Transarterial Embolization for Adhesive Capsulitis of the Shoulder: Midterm Outcomes on Function and Pain Relief.

PURPOSE: To determine the safety and potential effectiveness of transarterial embolization for adhesive capsulitis of the shoulder. MATERIALS AND METHODS: This prospective study analyzed consecutive adult patients with adhesive capsulitis referred for embolization between January 2018 and May 2023 after a poor response to treatment (symptoms and limitation of motion in ≥2 axes; ≤120° flexion, ≤50° external rotation and/or internal rotation with the shoulder abducted 90°) persisting for >3 months after having completed ≥6 weeks of analgesics and physical therapy. Different types of pain and mobility were measured before embolization and 1, 3, and 6 months after embolization. Overall upper limb function (Quick Disabilities of Arm, Shoulder, and Hand) and patient satisfaction were measured before and 6 months after embolization. Long-term follow-up comprised telephone interviews and clinical history reviews. RESULTS: A total of 20 patients (12 [60%] women; median age, 50.7; interquartile ranges [IQR], 45‒55 years) were included; 6 (30%) had diabetes and 15 (75%) were off work. Median duration of symptoms before embolization was 39.4 weeks (IQR, 28‒49 weeks), and median duration of rehabilitation therapy was 12.8 weeks (IQR, 8‒16 weeks). Six months after embolization, significant improvements were observed in nocturnal pain (P = .003), pain on moving (P = .001), external rotation (P < .001), internal rotation (P < .001), active flexion (P < .001), passive flexion (P = .03), active abduction (P < .001), passive abduction (P < .001), and overall function (P < .001). Despite objective improvements, patient satisfaction was nearly unchanged. Only 1 patient experienced a mild adverse event. CONCLUSION: Transarterial embolization is safe and potentially effective in treating adhesive capsulitis of the shoulder refractory to conventional treatment. Clinical improvements were maintained in the mid to long term.

Impact of COVID-19 on the degree of compliance with hand hygiene: a repeated cross-sectional study.

Hand hygiene (HH) is the paramount measure used to prevent healthcare-associated infections. A repeated cross-sectional study was undertaken with direct observation of the degree of compliance on HH of healthcare personnel during the SARS-CoV-2 pandemic. Between, 2018-2019, 9,083 HH opportunities were considered, and 5,821 in 2020-2022. Chi squared tests were used to identify associations. The crude and adjusted odds ratios were used along with a logistic regression model for statistical analyses. Compliance on HH increased significantly (p < 0.001) from 54.5% (95% CI: 53.5, 55.5) to 70.1% (95% CI: 68.9, 71.2) during the COVID-19 pandemic. This increase was observed in four of the five key moments of HH established by the World Health Organization (WHO) (p < 0.05), except at moment 4. The factors that were significantly and independently associated with compliance were the time period considered, type of healthcare-personnel, attendance at training sessions, knowledge of HH and WHO guidelines, and availability of hand disinfectant alcoholic solution in pocket format. Highest HH compliance occurred during the COVID-19 pandemic, reflecting a positive change in healthcare-personnel's behaviour regarding HH recommendations.

Empowering Diabetics: Advancements in Smartphone-Based Food Classification, Volume Measurement, and Nutritional Estimation.

Diabetes has emerged as a worldwide health crisis, affecting approximately 537 million adults. Maintaining blood glucose requires careful observation of diet, physical activity, and adherence to medications if necessary. Diet monitoring historically involves keeping food diaries; however, this process can be labor-intensive, and recollection of food items may introduce errors. Automated technologies such as food image recognition systems (FIRS) can make use of computer vision and mobile cameras to reduce the burden of keeping diaries and improve diet tracking. These tools provide various levels of diet analysis, and some offer further suggestions for improving the nutritional quality of meals. The current study is a systematic review of mobile computer vision-based approaches for food classification, volume estimation, and nutrient estimation. Relevant articles published over the last two decades are evaluated, and both future directions and issues related to FIRS are explored.

A Cost-Benefit Analysis Simulation for the Digitalisation of Cold Supply Chains.

