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Abstract Several studies published so far used highly selective image datasets from unclear sources to train computer vision models and that may lead to overestimated results, while those studies conducted in real-life remain scarce. To avoid image selection bias, we stacked convolutional and recurrent neural networks (CNN-RNN) to analyze complete optical coherence tomography (OCT) cubes in a row and predict diabetic macular edema (DME), in a real-world diabetic retinopathy screening program. A retrospective cohort study was carried out. Throughout 4-years, 5314 OCT cubes from 4408 subjects who attended to the diabetic retinopathy (DR) screening program were included. We arranged twenty-two (22) pre-trained CNNs in parallel with a bidirectional RNN layer stacked at the bottom, allowing the model to make a prediction for the whole OCT cube. The staff of retina experts built a ground truth of DME later used to train a set of these CNN-RNN models with different configurations. For each trained CNN-RNN model, we performed threshold tuning to find the optimal cut-off point for binary classification of DME. Finally, the best models were selected according to sensitivity, specificity, and area under the receiver operating characteristics curve (AUROC) with their 95% confidence intervals (95%CI). An ensemble of the best models was also explored. 5188 cubes were non-DME and 126 were DME. Three models achieved an AUROC of 0.94. Among these, sensitivity, and specificity (95%CI) ranged from 84.1–90.5 and 89.7–93.3, respectively, at threshold 1, from 89.7–92.1 and 80–83.1 at threshold 2, and from 80.2–81 and 93.8–97, at threshold 3. The ensemble model improved these results, and lower specificity was observed among subjects with sight-threatening DR. Analysis by age, gender, or grade of DME did not vary the performance of the models. CNN-RNN models showed high diagnostic accuracy for detecting DME in a real-world setting. This engine allowed us to detect extra-foveal DMEs commonly overlooked in other studies, and showed potential for application as the first filter of non-referable patients in an outpatient center within a population-based DR screening program, otherwise ended up in specialized care.

Abstract To compare baseline characteristics, initial response and 12-month efficacy and safety outcomes in eyes with branch and central retinal vein occlusion (BRVO and CRVO) treated with dexamethasone implants (DEX) or anti-vascular endothelial growth factor (anti-VEGF) we performed a multi-centre, retrospective and observational study using Fight Retinal Blindness! Registry. Of 725 eligible eyes, 10% received DEX initially with very frequent adjunctive anti-VEGF (BRVO-DEX 49%, CRVO-DEX 60%). The primary outcome of mean adjusted change in VA at 12 months with DEX and anti-VEGF initiated groups were not statistically significantly different (BRVO: DEX + 6.7, anti-VEGF + 10.6 letters; CRVO: DEX + 2.8, anti-VEGF + 6.8 letters). DEX initiated eyes had fewer injections and visits than anti-VEGF initiated eyes. The BRVO-DEX eyes had greater initial mean changes in VA and central subfield thickness (CST) and achieved inactivity sooner than BRVO-anti-VEGF eyes. The mean CST after the first three months was above 350 μm in all but the BRVO-anti-VEGF group, suggesting undertreatment. In routine care DEX is uncommonly used when available as initial treatment of BRVO and CRVO requiring supplemental anti-VEGF within the first year. The 12-month outcomes were similar, but DEX initiated eyes had fewer injections and visits but more episodes of raised IOP Vs those starting anti-VEGF.

Avec l’essor de l’économie comportementale, les Nudges se sont largement répandus dans divers aspects de la société et du numérique. Récemment, les progrès combinés des technologies de l’IA et des connaissances scientifiques, notamment en psychologie, en sciences humaines et sociales et en neurosciences, ont donné naissance à un nouveau phénomène appelé « l’Hypernudging ». Ce dernier se distingue par un changement d’échelle dans sa capacité à agir sur les décisions des individus. L’objectif de cette recherche, menée selon une approche socio-anthropologique, est d’avoir une meilleure compréhension des questions éthiques que soulève ce couplage des Nudges et de l’IA dans les interactions humain-IA. Dans cette perspective, nous avons réalisé une revue de littérature approfondie sur le sujet et mené une enquête exploratoire auprès d’un échantillon composé d’étudiants et de professionnels évoluant dans différents secteurs d’activités tels que la banque, la finance, le marketing ou les médias ainsi qu’auprès de deux agences de communication spécialistes des Nudges. Il s’agissait d’examiner les enjeux épistémologiques et sociotechniques de l’Hypernudging et de les confronter au développement des Nudges IA dans les organisations pour en dégager des pistes de recherche pour leur régulation éthique.

