Two mosquito salivary antigens demonstrate promise as biomarkers of recent exposure to P. falciparum infected mosquito bites.

Background: Measuring malaria transmission intensity using the traditional entomological inoculation rate is difficult. Antibody responses to mosquito salivary proteins such as SG6 have previously been used as biomarkers of exposure to Anopheles mosquito bites. Here, we investigate four mosquito salivary proteins as potential biomarkers of human exposure to mosquitoes infected with P. falciparum: mosGILT, SAMSP1, AgSAP, and AgTRIO. Methods: We tested population-level human immune responses in longitudinal and cross-sectional plasma samples from individuals with known P. falciparum infection from low and moderate transmission areas in Senegal using a multiplexed magnetic bead-based assay. Results: AgSAP and AgTRIO were the best indicators of recent exposure to infected mosquitoes. Antibody responses to AgSAP, in a moderate endemic area, and to AgTRIO in both low and moderate endemic areas, were significantly higher than responses in a healthy non-endemic control cohort (p-values = 0.0245, 0.0064, and <0.0001 respectively). No antibody responses significantly differed between the low and moderate transmission area, or between equivalent groups during and outside the malaria transmission seasons. For AgSAP and AgTRIO, reactivity peaked 2-4 weeks after clinical P. falciparum infection and declined 3 months after infection. Discussion: Reactivity to both AgSAP and AgTRIO peaked after infection and did not differ seasonally nor between areas of low and moderate transmission, suggesting reactivity is likely reflective of exposure to infectious mosquitos or recent biting rather than general mosquito exposure. Kinetics suggest reactivity is relatively short-lived. AgSAP and AgTRIO are promising candidates to incorporate into multiplexed assays for serosurveillance of population-level changes in P. falciparum-infected mosquito exposure.

Multi skin lesions classification using fine-tuning and data-augmentation applying NASNet.

Skin lesions are one of the typical symptoms of many diseases in humans and indicative of many types of cancer worldwide. Increased risks caused by the effects of climate change and a high cost of treatment, highlight the importance of skin cancer prevention efforts like this. The methods used to detect these diseases vary from a visual inspection performed by dermatologists to computational methods, and the latter has widely used automatic image classification applying Convolutional Neural Networks (CNNs) in medical image analysis in the last few years. This article presents an approach that uses CNNs with a NASNet architecture to recognize in a more accurate way, without segmentation, eight skin diseases. The model was trained end-to-end on Keras with augmented skin diseases images from the International Skin Imaging Collaboration (ISIC). The CNN architectures were initialized with weight from ImageNet, fine-tuned in order to discriminate well among the different types of skin lesions, and then 10-fold cross-validation was applied. Finally, some evaluation metrics are calculated as accuracy, sensitivity, and specificity and compare with other CNN trained architectures. This comparison shows that the proposed system offers higher accuracy results, with a significant reduction on the training paraments. To the best of our knowledge and based in the state-of-art recompiling in this work, the application of the NASNet architecture training with skin image lesion from ISIC archive for multi-class classification and evaluated by cross-validation, represents a novel skin disease classification system.

Dominio y aplicación del método clínico por los estudiantes del tercer año de la carrera de Medicina de la Universidad de Ciencias Médicas de Holguín / Mastery and application of the clinical method by third-year students of Medicine Career at Health Sciences University of Holguín

Introducción: la crisis del método clínico es una preocupación constante para los profesionales de la salud porque esta comprende aspectos muy sensibles de la práctica médica y la preparación para su empleo se produce tempranamente en la formación de los estudiantes. Objetivo: determinar el desempeño en la aplicación del método clínico de los estudiantes de tercer año de la carrera de Medicina en la provincia Holguín. Métodos: se realizó un estudio descriptivo con los estudiantes del tercer año de la carrera de Medicina de la Universidad de Ciencias Médicas de Holguín en el curso escolar 2009-2010. La muestra estuvo integrada por 439 estudiantes, el 66,6% de la población estudiada. Se consideraron los resultados obtenidos por los estudiantes en los exámenes prácticos de la asignatura de Medicina Interna. Resultados: el 95% de los alumnos presentaron dificultades en el interrogatorio del paciente, el 92% en el examen físico y el 93,6% no pudieron realizar el diagnóstico correcto. En cuanto a los criterios de los profesores sobre la interrelación interrogatorio-examen físico, análisis complementarios, diagnóstico y conducta, el 46,7% lo consideró regular y el 23,3%, malo. Conclusiones: Los estudiantes del tercer año de la carrera de Medicina carecieron del dominio y aplicaron de manera deficiente el método clínico durante los exámenes prácticos de Medicina Interna.