This paper investigates using simulation to predict the benefits and costs of digitalising cold distribution chains. The study focuses on the distribution of refrigerated beef in the UK, where digitalisation was implemented to re-route cargo carriers. By comparing simulations of both digitalised and non-digitalised supply chains, the study found that digitalisation can reduce beef waste and decrease the number of miles driven per successful delivery, leading to potential cost savings. Note that this work is not attempting to prove that digitalisation is appropriate for the chosen scenario, only to justify a simulation approach as a decision making tool. The proposed modelling approach provides decision-makers with more accurate predictions of the cost-benefit of increased sensorisation in supply chains. By accounting for stochastic and variable parameters, such as weather and demand fluctuations, simulation can be used to identify potential challenges and estimate the economic benefits of digitalisation. Moreover, qualitative assessments of the impact on customer satisfaction and product quality can help decision-makers consider the broader impacts of digitalisation. Overall, the study suggests that simulation can play a crucial role in facilitating informed decisions about the implementation of digital technologies in the food supply chain. By providing a better understanding of the potential costs and benefits of digitalisation, simulation can help organisations make more strategic and effective decisions.

New insights into the taxonomy of autoimmune diseases based on polyautoimmunity.

OBJECTIVE: The clinical coexistence of two or more autoimmune diseases (ADs) fulfilling classification criteria is termed "overt polyautoimmunity" (PolyA), whereas the presence of autoantibodies unrelated to an index AD, without clinical criteria fulfillment, is known as "latent PolyA". We aimed to explore a new taxonomy of ADs based on PolyA. METHODS: In a cross-sectional study of 292 subjects, we evaluated the presence of PolyA in 146, 45, 29, 17, and 17 patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), autoimmune thyroid disease (AITD) and systemic sclerosis (SSc), respectively, and 38 healthy controls. Clinical assessment, autoantibody profile (by autoantigen array chip), lymphocytes immunophenotype and cytokine profile (by flow cytometry) were evaluated simultaneously. A mixed cluster methodology was used to classify ADs. RESULTS: Latent PolyA was more frequent than overt PolyA, ranging from 69.9% in RA to 100% in SSc. Nevertheless, both latent and overt PolyA clustered together. Over-expressed IgG autoantibodies were found to be hallmarks for the identification of index ADs. The combination of autoantibodies allowed high accuracy in the classification of ADs. Three well-defined clusters based on PolyA were observed with distinctive clinical and immunological phenotypes. CONCLUSIONS: This proof-of-concept study indicates that ADs can be classified according to PolyA. PolyA should be considered in all studies dealing with ADs, including epidemiological, genetic, and clinical trials.

Noncovalent Assembly and Catalytic Activity of Hybrid Materials Based on Pd Complexes Adsorbed on Multiwalled Carbon Nanotubes, Graphene, and Graphene Nanoplatelets.

Green catalysts with excellent performance in Cu-free Sonogashira coupling reactions can be prepared by the supramolecular decoration of graphene surfaces with Pd(II) complexes. Here we report the synthesis, characterization, and catalytic properties of new catalysts obtained by the surface decoration of multiwalled carbon nanotubes (MWCNTs), graphene (G), and graphene nanoplatelets (GNPTs) with Pd(II) complexes of tetraaza-macrocyclic ligands bearing one or two anchor functionalities. The decoration of these carbon surfaces takes place under environmentally friendly conditions (water, room temperature, aerobic) in two steps: (i) π-π stacking attachment of the ligand via electron-poor anchor group 6-amino-3,4-dihydro-3-methyl-5-nitroso-4-oxo-pyrimidine and (ii) Pd(II) coordination from PdCl42-. Ligands are more efficiently adsorbed on the flat surfaces of G and GNPTs than on the curved surfaces of MWCNTs. All catalysts work very efficiently under mild conditions (50 °C, aerobic, 7 h), giving a similar high yield (90% or greater) in the coupling of iodobenzene with phenylacetylene to form diphenylacetylene in one catalytic cycle, but catalysts based on G and GNPTs (especially on GNPTs) provide greater catalytic efficiency in reuse (four cycles). The study also revealed that the active centers of the ligand-Pd type decorating the support surfaces are much more efficient than the Pd(0) and PdCl42- centers sharing the same surfaces. All of the results allow a better understanding of the structural factors to be controlled in order to obtain an optimal efficiency from similar catalysts based on graphene supports.

