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Rare diseases affect a growing number of individuals. One key problem for patients and their caregivers is the difficulty in reaching experts and associations competent on a particular disease. As a consequence, caregivers, often family members of the patient, learn much about the disease from their own experience. CaregiverMatcher is a proof of concept providing a smart solution to build a network of caregivers, linked by a matching mechanism based on graph neural networks. The caregivers and their experience with rare diseases are described by node features. Associations and care centers are invited to share their knowledge on the platform. [ABSTRACT FROM AUTHOR]

Recent advances in remote sensing enable the mapping and monitoring of carbon stocks without relying on extensive in situ measurements. The Democratic Republic of the Congo (DRC) is among the countries where national forest inventories (NFI) are either non-existent or out of date. Here we demonstrate a method for estimating national-scale gross forest aboveground carbon (AGC) loss and associated uncertainties using remotely sensed-derived forest cover loss and biomass carbon density data. Lidar data were used as a surrogate for NFI plot measurements to estimate carbon stocks and AGC loss based on forest type and activity data derived using time-series multispectral imagery. Specifically, DRC forest type and loss from the FACET (Forêts d’Afrique Centrale Evaluées par Télédétection) product, created using Landsat data, were related to carbon data derived from the Geoscience Laser Altimeter System (GLAS). Validation data for FACET forest area loss were created at a 30-m spatial resolution and compared to the 60-m spatial resolution FACET map. We produced two gross AGC loss estimates for the DRC for the last decade (2000–2010): a map-scale estimate (53.3 ± 9.8 Tg C yr ^−1 ) accounting for whole-pixel classification errors in the 60-m resolution FACET forest cover change product, and a sub-grid estimate (72.1 ± 12.7 Tg C yr ^−1 ) that took into account 60-m cells that experienced partial forest loss. Our sub-grid forest cover and AGC loss estimates, which included smaller-scale forest disturbances, exceed published assessments. Results raise the issue of scale in forest cover change mapping and validation, and subsequent impacts on remotely sensed carbon stock change estimation, particularly for smallholder dominated systems such as the DRC.

As reported by FAO (2005 State of the World’s Forests (Rome: UNFAO), 2010 Forest Resource Assessment (FRA) 2010/095 (Rome: UNFAO)), Indonesia experiences the second highest rate of deforestation among tropical countries. Hence, timely and accurate forest data are required to combat deforestation and forest degradation in support of climate change mitigation and biodiversity conservation policy initiatives. Within Indonesia, Sumatra Island stands out due to the intensive forest clearing that has resulted in the conversion of 70% of the island’s forested area through 2010. We present here a hybrid approach for quantifying the extent and change of primary forest in Sumatra in terms of primary intact and primary degraded classes using a per-pixel supervised classification mapping followed by a Geographic Information System (GIS)-based fragmentation analysis. Loss of Sumatra’s primary intact and primary degraded forests was estimated to provide suitable information for the objectives of the United Nations Framework on Climate Change (UNFCCC) Reducing Emission from Deforestation and Forest Degradation (REDD and REDD+) program. Results quantified 7.54 Mha of primary forest loss in Sumatra during the last two decades (1990–2010). An additional 2.31 Mha of primary forest was degraded. Of the 7.54 Mha cleared, 7.25 Mha was in a degraded state when cleared, and 0.28 Mha was in a primary state. The rate of primary forest cover change for both forest cover loss and forest degradation slowed over the study period, from 7.34 Mha from 1990 to 2000, to 2.51 Mha from 2000 to 2010. The Geoscience Laser Altimeter System (GLAS) data set was employed to evaluate results. GLAS-derived tree canopy height indicated a significant structural difference between primary intact and primary degraded forests (mean height 28 m ± 8.7 m and 19 m ± 8.2 m, respectively). The results demonstrate a method for quantifying primary forest cover stand-replacement disturbance and degradation that can be replicated across the tropics in support of REDD+ initiatives.

