Assessing the effect of environmental and socio-economic factors on skin melanoma incidence: an island-wide spatial study in Gran Canaria (Spain), 2007-2018.

INTRODUCTION: Skin melanoma incidence has risen in the last decades becoming a major public health problem in many regions of the world. Geographic variation of rates is not well understood. PURPOSE: To assess the spatial distribution of skin melanoma in Gran Canaria Island (Canary Islands, Spain) and to evaluate the role of environmental, socio-economic, and demographic factors in this distribution. METHODS: We performed a small-area study with disease mapping at the census-tract level (CT) in Gran Canaria between 2007 and 2018. After testing for spatial autocorrelation, we integrated individual-level health data with census-based demographic and socio-economic indicators, and satellite-based environmental data. Finally, we assessed the role of demographic, socio-economic and environmental factors on skin melanoma incidence using a Bayesian analytical framework, with options for non-spatial and spatial random effects. RESULTS: 1058 patients were diagnosed with invasive skin melanoma in the study period and geolocated to a CT (number of CT in Gran Canaria = 565). We found evidence of global spatial autocorrelation in skin melanoma incidence (Moran's I = 0.09, pseudo p-value = 0.001). A few hotspots were detected, fundamentally in urban northern tracts. A radial pattern of high values was also observed in selected ravines with historical isolation. Multivariable conditional autoregressive models identified urbanicity, percent of females, and a high socio-economic status as risk factors for disease. Solar radiation did not show a significant role. CONCLUSION: Urbanicity and a high socio-economic status were identified as the main risk factors for skin melanoma. These associations might reflect differential melanoma susceptibilities or be explained by health inequalities in detection. This study also uncovered high-risk areas in particular ravines. Future targeted research in these regions might help better understand the role of genetic and toxic factors in melanoma pathogenesis.

Neural Networks-Based On-Site Dermatologic Diagnosis through Hyperspectral Epidermal Images.

Cancer originates from the uncontrolled growth of healthy cells into a mass. Chromophores, such as hemoglobin and melanin, characterize skin spectral properties, allowing the classification of lesions into different etiologies. Hyperspectral imaging systems gather skin-reflected and transmitted light into several wavelength ranges of the electromagnetic spectrum, enabling potential skin-lesion differentiation through machine learning algorithms. Challenged by data availability and tiny inter and intra-tumoral variability, here we introduce a pipeline based on deep neural networks to diagnose hyperspectral skin cancer images, targeting a handheld device equipped with a low-power graphical processing unit for routine clinical testing. Enhanced by data augmentation, transfer learning, and hyperparameter tuning, the proposed architectures aim to meet and improve the well-known dermatologist-level detection performances concerning both benign-malignant and multiclass classification tasks, being able to diagnose hyperspectral data considering real-time constraints. Experiments show 87% sensitivity and 88% specificity for benign-malignant classification and specificity above 80% for the multiclass scenario. AUC measurements suggest classification performance improvement above 90% with adequate thresholding. Concerning binary segmentation, we measured skin DICE and IOU higher than 90%. We estimated 1.21 s, at most, consuming 5 Watts to segment the epidermal lesions with the U-Net++ architecture, meeting the imposed time limit. Hence, we can diagnose hyperspectral epidermal data assuming real-time constraints.

The incidence of skin melanoma in Gran Canaria (Canary Islands, Spain) is lower than expected in Southern Europe despite high-risk environmental conditions: an island-wide cross-sectional study.

BACKGROUND: The Canary Islands are a leading European touristic destination. The ultraviolet index (UVI) in the region is the highest in Spain, and similar to indexes registered in Australia and New Zealand, which hold the highest incidence of skin melanoma worldwide. Yet according to cancer registry data, the incidence in the Canary Islands in the late 1990s was the lowest in Spain (among the lowest in Europe) and about six times lower than in New Zealand. PURPOSE: To analyze the incidence rates of skin melanoma in Gran Canaria island between 2007 and 2018. METHODS: The study was based in the two centres of the Canary Islands' Healthcare Service centralizing melanoma care in Gran Canaria. We analyzed crude and age-standardized (ASR) incidence rates of invasive cutaneous melanoma for the period 2007-2018 following the inclusion criteria of the International Agency for Research on Cancer (IARC). Clinical and histological characteristics of melanoma patients were assessed. RESULTS: A total of 1058 patients were included. The incidence rates obtained matched the latest available Canary Islands' cancer registry data, confirming its reliability (ASR, Segi-Doll world standard population: 6.4 cases per 100,000 habitants for 2008-2012). The incidence was also below the latest IARC predictions for Southern Europe (GLOBOCAN 2018). Histological characteristics of patients were similar to other Southern European series. CONCLUSIONS: The incidence of skin melanoma in Gran Canaria is unexpectedly low for a Southern European population exposed to such a high UVI. Further research in the Canary Islands could provide insight into a better understanding of melanoma pathogenesis.

