Vision-Based Module for Herding with a Sheepdog Robot.

Livestock farming is assisted more and more by technological solutions, such as robots. One of the main problems for shepherds is the control and care of livestock in areas difficult to access where grazing animals are attacked by predators such as the Iberian wolf in the northwest of the Iberian Peninsula. In this paper, we propose a system to automatically generate benchmarks of animal images of different species from iNaturalist API, which is coupled with a vision-based module that allows us to automatically detect predators and distinguish them from other animals. We tested multiple existing object detection models to determine the best one in terms of efficiency and speed, as it is conceived for real-time environments. YOLOv5m achieves the best performance as it can process 64 FPS, achieving an mAP (with IoU of 50%) of 99.49% for a dataset where wolves (predator) or dogs (prey) have to be detected and distinguished. This result meets the requirements of pasture-based livestock farms.

Individualized Homeopathy for Depression in Climacteric Women: Comments on the Retraction by PLoS ONE.

In April 2020 PLoS ONE retracted an original clinical research article, published in 2015, in which we demonstrated that individualized homeopathic treatment improves depression symptoms in climacteric women. The original assessment of this study was carried out by an expert in psychiatry (depression research) with close to 35 years' experience in the field of mental health. During post-publication discussions, no serious breaches of scientific procedure or misconduct were even insinuated. Our team answered all "points of concern", raised by the current PLoS ONE editors, in extensive detail. All these were potential limitations of our study, which would usually be addressed by one of several appropriate post-publication actions, ranging from discussion of the concern within a systematic review, through to correcting the study itself by adding a correction notice. Therefore, in the interests of transparency and accuracy, a summary of the most relevant points is provided, so that a fair-minded reader can objectively form a clear opinion.

Efficacy of Homeopathy in Addition to a Multidisciplinary Intervention for Overweight or Obesity in Mexican Adolescents: Study Protocol for a Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Current recommendations for treating obesity in adolescence include a comprehensive approach (nutritional, behavioral, and exercise). Calcarea carbonica ostrearum (CCO) is a homeopathic medicine usually prescribed in obese individuals, but its effects on weight and body fat are not completely known. OBJECTIVE: The aim of this study will be to evaluate the efficacy of homeopathic CCO, in addition to a multidisciplinary intervention (diet, motivational support, and exercise program), on body fat and weight in obese adolescents. METHODS/DESIGN: A randomized, placebo-controlled, double-blind, parallel-group, superiority trial with 3-month study duration will be undertaken. The study will be conducted in a public research hospital in Mexico City, Hospital Juárez de México, in the outpatient services of homeopathy and sports medicine. Eighty non-diabetic adolescents, 12 to 19 years old, who are overweight or obese, will be included. The primary outcome: change in body fat percentage at week 12. The secondary outcomes: change in mean total weight, total body mass index, fat mass index, waist-hip ratio, lean muscle mass, fasting glucose, insulin, insulin resistance, lipid profile, score of Center for Epidemiologic Studies Depression Scale Revised (CESD-R) and score of Screen for Child Anxiety-Related Emotional Disorders (SCARED) at week 12. Efficacy data will be analyzed in the intention-to-treat sample. To determine the difference in the outcomes between groups at baseline and week 12, data will be analyzed using Student's t-test. DISCUSSION: This is the first randomized controlled trial aimed to determine the fat-reducing efficacy in obese adolescents of a homeopathic medicine, CCO, given in addition to a multidisciplinary intervention, compared with placebo plus the same intervention. It is an attempt to support scientific evidence in homeopathy for one of the most common chronic diseases, which causes high mortality due to its complications. CLINICALTRIALS. GOV IDENTIFIER: NCT03945396: https://clinicaltrials.gov/ct2/show/NCT03945396?term=homeopathy+for+obesity+in+Mexican+adolescents&rank=1.

Engineering high-gravity fermentations for ethanol production at elevated temperature with Saccharomyces cerevisiae.

