elle nous aider à comprendre les éléments archaïques présents dans le jeu des enfants de 0 à 4 ans, dans un dispositif clinique inspiré de la Maison Verte créée par Françoise Dolto? Dans cet article, nousdécrirons les similitudes entre le rêve et le jeu de l'enfant, notamment en ce qui concerne le travail du rêve. Nous proposerons que les mêmes mécanismes oniriques sont présents dans le jeu de l'enfant dans le cadre d'un contenu manifeste. Ensuite, nous proposerons qu'il est possible d'interpréter le contenu latent de ce jeu en transposant la méthode d'interprétation des rêves grâce aux informations fournies par les parents accompagnan l'enfant. Pour expliquercette technique, nous examinerons un exemple de jeu d'enfants, tiré d'un Lieu d'Accueil pour Enfants et Parents qui adhère aux principes de la Maison Verte AU

How can the dream interpretation method help us to understand the archaic elements present in the play of children from 0 to 4 years old, in a clinical device inspired by the Maison Verte project created by Françoise Dolto? In this article we will describethe similarities between the child's dream and play, particularly regarding to dream-work. We will propose that the same dream mechanisms are present in the child's play as part of a manifest content. Then we will propose that it is possible to interpret the latent content of this play by transposing the dream interpretation method thanks to the information provided by the parents. To explain this technique, we will examine an example of children's play, taken from a Dolto's Maison Verte Project AU

Como o método da interpretação dos sonhos pode nos ajudar a compreender os elementos arcaicos presentes nas brincadeiras das crianças de 0 a 4 anos, em um dispositivo clínico inspirado na Maison Verte criada por Françoise Dolto? Neste artigo, descreveremos as semelhanças entre o sonho e a brincadeira da criança, principalmente no que diz respeito ao trabalho onírico. Proporemos que os mesmos mecanismos oníricos estão presentes na brincadeira da criança como parte de um conteúdo manifesto. Imediatamente propomos que é possível interpretar o conteúdo latente desta brincadeira transpondo o método de interpretação dos sonhos graças às informações fornecidas pelos pais. Para explicar est técnica examinaremos um exemplo de brincadeira infantil, retirado de um Local de Acolhimento para Crianças e Pais que segue os princípios da Maison Verte AU

Esophageal high-resolution manometry demands visual interpretation in addition to mathematical software-based analysis.

PURPOSE: Esophageal high-resolution manometry (HRM) revolutionized esophageal function testing due to the intuitive colorful and agreeable-to-the-eyes plots (Clouse plots). HRM execution and interpretation is guided by the Chicago Classification. The well-established metrics for interpretation allows a reliable automatic software analysis. Analysis based on these mathematical parameters, however, ignores the valuable visual interpretation unique to human eyes and based on expertise. METHODS: We compiled some situations where visual interpretation added useful information for HRM interpretation. RESULTS: Visual interpretation may be useful in cases of hypomotility, premature waves, artifacts, segmental abnormalities of peristalsis, and extra-luminal non-contractile findings. CONCLUSION: These extra findings can be reported apart from the conventional parameters.

Variant curation and interpretation in hereditary cancer genes: An institutional experience in Latin America.

BACKGROUND: Variant curation refers to the application of evidence-based methods for the interpretation of genetic variants. Significant variability in this process among laboratories affects clinical practice. For admixed Hispanic/Latino populations, underrepresented in genomic databases, the interpretation of genetic variants for cancer risk is challenging. METHODS: We retrospectively evaluated 601 sequence variants detected in patients participating in the largest Institutional Hereditary Cancer Program in Colombia. VarSome and PathoMAN were used for automated curation, and ACMG/AMP and Sherloc criteria were applied for manual curation. RESULTS: Regarding the automated curation, 11% of the variants (64/601) were reclassified, 59% (354/601) had no changes in its interpretation, and the other 30% (183/601) presented conflicting interpretations. With respect to manual curation, of the 183 variants with conflicting interpretations, 17% (N = 31) were reclassified, 66% (N = 120) had no changes in their initial interpretation, and 17% (N = 32) remained with conflicting interpretation status. Overall, 91% of the VUS were downgraded and 9% were upgraded. CONCLUSIONS: Most VUS were reclassified as benign/likely benign. Since false-positive and -negative results can be obtained with automated tools, manual curation should also be used as a complement. Our results contribute to improving cancer risk assessment and management for a broad range of hereditary cancer syndromes in Hispanic/Latino populations.

Career Adapt-Abilities Scale (CAAS-Brasil): propriedades psicométricas, diferenças em função de variáveis sociodemográficas e padrões normativos / Career Adapt-Abilities Scale (CAAS-Brazil): psychometric properties, differences as a function of sociodemographic variables and normative standards / Career Adapt-Abilities Scale (CAAS-Brasil): propiedades psicométricas, diferencias en función de variables sociodemográficas y estándares normativos

O objetivo deste artigo foi propor padrões normativos para a Career Adapt-Abilities Scale (CAAS-Brasil) considerando diferenças em função das variáveis sociodemográficas: sexo, estado civil, faixa etária, escolaridade e faixa de rendimento. A amostra foi composta por 2.999 indivíduos, idades variando de 14 a 77 anos, maioria do sexo feminino (63%) e representantes de 21 estados brasileiros. As propriedades psicométricas da CAAS-Brasil foram investigadas por meio de Teoria de Resposta ao Item e coeficiente ômega. Os resultados evidenciaram invariância para a CAAS-Brasil e maiores diferenças de médias nas variáveis faixa etária, escolaridade e faixa de rendimento. A partir disso, foram apresentados padrões normativos para a amostra geral e dividida, considerando as variáveis que apresentaram diferenças. Os padrões normativos apresentados neste artigo possibilitarão que profissionais de orientação profissional e de carreira interpretem, com base em normas, os escores de adaptabilidade de carreira de seus orientandos, tornando a avaliação mais substantiva. (AU)

This article aimed to propose normative standards for the Career Adapt-Abilities Scale (CAAS-Brazil) considering differences in terms of sociodemographic variables: gender, marital status, age group, education level, and income. The sample consisted of 2999 individuals, within the age range of 14 to 77 years, mostly women (63%) from 21 Brazilian states. The psychometric properties of CAAS-Brazil were investigated using Item Response Theory and the Omega coefficient. Results showed invariance for the CAAS-Brazil and greater mean differences in the variables age group, education, and income. From this, normative standards for the overall sample were presented and divided considering the variables that showed differences. The normative standards presented in this article will enable career guidance professionals to interpret the career adaptability scores of their students, making the assessment more robust. (AU)

El objetivo de este artículo fue proponer estándares normativos para la Career Adapt-Abilities Scale (CAAS-Brasil) considerando diferencias en términos de variables sociodemográficas: género, estado civil, grupo de edad, escolaridad y rango de ingresos. La muestra estuvo constituida por 2.999 individuos, con edades comprendidas entre 14 y 77 años, en su mayoría mujeres (63%) y representantes de 21 estados brasileños. Las propiedades psicométricas de CAAS-Brasil se investigaron mediante la Teoría de Respuesta al Ítem y el coeficiente Omega. Los resultados mostraron invarianza para el CAAS-Brasil y mayores diferencias de medias en las variables edad, escolaridad e ingresos. A partir de esto, se presentaron estándares normativos para la muestra general y se dividieron considerando las variables que manifestaron diferencias. Los estándares normativos presentados en este artículo permitirán a los profesionales de la orientación profesional interpretar y la orientación interpretar, basándose en normas, las puntuaciones de adaptabilidad profesional de sus alumnos, haciendo que la evaluación sea más sustantiva. (AU)