The role of education on Cancer amenable mortality among non-Hispanic blacks & non-Hispanic whites in the United States (1989-2018).

BACKGROUND: Cancer mortality in the U.S. has fallen in recent decades; however, individuals with lower levels of education experienced a smaller decline than more highly educated individuals. This analysis aimed to measure the influence of education lower than a high school diploma, on cancer amenable mortality among Non-Hispanic Whites (NHW) and Non-Hispanic Blacks (NHB) in the U.S. from 1989 to 2018. METHODS: We analyzed data from 8.2 million death certificates of men and women who died from cancer between 1989 and 2018. We examined 5-year and calendar period intervals, as well as annual percent changes (APC). APC was adjusted for each combination of sex, educational level, and race categories (8 models) to separate the general trend from the effects of age. RESULTS: Our study demonstrated an increasing mortality gap between the least and the most educated NHW and NHB males and females who died from all cancers combined and for most other cancer types included in this study. The gap between the least and the most educated was broader among NHW males and females than among NHB males and females, respectively, for most malignancies. CONCLUSIONS: In summary, we reported an increasing gap in the age-adjusted cancer mortality among the most and the least educated NHW and NHB between 25 and 74 years of age. We demonstrated that although NHB exhibited the greatest age-adjusted mortality rates for most cancer locations, the gap between the most and the least educated was shown for NHW.

Machine learning research towards combating COVID-19: Virus detection, spread prevention, and medical assistance.

COVID-19 was first discovered in December 2019 and has continued to rapidly spread across countries worldwide infecting thousands and millions of people. The virus is deadly, and people who are suffering from prior illnesses or are older than the age of 60 are at a higher risk of mortality. Medicine and Healthcare industries have surged towards finding a cure, and different policies have been amended to mitigate the spread of the virus. While Machine Learning (ML) methods have been widely used in other domains, there is now a high demand for ML-aided diagnosis systems for screening, tracking, predicting the spread of COVID-19 and finding a cure against it. In this paper, we present a journey of what role ML has played so far in combating the virus, mainly looking at it from a screening, forecasting, and vaccine perspective. We present a comprehensive survey of the ML algorithms and models that can be used on this expedition and aid with battling the virus.

Promoting exercise, reducing sedentarism or both for diabetes prevention: The "Seguimiento Universidad De Navarra" (SUN) cohort.

BACKGROUND AND AIM: Both physical activity (PA) and sedentary behaviors have demonstrated independent associations with the development of type 2 diabetes mellitus (T2DM). However, the combination of both, has been less explored. We aimed to compare the associations of PA-only versus the simultaneous effect of PA and sedentary behaviors on T2DM in a Mediterranean cohort. METHODS AND RESULTS: Participants (n = 19,524) initially free of T2DM from the SUN Project were followed-up for a median of 10.4 years. Analyses were conducted in 2018. PA and sedentary parameters (TV viewing time and sitting time) were assessed through a validated questionnaire. The amount of each PA was expressed in METs-h/wk. After that, a previously developed 8-item active + sedentary lifestyle score was computed. T2DM was defined according to ADA criteria. To adjust for potential confounders, Cox regression models were adjusted. Among 19,524 participants, 175 cases of new-onset T2DM were observed during follow-up. After multivariable adjustment, higher PA was strongly inversely associated with T2DM, showing highly significant differences between extreme quartiles (HR = 0.51; 95% CI 0.32-0.79 p for trend<0.001). When considering not only PA, but also the more comprehensive active + sedentary lifestyle combined score, even stronger differences were found between the lowest and the highest categories (HR = 0.40; 95%CI 0.20-0.80; p for trend<0.001). CONCLUSION: Sedentary lifestyles, in addition to PA patterns, should be included in the assessment of T2DM risk. Promoting PA should be coupled with the avoidance of a sedentary lifestyle to lower the risk of T2DM.

Pelvic floor: vaginal or caesarean delivery? A review of systematic reviews.