Thermal damage, high osmolarity, and ethanol toxicity in the yeast Saccharomyces cerevisiae limit titer and productivity in fermentation to produce ethanol. We show that long-term adaptive laboratory evolution at 39.5°C generates thermotolerant yeast strains, which increased ethanol yield and productivity by 10% and 70%, in 2% glucose fermentations. From these strains, which also tolerate elevated-osmolarity, we selected a stable one, namely a strain lacking chromosomal duplications. This strain (TTY23) showed reduced mitochondrial metabolism and high proton efflux, and therefore lower ethanol tolerance. This maladaptation was bolstered by reestablishing proton homeostasis through increasing fermentation pH from 5 to 6 and/or adding potassium to the media. This change allowed the TTY23 strain to produce 1.3-1.6 times more ethanol than the parental strain in fermentations at 40°C with glucose concentrations ~300 g/L. Furthermore, ethanol titers and productivities up to 93.1 and 3.87 g·L -1 ·hr -1 were obtained from fermentations with 200 g/L glucose in potassium-containing media at 40°C. Albeit the complexity of cellular responses to heat, ethanol, and high osmolarity, in this study we overcome such limitations by an inverse metabolic engineering approach.

Addition of analysis of KRAS mutation or immunohistochemistry with MUC1 and carcinoembryonic antigen improves the diagnostic performance of fine needle aspiration cytology for the diagnosis of pancreatic carcinoma.

BACKGROUND: Pancreatic adenocarcinoma (PAC) is a health problem because of high lethality, increasing incidence and the absence of an early diagnosis. Biopsy by fine needle aspiration guided by endoscopic ultrasound has allowed obtaining tissue for cytopathological analysis, but there are several problems with their interpretation. We aimed to compare the diagnostic performance of the cytopathological analysis with the addition of either an immunohistochemical (IHC) panel or the KRAS mutation for the diagnosis of PAC. METHODS: We evaluated 62 pancreatic lesions by fine needle aspiration guided by endoscopic ultrasound, applying an IHC panel with mucin (MUC)-1, MUC4, carcinoembryonic antigen (CEA) and p53. All cases also had a KRAS mutation determination. Three cytopathologists blinded to clinical data and the KRAS status reviewed the cytology independently. We calculated diagnostic performances for the cytology alone, cytology+IHC and cytology+KRAS to show the best method to diagnose PAC. RESULTS: From 62 samples, 50 (80.6%) were PAC and 12 benign lesions. The cytopathological analysis correctly interpreted 26 malignant and 12 non-neoplastic cases (sensitivity 52%, specificity 100% and diagnostic accuracy 61.3%). The KRAS mutation was present in 88% of PAC. The cytology+ KRAS mutation increased the sensitivity by 10% and the diagnostic accuracy by 8%. The sensitivity increased by 2% adding either MUC1 or CEA to the cytology, and the diagnostic accuracy by 10 or 18%, respectively. CONCLUSION: The addition of IHC either with CEA or MUC1 improved the diagnostic performance of the cytology alone to diagnose PAC. The cytology + IHC evaluation was superior to the cytology + KRAS mutation to diagnose PAC.

3D Tdoa Problem Solution with Four Receiving Nodes.

Time difference of arrival (TDOA) positioning methods have experienced growing importance over the last few years due to their multiple applications in local positioning systems (LPSs). While five sensors are needed to determine an unequivocal three-dimensional position, systems with four nodes present two different solutions that cannot be discarded according to mathematical standards. In this paper, a new methodology to solve the 3D TDOA problems in a sensor network with four beacons is proposed. A confidence interval, which is defined in this paper as a sphere, is defined to use positioning algorithms with four different nodes. It is proven that the separation between solutions in the four-beacon TDOA problem allows the transformation of the problem into an analogous one in which more receivers are implied due to the geometric properties of the intersection of hyperboloids. The achievement of the distance between solutions needs the application of genetic algorithms in order to find an optimized sensor distribution. Results show that positioning algorithms can be used 96.7% of the time with total security in cases where vehicles travel at less than 25 m/s.

Genetic Algorithm Approach to the 3D Node Localization in TDOA Systems.