Abstract Background Patients suffering from symptomatic macromastia are usually underserved, as they have to put up with very long waiting lists and are usually selected under restrictive criteria. The Oncoplastic Breast Surgery subspeciality requires a cross-specialty training, which is difficult, in particular, for trainees who have a background in general surgery, and not easily available. The introduction of reduction mammaplasty into a Breast Cancer Unit as treatment for symptomatic macromastia could have a synergic effect, making the scarce therapeutic offer at present available to these patients, who are usually treated in Plastic Departments, somewhat larger, and accelerating the uptake of oncoplastic training as a whole and, specifically, the oncoplastic breast conserving procedures based on the reduction mammaplasty techniques such as displacement conservative techniques and onco-therapeutic mammaplasty. This is a retrospective study analyzing the outcome of reduction mammaplasty for symptomatic macromastia in our Breast Cancer Unit. Methods A cohort study of 56 patients who underwent bilateral reduction mammaplasty at our Breast Unit between 2005 and 2009 were evaluated; morbidity and patient satisfaction were considered as end points. Data were collected by reviewing medical records and interviewing patients. Results Eight patients (14.28%) presented complications in the early postoperative period, two of them being reoperated on. The physical symptoms disappeared or significantly improved in 88% of patients and the degree of satisfaction with the care process and with the overall outcome were really high. Conclusion Our experience of the introduction of reduction mammaplasty in our Breast Cancer Unit has given good results, enabling us to learn the use of different reduction mammaplasty techniques using several pedicles which made it posssible to perform oncoplastic breast conserving surgery. In our opinion, this management policy could bring clear advantages both to patients (large-breasted and those with a breast cancer) and surgeons.

ABSTRACT The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However, the use of teleneuropsychology to provide cognitive rehabilitation has contributed significantly to the continuity of the treatment. Objectives: To measure the effects of cognitive telerehabilitation on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with mild cognitive impairment. Methods: A sample of 60 patients with mild cognitive impairment according to Petersen’s criteria was randomly divided into two groups: 30 treatment cases and 30 controls (waiting list group). Subjects were matched by age, sex, and Montreal Cognitive Assessment. The treatment group received ten cognitive telerehabilitation sessions of 45 minutes duration once a week. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different linear mixed models were estimated to test treatment effect (cognitive telerehabilitation vs. controls) on each outcome of interest over time (pre/post-intervention). Results: A significant group (control/treatment) x time (pre/post) interaction revealed that the treatment group at week 10 had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency (p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ satisfaction p=0.004) and use of memory strategies (MMQ strategy p=0.000), as well as, and a significant reduction of affective symptomatology: depression (GDS p=0.000), neuropsychiatric symptoms (NPI-Q p=0.045), forgetfulness (EDO-10 p=0.000), and stress (DAS stress p=0.000). Conclusions: Our study suggests that CTR is an effective intervention.

Los adornos-colgantes son uno de los ornamentos más utilizados por los cazadores recolectores durante el Magdaleniense. En este artículo presentamos uno nuevo recuperado de la cueva de Aizkoltxo (Mendaro, Gipuzkoa) grabado cuidadosamente con representaciones tanto figurativas –una cierva y dos zoomorfos marinos– como no figurativas –aspas y trazos simples– en una lámina de una costilla en la que se practicó una única perforación hecha por rotación bipolar. Ha sido datada en el Magdaleniense Final, un momento en el que el yacimiento fue muy frecuentado a juzgar por la abundancia de industria lítica, ósea y restos faunísticos localizados. La importancia de este objeto no radica en su singularidad sino en las similitudes que presenta con otros en la región cantábrica (Valle y El Pendo) y el sur de Francia (Lortet, La Vache, Arancou y Chaffaud). Esto se debe tanto al soporte, costilla, como a la decoración. Los animales marinos apuntan a afinidades en el código simbólico de esta cronología, indicando lazos entre los diferentes grupos que vivieron en Europa occidental entre hace 16.500 y 13.000 años cal BP.

The evolution of connected objects since the 1990s shows that they are increasingly present in our daily lives. From the development of their technical infrastructures, known as the "Internet of Things", to their increasingly ubiquitous connection, technologies are now converging with artificial intelligence and big data towards an "Internet of Behavior", which is increasingly interfaced with bodies and whose challenge is now behavioral analysis. Particularly in the fields of computer science, medicine and marketing, a prolific scientific literature on the subject and its various sociotechnical issues presents these new digital objects as promises of innovation in a growing number of areas, including health, well-being, transportation, architecture (smart buildings), urbanism (smart cities), energy (smart grids), ecology and sports. However, the use of connected objects remains controversial. Contributions from the humanities and social sciences highlight socio-political and anthropological issues regarding the datafication of the world and the impacts on social relations. Although these new objects are profoundly modifying daily life through continuous immersion based on data and automation, anthropological mutations and legal issues remain largely underestimated and even less evaluated.