INTRODUCTION AND HYPOTHESIS: In recent years the number of caesarean sections has increased worldwide for different reasons. to review the scientific evidence relating to the impact of the type of delivery on pelvic floor disorders (PFDs) such as urinary and faecal incontinence and pelvic organ prolapse. METHODS: A review of systematic reviews and meta-analysis, drawn from the following databases: MEDLINE (via PubMed), Scopus, Web of Science, The Cochrane Library and LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud/Latin American and Caribbean Health Sciences Literature) prior to January 2019. The directives of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used in assessing article quality. RESULTS: Eleven systematic reviews were evaluated, 6 of which found a significantly decreased risk of urinary incontinence associated with caesarean section and 3 meta-analyses showed a significant reduction in POP for caesarean section, compared with vaginal delivery. Of 5 reviews that examined delivery type and faecal incontinence, only one indicated a lower incidence of faecal incontinence associated with caesarean delivery. However, most of the studies included in these reviews were not adjusted for important confounding factors and the risk of PFDs was not analysed by category of caesarean delivery (elective or urgent). CONCLUSION: When compared with vaginal delivery, caesarean is associated with a reduced risk of urinary incontinence and pelvic organ prolapse. These results should be interpreted with caution and do not help to address the question of whether elective caesareans are protective of the maternal pelvic floor.

Areas of Interest and Attitudes Toward Antiobesity Drugs: Thematic and Quantitative Analysis Using Twitter.

BACKGROUND: Antiobesity drugs are prescribed for the treatment of obesity in conjunction with healthy eating, physical activity, and behavior modification. However, poor adherence rates have been reported. Attitudes or beliefs toward medications are important to ascertain because they may be associated with patient behavior. The analysis of tweets has become a tool for health research. OBJECTIVE: The aim of this study is to investigate the content and key metrics of tweets referring to antiobesity drugs. METHODS: In this observational quantitative and qualitative study, we focused on tweets containing hashtags related to antiobesity drugs between September 20, 2019, and October 31, 2019. Tweets were first classified according to whether they described medical issues or not. Tweets with medical content were classified according to the topic they referred to: side effects, efficacy, or adherence. We additionally rated it as positive or negative. Furthermore, we classified any links included within a tweet as either scientific or nonscientific. Finally, the number of retweets generated as well as the dissemination and sentiment score obtained by the antiobesity drugs analyzed were also measured. RESULTS: We analyzed a total of 2045 tweets, 945 of which were excluded according to the criteria of the study. Finally, 320 out of the 1,100 remaining tweets were also excluded because their content, although related to drugs for obesity treatment, did not address the efficacy, side effects, or adherence to medication. Liraglutide and semaglutide accumulated the majority of tweets (682/780, 87.4%). Notably, the content that generated the highest frequency of tweets was related to treatment efficacy, with liraglutide-, semaglutide-, and lorcaserin-related tweets accumulating the highest proportion of positive consideration. We found the highest percentages of tweets with scientific links in those posts related to liraglutide and semaglutide. Semaglutide-related tweets obtained the highest probability of likes and were the most disseminated within the Twitter community. CONCLUSIONS: This analysis of posted tweets related to antiobesity drugs shows that the interest, beliefs, and experiences regarding these pharmacological treatments are heterogeneous. The efficacy of the treatment accounts for the majority of interest among Twitter users.

Differences in the clinical management of women and men after detection of a solitary pulmonary nodule in clinical practice.

OBJECTIVES: To explore differences in the clinical management of men and women in the 5 years after detecting a solitary pulmonary nodule (SPN) by chest radiograph or CT in routine clinical practice. METHODS: We followed up 545 men and 347 women with an SPN detected by chest radiograph or CT in a retrospective cohort of 25,422 individuals undergoing routine thoracic imaging in 2010-2011. We compared the frequency of each management strategy (no further test, immediate intervention or follow up) according to sex by means of chi-squared. We estimated the relative risk of women versus men of having been followed up instead of an immediate intervention using multivariate logistic regression. We compared by sex the time between detection of the nodule and lung cancer diagnosis, the time between diagnosis and death by means of Mann-Whitney U test and the cumulative effective dose of radiation in each management strategy by means of t test. RESULTS: Women were more likely than men to have follow-up rather than immediate intervention (aRR = 1.8, CI 1.3-2.7, p = 0.002), particularly in those who underwent CT (aRR = 4.2, CI 1.9-9.3, p < 0.001). The median time between SPN detection and lung cancer diagnosis was higher in women (4.2 months, interquartile range (IQR) 5.1) than in men (1.5 months, IQR 16.2). The mean cumulative effective dose was 21.3 mSv, 19.4 mSv in men and 23.9mv in women (p = 0.023). CONCLUSIONS: Our results could reflect decisions based on a greater suspicion of lung cancer in men. The incidental detection of SPNs is increasing, and it is necessary to establish clear strategies aimed to reduce variability in their management according to patient's sex. KEY POINTS: • After incidental finding of SPN, women were less likely to receive an immediate intervention. • Accumulative radiation was higher in women than in men. • Our results could reflect decisions based on a greater suspicion of lung cancer in men.

