Phenomena of Intussusceptive Angiogenesis and Intussusceptive Lymphangiogenesis in Blood and Lymphatic Vessel Tumors.

Intussusceptive angiogenesis (IA) and intussusceptive lymphangiogenesis (IL) play a key role in the growth and morphogenesis of vessels. However, there are very few studies in this regard in vessel tumors (VTs). Our objective is to assess the presence, characteristics, and possible mechanisms of the formation of intussusceptive structures in a broad spectrum of VTs. For this purpose, examples of benign and malignant blood and lymphatic VTs were studied via conventional procedures, semithin sections, and immunochemistry and immunofluorescence microscopy. The results demonstrated intussusceptive structures (pillars, meshes, and folds) in benign (lobular capillary hemangioma or pyogenic granuloma, intravascular papillary endothelial hyperplasia or Masson tumor, sinusoidal hemangioma, cavernous hemangioma, glomeruloid hemangioma, angiolipoma, and lymphangiomas), low-grade malignancy (retiform hemangioendothelioma and Dabska tumor), and malignant (angiosarcoma and Kaposi sarcoma) VTs. Intussusceptive structures showed an endothelial cover and a core formed of connective tissue components and presented findings suggesting an origin through vessel loops, endothelialized thrombus, interendothelial bridges, and/or splitting and fusion, and conditioned VT morphology. In conclusion, the findings support the participation of IA and IL, in association with sprouting angiogenesis, in VTs, and therefore in their growth and morphogenesis, which is of pathophysiological interest and lays the groundwork for in-depth molecular studies with therapeutic purposes.

Mad activisms in mental health: a integrative review. / Activismos locos en salud mental: una revisión integrativa.

The following text presents the results of a integrative review whose purpose was to identify and analyze the production of academic literature on mad activism in the field of mental health and its link with the notions of disability and neurodiversity. From searches conducted in May 2023 in the Web of Science, Scopus, and PubMed databases, 52 articles were selected, and thematic content analysis strategies were applied. The results account for various articulations between the concepts addressed, establishing a critical look at the biomedical model in mental health. In the forms of mad activism, the human rights approach, the fight against stigma and its influence on the reform processes of the mental health system become relevant. On the other hand, a framework of social justice, identity policies and practices of mutual support from the community are established. As a whole, they emphasize methodological innovations and an intersectional perspective on the production of knowledge. It is concluded that it is possible to situate madness as a field of constitution of a political actor and epistemic subject. Based on this, possible lines of research on mad activisms in Latin America are formulated.

Se exponen los resultados de una revisión integrativa que tuvo como propósito identificar y analizar la producción de literatura académica sobre el activismo loco en el campo de la salud mental y su vinculación con las nociones de discapacidad y neurodiversidad. De las búsquedas realizadas en mayo del 2023, en las bases de datos Web of Science, Scopus y PubMed, se seleccionaron 52 artículos, y se aplicaron estrategias de análisis de contenido temático. Los resultados dan cuenta de diversas articulaciones entre los conceptos abordados, estableciendo una mirada crítica hacia el modelo biomédico en salud mental. En las formas de activismo loco, adquieren relevancia el enfoque de derechos humanos, la lucha contra el estigma y su influencia en los procesos de reforma al sistema de salud mental. Por otra parte, establecen un marco de justicia social, políticas de identidad y prácticas de apoyo mutuo desde la comunidad. En su conjunto, enfatizan innovaciones metodológicas y una mirada interseccional en la producción de conocimientos. Se concluye que es posible situar la locura como campo de constitución de un actor político y sujeto epistémico. Con base en ello, se formulan posibles líneas de investigación sobre los activismos locos en América Latina.