Abstract Mapping and monitoring carbon stocks in forested regions of the world, particularly the tropics, has attracted a great deal of attention in recent years as deforestation and forest degradation account for up to 30% of anthropogenic carbon emissions, and are now included in climate change negotiations. We review the potential for satellites to measure carbon stocks, specifically aboveground biomass (AGB), and provide an overview of a range of approaches that have been developed and used to map AGB across a diverse set of conditions and geographic areas. We provide a summary of types of remote sensing measurements relevant to mapping AGB, and assess the relative merits and limitations of each. We then provide an overview of traditional techniques of mapping AGB based on ascribing field measurements to vegetation or land cover type classes, and describe the merits and limitations of those relative to recent data mining algorithms used in the context of an approach based on direct utilization of remote sensing measurements, whether optical or lidar reflectance, or radar backscatter. We conclude that while satellite remote sensing has often been discounted as inadequate for the task, attempts to map AGB without satellite imagery are insufficient. Moreover, the direct remote sensing approach provided more coherent maps of AGB relative to traditional approaches. We demonstrate this with a case study focused on continental Africa and discuss the work in the context of reducing uncertainty for carbon monitoring and markets.

Abstract Background The project "Assessment and prevention of acute health effects of weather conditions in Europe" (PHEWE) had the aim of assessing the association between weather conditions and acute health effects, during both warm and cold seasons in 16 European cities with widely differing climatic conditions and to provide information for public health policies. Methods The PHEWE project was a three-year pan-European collaboration between epidemiologists, meteorologists and experts in public health. Meteorological, air pollution and mortality data from 16 cities and hospital admission data from 12 cities were available from 1990 to 2000. The short-term effect on mortality/morbidity was evaluated through city-specific and pooled time series analysis. The interaction between weather and air pollutants was evaluated and health impact assessments were performed to quantify the effect on the different populations. A heat/health watch warning system to predict oppressive weather conditions and alert the population was developed in a subgroup of cities and information on existing prevention policies and of adaptive strategies was gathered. Results Main results were presented in a symposium at the conference of the International Society of Environmental Epidemiology in Paris on September 6th 2006 and will be published as scientific articles. The present article introduces the project and includes a description of the database and the framework of the applied methodology. Conclusion The PHEWE project offers the opportunity to investigate the relationship between temperature and mortality in 16 European cities, representing a wide range of climatic, socio-demographic and cultural characteristics; the use of a standardized methodology allows for direct comparison between cities.

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To compare the quality of randomized controlled trials (RCTs) published in predatory and nonpredatory journals in the field of physical therapy. From a list of 18 journals included either on Beall's list (n=9) or in the Directory of Open Access Journals (DOAJ) (n=9), 2 independent assessors extracted all the RCTs published between 2014 and 2017. When journals published more than 40 RCTs, a sample of 40 trials was randomly extracted, preserving the proportions among years. Indexing in PubMed, country of journal publication, and dates of submission or acceptance were also recorded for each journal. The PEDro (Physiotherapy Evidence Database) scale and duration of the peer review. Four hundred ten RCTs were included. The mean PEDro score of articles published in non-Beall, DOAJ journals was higher than those published in Beall journals (mean score ± SD, 5.8±1.7 vs 4.5±1.5; P <.001), with the differences increasing when the indexing in PubMed was also considered (6.5±1.5 vs 4.4±1.5; P <.001). The peer review duration was significantly longer in non-Beall than in Beall journals (mean duration [d] ± SD, 145.2±92.9 vs 45.4±38.8; P <.001) and in journals indexed in PubMed than in nonindexed journals (136.6±100.7 vs 60.4±55.7; P <.001). Indexing in PubMed was the strongest independent variable associated with the PEDro score (adjusted R 2 =0.182), but noninclusion on Beall's list explained an additional, albeit small, portion of the PEDro score variance (cumulative adjusted R 2 =0.214). Potentially predatory journals publish lower-quality trials and have a shorter peer review process than non-Beall journals included in the DOAJ database. • Predatory physical therapy journals publish randomized controlled trials of lower quality and have shorter times for peer review process than journals not included in Beall's list. • Due to the great number of papers published by predatory physical therapy journals, there is a clear risk that predatory publishers substantially contribute to the dissemination of unsound research findings. [ABSTRACT FROM AUTHOR]

