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BACKGROUND AND STUDY AIMS: mucosal visualization during upper gastrointestinal (UGI) endoscopy can be impaired by the presence of foam, bubbles, and mucus. Some UGI endoscopy visibility scales were proposed but without a multicenter validation. This study aimed to develop and validate the Gastroscopy RAte of Cleanliness Evaluation (GRACE) scale. PATIENTS AND METHODS: a multicenter international cross-sectional study was conducted. The GRACE scale is based on a score from 0-worst to 3-excellent of esophagus, stomach, and duodenum, for a total ranging from 0 to 9. In the first phase, four expert endoscopists evaluated 60 selected images twice with a two-week interval; in the second phase, the same 60 images were scored twice by one expert and one non-expert endoscopist from 27 different Endoscopy Departments worldwide. For reproducibility assessment and clinical validation, a real-time scale application was performed on consecutive patients undergoing gastroscopy in each center. RESULTS: in the internal validation, the interobserver agreement was 0.81 (95%CI[0.73-0.87]) and 0.80 (95%CI[0.72-0.86]), with a reliability of 0.73 (95%CI[0.63-0.82]) and 0.72 (95%CI[0.63-0.81]), in the two rounds, respectively. In the external validation, the overall interobserver agreement was 0.85 (95%CI[0.82-0.88]) with a reliability of 0.79 (95%CI[0.73-0.84]). In the real-time evaluation phase, the overall percentage of correct classifications was 0.80 (95%CI[0.77-0.82]). CONCLUSIONS: the GRACE scale showed good interobserver agreement and reliability and good validity. The spread of this scale could enhance the quality and standardize the cleanliness of the mucosa assessment during UGI endoscopy, pushing endoscopists to obtain excellent visibility and reducing the risk of missing lesions.
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INTRODUCTION: Corpus-restricted atrophic gastritis is a chronic inflammatory disorder leading to possible development of type 1 neuroendocrine tumors (T1gNET), intraepithelial neoplasia (IEN), and gastric cancer (GC). We aimed to assess occurrence and predictors of gastric neoplastic lesions in patients with corpus-restricted atrophic gastritis at long-term follow-up. METHODS: A prospective single-center cohort of patients with corpus-restricted atrophic gastritis adhering to endoscopic-histological surveillance was considered. Follow-up gastroscopies were scheduled according to the management of epithelial precancerous conditions and lesions of the stomach guidelines. In case of new/worsening of known symptoms, gastroscopy was anticipated. Cox regression analyses and Kaplan-Meier survival curves were obtained. RESULTS: Two hundred seventy-five patients with corpus-restricted atrophic gastritis (72.0% female, median age 61 [23-84] years) were included. At a median follow-up of 5 (1-17) years, the annual incidence rate person-year was 0.5%, 0.6%, 2.8%, and 3.9% for GC/high-grade IEN, low-grade IEN, T1gNET, and all gastric neoplastic lesions, respectively. All patients showed at baseline operative link for gastritis assessment (OLGA)-2, except 2 low-grade (LG) IEN patients and 1 T1gNET patient with OLGA-1. Age older than 60 years (hazard ratio [HR] 4.7), intestinal metaplasia without pseudopyloric metaplasia (HR 4.3), and pernicious anemia (HR 4.3) were associated with higher risk for GC/HG-IEN or LG-IEN development and shorter mean survival time for progression (13.4, 13.2, and 11.1, respectively, vs 14.7 years, P = 0.01). Pernicious anemia was an independent risk factor for T1gNET (HR 2.2) and associated with a shorter mean survival time for progression (11.7 vs 13.6 years, P = 0.04) as well as severe corpus atrophy (12.8 vs 13.6 years, P = 0.03). DISCUSSION: Patients with corpus-restricted atrophic gastritis are at increased risk for GC and T1gNET despite low-risk OLGA scores, and those aged older than 60 years with corpus intestinal metaplasia or pernicious anemia seem to display a high-risk scenario.