Positioning asynchronous architectures based on time measurements are reaching growing importance in Local Positioning Systems (LPS). These architectures have special relevance in precision applications and indoor/outdoor navigation of automatic vehicles such as Automatic Ground Vehicles (AGVs) and Unmanned Aerial Vehicles (UAVs). The positioning error of these systems is conditioned by the algorithms used in the position calculation, the quality of the time measurements, and the sensor deployment of the signal receivers. Once the algorithms have been defined and the method to compute the time measurements has been selected, the only design criteria of the LPS is the distribution of the sensors in the three-dimensional space. This problem has proved to be NP-hard, and therefore a heuristic solution to the problem is recommended. In this paper, a genetic algorithm with the flexibility to be adapted to different scenarios and ground modelings is proposed. This algorithm is used to determine the best node localization in order to reduce the Cramér-Rao Lower Bound (CRLB) with a heteroscedastic noise consideration in each sensor of an Asynchronous Time Difference of Arrival (A-TDOA) architecture. The methodology proposed allows for the optimization of the 3D sensor deployment of a passive A-TDOA architecture, including ground modeling flexibility and heteroscedastic noise consideration with sequential iterations, and reducing the spatial discretization to achieve better results. Results show that optimization with 15% of elitism and a Tournament 3 selection strategy offers the best maximization for the algorithm.

Interlocked Supramolecular Polymers Created by Combination of Halogen- and Hydrogen-Bonding Interactions through Anion-Template Self-Assembly.

We present the synthesis and oxoanion-assembling properties of a monomer with a naphthalene ring as a central core decorated with two arms containing iodotriazolium rings as anion binding sites. Interactions with SO42-, H2PO4-, and HP2O73- anions, via a cooperative mechanism, afforded new supramolecular materials stabilized by a combination of halogen- and hydrogen-bonding interactions. 1H NMR experiments and solid-state structure provided evidence for the initial formation of a supramolecular linear chain, nucleation step, and then two different supramolecular chains are interpenetrated with each other, elongation steps, involving the formation of hydrogen bonds between two oxygens of the anion from one of the chains and the naphthalene inner protons from the other chain. Scanning electron microscopy studies revealed that the morphology of the crystals changed dramatically with the nature of the anion added.

Design and Implementation of a Stereo Vision System on an Innovative 6DOF Single-Edge Machining Device for Tool Tip Localization and Path Correction.

In the current meso cutting technology industry, the demand for more advanced, accurate and cheaper devices capable of creating a wide range surfaces and geometries is rising. To fulfill this demand, an alternative single point cutting device with 6 degrees of freedom (6DOF) was developed. Its main advantage compared to milling has been the need for simpler cutting tools that require an easier development. To obtain accurate and precise geometries, the tool tip must be monitored to compensate its position and make the proper corrections on the computer numerical control (CNC). For this, a stereo vision system was carried out as a different approach to the modern available technologies in the industry. In this paper, the artificial intelligence technologies required for implementing such vision system are explored and discussed. The vision system was compared with commercial measurement software Dino Capture, and a dedicated metrological microscope system TESA V-200GL. Experimental analysis were carried out and results were measured in terms of accuracy. The proposed vision system yielded an error equal to ±3 µm in the measurement.

Response to Individualized Homeopathic Treatment for Depression in Climacteric Women with History of Domestic Violence, Marital Dissatisfaction or Sexual Abuse: Results from the HOMDEP-MENOP Study.