Video is a medium increasingly used in education. The styles of videos produced for academic purposes have been studied in the literature based mainly on those initially designed by instructors for use in MOOCs. In this work, we define a novel taxonomy of academic video design styles based on the videos produced by students. We have defined 10 different styles after reviewing 105 student-generated videos over 5 years. These types of videos reflect the tastes of students when making a video, which do not necessarily coincide with those of instructors. Based on our classification, a comparative analysis was done between the types of videos developed by instructors and by students, and significant differences were found. The style most commonly used by instructors is similar to the presentation slides while students' videos are based on the integration of videos and images they search for on the Internet.

The aim of this paper is to explore how female players of Basque pelota (pelotaris) construct their gender identity in a traditionally masculine sport. The theory of performativity is used to understand how females negotiate, resist or challenge the dominant gender discourse. Data were collected through 10 in-depth interviews with players. Through inductive analysis we found that the sociocultural context surrounding Basque pelota reinforces the binary system of gender embodiment, which includes hegemonic masculinities and idealised femininities. However, our findings also suggest that whilst some players adhere to this dominant discourse, others actively resist and transgress it through the embodiment of alternative identities. In doing this, these players create new and inclusive identities, therefore escaping a simplistic binary and embracing a multiplicity of gender identities. As a result, they can become active agents in the promotion of equity in sport.

The aim of this study was to analyse the meanings that underlie women's participation in and commitment to leisure-time sport related to Basque pelota. Thirty-eight women between 22 and 60 years old participated in this ethnographic study, which conducted 21 semi-structured interviews. The theoretical framework used for the analysis was informed by a feminist approach and the Serious Leisure Perspective. A hybrid approach, deductive-inductive coding was employed. The data analysis revealed that recreational and competitive female athletes had different levels of engagement and attributed different meanings to their sport practice depending on their form of participation, their commitment, and the lifestyle built around it. It is concluded that the seriousness with which the activities are carried out influences the sport involvement of female Basque pelota players, which should be taken into account to adapt the activities and make an offer related to the characteristics of each pelotari type's context. [ABSTRACT FROM AUTHOR]

Abstract Glycine N-Methyltransferase (GNMT) is a metabolic enzyme that integrates metabolism and epigenetic regulation. The product of GNMT, sarcosine, has been proposed as a prostate cancer biomarker. This enzyme is predominantly expressed in the liver, brain, pancreas, and prostate tissue, where it exhibits distinct regulation. Whereas genetic alterations in GNMT have been associated to prostate cancer risk, its causal contribution to the development of this disease is limited to cell line-based studies and correlative human analyses. Here we integrate human studies, genetic mouse modeling, and cellular systems to characterize the regulation and function of GNMT in prostate cancer. We report that this enzyme is repressed upon activation of the oncogenic Phosphoinositide-3-kinase (PI3K) pathway, which adds complexity to its reported dependency on androgen signaling. Importantly, we demonstrate that expression of GNMT is required for the onset of invasive prostate cancer in a genetic mouse model. Altogether, our results provide further support of the heavy oncogenic signal-dependent regulation of GNMT in prostate cancer.

The Child Abuse Potential Inventory (CAP) is a widely used instrument to assess the potential for child abuse. The brief version of the CAP (BCAP) is a proven time-efficient screener tool. This investigation aims to propose a Spanish BCAP version by analyzing the factor structure of its Abuse Scale (aim 1) and, if needed, developing a valid BCAP Lie Scale (aim 2). Study 1 comprised 205 mothers with problems coping with their children's behavior recruited from family support and treatment programs. Confirmatory factor analysis (CFA), internal consistency, and convergent validity were conducted. Study 2 applied an experimental between-subject design to assess a convenience sample of the Spanish population (N = 260) with 124 participants in Condition 1 (honest) and 136 in Condition 2 (lie). Differences between conditions were analyzed. Study 1: CFA showed adequate fit indices for the seven-factor model (RMSEA = .04 CFI = .98, TLI = .98). Internal consistency and convergent validity were adequate for the Abuse Scale. Findings also showed that the BCAP Lie Scale does not accomplish the main requirements to detect participants answering in a socially desirable way. Study 2: A new set of six items showing significant differences between conditions (U = 15,481.00, z = 11.14, p < .001, r = .77) is proposed to compose the Lie Scale. The findings support that the Spanish BCAP is a valid instrument to assess mothers recruited from Child Protection Services. The new BCAP Lie Scale could be useful to select valid inventories. Further research with more representative samples is recommended., Author(s): Gabriela R. Rivas [sup.1] , Ignacia Arruabarrena [sup.1] , Joaquín De Paúl [sup.1] Author Affiliations: (1) grid.11480.3c, 0000000121671098, Department of Social Psychology, Faculty of Psychology, University of the Basque [...]