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Anemia Perniciosa , Gastrite Atrófica , Gastrite , Infecções por Helicobacter , Lesões Pré-Cancerosas , Neoplasias Gástricas , Humanos , Feminino , Idoso , Pessoa de Meia-Idade , Masculino , Gastrite Atrófica/complicações , Gastrite Atrófica/epidemiologia , Gastrite Atrófica/patologia , Incidência , Estudos de Coortes , Anemia Perniciosa/epidemiologia , Anemia Perniciosa/complicações , Anemia Perniciosa/patologia , Estudos Prospectivos , Gastrite/complicações , Fatores de Risco , Neoplasias Gástricas/patologia , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/patologia , Metaplasia/patologia , Infecções por Helicobacter/complicações , Mucosa Gástrica/patologiaRESUMO
ESGE suggests conventional endoscopic submucosal dissection (ESD; marking and mucosal incision followed by circumferential incision and stepwise submucosal dissection) for most esophageal and gastric lesions. ESGE suggests tunneling ESD for esophageal lesions involving more than two-thirds of the esophageal circumference. ESGE recommends the pocket-creation method for colorectal ESD, at least if traction devices are not used. The use of dedicated ESD knives with size adequate to the location/thickness of the gastrointestinal wall is recommended. It is suggested that isotonic saline or viscous solutions can be used for submucosal injection. ESGE recommends traction methods in esophageal and colorectal ESD and in selected gastric lesions. After gastric ESD, coagulation of visible vessels is recommended, and post-procedural high dose proton pump inhibitor (PPI) (or vonoprazan). ESGE recommends against routine closure of the ESD defect, except in duodenal ESD. ESGE recommends corticosteroids after resection of â>â50â% of the esophageal circumference. The use of carbon dioxide when performing ESD is recommended. ESGE recommends against the performance of second-look endoscopy after ESD. ESGE recommends endoscopy/colonoscopy in the case of significant bleeding (hemodynamic instability, drop in hemoglobin >â2âg/dL, severe ongoing bleeding) to perform endoscopic hemostasis with thermal methods or clipping; hemostatic powders represent rescue therapies. ESGE recommends closure of immediate perforations with clips (through-the-scope or cap-mounted, depending on the size and shape of the perforation), as soon as possible but ideally after securing a good plane for further dissection.
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Neoplasias Colorretais , Ressecção Endoscópica de Mucosa , Hemostase Endoscópica , Humanos , Colonoscopia , Ressecção Endoscópica de Mucosa/métodos , Endoscopia Gastrointestinal/métodosRESUMO
With wearable sensors, the acquisition of physiological signals has become affordable and feasible in everyday life. Specifically, Photoplethysmography (PPG), being a low-cost and highly portable technology, has attracted notable interest for measuring and diagnosing cardiac activity, one of the most important physiological and autonomic indicators. In addition to the technological development, several specific signal-processing algorithms have been designed to enable reliable detection of heartbeats and cope with the lower quality of the signals. In this study, we compare three heartbeat detection algorithms: Derivative-Based Detection (DBD), Recursive Combinatorial Optimization (RCO), and Multi-Scale Peak and Trough Detection (MSPTD). In particular, we considered signals from two datasets, namely, the PPG-DALIA dataset (N = 15) and the FANTASIA dataset (N = 20) which differ in terms of signal characteristics (sampling frequency and length) and type of acquisition devices (wearable and medical-grade). The comparison is performed both in terms of heartbeat detection performance and computational workload required to execute the algorithms. Finally, we explore the applicability of these algorithms on the cardiac component obtained from functional Near InfraRed Spectroscopy signals (fNIRS).The results indicate that, while the MSPTD algorithm achieves a higher F1 score in cases that involve body movements, such as cycling (MSPTD: Mean = 74.7, SD = 14.4; DBD: Mean = 54.4, SD = 21.0; DBD + RCO: Mean = 49.5, SD = 22.9) and walking up and down the stairs (MSPTD: Mean = 62.9, SD = 12.2; DBD: Mean = 50.5, SD = 11.9; DBD + RCO: Mean = 45.0, SD = 14.0), for all other activities the three algorithms perform similarly. In terms of computational complexity, the computation time of the MSPTD algorithm appears to grow exponentially with the signal sampling frequency, thus requiring longer computation times in the case of high-sampling frequency signals, where the usage of the DBD and RCO algorithms might be preferable. All three algorithms appear to be appropriate candidates for exploring the applicability of heartbeat detection on fNIRS data.