Untangling the association between prostate-specific antigen and diabetes: a systematic review and meta-analysis.

Objectives: Several studies have shown an inverse association between diabetes mellitus and prostate cancer (PCa). Some researchers suggest that this relationship is due to reduced PCa detection in diabetics due to lower prostate-specific antigen (PSA) levels compared to non-diabetics. Our objective is to analyze the impact of diabetes on PSA in asymptomatic men without known prostate pathology and without prior prostate intervention. Methods: We searched Medline (via PubMed), Embase and Scopus. We included studies that reported the relationship between serum PSA levels and diabetes or diabetes treatment in asymptomatic adult men without known prostate pathology, and without prior prostate intervention. Pooled mean differences were compared between diabetics and non-diabetics. Results: Of 2,392 screened abstracts, thirteen studies met the inclusion criteria and 8 (62%) reported appropriate measures that could be included in a meta-analysis. Eleven (85%) examined the influence of diabetes on PSA levels and 8 (62%) evaluated the influence of diabetes treatments on PSA levels. Overall diabetics had a significantly lower PSA level compared to non-diabetics (mean difference: -0.07 ng/mL; 95% CI -0.10, -0.04). Conclusions: Diabetes and related factors (such as disease duration, severity and treatment) were significantly associated with lower PSA levels among asymptomatic men, yet differences were small and are unlikely to influence PCa detection in a screening setting.

Direct capillary electrophoresis analysis of basic and acidic drugs from microliter volume of human body fluids after liquid-phase microextraction through nano-fibrous membrane.

In the present work, a disposable microextraction device with a polyamide 6 nano-fibrous supported liquid membrane (SLM) is employed for the pretreatment of minute volumes of biological fluids. The device is placed in a sample vial for an at-line coupling to a commercial capillary electrophoresis instrument with UV-Vis detection (CE-UV) and injections are performed fully automatically from the free acceptor solution above the SLM with no contact between the capillary and the membrane. Up to 4-fold enrichment of model basic (nortriptyline, haloperidol, loperamide, and papaverine) and acidic (ibuprofen, naproxen, ketoprofen, and diclofenac) drugs is achieved by optimizing the ratio of the donor to the acceptor solution volumes (16 to 4 µL, respectively). The actual setup enables SLM extractions from less than a drop of sample and is suitable for pretreatment of scarce human body fluids. Two unique methods are reported for efficient clean-up and enrichment of the basic and acidic drugs from capillary blood (formed as dried blood spot), serum, and urine samples, which enable their determination at therapeutic and/or toxic levels. The hyphenation of the SLM extraction with CE-UV analysis provides good repeatability (RSD, 2.4-14.9%), linearity (r2, 0.988-1.000), sensitivity (LOD, 0.017-0.22 mg L-1), and extraction recovery (ER, 20-106%) at short extraction times (10 min) and with minimum consumption of samples and reagents. Graphical abstract.

How many and which physicians? A comparative study of the evolution of the supply of physicians and specialist training in Brazil and Spain.