Incredible Years (IY) is a well-established multicomponent group-based program designed to promote young children’s emotional and social competence, to prevent and treat child behavioral and emotional problems, and to improve parenting practices and the parent-child relationship. This study presents the first randomized controlled trial carried out in Spain to test the effectiveness of the Incredible Years Basic Parenting and Small Group Dinosaur Programs in a sample of families involved in child welfare due to substantiated or risk for child maltreatment. One hundred and eleven families with 4- to 8-year-old children were randomly allocated to IY or to a control group who received standard services. Baseline, post-intervention, and 12-month follow-up assessments were compared. Results showed that compared to the control group, the IY intervention made a significant positive difference in parents’ observed and reported use of praise, and a significant reduction in reported use of inconsistent discipline, parenting stress, depressive symptomatology, and perception of child behavior problems. A full serial mediation effect was found between participation in IY, changes in parenting practices, subsequent parenting stress reduction, and both final child abuse potential reduction and perception of child behavior problems. No moderating influence on IY effects was found. Findings provide evidence that transporting the IY Basic Parenting and the Small Group Dinosaur Programs with fidelity is feasible in Child Welfare Services in Spain.

Abstract Video is a medium increasingly used in education. The styles of videos produced for academic purposes have been studied in the literature based mainly on those initially designed by instructors for use in MOOCs. In this work, we define a novel taxonomy of academic video design styles based on the videos produced by students. We have defined 10 different styles after reviewing 105 student-generated videos over 5 years. These types of videos reflect the tastes of students when making a video, which do not necessarily coincide with those of instructors. Based on our classification, a comparative analysis was done between the types of videos developed by instructors and by students, and significant differences were found. The style most commonly used by instructors is similar to the presentation slides while students' videos are based on the integration of videos and images they search for on the Internet.

Purpose: The purpose of the study is to describe a bailout technical strategy to prevent below-the-knee (BTK) distal embolization during procedures with increased inherent risk using universally-available "off-the-shelf" devices. Technique: A conventional retrograde access is obtained of the BTK target vessel where embolization protection is sought. Before starting any potential proximal maneuver with an associated significant risk of distal embolization (eg, atherectomy and mechanical thrombectomy), a low-profile balloon is inserted and inflated through the distal retrograde access, so that any debris resulting from the recanalization procedure is blocked by the stagnant column of blood generated by the inflated balloon. Once the revascularization procedure has been completed, a 4F curved catheter is antegradely advanced down to the distally-inflated balloon, and in case of distal embolization the debris is aspirated in a standard fashion way. Conclusion: A retrograde balloon-assisted "off-the-shelf" embolic protection approach may be considered for BTK revascularization procedures where there is an inherent increased risk of distal trash, especially in the presence of distal single-vessel runoff. Clinical Impact: Distal embolization following endovascular procedures can have devastating consequences and there is a general recommendation for selective use of EPDs in high-risk-scenarios. The increased cost and low availability of the current EPD devices for BTK/BTA arteries have prohibited their widespread use. The retrograde balloon-assisted "off-the-shelf" EPD prevents distal embolization during procedures with increased risk of distal trash using inexpensive, nonspecific equipment available in any basic endovascular suite. [ABSTRACT FROM AUTHOR]

The majority of breast cancers are estrogen receptor (ER)+ and agents targeting the ER signaling pathway have markedly increased survival for women with breast cancer for decades. However, therapeutic resistance eventually emerges, especially in the metastatic setting. In the past decade disrupted epigenetic regulatory processes have emerged as major contributors to carcinogenesis in many cancer types. Aberrations in chromatin modifiers and transcription factors have also been recognized as mediators of breast cancer development and therapeutic outcome, and new epigenetic-based therapies in combination with targeted therapies have been proposed. Here we will discuss recent progress in our understanding of the chromatin-based mechanisms of breast tumorigenesis, how these mechanisms affect therapeutic response to standard of care treatment, and discuss new strategies towards therapeutic intervention to overcome resistance.