BACKGROUND: Although individualized homeopathic treatment is effective for depression in climacteric women, there is a lack of well-designed studies of its efficacy for depression in battered women or in post-traumatic stress disorder. The aim of this study was to assess the association between individualized homeopathic treatment or fluoxetine and response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. MATERIALS AND METHODS: One hundred and thirty-three Mexican climacteric women with moderate-to-severe depression enrolled in the HOMDEP-MENOP Study (a randomized, placebo-controlled, double-blind, double-dummy, three-arm trial, with a 6-week follow-up study) were evaluated. Domestic violence, marital dissatisfaction and sexual abuse were assessed at baseline. Response to depression treatment was defined by a decrease of 50% or more from baseline score of Hamilton scale. Association between domestic violence, sexual abuse, and marital dissatisfaction and response to depression treatment was analyzed with bivariate analysis in the three groups. Odds ratio (OR) and 95% confidence interval (CI) were calculated. RESULTS: Homeopathy versus placebo had a statistically significant association with response to depression treatment after adjusting for sexual abuse (OR [95% CI]: 11.07 [3.22 to 37.96]), domestic violence (OR [95% CI]: 10.30 [3.24 to 32.76]) and marital dissatisfaction (OR [95% CI]: 8.61 [2.85 to 25.99]). CONCLUSIONS: Individualized homeopathic treatment is associated with response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. Further studies should be conducted to evaluate its efficacy specifically for post-traumatic stress disorder in battered women. CLINICALTRIALS. GOV IDENTIFIER: NCT01635218,: URL: http://clinicaltrials.gov/ct2/show/NCT01635218?term=depression+homeopathy&rank=1.

Is metabolic dysregulation associated with antidepressant response in depressed women in climacteric treated with individualized homeopathic medicines or fluoxetine? The HOMDEP-MENOP Study.

BACKGROUND: Climacteric is associated with both depression and metabolic dysregulation. Scarce evidence suggests that metabolic dysregulation may predict poor response to conventional antidepressants. Response to depression treatment has not been studied in homeopathic medicine. The aim of this study was to investigate the prevalence of metabolic disorders in depressed climacteric women treated with homeopathic medicines, fluoxetine or placebo, and if these alterations have any association with response to depression treatment. METHODS: One hundred and thirty-three Mexican women (40-65 years) with depression, enrolled in the HOMDEP-MENOP study, a randomized, placebo-controlled, double-blind, double-dummy, three-arm trial with a 6 week follow-up, underwent a complete medical history and clinical examination. Metabolic parameters were assessed at baseline. Association between baseline metabolic parameters and response to depression treatment was analyzed with bivariate analysis in the three groups. Odds ratios (OR) with their 95% confidence interval (95% CI) were calculated. Metabolic parameters were considered for inclusion in the logistic regression model if they had a statistically significant relationship with response rate on bivariate analysis at p<0.05 or if they were clinically relevant. RESULTS: Overall combined prevalence (obesity and overweight) was 86.5%; 52.3% had hypertriglyceridemia; 44.7% hypercholesterolemia; 46.7% insulin resistance; and 16% subclinical hypothyroidism. There was no statistically significant association between dyslipidemia, overweight, or insulin resistance and non-response in the homeopathy group [OR (95% CI) 1.57 (0.46-5.32), p=0.467; 0.37 (0.003-1.11), p=0.059; 0.67 (0.16-2.7), p=0.579, respectively]. CONCLUSION: Metabolic dysregulation was not significantly associated with response to depression treatment in depressed climacteric women treated with individualized homeopathic treatment (IHT), fluoxetine or placebo. Due to the high prevalence of metabolic disorders and its relationship with depression in the climacteric, further investigation should be focused on whether individualized prescriptions based on classical homeopathy for depressed climacteric women have an effect on metabolic parameters, and/or if treating the metabolic disorders at the same time could lead to higher response rates. ClinicalTrials.gov Identifier: NCT01635218 URL: http://clinicaltrials.gov/ct2/show/NCT01635218?term=depression+homeopathy&rank=1.

Host-Guest Chemistry: Oxoanion Recognition Based on Combined Charge-Assisted C-H or Halogen-Bonding Interactions and Anion⋠⋠⋠Anion Interactions Mediated by Hydrogen Bonds.