BACKGROUND: In the face of the medical workforce shortage, several countries have promoted the opening of medical schools and the expansion of undergraduate and specialization education in medicine. Few studies have compared the characteristics and effects of expanding the supply of general practitioners and specialist physicians between countries. Brazil and Spain, two countries with distinct historical processes and socioeconomic scenarios, yet both with universal public health systems and common aspects in training and medical work, have registered a significant increase in the number of physicians and can be used to understand the challenges of strategic planning for the medical workforce. METHODS: This study provides a descriptive approach using longitudinal data from official databases in Brazil and Spain from 1998 to 2017. Among the comparable indicators, the absolute numbers of physicians, the population size, and the physician's ratio by inhabitants were used. The number of medical schools and undergraduate places in public and private institutions, the supply of residency training posts, and the number of medical specialists and medical residents per 100 000 inhabitants were also used to compare both countries. Seventeen medical specialties with the highest number of specialists and comparability between the two countries were selected for further comparison. RESULTS: Due to the opening of medical schools, the density of physicians per 1 000 inhabitants grew by 28% in Spain and 51% in Brazil between 1998 and 2017. In that period, Spain and Brazil increased the supply of annual undergraduate places by 60% and 137%, respectively. There is a predominance of private institutions providing available undergraduate places, and the supply of medical residency posts is smaller than the contingent of medical graduates/general practitioners each year. CONCLUSION: Both countries have similar specialist densities in cardiology, dermatology, and neurosurgery specialties. However, family medicine and community in Spain has 91.27 specialists per 100 000 inhabitants, while in Brazil, the density is only 2.64. The comparative study indicated the complexity of the countries' decisions on increasing the medical supply of general practitioners and specialist physicians. Research and planning policies on the medical workforce must be aligned with the actual health needs of populations and health systems.

The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort.

BACKGROUND: Frailty in older adults is a common multidimensional clinical entity, a state of vulnerability to stressors that increases the risk of adverse outcomes such as functional decline, institutionalization or death. The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. METHODS: A prospective cohort study was conducted in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). The cohort was made up of 616 individuals. Data collection included a baseline multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, and the Central Registry of Catalonia for mortality. A prognostic index for a HC and NH at 8 years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine-Gray regression models were used. RESULTS: At baseline, mean age was 76.4 years and 55.5% were women. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of Daily Living, number of prescriptions, and the presence of social risk. CONCLUSIONS: Prognostic models based on comprehensive geriatric assessments can predict the need for the commencement of HC and NH admission in community-dwelling older adults. Our findings underline the necessity to measure functional capacity, mobility, number of prescriptions, and social aspects of older adults in primary healthcare centers. In such a setting they can be offered longitudinal holistic assessments so as to benefit from preventive actions in order to remain independent in the community for as long as possible.

Eating Disorder Awareness Campaigns: Thematic and Quantitative Analysis Using Twitter.

BACKGROUND: Health awareness initiatives are frequent but their efficacy is a matter of controversy. We have investigated the effect of the Eating Disorder Awareness Week and Wake Up Weight Watchers campaigns on Twitter. OBJECTIVE: We aimed to examine whether the Eating Disorder Awareness Week and Wake Up Weight Watchers initiatives increased the volume and dissemination of Twitter conversations related to eating disorders and investigate what content generates the most interest on Twitter. METHODS: Over a period of 12 consecutive days in 2018, we collected tweets containing the hashtag #wakeupweightwatchers and hashtags related to Eating Disorder Awareness Week (#eatingdisorderawarenessweek, #eatingdisorderawareness, or #EDAW), with the hashtag #eatingdisorder as a control. The content of each tweet was rated as medical, testimony, help offer, awareness, pro-ana, or anti-ana. We analyzed the number of retweets and favorites generated, as well as the potential reach and impact of the hashtags and the characteristics of contributors. RESULTS: The number of #wakeupweightwatchers tweets was higher than that of Eating Disorder Awareness Week and #eatingdisorder tweets (3900, 2056, and 1057, respectively). The content of tweets was significantly different between the hashtags analyzed (P<.001). Medical content was lower in the awareness campaigns. Awareness and help offer content were lower in #wakeupweightwatchers tweets. Retweet and favorite ratios were highest in #wakeupweightwatchers tweets. Eating Disorder Awareness Week achieved the highest impact, and very influential contributors participated. CONCLUSIONS: Both awareness campaigns effectively promoted tweeting about eating disorders. The majority of tweets did not promote any specific preventive or help-seeking behaviors.

Depression and excess mortality in the elderly living in low- and middle-income countries: Systematic review and meta-analysis.