Curve-Based Classification Approach for Hyperspectral Dermatologic Data Processing.

This paper shows new contributions in the detection of skin cancer, where we present the use of a customized hyperspectral system that captures images in the spectral range from 450 to 950 nm. By choosing a 7 × 7 sub-image of each channel in the hyperspectral image (HSI) and then taking the mean and standard deviation of these sub-images, we were able to make fits of the resulting curves. These fitted curves had certain characteristics, which then served as a basis of classification. The most distinct fit was for the melanoma pigmented skin lesions (PSLs), which is also the most aggressive malignant cancer. Furthermore, we were able to classify the other PSLs in malignant and benign classes. This gives us a rather complete classification method for PSLs with a novel perspective of the classification procedure by exploiting the variability of each channel in the HSI.

Oral health-related quality of life in the LGBTIQ+ population: a cross-sectional study.

The aim of this cross-sectional study was to investigate the associations between oral health-related quality of life (OHRQoL) and socioeconomic and demographic variables, suicidal ideation, self-perception of oral health, and experiences of dental care in the Brazilian adult LGBTIQ+ population. A sample of 464 participants completed self-administered online questionnaires and provided information for OHRQoL assessment, using the OHIP-14 instrument at three hierarchical levels of explanatory variables: LGBTIQ+ identities; socioeconomic and demographic data and existential suffering; and self-perception of oral health and experience of dental care. The collected data were fitted to hierarchical multiple logistic regression models, in which the associations between each independent variable with the OHIP-14 prevalence outcome were analyzed. The OHIP-14-prevalence index showed that 33.2% of the participants answered 'frequently' or 'always', and the highest frequencies were obtained for the psychological discomfort (27.8%), psychological disability (18.3%), and physical pain (17.5%) domains. According to the adjusted final model, LGBTIQ+ individuals who were more likely to have their OHRQoL affected were those who were indifferent (OR=3.21; 95% CI: 1.26-8.20), dissatisfied (OR=10.45; 95% CI: 3.86-28.26), or very dissatisfied (OR=53.93; 95% CI: 12.12-239.93) with their oral health status, and also those who had or have difficulty accessing dental treatment (OR=2.06; 95% CI: 1.24-3.41) (p<0.05). It may be concluded that the OHRQoL of the investigated Brazilian LGBTIQ+ population showed associations with individual aspects and with access to dental services.

Quantification of p-phenylenediamine and 2-hydroxy-1,4-naphthoquinone in henna tattoos.

BACKGROUND: Very few studies are available in which the components of henna products used by tattoo artists have been analysed. OBJECTIVE: The aim of this study was to quantify the amounts of lawsone (2-hydroxy-1,4-naphthoquinone, the active ingredient in henna) and p-phenylenediamine (PPD) in products used by tattoo artists and in commercial henna preparations used as hair dyes or to create temporary tattoos. METHODS: We used high-performance liquid chromatography to detect and quantify lawsone and PPD concentrations in three products used by henna tattoo artists, 11 commercially available henna preparations, and a batch of henna leaves (Lawsonia inermis). RESULTS: The henna leaves contained 1.85-1.87% lawsone. Only one of the three preparations used by tattoo artists contained lawsone (0.21-0.35%), and all three were adulterated with PPD (1-64%). Of the 11 commercial henna preparations analysed, nine contained lawsone (1-2%) and two contained PPD (2% and 12%). CONCLUSIONS: Products purporting to be henna, but that in fact contain no henna, are being offered. Moreover, these products may contain PPD, which is associated with health risks, especially severe allergic reactions.