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Algoritmos , Fotopletismografia , Humanos , Frequência Cardíaca/fisiologia , Fotopletismografia/métodos , Processamento de Sinais Assistido por Computador , Análise EspectralRESUMO
Recent migration and globalization trends have led to the emergence of ethnically, religiously, and linguistically diverse countries. Understanding the unfolding of social dynamics in multicultural contexts becomes a matter of common interest to promote national harmony and social cohesion among groups. The current functional magnetic resonance imaging (fMRI) study aimed to (i) explore the neural signature of the in-group bias in the multicultural context; and (ii) assess the relationship between the brain activity and people's system-justifying ideologies. A sample of 43 (22 females) Chinese Singaporeans (M = 23.36; SD = 1.41) was recruited. All participants completed the Right Wing Authoritarianism Scale and Social Dominance Orientation Scale to assess their system-justifying ideologies. Subsequently, four types of visual stimuli were presented in an fMRI task: Chinese (in-group), Indian (typical out-group), Arabic (non-typical out-group), and Caucasian (non-typical out-group) faces. The right middle occipital gyrus and the right postcentral gyrus showed enhanced activity when participants were exposed to in-group (Chinese) rather than out-group (Arabic, Indian, and Caucasian) faces. Regions having a role in mentalization, empathetic resonance, and social cognition showed enhanced activity to Chinese (in-group) rather than Indian (typical out-group) faces. Similarly, regions typically involved in socioemotional and reward-related processing showed increased activation when participants were shown Chinese (in-group) rather than Arabic (non-typical out-group) faces. The neural activations in the right postcentral gyrus for in-group rather than out-group faces and in the right caudate in response to Chinese rather than Arabic faces were in a significant positive correlation with participants' Right Wing Authoritarianism scores (p < 0.05). Furthermore, the activity in the right middle occipital gyrus for Chinese rather than out-group faces was in a significant negative correlation with participants' Social Dominance Orientation scores (p < 0.05). Results are discussed by considering the typical role played by the activated brain regions in socioemotional processes as well as the role of familiarity to out-group faces.
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Encéfalo , Reconhecimento Visual de Modelos , Feminino , Humanos , Reconhecimento Visual de Modelos/fisiologia , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética , Mapeamento Encefálico , Reconhecimento Psicológico/fisiologiaRESUMO
Brain-to-brain coupling during co-viewing of video stimuli reflects similar intersubjective mentalisation processes. During an everyday joint activity of watching video stimuli (television shows) with her child, an anxiously attached mother's preoccupation with her child is likely to distract her from understanding the mental state of characters in the show. To test the hypothesis that reduced coupling in the medial prefrontal cortex (PFC) would be observed with increasing maternal attachment anxiety (MAA), we profiled mothers' MAA using the Attachment Style Questionnaire and used functional Near-infrared Spectroscopy (fNIRS) to assess PFC coupling in 31 mother-child dyads while they watched three 1-min animation videos together. Reduced coupling was observed with increasing MAA in the medial right PFC cluster which is implicated in mentalisation processes. This result did not survive control analyses and should be taken as preliminary. Reduced coupling between anxiously-attached mothers and their children during co-viewing could undermine quality of shared experiences.