OBJECTIVE: To investigate the association between depression and mortality in the elderly living in low- and middle-income countries. METHODS: A systematic review and meta-analysis was performed. We searched in five electronic databases for observational studies investigating the association between mortality and depression. Two reviewers worked independently to select articles, extract data, and assess study quality. RESULTS: A total of 10 studies including 13 828 participants (2402 depressed and 11 426 nondepressed) from six countries (Brazil, four articles; China, two articles; Botswana, India, South Africa, and South Korea, one article) were included. The overall unadjusted relative risk (RR) of mortality in depressed relative to nondepressed participants was 1.62 (95% CI, 1.39-1.88; P < 0.001), with high heterogeneity (I2  = 66%; 95% CI, 33-83; P < 0.005). After adjustment for publication bias, the overall RR decreased to 1.60 (95% CI, 1.37-1.86; P < 0.001). No significant differences were observed between subgroups except those defined by study quality. The high-quality studies had a pooled RR of 1.48 (95% CI, 1.32-1.67; P < 0.001), while the low-quality studies resulted had a pooled RR of 1.82 (95% CI, 1.25-2.65; P < 0.005). CONCLUSIONS: Depression is associated with excess mortality in the elderly living in low- and middle-income countries. In addition, this excess mortality does not differ substantially from that found in high-income countries. This suggests environmental factors occurring in low- and middle-income countries might not have a direct association with the excess mortality in the depressed elderly.

Areas of Interest and Stigmatic Attitudes of the General Public in Five Relevant Medical Conditions: Thematic and Quantitative Analysis Using Twitter.

BACKGROUND: Twitter is an indicator of real-world performance, thus, is an appropriate arena to assess the social consideration and attitudes toward psychosis. OBJECTIVE: The aim of this study was to perform a mixed-methods study of the content and key metrics of tweets referring to psychosis in comparison with tweets referring to control diseases (breast cancer, diabetes, Alzheimer, and human immunodeficiency virus). METHODS: Each tweet's content was rated as nonmedical (NM: testimonies, health care products, solidarity or awareness and misuse) or medical (M: included a reference to the illness's diagnosis, treatment, prognosis, or prevention). NM tweets were classified as positive or pejorative. We assessed the appropriateness of the medical content. The number of retweets generated and the potential reach and impact of the hashtags analyzed was also investigated. RESULTS: We analyzed a total of 15,443 tweets: 8055 classified as NM and 7287 as M. Psychosis-related tweets (PRT) had a significantly higher frequency of misuse 33.3% (212/636) vs 1.15% (853/7419; P<.001) and pejorative content 36.2% (231/636) vs 11.33% (840/7419; P<.001). The medical content of the PRT showed the highest scientific appropriateness 100% (391/391) vs 93.66% (6030/6439; P<.001) and had a higher frequency of content about disease prevention. The potential reach and impact of the tweets related to psychosis were low, but they had a high retweet-to-tweet ratio. CONCLUSIONS: We show a reduced number and a different pattern of contents in tweets about psychosis compared with control diseases. PRT showed a predominance of nonmedical content with increased frequencies of misuse and pejorative tone. However, the medical content of PRT showed high scientific appropriateness aimed toward prevention.

Toward Creating a Subsurface Camera.

In this article, the framework and architecture of a Subsurface Camera (SAMERA) are envisioned and described for the first time. A SAMERA is a geophysical sensor network that senses and processes geophysical sensor signals and computes a 3D subsurface image in situ in real time. The basic mechanism is geophysical waves propagating/reflected/refracted through subsurface enter a network of geophysical sensors, where a 2D or 3D image is computed and recorded; control software may be connected to this network to allow view of the 2D/3D image and adjustment of settings such as resolution, filter, regularization, and other algorithm parameters. System prototypes based on seismic imaging have been designed. SAMERA technology is envisioned as a game changer to transform many subsurface survey and monitoring applications, including oil/gas exploration and production, subsurface infrastructures and homeland security, wastewater and CO2 sequestration, and earthquake and volcano hazard monitoring. System prototypes for seismic imaging have been built. Creating SAMERA requires interdisciplinary collaboration and the transformation of sensor networks, signal processing, distributed computing, and geophysical imaging.