"Trabajar como loco": significados sobre la inclusión laboral de la comunidad de trabajo "Locooperativa"

El presente artículo indaga en los significados sobre la inclusión laboral de la comunidad de trabajo "Locooperativa", iniciativa de trabajo asociativo en salud mental de Santiago de Chile. Mediante un abordaje cualitativo se discuten las aproximaciones críticas de sus participantes sobre los mecanismos de adscripción y naturalización del trabajo asalariado, estableciendo un rechazo a las exigencias de la producción capitalista como formas de "trabajo cuerdo". Frente a ello, los(as) integrantes de la "Locooperativa" promueven el derecho a "trabajar como loco", una concepción alternativa del trabajo asociado a una participación proactiva, creativa y horizontal en el ámbito laboral, con base en la valoración de la democracia económica, la solidaridad y el trabajo colectivo. Se concluye que estas orientaciones implican un cuestionamiento hacia las formas tradicionales de inclusión laboral, configurando nuevos sentidos en el mundo del trabajo desde el cooperativismo en la sociedad contemporánea.

Este artigo investiga os significados da inclusão laboral na comunidade de trabalho "Locooperativa", uma iniciativa de trabalho associativo em saúde mental em Santiago, Chile. Por meio de abordagem qualitativa, se discute as aproximações críticas dos seus participantes sobre os mecanismos de atribuição e naturalização do trabalho assalariado, estabelecendo uma rejeição às exigências da produção capitalista como formas de "trabalho são". Diante disso, os integrantes da "Locooperativa" promovem o direito de "trabalhar como um louco", uma concepção alternativa de trabalho associada à participação proativa, criativa e horizontal no local de trabalho, baseada na valorização da democracia econômica, da solidariedade e do trabalho coletivo. . Conclui-se que essas orientações implicam um questionamento das formas tradicionais de inclusão laboral, configurando novos significados no mundo do trabalho a partir do cooperativismo na sociedade contemporânea.

This article investigates the meanings of labor inclusion in the "Locooperativa" work community, an initiative for associative work in mental health in Santiago, Chile. Through a qualitative approach, the critical approaches of its participants on the mechanisms of ascription and naturalization of salaried work are addressed, establishing a rejection of the demands of capitalist production as forms of "sane work." Faced with this, the members of the "Locooperativa" promote the right to "work like crazy", an alternative conception of work associated with proactive, creative and horizontal participation in the workplace, based on the valuation of Economic democracy, solidarity and collective work. It is concluded that these orientations imply a questioning of traditional forms of labor inclusion, configuring new meanings in the world of work from cooperativism in contemporary society.

First record of Colpodidium caudatum (Ciliophora, Colpodidiidae) in Europe.

The present study documents the discovery of the first European population of Colpodidium caudatum (Ciliophora, Colpodidiidae) in a water drain in a school playground in Manzanares (Ciudad Real, Spain). This species has been documented on every continent except Antarctica and Europe, until now. The ciliate was isolated from wet run-off soil collected from the water drain and was grown in semi-permanent cultures in the laboratory. The infraciliature of the ciliate was revealed using silver carbonate impregnation and cell measurements were taken from living and silver-impregnated specimens. A comparative analysis of published data from various populations of C. caudatum across the globe showed high intraspecific morphological variability in this species. To differentiate between species within the Colpodidium genus, a dichotomous key is presented. This investigation shows that C. caudatum is a ciliate that is found all over the world and is particularly associated with terrestrial habitats that are periodically flooded.

The Green Surgical Block 4.0: Automation of the operating theatre's climate conditions through a real-time patient-flow solution.

The energy consumed by surgery units constitutes a staggering part of the overall healthcare carbon footprint. Partly due to the demanding climate conditions necessitated by operating theatres (OTs), energy is also wasted because of poorly managed heating, ventilation and air-conditioning systems (HVACs) that consume up to 57% of the total energy used in a hospital. With their goal of optimising OTs' performance and reducing patient waiting lists, heads of surgery units worldwide do not dare to risk cancelling scheduled surgery because of problems with the OT environment conditions (ie temperature, humidity, pressure). Current solutions are monolithic, complex and completely disconnected from healthcare logic, failing to take into account the idiosyncrasy of hospitals. This article presents an innovation that uses real-time patient flow data to automate and optimise the OT's climate conditions.