Background and Purposes: Hip fracture represents one of the most severe injuries in the older adults. In long-term survivors, disability is common and walking ability may be considered an important predictor of functional recovery. We investigated whether 4-m gait speed, assessed in older persons early after surgical repair of hip fracture, could predict functional recovery and subsequent development of major clinical outcomes. Methods: This was a prospective cohort study. We included adults older than 65 years, admitted to a community acute care hospital with hip fracture, undergoing surgical repair. As soon as the participant was able to stand and walk, using walking aids as needed but with no person's help, the 4-m walking speed was tested as the main predictive variable. The outcome variables included the change in the Barthel Index (BI) from prehospital through 1 year postoperative as a continuous variable and 2 dichotomous outcomes, that is, (1) a decrease in BI greater than 5 points in 1 year and (2) a composite endpoint, combining 5+ points BI decline, death, falls, institutionalization, and need for 24-hour home assistance in 1 year. Results: Sixty-two participants (mean age = 85 years) were enrolled and evaluated, on average 6 days (standard error of the mean [SEM] = 0.2) after hip fracture surgery. Compared with prefracture (mean = 96.3; SEM = 0.9), BI decreased 1 month after surgery (mean = 76.5; SEM = 2.1) and recovered only partially at 2 (mean = 84.1; SEM = 2.2) and 12 months (mean = 87.2; SEM = 2.8). A predischarge value of the walking speed below the median (20.5 cm/s) predicted a substantial BI reduction throughout the 12 months. Furthermore, the adjusted risk of a decline in functional status was reduced by 5% (odds ratio = 0.95; 95% confidence interval, 0.91-0.997; P =.038) and that of the combined outcome by 7% (odds ratio = 0.93; 95% confidence interval, 0.88-0.99; P =.013) for each centimeter per second of predischarge walking speed. Discussion and Conclusion: The 4-m walking speed, measured early after surgical repair of hip fracture, has profound long-term prognostic implications. This assessment approach might prove helpful in clinical decision-making on the postoperative management of older hip fracture persons. [ABSTRACT FROM AUTHOR]

Introduction Exposure to particulate matter with diameter ≤10 μm (PM 10 ) entails well documented adverse effects on human health. In the last decade, concentration of PM 10 in Lombardy (10 million inhabitants), Italy, has been gradually decreasing. We evaluated how the mortality burden due to PM 10 varied in that same period. Methods We focused on 13 areas of the Region in 2003–2014: 11 cities with more than 50,000 inhabitants, 1 smaller alpine town and 1 agricultural province. For each area, we collected PM 10 annual average concentrations and natural mortality data, and we used the posterior area-specific effects from a previous Bayesian meta-analysis to estimate the short-term impact of PM 10 on mortality, in terms of deaths attributable (AD) to annual average exposures exceeding the WHO threshold of 20 μg/m 3 . Results PM 10 annual average values showed a non-homogenous decreasing trend in the investigated time period in most of the areas. Overall, the population-weighted exposure levels decreased, except for a peak in 2011, but never met the WHO threshold. In 2003–2006, PM 10 levels were responsible, on average, for 343.0 annual AD from natural causes that decreased to 253.5 in 2007–2010 and to 208.3 in 2011–2014. Overall we estimated that PM 10 was responsible for about 1% of all natural deaths (min-max range: 0.86%–1.42%); the impact was heterogeneous among areas. Conclusions By collecting routinely available data for the most populated areas in Lombardy, we returned a picture of air pollution and health trends in the last decade. Notwithstanding the observed reduction in PM 10 between 2003 and 2014 and the resulting decline in the number of AD, the impact is still relevant. Hence, appropriate policies for emission reduction could have a further beneficial effect on population health. Studies based on routine data and local effect estimates are recommended to properly inform the policy-making process. [ABSTRACT FROM AUTHOR]