Introduction: the crisis of the clinical method is a constant concern for all the health professionals as it turns around many sensitive aspects of the medical practice and takes place at an early stage in their formation as doctors. Objective: to determine the role of clinical method application by third-year students of Medicine Career of Holguín province. Methods: A descriptive study in the third-year medical students from the University of Medical Sciences in Holguín was conducted during the school year 2009-2010. The sample comprised 439 students representing 66.6% of the studied population. The results obtained in the practical examinations of Internal Medicine Subject were considered. Results: Ninety-five percent of the students had difficulties in interviewing the patients; 92% had problems in the physical examination and 93.6% had troubles in making the accurate diagnosis. As for the professors' assessment of the interrelation between interview-physical examinations, routine tests, diagnosis and treatment: 46.7% considered it fair and 23.3%, bad. Conclusions: the mastery and the application of the clinical method during the practical examinations of Internal Medicine are deficient, since the students were unable, through the interview and the physical exam, to make a correct diagnosis or develop a logical reasoning of diagnosis-treatment.

Dominio y aplicación del método clínico por los estudiantes del tercer año de la carrera de Medicina de la Universidad de Ciencias Médicas de Holguín / Mastery and Application of the Clinical Method by Third-Year Students of Medicine Care er at Heal th Sciences University of Holguin

Introducción: la crisis del método clínico es una preocupación constante para los profesionales de la salud porque esta comprende aspectos muy sensibles de la práctica médica y la preparación para su empleo se produce tempranamente en la formación de los estudiantes.Objetivo: determinar el desempeño en la aplicación del método clínico de los estudiantes de tercer año de la carrera de Medicina en la provincia Holguín. Métodos: se realizó un estudio descriptivo con los estudiantes del tercer año de la carrera de Medicina de la Universidad de Ciencias Médicas de Holguín en el curso escolar 2009- 2010. La muestra estuvo integrada por 439 estudiantes, el 66,6 por ciento de la población estudiada. Se consideraron los resultados obtenidos por los estudiantes en los exámenes prácticos de la asignatura de Medicina Interna. Resultados: el 95 por ciento de los alumnos presentaron dificultades en el interrogatorio del paciente, el 92 por ciento en el examen físico y el 93,6 por ciento no pudieron realizar el diagnóstico correcto. En cuanto a los criterios de los profesores sobre la interrelación interrogatorio-examen físico, análisis complementarios, diagnóstico y conducta, el 46,7 por ciento lo consideró regular y el 23,3 por ciento , malo. Conclusiones: los estudiantes del tercer año de la carrera de Medicina carecieron del dominio y aplicaron de manera deficiente el método clínico durante los exámenes prácticos de Medicina Interna(AU)...

Introduction: the crisis of the clinical method is a constant concern for all the health professionals as it turns around many sensitive aspects of the medical practice and takes place at an early stage in their formation as doctors. Objective: to determine the role of clinical method application by t hird- year students of Medicine Career of Holguín province. Methods: a descriptive study in the third- year medical students from the University of Medical Sciences in Holguín was conducted during the school year ,2009- 2010, The sample comprised ,439, students representing ,66.6 percent, of the studied population. The results obt ained in the practical examinations of Internal Medicine Subject were considered. Results: ninety - five percent of the students had difficulties in interviewing the patients,92 percent, had problems in the physical examination and ,93.6 percent, had troubles in making theaccurate diagnosis. As for the professors' assessment of the interrelation between interview - physical examinations, routine tests, diagnosis and treatment: ,46.7 percent, considered it fair and, 23.3 percent, bad. Conclusions: the mastery and the application of the clinical method during the practical examinations of Internal Medicine are deficient, since the students were unable, through the interview and the physical exam, to make a correct diagnosis or develop a logical reasoning of diagnosis -treatment(au)...