Multicentre Prospective Study Analysing Relevant Factors Related to Marginal Bone Loss: A Two-Year Evolution.

INTRODUCTION: The aim of this prospective descriptive study was to analyse the possible variables associated with marginal bone loss in rehabilitated implants (Proclinic S.A.U, Zaragoza, Spain) two years after their prosthetic loading. MATERIALS AND METHODS: Three clinical centres collaborated for a period of two years after the prosthetic rehabilitation of the implants (Proclinic S.A.U, Zaragoza, Spain), in which marginal bone loss and the possible associated variables were evaluated. The collection form comprised different variables throughout different stages of the implant procedure, from implant insertion to the subsequent prosthetic rehabilitation, over a two-year period. Data of the patients and implant characteristics were studied. Statistical analysis was performed with SPSS for qualitative (univariate logistic regressions, Chi2 test, and Haberman's corrected standardised residuals) and quantitative variables (Kolmogorov-Smirnov test). RESULTS: The total study sample consisted of 218 implants (Proclinic S.A.U, Zaragoza, Spain). The sample presented a frequency of 99 men (45.4%) and 119 women (54.6%). The mean age of the patients among the reported cases was 58.56 ± 10.12 years. A statistically significant association was found between marginal bone loss 2 years after prosthetic rehabilitation placement and several variables, including age (under 55 years, 0.25 mm ± 0.56; 55-64 years, 0.74 mm ± 0.57; over 65 years, 0.63 mm ± 0.55; p < 0.0001), gender (female, 0.74 mm ± 0.61; male, 0.34 mm ± 0.51; p < 0.0001), bone quality (D1, 0.75 mm ± 0.62; D2, 0.43 mm ± 0.57; D3, 0.65 mm ± 0.60; p < 0.01), implant diameter (up to 4 mm, 0.49 mm ± 0.58; more than 4 mm, 1.21 mm ± 0.30; p < 0.0001), prosthetic connection type (direct to implant, 0.11 mm ± 0.58; transepithelial straight, 0.67 mm ± 0.57; transepithelial angled, 0.33 mm ± 0.25; p < 0001), implant model (internal conical, 0.17 mm ± 0.24; external conical, 0.48 mm ± 0.61; external cylindrical, 1.12 mm ± 0.32; p < 0.0001), prosthetic restoration type (full denture, 0.59 mm ± 0.59; partial denture, 0.50 mm ± 0.85; unitary crown, 0.08 mm ± 0.19; p < 0.05), and insertion torque (>35 N/cm, 0.53 mm ± 0.58; <35 N/cm, 1.04 mm ± 0.63; p < 0.01). CONCLUSIONS: At 2 years, marginal bone loss following prosthetic rehabilitation was shown to be influenced by multiple factors. Correct implantological planning is of vital importance for successful rehabilitation.

Effects of long-term individual housing of middle-aged female Octodon degus on spatial learning and memory in the Barnes maze task.

Introduction: Prolonged social isolation is a form of passive chronic stress that has consequences on human and animal behavior. The present study was undertaken to elucidate whether the long-term isolation would precipitate age-related changes in anxiety and spatial learning and memory in degus. Methods: We investigated the effects of long-term social isolation on anxiety levels in the light-dark test, and spatial orientation abilities in the Barnes maze. Middle-aged female Octodon degus were allocated to either group-housed (3 animals per cage) or individually-housed for 5 months. Results: Under this experimental condition, there were no significant group differences in the anxiety level tested in the light-dark test and in the motivation to escape from the Barnes maze. There were no significant differences in cortisol levels between individually- and group-housed animals. On the last acquisition training day of spatial learning, individually- housed animals had a significantly higher number of correct responses and a smaller number of reference and working memory errors than the group-housed animals. In addition, isolated animals showed a tendency for reference and working memory impairment on the retention trial, while group-housed degus showed improvement in these parameters. Discussion and conclusion: The present study indicates that prolonged social isolation during adulthood in female degus has a dual effect on spatial orientation. Specifically, it results in a significant improvement in acquisition skills but a slight impairment in memory retention. The obtained cognitive changes were not accompanied by modification in anxiety and cortisol levels.