Objective The endocannabinoid system hypertonicity features obesity. Excess circulating 2-arachidonoylglycerol was variously associated with obesity-related metabolic impairment; however, unstandardized experimental and analytical settings have clouded its usefulness as a dysmetabolism biomarker. We aimed at assessing the influence of body mass index (BMI), menopause in women, and aging in men on 2-arachidonoylglycerol relationship with metabolic parameters. Methods Adult, unmedicated women (premenopausal (preMW): n = 103; menopausal (MW): n = 81) and men (n = 144) were stratified in normal weight (NW; BMI: 18.5–24.9 kg/m 2 ), overweight (OW; BMI: 25.0–29.9 kg/m 2 ), and obese (OB; BMI ≥ 30.0 kg/m 2 ) classes. Anthropometric and metabolic parameters were determined. Plasma 2-arachidonoylglycerol was measured by a validated liquid chromatography-mass spectrometry assay. Results 2-arachidonoylglycerol level was raised by menopause (P < 0.001) and by obesity in preMW (P < 0.001) and in men (P = 0.019). In the overall cohorts, 2-arachidonoylglycerol displayed BMI-independent relationships with dyslipidemia (preMW, MW and men), insulin resistance (MW and men), and hypertension (men), but not with waist circumference. Within preMW BMI classes, 2-arachidonoylglycerol correlations were found with triglycerides (P = 0.020) and total cholesterol (TC; P = 0.040) in OB women. In MW, 2-arachidonoylglycerol correlation with triglycerides was found in NW (P = 0.001) and OW (P = 0.034), but not in OB class. Moreover, we found 2-arachidonoylglycerol correlations with TC (P = 0.003), glucose (P < 0.001), and HOMA-IR (P = 0.035) specific for NW MW class. In men, 2-arachidonoylglycerol correlated with triglycerides in NW, OW (both P < 0.001), and OB (P = 0.029), with SBP (P = 0.023) and diastolic BP (DBP; P = 0.048) in OB, and with TC (P < 0.001) in OW class. In NW class 2-arachidonoylglycerol correlations were found with insulin (P = 0.003) and HOMA-IR (P = 0.001), both enhanced by aging (both P = 0.004), and with glucose (P = 0.015) and HDL (P = 0.004). Conclusions Plasma 2AG is a biomarker of clustering metabolic dysfunctions, especially in lean men and menopausal women, and could be of help in identifying subjects with elevated cardiometabolic risk despite a healthy anthropometric appearance. [ABSTRACT FROM AUTHOR]

Objective A prospective observational clinical study was undertaken to assess the accuracy of preoperative Axillary Ultrasound (AUS) plus Fine-Needle Aspiration Cytology (FNAC) as well as and its clinical utility, that is the capacity of the information supplied by the test to guide the clinical decision-making. Materials and methods from January 2013 to August 2015, 400 female patients with pT1-3 cN0 operable breast cancer underwent AUS with FNAC at the Breast Unit of the “ IRCCS San Martino-IST ” in Genoa (Italy). Results 127 out of 400 patients (31.7%) had axillary lymph node metastases; in 69 out of 127 node-positive patients (54.3%) AUS detected at least one abnormal lymph node, and in 56 out of 127 patients (44.1%) the abnormal sonographic pattern of the lymph node was coupled with a positive FNAC finding. No false-positive finding by both AUS-alone or combined AUS/FNAC was observed. AUS-alone had sensitivity of 54.3% (69/127), specificity of 100% (273/273), PPV of 100% (69/69), NPV of 82.5% (273/331), and accuracy of 85.5% (342/400). Combined AUS/FNAC had sensitivity of 44.1% (56/127), specificity of 100% (273/273), PPV of 100% (56/56), NPV of 79.4% (273/344), and accuracy of 82.2% (329/400). Conclusions AUS-alone or combined AUS/FNAC had a high accuracy rate coupled with a more than satisfactory efficiency due to their low costs and easy access for the preoperative staging of the axilla. Notably, AUS-alone might be suggested for the preoperative staging of patients with early stage breast cancer because FNAC did not increased the specificity but reduced the sensitivity of the technique. Patients with negative findings might undergo either SLNB or close observation while waiting for the definitive results of ongoing SOUND randomized clinical trial. [ABSTRACT FROM AUTHOR]

• Intellectual and social proximity among scholarly journals explored by network fusion techniques. • Information in multilayer networks of journals are fused in a similarity network. • Partial distance correlations measure contribution of layers to the fused network. • The community morphology of the fused network is explored by using modularity. • Communities of journals are mainly defined by editors as gatekeepers of science. This paper explores intellectual and social proximity among scholarly journals by using network fusion techniques. Similarities among journals are initially represented by means of a three-layer network based on co-citations, common authors and common editors. The information contained in the three layers is then combined by building a fused similarity network. The fusion consists in an unsupervised process that exploits the structural properties of the layers. Subsequently, partial distance correlations are adopted for measuring the contribution of each layer to the structure of the fused network. Finally, the community morphology of the fused network is explored by using modularity. In the three fields considered (i.e. economics, information and library sciences and statistics) the major contribution to the structure of the fused network arises from editors. This result suggests that the role of editors as gatekeepers of journals is the most relevant in defining the boundaries of scholarly communities. In information and library sciences and statistics, the clusters of journals reflect sub-field specializations. In economics, clusters of journals appear to be better interpreted in terms of alternative methodological approaches. [ABSTRACT FROM AUTHOR]