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Relações Mãe-Filho , Apego ao Objeto , Feminino , Humanos , Encéfalo , Mães , Inquéritos e QuestionáriosRESUMO
Criticism is a form of interpersonal social rejection and destructive conflict behavior which has been associated with poor relationship outcomes in both parent-child and marital relationships. However, the role of the individual's perceptions of parental and spousal criticism in influencing the perceptions of criticism of other members in the family unit has not been examined. This study investigated the associations between parental bonding and perceptions of parental and spousal criticism across generations in Singapore. In all, 134 Singaporean married parent dyads (G2) and one child (G3) of each dyad were recruited. G2 parent participants completed the Perceived Criticism measure for their parents (G1) and spouses, the Parental Bonding Instrument and the Quality of Marriage Index. G3 children participants completed the Perceived Criticism measure for their parents (G2). Path analysis found that G2 perceptions of parental bonding were significant predictors of G2's perceptions of G1 parental criticism, which significantly predicted both G2's perceptions of spousal criticism and G3's perceptions of G2 parental criticism. Perceptions of spousal criticism were also found to predict marital relationship quality in G2 participants. Findings highlight the intergenerational transmission of perceptions of criticism across relationships in the family unit, providing support that parenting practices and communication patterns in one generation can predict those in the next generation in the Singaporean context. Future studies can look to replicate the findings in other cultures and include further investigations into sibling relationships as well.
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Adolescent mental health problems are rising rapidly around the world. To combat this rise, clinicians and policymakers need to know which risk factors matter most in predicting poor adolescent mental health. Theory-driven research has identified numerous risk factors that predict adolescent mental health problems but has difficulty distilling and replicating these findings. Data-driven machine learning methods can distill risk factors and replicate findings but have difficulty interpreting findings because these methods are atheoretical. This study demonstrates how data- and theory-driven methods can be integrated to identify the most important preadolescent risk factors in predicting adolescent mental health. Machine learning models examined which of 79 variables assessed at age 10 were the most important predictors of adolescent mental health at ages 13 and 17. These models were examined in a sample of 1176 families with adolescents from nine nations. Machine learning models accurately classified 78% of adolescents who were above-median in age 13 internalizing behavior, 77.3% who were above-median in age 13 externalizing behavior, 73.2% who were above-median in age 17 externalizing behavior, and 60.6% who were above-median in age 17 internalizing behavior. Age 10 measures of youth externalizing and internalizing behavior were the most important predictors of age 13 and 17 externalizing/internalizing behavior, followed by family context variables, parenting behaviors, individual child characteristics, and finally neighborhood and cultural variables. The combination of theoretical and machine-learning models strengthens both approaches and accurately predicts which adolescents demonstrate above average mental health difficulties in approximately 7 of 10 adolescents 3-7 years after the data used in machine learning models were collected.
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Comportamento do Adolescente , Transtornos do Comportamento Infantil , Criança , Humanos , Adolescente , Poder Familiar/psicologia , Saúde Mental , Fatores de Risco , Transtornos do Comportamento Infantil/psicologia , Avaliação de Resultados em Cuidados de Saúde , Comportamento do Adolescente/psicologiaRESUMO
ESGE recommends that the evaluation of superficial gastrointestinal (GI) lesions should be made by an experienced endoscopist, using high definition white-light and chromoendoscopy (virtual or dye-based).ESGE does not recommend routine performance of endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)-CT prior to endoscopic resection.ESGE recommends endoscopic submucosal dissection (ESD) as the treatment of choice for most superficial esophageal squamous cell and superficial gastric lesions.For Barrett's esophagus (BE)-associated lesions, ESGE suggests the use of ESD for lesions suspicious of submucosal invasion (Paris type 0-Is, 0-IIc), for malignant lesions >â20âmm, and for lesions in scarred/fibrotic areas.ESGE does not recommend routine use of ESD for duodenal or small-bowel lesions.ESGE suggests that ESD should be considered for en bloc resection of colorectal (but particularly rectal) lesions with suspicion of limited submucosal invasion (demarcated depressed area with irregular surface pattern or a large protruding or bulky component, particularly if the lesions are larger than 20âmm) or for