Telocytes/CD34+ Stromal Cells in the Normal, Hyperplastic, and Adenomatous Human Parathyroid Glands.

Telocytes/CD34+ stromal cells (TCs/CD34+ SCs) have been studied in numerous organs and tissues, but their presence and characteristics in the parathyroid glands have not been explored. Using immunological and ultrastructural procedures, we assess the location, arrangement, and behavior of TCs/CD34+ SCs in normal human parathyroids, during their development and in their most frequent pathologic conditions. In normal parathyroids, TCs/CD34+ SCs show a small somatic body and long thin processes with a moniliform aspect, form labyrinthine systems, connect other neighboring TCs/CD34+ SCs, vessels, adipocytes, and parenchymal cells directly or by extracellular vesicles, and associate with collagen I. TCs/CD34+ SCs and collagen I are absent around vessels and adipocytes within parenchymal clusters. In developing parathyroids, TCs/CD34+ SC surround small parenchymal nests and adipocytes. In hyperplastic parathyroids, TCs/CD34+ SCs are prominent in some thickened internodular septa and surround small extraglandular parenchymal cell nests. TCs/CD34+ SCs are present in delimiting regions with compressed parathyroids and their capsule in adenomas but absent in most adenomatous tissue. In conclusion, TCs/CD34+ SCs are an important cellular component in the human parathyroid stroma, except around vessels within parenchymal nests. They show typical characteristics, including those of connecting cells, are present in developing parathyroids, and participate in the most frequent parathyroid pathology, including hyperplastic and adenomatous parathyroids.

Delimiting CD34+ Stromal Cells/Telocytes Are Resident Mesenchymal Cells That Participate in Neovessel Formation in Skin Kaposi Sarcoma.

Kaposi sarcoma (KS) is an angioproliferative lesion in which two main KS cell sources are currently sustained: endothelial cells (ECs) and mesenchymal/stromal cells. Our objective is to establish the tissue location, characteristics and transdifferentiation steps to the KS cells of the latter. For this purpose, we studied specimens of 49 cases of cutaneous KS using immunochemistry and confocal and electron microscopy. The results showed that delimiting CD34+ stromal cells/Telocytes (CD34+SCs/TCs) in the external layer of the pre-existing blood vessels and around skin appendages form small convergent lumens, express markers for ECs of blood and lymphatic vessels, share ultrastructural characteristics with ECs and participate in the origin of two main types of neovessels, the evolution of which gives rise to lymphangiomatous or spindle-cell patterns-the substrate of the main KS histopathological variants. Intraluminal folds and pillars (papillae) are formed in the neovessels, which suggests they increase by vessel splitting (intussusceptive angiogenesis and intussusceptive lymphangiogenesis). In conclusion, delimiting CD34+SCs/TCs are mesenchymal/stromal cells that can transdifferentiate into KS ECs, participating in the formation of two types of neovessels. The subsequent growth of the latter involves intussusceptive mechanisms, originating several KS variants. These findings are of histogenic, clinical and therapeutic interest.

Intussusceptive angiogenesis facilitated by microthrombosis has an important example in angiolipoma. An ultrastructural and immunohistochemical study.

The microvasculature of angiolipoma frequently presents thrombi. Our objectives are to assess whether intussusceptive angiogenesis (IA) participates in vasculature formation in non-infiltrating angiolipoma and, if so, to explore how thrombi are involved in the IA process. For this purpose, we studied angiolipoma specimens (n: 52), using immunohistochemistry, and confocal and electron microscopy. The results showed the presence of folds and pillars, hallmarks of IA, dividing the vessel lumen. Folds showed a cover formed by reoriented endothelial cells from the vessel wall, or from newly formed folds, and a core initially formed by thrombus fragments (clot components as transitional core), which was replaced by extracellular matrix and invaginating pericytes establishing numerous peg-and-socket junctions with endothelial cells (mature core). A condensed plasmatic electron-dense material surrounded and connected folds and pillars with each other and with the vascular wall, which suggests a clot role in fold/pillar arrangement. In conclusion, we contribute to IA participation in capillary network formation in angiolipoma and the immunohistochemical and ultrastructural events by which microthrombosis facilitates IA. Therefore, in addition to the histogenesis of angiolipoma, we provide an easily obtainable substrate for future studies on clot component action in IA, of clinical and therapeutic interest.