Isolation and Molecular Characterization of Two Novel Lytic Bacteriophages for the Biocontrol of Escherichia coli in Uterine Infections: In Vitro and Ex Vivo Preliminary Studies in Veterinary Medicine.

E. coli is one of the etiological agents responsible for pyometra in female dogs, with conventional treatment involving ovariohysterectomy. Here, we report the isolation and full characterization of two novel lytic phages, viz. vB_EcoM_Uniso11 (ph0011) and vB_EcoM_Uniso21 (ph0021). Both phages belong to the order Caudovirales and present myovirus-like morphotypes, with phage ph0011 being classified as Myoviridae genus Asteriusvirus and phage ph0021 being classified as Myoviridae genus Tequatrovirus, based on their complete genome sequences. The 348,288 bp phage ph0011 and 165,222 bp phage ph0021 genomes do not encode toxins, integrases or antimicrobial resistance genes neither depolymerases related sequences. Both phages were shown to be effective against at least twelve E. coli clinical isolates in in vitro antibacterial activity assays. Based on their features, both phages have potential for controlling pyometra infections caused by E. coli. Phage ph0011 (reduction of 4.24 log CFU/mL) was more effective than phage ph0021 (reduction of 1.90 log CFU/mL) after 12 h of incubation at MOI 1000. As a cocktail, the two phages were highly effective in reducing the bacterial load (reduction of 5.57 log CFU/mL) at MOI 100, after 12 h of treatment. Both phages were structurally and functionally stabilized in vaginal egg formulations.

Non-Invasive Skin Cancer Diagnosis Using Hyperspectral Imaging for In-Situ Clinical Support.

Skin cancer is one of the most common forms of cancer worldwide and its early detection its key to achieve an effective treatment of the lesion. Commonly, skin cancer diagnosis is based on dermatologist expertise and pathological assessment of biopsies. Although there are diagnosis aid systems based on morphological processing algorithms using conventional imaging, currently, these systems have reached their limit and are not able to outperform dermatologists. In this sense, hyperspectral (HS) imaging (HSI) arises as a new non-invasive technology able to facilitate the detection and classification of pigmented skin lesions (PSLs), employing the spectral properties of the captured sample within and beyond the human eye capabilities. This paper presents a research carried out to develop a dermatological acquisition system based on HSI, employing 125 spectral bands captured between 450 and 950 nm. A database composed of 76 HS PSL images from 61 patients was obtained and labeled and classified into benign and malignant classes. A processing framework is proposed for the automatic identification and classification of the PSL based on a combination of unsupervised and supervised algorithms. Sensitivity and specificity results of 87.5% and 100%, respectively, were obtained in the discrimination of malignant and benign PSLs. This preliminary study demonstrates, as a proof-of-concept, the potential of HSI technology to assist dermatologists in the discrimination of benign and malignant PSLs during clinical routine practice using a real-time and non-invasive hand-held device.

Microscopical methods promote the understanding of the integument biology of Rhinella ornata.

In Rhinella ornata, the integument of different body regions was investigated using low-vacuum scanning electron and light microscopy through histochemical and immunohistochemical methods, and revealed the basic structure found in other anurans. Keratinocytes formed the keratinized squamous stratified epithelium, and flask cells occurred among the epidermal superficial layer. Just below the epidermis, the dermis was subdivided into a spongious dermis and a compact dermis. Mixed and granular glands were located in the spongious dermis, and myoepithelial cells surrounded their secretory portions. The Eberth-Katschenko (EK) layer occurred as basophilic areas between the spongious and compact dermis and throughout the spongious dermis. A series of alternating layers of bundles of collagenous fibers characterized the compact dermis, being firmly attached to a thin hypodermis. Regarding the morphological features, each integument region revealed distinct structural aspects. The dorsal integument was rougher than ventral, having conical tubercles and spines upon the verrucae. In the ventral and subgular regions, the slightly elevations are visualized, tubercles were absent but some spines occurred. The pelvic integument had a non-keratinized epidermis with an irregular profile and small poorly developed elevations. In addition, the EK layer was absent, and the presence of numerous blood vessels suggests its participation in water absorption and distribution. In the parotoid gland, the epidermis was similar to the dorsal integument; except that the reticular dermis was present, and contained three exocrine glandular types. Expression of cytokeratin was evident in the basal and intermediary layer, but absent in the cornified layer. Flask cells showed strong cytokeratin labeling. Consequently, the integument had the basic morphology, but exhibits regional characteristics, which may be related to the physiology of each surface.