Several bis-triazolium-based receptors have been synthesized and their anion-recognition capabilities have been studied. The central chiral 1,1'-bi-2-naphthol (BINOL) core features either two aryl or ferrocenyl end-capped side arms with central halogen- or hydrogen-bonding triazolium receptors. NMR spectroscopic data indicate the simultaneous occurrence of several charge-assisted aliphatic and heteroaromatic C-H noncovalent interactions and combinations of C-H hydrogen and halogen bonding. The receptors are able to selectively interact with HP2 O7 (3-) , H2 PO4 (-) , and SO4 (2-) anions, and the value of the association constant follows the sequence: HP2 O7 (3-) >SO4 (2-) >H2 PO4 (-) . The ferrocenyl end-capped 7(2+) ⋅2 BF4 (-) receptor allows recognition and differentiation of H2 PO4 (-) and HP2 O7 (3-) anions by using different channels: H2 PO4 (-) is selectively detected through absorption and emission methods and HP2 O7 (3-) by using electrochemical techniques. Significant structural results are the observation of an anion⋅⋅⋅anion interaction in the solid state (2:2 complex, 6(2+) ⋅[H2 P2 O7 ](2-) ), and a short C-I⋅⋅⋅O contact is observed in the structure of the complex [8(2+) ][SO4 ]0.5 [BF4 ].

HDAC7 is a repressor of myeloid genes whose downregulation is required for transdifferentiation of pre-B cells into macrophages.

B lymphopoiesis is the result of several cell-commitment, lineage-choice, and differentiation processes. Every differentiation step is characterized by the activation of a new, lineage-specific, genetic program and the extinction of the previous one. To date, the central role of specific transcription factors in positively regulating these distinct differentiation processes to acquire a B cell-specific genetic program is well established. However, the existence of specific transcriptional repressors responsible for the silencing of lineage inappropriate genes remains elusive. Here we addressed the molecular mechanism behind repression of non-lymphoid genes in B cells. We report that the histone deacetylase HDAC7 was highly expressed in pre-B cells but dramatically down-regulated during cellular lineage conversion to macrophages. Microarray analysis demonstrated that HDAC7 re-expression interfered with the acquisition of the gene transcriptional program characteristic of macrophages during cell transdifferentiation; the presence of HDAC7 blocked the induction of key genes for macrophage function, such as immune, inflammatory, and defense response, cellular response to infections, positive regulation of cytokines production, and phagocytosis. Moreover, re-introduction of HDAC7 suppressed crucial functions of macrophages, such as the ability to phagocytose bacteria and to respond to endotoxin by expressing major pro-inflammatory cytokines. To gain insight into the molecular mechanisms mediating HDAC7 repression in pre-B cells, we undertook co-immunoprecipitation and chromatin immunoprecipitation experimental approaches. We found that HDAC7 specifically interacted with the transcription factor MEF2C in pre-B cells and was recruited to MEF2 binding sites located at the promoters of genes critical for macrophage function. Thus, in B cells HDAC7 is a transcriptional repressor of undesirable genes. Our findings uncover a novel role for HDAC7 in maintaining the identity of a particular cell type by silencing lineage-inappropriate genes.

[Placement of pH-monitoring probes using height-related formulas. Is it an applicable method to adults?]. / Colocación de sondas de pHmetría mediante fórmula relacionada con la talla. ¿Es un método aplicable a los adultos?

INTRODUCTION: Oesophageal pH-monitoring allows the quantification of gastric reflux episodes in patients with gastroesophageal reflux disease (GERD). The accuracy of the test depends on correct positioning of the pH sensor 5 cm above the lower oesophageal sphincter (LES). The most precise manner to locate the LES is through prior determination by oesophageal manometry. However, because this technique is uncomfortable, mathematical formulas tend to be used in children. OBJECTIVES: To evaluate the applicability of paediatric formulas to estimate oesophageal length in adults and their effect on diagnostic accuracy. MATERIAL AND METHODS: A prospective study was carried out in adult patients, in whom the distance between the nasal orifice and the LES was determined by manometry and was compared with the estimated height-related distance calculated by four paediatric formulas (numbered 1 to 4). We also evaluated the relationship between the position of the probe and the percentage of reflux detected in our series of impedance measurements. RESULTS: Formula 1 (9.31 + height in cm × 0.197) was the most accurate (comparison of means -0.38 with 95%CI -0.70/-0.06, P = .019). With this formula, none of the patients had estimation errors of ± 6 cm. With formulas 2, 3 and 4, the percentage of error was 4.4%, 1.5% and 32.0%, respectively. CONCLUSION: Oesophageal length estimation in adults by using formula 1 is acceptable and can be used in adult patients who refuse to undergo prior manometry.