Activismos locos en salud mental: una revisión integrativa / Mad activisms in mental health: a integrative review

RESUMEN Se exponen los resultados de una revisión integrativa que tuvo como propósito identificar y analizar la producción de literatura académica sobre el activismo loco en el campo de la salud mental y su vinculación con las nociones de discapacidad y neurodiversidad. De las búsquedas realizadas en mayo del 2023, en las bases de datos Web of Science, Scopus y PubMed, se seleccionaron 52 artículos, y se aplicaron estrategias de análisis de contenido temático. Los resultados dan cuenta de diversas articulaciones entre los conceptos abordados, estableciendo una mirada crítica hacia el modelo biomédico en salud mental. En las formas de activismo loco, adquieren relevancia el enfoque de derechos humanos, la lucha contra el estigma y su influencia en los procesos de reforma al sistema de salud mental. Por otra parte, establecen un marco de justicia social, políticas de identidad y prácticas de apoyo mutuo desde la comunidad. En su conjunto, enfatizan innovaciones metodológicas y una mirada interseccional en la producción de conocimientos. Se concluye que es posible situar la locura como campo de constitución de un actor político y sujeto epistémico. Con base en ello, se formulan posibles líneas de investigación sobre los activismos locos en América Latina.

ABSTRACT The following text presents the results of a integrative review whose purpose was to identify and analyze the production of academic literature on mad activism in the field of mental health and its link with the notions of disability and neurodiversity. From searches conducted in May 2023 in the Web of Science, Scopus, and PubMed databases, 52 articles were selected, and thematic content analysis strategies were applied. The results account for various articulations between the concepts addressed, establishing a critical look at the biomedical model in mental health. In the forms of mad activism, the human rights approach, the fight against stigma and its influence on the reform processes of the mental health system become relevant. On the other hand, a framework of social justice, identity policies and practices of mutual support from the community are established. As a whole, they emphasize methodological innovations and an intersectional perspective on the production of knowledge. It is concluded that it is possible to situate madness as a field of constitution of a political actor and epistemic subject. Based on this, possible lines of research on mad activisms in Latin America are formulated.

Case report: Diagnosis and intervention of a non-24-h sleep-wake disorder in a sighted child with a psychiatric disorder.

Circadian rhythm sleep-wake disorders (CRSWD) are sleep dysfunctions related to circadian functioning. They are characterized by symptoms of insomnia or excessive sleepiness that occur because the intrinsic circadian pacemaker is not entrained to a 24-h light/dark cycle. Affected individuals with a free-running disorder or hypernycthemeral syndrome (N24SWD) have a longer sleep-wake cycle that produces a sleep pattern that typically delays each day. The disorder is seen in 70% of blind people, and among people with healthy vision, it is a rare pathology. Among sighted cases, 80% are young men and 28% have a psychiatric disorder. The patient was a 14-year-old boy with a psychiatric pathology diagnosed with a PANDAS syndrome (pediatric autoimmune neuropsychiatric disorders associated with streptococci), a sudden acute and debilitating onset of intense anxiety and mood lability accompanied by obsessive compulsive-like issues and/or tics, in association with a streptococcal A infection that occurs immediately prior to the symptoms. As a comorbidity, he exhibited severe insomnia due to an irregular sleep pattern that strongly delayed his sleep schedule day to day. It affected his daily routines, as he was not going to school, and aggravated, furthermore, the psychiatric symptoms. He was referred for sleep consultation, where the case was explored by ambulatory circadian monitoring (ACM) using the novel system Kronowise® (Chronolab, University of Murcia) and diagnosed with a non-24-h sleep-wake disorder (N24SWD). The first treatment approach for the patient was focused on improving symptoms during the acute infection and psychiatric symptoms. Additionally, sleep pathology was treated by light therapy and melatonin. After 8 months and different trials, it was possible to establish a treatment to normalize the symptoms and fix his sleep rhythm in a normal schedule as well as to reduce anxious symptoms during the day. The association of PANDAS and N24SWD has not previously been reported in the literature.