Oral health-related quality of life in the LGBTIQ+ population: a cross-sectional study

Abstract The aim of this cross-sectional study was to investigate the associations between oral health-related quality of life (OHRQoL) and socioeconomic and demographic variables, suicidal ideation, self-perception of oral health, and experiences of dental care in the Brazilian adult LGBTIQ+ population. A sample of 464 participants completed self-administered online questionnaires and provided information for OHRQoL assessment, using the OHIP-14 instrument at three hierarchical levels of explanatory variables: LGBTIQ+ identities; socioeconomic and demographic data and existential suffering; and self-perception of oral health and experience of dental care. The collected data were fitted to hierarchical multiple logistic regression models, in which the associations between each independent variable with the OHIP-14 prevalence outcome were analyzed. The OHIP-14-prevalence index showed that 33.2% of the participants answered 'frequently' or 'always', and the highest frequencies were obtained for the psychological discomfort (27.8%), psychological disability (18.3%), and physical pain (17.5%) domains. According to the adjusted final model, LGBTIQ+ individuals who were more likely to have their OHRQoL affected were those who were indifferent (OR=3.21; 95% CI: 1.26-8.20), dissatisfied (OR=10.45; 95% CI: 3.86-28.26), or very dissatisfied (OR=53.93; 95% CI: 12.12-239.93) with their oral health status, and also those who had or have difficulty accessing dental treatment (OR=2.06; 95% CI: 1.24-3.41) (p<0.05). It may be concluded that the OHRQoL of the investigated Brazilian LGBTIQ+ population showed associations with individual aspects and with access to dental services.

Tethered 3-min all-out test did not predict the traditional critical force parameters in inexperienced swimmers.

BACKGROUND: Critical power model can be performed in tethered swimming (i.e. critical force model). Although critical force can be used to prescribe aerobic training, its determination depends on at least three exhaustive efforts in altered days. In this context, previously studies have demonstrate that critical power model can be estimated by a single 3-min all-out test (3MT), which was not investigated in swimming yet. Thus, the aim of this study was to compare the parameters obtained during the tethered swimming 3MT to those obtained during the traditional critical force model. METHODS: Seven swimmers (four female and three male) underwent a tethered swimming 3MT and three exhaustive efforts to determine the traditional critical force parameters (i.e. critical force [CF] and anaerobic impulse capacity [AIC]). RESULTS: The critical force (CF3-MIN) and force-time integral above the CF3-MIN (AIC3-MIN) determined during the tethered 3MT were not different to CF and AIC, respectively (P value >0.55). However, these parameters were not correlated (P value >0.45). In addition, we verified large limits of agreement between CF3MIN and CF (±19.7 N), which was also observed between AIC3MIN and AIC (±0.84 Log[N·min]). CONCLUSIONS: These findings demonstrated that tethered 3MTs should not be used to predict traditional critical force parameters, at least when the swimmers are inexperienced in long tethered all-out efforts.

Correlações entre os componentes da aptidão física de idosos participantes de grupos de convivência / Correlations between the components of physical fitness of elderly companionship groups

A avaliação da aptidão física contribui para prescrição clínica do exercício. O objetivo foi avaliar e correlacionar componentes da aptidão física. Estudo transversal com 331 idosos de grupos de convivência (≥ 60 anos), estratificados por sexo, faixa etária, avaliados pela bateria Testes de Aptidão Física para Idosos (TAFI). Resultados foram analisados pela ANOVA One Way, correlação de Pearson, Regressão simples e múltipla. Em idosas a força de membros inferiores (MMII) apresentou correlação com flexibilidade e explicou agilidade/equilíbrio. Força de membros superiores (MMSS) associou-se com flexibilidade de MMSS, 12% da flexibilidade pode explicar a força de MMSS. No sexo masculino, força de MMII correlacionou-se com resistência aeróbica e explicou 55% da resistência aeróbica. Conclui-se que no sexo feminino com aumento da idade, a força/resistência dos MMII associou-se de maneira crescente com agilidade/equilíbrio dinâmico, já no sexo masculino a força dos MMII associou-se com a resistência aeróbica. (AU)