Dual Role of the 1,2,3-Triazolium Ring as a Hydrogen-Bond Donor and Anion-π Receptor in Anion-Recognition Processes.

Several bis(triazolium)-based receptors have been synthesized as chemosensors for anion recognition. The central naphthalene core features two aryltriazolium side-arms. NMR experiments revealed differences between the binding modes of the two triazolium rings: one triazolium ring acts as a hydrogen-bond donor, the other as an anion-π receptor. Receptors 9(2+)⋅2BF4(-) (C6H5), 11(2+)⋅2BF4(-) (4-NO2-C6H4), and 13(2+)⋅2BF(4-) (ferrocenyl) bind HP2O7(3-) anions in a mixed-binding mode that features a combination of hydrogen-bonding and anion-π interactions and results in strong binding. On the other hand, receptor 10(2+)⋅2 BF4(-) (4-CH3O-C6H4) only displays combined Csp2-H/anion-π interactions between the two arms of the receptors and the bound anion rather than triazolium (CH)(+)⋅⋅⋅anion hydrogen bonding. All receptors undergo a downfield shift of the triazolium protons, as well as the inner naphthalene protons, in the presence of H2PO4(-) anions. That suggests that only hydrogen-bonding interactions exist between the binding site and the bound anion, and involve a combination of cationic (triazolium) and neutral (naphthalene) C-H donor interactions. Theoretical calculations relate the electronic structure of the substituent on the aromatic group with the interaction energies and provide a minimum-energy conformation for all the complexes that explains their measured properties.

[Health status of the elderly in primary health care practices using an integral geriatric assessment]. / Estado de salud en el adulto mayor en atención primaria a partir de una valoración geriátrica integral.

OBJECTIVE: To determine the health status of patients 60 years of age or over in Primary Health Care practices using an integral geriatric assessment. DESIGN: Descriptive cross-sectional study. LOCATION: Five primary care units, Instituto Mexicano del Seguro Social; México. PARTICIPANTS: Elderly patient aged 60 years of age or over, who were seen in primary health care practices. Previously signed informed consent was given, with exclusion criteria being non-completion of the integral geriatric assessment. A technical sample of conglomerates and quota was used. MAIN MEASUREMENTS: Medical dimension variables: visual, hearing (Hearing Handicap Inventory for the Elderly), urinary incontinence (Consultation in Incontinence Questionnaire), nutritional condition (Mini Nutritional Assessment), personal clinical history, polypharmacy; mental impairment (Mini Mental State Examination), depression (Yesavaje); functional: basic (Katz) and instrumental (Lawton and Brody) activities of daily living, mobility (Up and go) and social (Social sources scale). The analysis included percentages and confidence intervals. RESULTS: In the medical dimensions; 42.3% with visual impairment, 27.7% hearing, 68.3% urinary incontinence, 37.0% malnutrition, and 54.7% polypharmacy. In the mental dimension: 4.0% severe mental impairment, and 11% depression: functional dimension: 2.0% total dependence of activities of daily living; 14.3% instrumental activities impairment; 29.0% mobility impairment, and 48.0% had moderately deteriorated social resources. CONCLUSION: The health status of the elderly seen in primary health care practices is characterized by independent patients with different levels of alterations in the medical dimensions, low levels in mental alteration, and moderately deteriorated social resources.

Biliary Pancreatitis. Liver Function Tests and Common Biliopancreatic Channel Kinetics--Biliopancreatic Reflux.