In the fields of nanomedicine, biophotonics and radiation therapy, nanoparticle (NP) detection in cell models often represents a fundamental step for many in vivo studies. One common question is whether NPs have or have not interacted with cells. In this context, we propose an imaging based technique to detect the presence of NPs in eukaryotic cells. Darkfield images of cell cultures at low magnification (10×) are acquired in different spectral ranges and recombined so as to enhance the contrast due to the presence of NPs. Image analysis is applied to extract cell-based parameters (i.e. mean intensity), which are further analyzed by statistical tests (Student’s t -test, permutation test) in order to obtain a robust detection method. By means of a statistical sample size analysis, the sensitivity of the whole methodology is quantified in terms of the minimum cell number that is needed to identify the presence of NPs. The method is presented in the case of HeLa cells incubated with gold nanorods labeled with anti-CA125 antibodies, which exploits the overexpression of CA125 in ovarian cancers. Control cases are considered as well, including PEG-coated NPs and HeLa cells without NPs. [ABSTRACT FROM AUTHOR]

Background: The aim of this systematic review is to evaluate and synthesize scientific evidence on the effect of surgical interventions for removal of mandibular third molar (M3M) on periodontal healing of adjacent mandibular second molar (M2M).Methods: The protocol was registered at PROSPERO (International Prospective Register of Systematic Reviews) as CRD42012003059. Medline, Cochrane, and EMBASE databases were interrogated to identify randomized controlled trials (RCTs) up to December 22, 2014. Patients with M3Ms fully developed, unilaterally or bilaterally impacted, were considered. Outcomes were clinical attachment level gain (CALg) and probing depth reduction (PDr) with a follow-up ≥ 6 months. Patient-subjective outcomes, such as pain, discomfort, and complications, and financial aspects and chair time, were also explored. A Bayesian network meta-analysis model was used to estimate direct and indirect effects and to establish a ranking of treatments.Results: Sixteen RCTs were included and categorized into four groups investigating the following: 1) regenerative/grafting procedures (10 RCTs); 2) flap design (three RCTs); 3) type of suturing (one RCT); and 4) periodontal care of M2M (two RCTs). Guided tissue regeneration (GTR) with resorbable (GTRr) and non-resorbable (GTRnr) membrane and GTRr with anorganic xenograft (GTRr + AX) showed the highest mean ranking for CALg (2.99, 90% credible interval [CrI] = 1 to 5; 2.80, 90% CrI = 1 to 6; and 2.29, 90% CrI = 1 to 6, respectively) and PDr (2.83, 90% CrI = 1 to 5; 2.52, 90% CrI = 1 to 5; and 2.77, 90% CrI = 1 to 6, respectively). GTRr + AX showed the highest probability (Pr) of being the best treatment for CALg (Pr = 45%) and PDr (Pr = 32%). Direct and network quality of evidence were rated from very low to moderate.Conclusions: To the best of the authors' knowledge, the present review is the first one to evaluate quantitatively and qualitatively the effect of different interventions on periodontal healing distal to the second molar after extraction of the third molar. GTR-based procedures with or without combined grafting therapies provide some adjunctive clinical benefit compared to standard non-regenerative/non-grafting procedures. However, the overall low quality of evidence suggests a low degree of confidence and certainty in treatment effects. Evidence on variations of surgical M3M removal techniques based on flap design, type of suturing, and periodontal care of M2M is limited both qualitatively and quantitatively. [ABSTRACT FROM AUTHOR]

Purpose Our aim was to determine the non-inferiority of normal saline flushing compared to heparin flushing in maintaining the patency of totally implanted venous access devices (TIVADs). Method Four hundred and thirty patients were recruited from 14 Italian centres. Patients were randomized to heparin group or to normal saline group. The primary outcome of the study was TIVAD occlusion. Results After randomisation, 203 patients were assigned to normal saline group and 212 to heparin group. Median follow up time was 204 days in normal saline group and 294 in the heparin group. We observed 24 withdrawal occlusions (5.78%): 10 in the heparin group and 14 in the normal saline group. One total occlusion was observed in the normal saline group. Taking as reference the arm treated with heparin, the absolute risk difference was 2.67 with the 90% CI including the non – inferiority margin of 4%. No significant difference between hazards of occlusion was found. Conclusions This study failed to demonstrate that normal saline flushing is not inferior to heparin flushing, even if a significant difference between the two treatments was not found. The use of heparin is controversial and other prospective trials are necessary in this field. Trial registration EudraCT number: 2009-013620-22. [ABSTRACT FROM AUTHOR]