The evaluation of physical fitness contributes to clinical prescription of the exercise. The objective was to evaluate and correlate components of physical fitness. Cross-sectional study with 331 elderly (≥ 60 years) stratified by gender, age groups, evaluated by Senior Fitness Test. Results were analyzed by One Way ANOVA, Pearson's correlation and multiple and simple regression. In women, strength/resistance of lower limbs (LL) presented correlation with flexibility of LL and explained agility/balance. Strength of upper limbs (UL) was associated with UL flexibility, 12% of flexibility can explain the strength/resistance of UL. In men, strength/resistance of LL showed correlation with aerobic resistance and explained 55% of aerobic resistance. We concluded that older women showed strength/endurance of LL increasingly associated with agility/dynamic balance, while in male, strength/endurance of the LL was related to aerobic endurance. (AU)

MC1R gene variants and sporadic malignant melanoma susceptibility in the Canary Islands population.

Several MC1R variants are associated with increased risk of malignant melanoma (MM) in a variety of populations. We aim to examine the influence of the MC1R variants (RHC: D84E, R151C, R160W; NRHC: V60L, R163Q and the synonymous polymorphism T314T) on the MM risk in a population from the Canary Islands. Overall, 1,046 Caucasian individuals were included in the study. A thousand of them were genotyped for MC1R variants: 509 were sporadic MM patients and 491 were healthy control subjects from general population. The analysis was adjusted for age, sex, hair colour, eye colour, skin phototype and ancestry. We found that carriers of the R151C and R163Q variants were at an increased risk for melanoma OR 2.76 (1.59-4.78) and OR 5.62 (2.54-12.42), respectively. The risk of carrying RHC variants was 3.04 (1.90-4.86). Current study confirms the increased MM risk for R151C carriers. It also supports the association between R163Q variant and MM risk in the population on the Canary Islands, as opposed to reported on northern populations. These results highlight the importance of the sample population selection in this kind of studies.

Kinetic and kinematic analysis of gait during transport of the wheeled backpack in schoolchildren from 7 to 10 years of age / Análise cinética e cinemática da marcha durante o transporte da mochila com rodas em escolares de 7 a 10 anos de idade

Introduction: The overweight of school backpacks results in an increase of mechanical load in the locomotive apparatus of the students during the locomotion. Objective: Analyze and compare kinetic and kinematic temporal/spatial variables during gait and transport of backpacks with wheels (10% body weight of load) in schoolchildren aged 7 to 10 years. Methods: Ten healthy children (7.8 ± 1.6 years) participate in two experimental conditions, first condition involved the gait in the plane, and the second condition the backpack transport provided with wheels in the plane (10% body weight) occurred. Results: Soil reaction forces in force platform did not show any differences between the conditions. The similarities indicate that wheeled backpacks do not require time changes or application of forces to perform the task when compared to the unladen gait in the plane. The kinematics of the ankle, knee and pelvis remained unchanged. Conclusion: The use of 10% BW of load in the backpack during transport was not influenced gait.

Introdução: A sobrecarga em mochilas escolares pode resultar em aumento de carga mecânica sobre o aparelho locomotuvo de estudantes durante a marcha. Objetivo: Analisar e comparar as variáveis temporais/espaciais cinéticas e cinemáticas durante a marcha e o transporte de mochilas com rodas (10% peso corporal (PC)) em escolares de 7 a 10 anos. Métodos: Dez crianças, saudáveis (7.8 ± 1.6 anos) participaram de duas condições experimentais, sendo a primeira envolvendo a marcha, enquanto a segunda ocorreu o transporte de mochila provida de rodas, 10% PC. Resultados: As forças de reação do solo não apresentaram diferenças entre as duas condições. Porém, mostrou-se que mochilas com rodas não alteram aplicação de forças para execução da tarefa quando comparadas a marcha sem carga na locomoção. A cinemática do tornozelo, do joelho e da pelve permaneceram inalteradas. Conclusão: O uso de rodas na mochila para o transporte de carga de 10% PC não influenciou no padrão de marcha aplicado durante a marcha no plano.