OBJECTIVE: To determine the prevalence of biliopancreatic reflux (BPR) in patients with biliary pancreatitis (BP) undergoing elective cholecystectomy with intraoperative cholangiography (IOC) in comparison with a control group of symptomatic cholelithiasis (CG). PATIENTS AND METHODS: Retrospective review of 107 consecutive BP cases. BPR was determined by IOC and liver function tests (LFT) were recorded at admission (A), 48hours, and preoperative examination (P). LFT analysis between A and P were analysed between groups with respect to BPR, time interval to cholecystectomy within the same group and by determination of observed value/maximum normal value ratio (OV/MNV). RESULTS: BPR incidence was 38.3% in BP in comparison with 5% in CG (p=0.0001) it was independent from interval time to cholecystectomy, in contrast with Odditis, suggesting an anatomical condition for CCBP and a functional one for Odditis. LFT analysis showed no differences in relation to BPR incidence. LFT excluding AP and GGT returned to normal values with significant differences in OV/MNV when BPR was present which points to an increased cholestasis in BPR group. US dilatation of CBD was noted in 10.3% and was associated to CCBP. CONCLUSIONS: BPR in BP increases cholestasis and contributes to confusion in the estimation of common bile duct stones increasing ERCP-EE rates. US and biochemical markers of CBDS show a low specificity due to BPR-CCBP which suggests that MRI-cholangiography is a mandatory exploration before ERCP-EE examination.

[Natural history of breast cancer diagnostic procedures]. / Historia natural del proceso diagnóstico del cáncer de mama.

OBJECTIVE: To build a model that explains the natural history of breast cancer diagnostic procedures. METHODS: Descriptive cross-sectional study of 245 women between 40 and 69 years of age, selected by simple random sampling, who underwent a mammography and met the requirements of the breast cancer diagnostic procedure. Diagnosis was made by biopsy. For the diagnostic procedure, an estimate was made of the percentage of patients seen by each service, the total number of patients per service, and the total number of consultations in each service, with 95% confidence intervals. RESULTS: Of the patients who initiated the breast cancer diagnostic procedure in preventive medicine services, 20% underwent a mammography; 23.7% were seen in family medicine services and of these patients, 70.9% were referred to a breast clinic, where 7.3% underwent a harpoon biopsy. The prevalence of breast cancer confirmed by biopsy was 0.48% (95%CI: 0.0-1.3). Per 1 000 patients who initiated the procedure, 47.4 were seen in family medicine services and 33.6 in a breast clinic, and open biopsies were performed on 2.4. Per 1 000 patients who initiated the procedure, there were 211.4 consultations in radiology services, 51.6 in family medicine services, and 54.6 in a breast clinic. CONCLUSIONS: The model described here may be useful in planning and evaluation activities.

Use of [18F]fluorocholine PET/CT in the detection of primary hyperparathyroidism in paediatrics: a case report.

OBJECTIVES: The most common cause of primary hyperparathyroidism (PPH) in children is a parathyroid adenoma. Among this population, PPH exhibits higher levels of morbidity, severity and target organ involvement compared to adults. When there is suspicion of PPH, cervical ultrasound and 99mTc-sestamibi SPECT/CT are the imaging test traditionally indicated. Among adults, the use of [18F]fluorocholine PET/CT has shown a higher sensitivity than ultrasound and [99mTc]sestamibi SPECT/CT, leading to an expanding adoption in recent years. However, its role in paediatrics has not been clearly defined yet. CASE PRESENTATION: The patient is an adolescent female aged 13 years presented with lithiasis. The analytical study revealed elevated PTH, hipovitaminosis D, hypercalcaemia and hypophosphataemia. Due to the suspicion of PPH, cervical ultrasound and 99mTc-sestamibi SPECT/C were performed, failing to identify hyperfunctioning parathyroid glands. We proceeded to carry out a [18F]fluorocholine PET/CT where a hypermetabolic nodular image was identified, compatible with a hyperfunctioning parathyroid adenoma. The patient underwent surgery, resulting in the normalisation of PTH levels. Pathological anatomy confirmed the presence of a parathyroid adenoma. CONCLUSIONS: In cases where conventional imaging tests yield negative results or discrepancies, we suggest the possibility of the use of [18F]fluorocholine PET/CT for the detection of hyperfunctioning parathyroid adenomas.