Locura sin Estado: prácticas de apoyo mutuo y activismo comunitario en salud mental de la organización "Autogestión Libre-mente" / Loucura sem Estado: práticas de apoio mútuo e ativismo comunitário em saúde mental da organização "Autogestión Libre-mente" / Madness without State: practices of Mutual Support and Community Activism in Mental Health of the Organization "Autogestión Libre-mente"

Resumen El presente texto se aproxima a la invención de otros modos de bienestar y cuidado en torno a necesidades no cubiertas por el sistema de salud mental. A través de una aproximación etnográfica, se estudian las prácticas de activismo comunitario y apoyo mutuo del colectivo "Autogestión Libre-mente", agrupación de Santiago de Chile que realiza reuniones semanales bajo los principios de la asociación voluntaria y la ayuda entre pares. Los valores de horizontalidad y reciprocidad como ejes del trabajo compartido implican un fuerte contenido político y un sentido "terapéutico", sin que éste último sea la finalidad explícita de las actividades que organizan. En torno a esta experiencia se reflexiona sobre las implicancias de la metodología asamblearia y la democracia deliberativa en la configuración de nuevas formas de salud mental desde la comunidad en el escenario contemporáneo. (AU)

Resumo Este texto aborda a invenção de outras formas de bem-estar e cuidado em torno de necessidades não cobertos pelo sistema de saúde mental. Através de uma abordagem etnográfica, são estudadas as práticas de ativismo comunitário e apoio mútuo do coletivo " Autogestión Libre-mente ", um grupo de Santiago do Chile que realiza reuniões semanais sob os princípios de associação voluntária e apoio entre pares. Os valores da horizontalidade e da reciprocidade como eixos de trabalho partilhado implicam um forte teor político e um sentido "terapêutico", sem que este seja o propósito explícito das atividades que organizam. Em torno dessa experiência, refletimos sobre as implicações da metodologia assembleia e da democracia deliberativa na configuração de novas formas de saúde mental da comunidade no cenário contemporâneo. (AU)

Abstract This text approaches the invention of other ways of well-being and care around needs not covered by the mental health system. Through an ethnographic approach, the practices of community activism and mutual support of the collective "Autogestión Libre-mente" are studied, a group from Santiago de Chile that holds weekly meetings under the principles of voluntary association and peer support. The values of horizontality and reciprocity as axes of shared work imply a strong political content and a "therapeutic" sense, without the latter being the explicit purpose of the activities they organize. Around this experience we reflect on the implications of the assembly methodology and deliberative democracy in the configuration of new forms of mental health from the community in the contemporary scenario. (AU)

Phase Response Curve to Light under Ambulatory Conditions: A Pilot Study for Potential Application to Daylight Saving Time Transitions.

Several studies have investigated the relationship between daylight saving time (DST) and sleep alterations, psychiatric disorders, cardiovascular events and traffic accidents. However, very few have monitored participants while maintaining their usual lifestyle before and after DST. Considering that DST transitions modify human behavior and, therefore, people's light exposure patterns, the aim of this study was to investigate the potential effects of DST on circadian variables, considering sleep and, for the first time, the human phase response curve to light. To accomplish this, eight healthy adults (33 ± 11 years old, mean ± SD) were recruited to monitor multivariable circadian markers and light exposure by means of a wearable ambulatory monitoring device: Kronowise®. The following night phase markers were calculated: midpoints of the five consecutive hours of maximum wrist temperature (TM5) and the five consecutive hours of minimum time in movement (TL5), sleep onset and offset, as well as sleep duration and light intensity. TM5 for wrist temperature was set as circadian time 0 h, and the balance between advances and delays considering the phase response curve to light was calculated individually before and after both DST transitions. To assess internal desynchronization, the possible shift in TM5 for wrist temperature and TL5 for time in movement were compared. Our results indicate that the transition to DST seems to force the circadian system to produce a phase advance to adapt to the new time. However, the synchronizing signals provided by natural and personal light exposure are not in line with such an advance, which results in internal desynchronization and the need for longer synchronization times. On the contrary, the transition back to ST, which implies a phase delay, is characterized by a faster adaptation and maintenance of internal synchronization, despite the fact that exposure to natural light would favor a phase advance. Considering the pilot nature of this study, further research is needed with higher sample sizes.

Texture Analysis in MRI of the Knee for an Early Diagnosis of Osteoarthritis.

Osteoarthritis is one of the most disabling diseases in developed countries. Its etiology is not firmly established, and the diagnosis is made by observing radiographs, assigning a degree of severity based on the information displayed. For this reason, the diagnosis is usually late and determined by the subjectivity of the doctor, which implies a restriction of the treatment. Magnetic resonance imaging (MRI) has allowed us to see in greater detail the alterations produced in soft joint structures. In this work, biomarkers for an early diagnosis of knee osteoarthritis have been developed by means of textures analysis on MRI. For this purpose, 50 subjects underwent T1-weighted MR image acquisitions: 25 controls and 25 diagnosed with knee osteoarthritis between grades I and III. Six regions were segmented on these images, corresponding to the femorotibial cartilage, femoral condyles, and tibial plateau. 43 textures were extracted for each region of interest (ROI) employing 5 statistical methods and 5 different predictive models were trained and compared. In addition, a study of the thickness of the cartilage was carried out to make a comparison with the texture analysis. The best result has been obtained using a K-nearest neighbor model with the combination of 33 textures (maximum value of AUC = 0.7684). Furthermore, in the analysis of the cartilage thickness, no statistically significant differences were found. Finally, it is concluded that the texture analysis has great potential for the diagnosis of knee osteoarthritis. Clinical Relevance - The current study establishes a methodology for an early diagnosis of knee osteoarthritis by means of MRI-based texture analysis, in a fast and objective manner.

Surgical block 4.0: a digital intervention based on a real-time location patient-flow solution to support the automation of surgical pathways.

As internet of things (IoT) technologies are increasingly adopted by healthcare and hospitals, new opportunities are emerging to transform patient pathways and achieve efficient delivery of care. This implemented project follows the drivers and requirements of industry 4.0, based on surgical process analysis and optimisation using IoT technology, with the goal of creating '4.0 hospitals'. Our study presents the implementation of a novel IoT application, aiming to give support to multidisciplinary surgical teams through the optimisation of patient pathways to facilitate the surgical process. The implemented solution is based on real-time location systems (RTLS) technology, a subgroup within IoT, and it originated through the hospital needing to address the sudden surge of surgical elective care demand. The solution also enhances patient safety, facilitates quality of care by increasing communication and reduces costs. This IoT tool has facilitated the increase of theatre utilisation from 70.02% to 82.5% in 2 years, which has translated into an increase of surgical activity capacity, with an impact on reducing the waiting list.

Living at the Wrong Time: Effects of Unmatching Official Time in Portugal and Western Spain.

Human circadian rhythmicity is subjected to the internal circadian clock, the sun and social clocks (official time, social/work schedules). The discrepancy among these clocks, as occurs when official time does not match its geographical time zone, may produce circadian disruption. Western Spain (GMT+1/+2) and Portugal (GMT0/+1) share similar longitudes (sun time) but have different official times. This provides a unique opportunity to evaluate the effects of official time on circadian rhythmicity and sleep in elderly and retired populations (with no remunerated duties presumed, although other social commitments may be present) at both locations. Although both populations slept enough for their age (7-8 h), circadian robustness (e.g., interdaily stability, relative amplitude) was greater in Portugal, especially during weekdays, while greater desynchronization (both body temperature vs. motor activity and body temperature vs. light exposure) tended to occur in the Spaniards. Once corrected by GMT0, meals took place later in Spain than in Portugal, especially as the day progresses, and a possible interplay between bed/meal timings and internal desynchronization was found. Our results point to the possible deleterious effect on circadian system robustness when official time is misaligned with its geographical time zone.

Comparison of the Behavior of Perivascular Cells (Pericytes and CD34+ Stromal Cell/Telocytes) in Sprouting and Intussusceptive Angiogenesis.

Perivascular cells in the pericytic microvasculature, pericytes and CD34+ stromal cells/telocytes (CD34+SCs/TCs), have an important role in angiogenesis. We compare the behavior of these cells depending on whether the growth of endothelial cells (ECs) from the pre-existing microvasculature is toward the interstitium with vascular bud and neovessel formation (sprouting angiogenesis) or toward the vascular lumen with intravascular pillar development and vessel division (intussusceptive angiogenesis). Detachment from the vascular wall, mobilization, proliferation, recruitment, and differentiation of pericytes and CD34+SCs/TCs, as well as associated changes in vessel permeability and functionality, and modifications of the extracellular matrix are more intense, longer lasting over time, and with a greater energy cost in sprouting angiogenesis than in intussusceptive angiogenesis, in which some of the aforementioned events do not occur or are compensated for by others (e.g., sparse EC and pericyte proliferation by cell elongation and thinning). The governing mechanisms involve cell-cell contacts (e.g., peg-and-socket junctions between pericytes and ECs), multiple autocrine and paracrine signaling molecules and pathways (e.g., vascular endothelial growth factor, platelet-derived growth factor, angiopoietins, transforming growth factor B, ephrins, semaphorins, and metalloproteinases), and other factors (e.g., hypoxia, vascular patency, and blood flow). Pericytes participate in vessel development, stabilization, maturation and regression in sprouting angiogenesis, and in interstitial tissue structure formation of the pillar core in intussusceptive angiogenesis. In sprouting angiogenesis, proliferating perivascular CD34+SCs/TCs are an important source of stromal cells during repair through granulation tissue formation and of cancer-associated fibroblasts (CAFs) in tumors. Conversely, CD34+SCs/TCs have less participation as precursor cells in intussusceptive angiogenesis. The dysfunction of these mechanisms is involved in several diseases, including neoplasms, with therapeutic implications.

A comparison of Covid-19 early detection between convolutional neural networks and radiologists.

BACKGROUND: The role of chest radiography in COVID-19 disease has changed since the beginning of the pandemic from a diagnostic tool when microbiological resources were scarce to a different one focused on detecting and monitoring COVID-19 lung involvement. Using chest radiographs, early detection of the disease is still helpful in resource-poor environments. However, the sensitivity of a chest radiograph for diagnosing COVID-19 is modest, even for expert radiologists. In this paper, the performance of a deep learning algorithm on the first clinical encounter is evaluated and compared with a group of radiologists with different years of experience. METHODS: The algorithm uses an ensemble of four deep convolutional networks, Ensemble4Covid, trained to detect COVID-19 on frontal chest radiographs. The algorithm was tested using images from the first clinical encounter of positive and negative cases. Its performance was compared with five radiologists on a smaller test subset of patients. The algorithm's performance was also validated using the public dataset COVIDx. RESULTS: Compared to the consensus of five radiologists, the Ensemble4Covid model achieved an AUC of 0.85, whereas the radiologists achieved an AUC of 0.71. Compared with other state-of-the-art models, the performance of a single model of our ensemble achieved nonsignificant differences in the public dataset COVIDx. CONCLUSION: The results show that the use of images from the first clinical encounter significantly drops the detection performance of COVID-19. The performance of our Ensemble4Covid under these challenging conditions is considerably higher compared to a consensus of five radiologists. Artificial intelligence can be used for the fast diagnosis of COVID-19.