lesions that otherwise cannot be completely removed by snare-based techniques.ESGE recommends that an en bloc R0 resection of a superficial GI lesion with histology no more advanced than intramucosal cancer (no more than m2 in esophageal squamous cell carcinoma), well to moderately differentiated, with no lymphovascular invasion or ulceration, should be considered a very low risk (curative) resection, and no further staging procedure or treatment is generally recommended.ESGE recommends that the following should be considered to be a low risk (curative) resection and no further treatment is generally recommended: an en bloc R0 resection of a superficial GI lesion with superficial submucosal invasion (sm1), that is well to moderately differentiated, with no lymphovascular invasion, of size ≤â20âmm for an esophageal squamous cell carcinoma or ≤â30âmm for a stomach lesion or of any size for a BE-related or colorectal lesion, and with no lymphovascular invasion, and no budding grade 2 or 3 for colorectal lesions.ESGE recommends that, after an endoscopically complete resection, if there is a positive horizontal margin or if resection is piecemeal, but there is no submucosal invasion and no other high risk criteria are met, this should be considered a local-risk resection and endoscopic surveillance or re-treatment is recommended rather than surgery or other additional treatment.ESGE recommends that when there is a diagnosis of lymphovascular invasion, or deeper infiltration than sm1, or positive vertical margins, or undifferentiated tumor, or, for colorectal lesions, budding grade 2 or 3, this should be considered a high risk (noncurative) resection, and complete staging and strong consideration for additional treatments should be considered on an individual basis in a multidisciplinary discussion.ESGE recommends scheduled endoscopic surveillance with high definition white-light and chromoendoscopy (virtual or dye-based) with biopsies of only the suspicious areas after a curative ESD.
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Esôfago de Barrett , Neoplasias Colorretais , Ressecção Endoscópica de Mucosa , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Esôfago de Barrett/cirurgia , Neoplasias Colorretais/patologia , Ressecção Endoscópica de Mucosa/métodos , Endoscopia Gastrointestinal/métodos , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Humanos , Margens de Excisão , Resultado do TratamentoRESUMO
Micro RNA (miRNA) research has great implications in uncovering the aetiology of neuropsychiatric conditions due to the role of miRNA in brain development and function. Schizophrenia, a complex yet devastating neuropsychiatric disorder, is one such condition that had been extensively studied in the realm of miRNA. Although a relatively new field of research, this area of study has progressed sufficiently to warrant dozens of reviews summarising findings from past to present. However, as a majority of reviews cannot encapsulate the full body of research, there is still a need to synthesise the diversity of publications made in this area in a systematic but easy-to-understand manner. Therefore, this study adopted bibliometrics and scientometrics, specifically document co-citation analysis (DCA), to review the literature on miRNAs in the context of schizophrenia over the course of history. From a literature search on Scopus, 992 papers were found and analysed with CiteSpace. DCA analysis generated a network of 13 major clusters with different thematic focuses within the subject area. Finally, these clusters are qualitatively discussed. miRNA research has branched into schizophrenia, among other medical and psychiatric conditions, due to previous findings in other forms of non-coding RNA. With the rise of big data, bioinformatics analyses are increasingly common in this field of research. The future of research is projected to rely more heavily on interdisciplinary collaboration. Additionally, it can be expected that there will be more translational studies focusing on the application of these findings to the development of effective treatments.
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MicroRNAs , Esquizofrenia , Humanos , MicroRNAs/genética , Esquizofrenia/genética , BibliometriaRESUMO
INTRODUCTION: Corpus atrophic gastritis (CAG) is associated with intestinal metaplasia (IM) and pseudopyloric metaplasia (PPM). Prospective data on corpus mucosa PPM and its link to the development of gastric cancer (GC) are lacking. This study aimed to investigate the relationship between the presence of corpus mucosa PPM at baseline and the development of GC at follow-up in patients with CAG. METHODS: A longitudinal cohort study was conducted on patients with consecutive CAG adhering to endoscopic-histological surveillance. Patients were stratified for the presence/absence of corpus PPM without concomitant corpus IM at baseline, and the occurrence of gastric neoplastic lesions at the longest available follow-up was assessed. RESULTS: A total of 292 patients with CAG with a follow-up of 4.2 (3-17) years were included. At baseline, corpus PPM without corpus IM was diagnosed in 62 patients (21.2%). At the follow-up, GC was detected in 5 patients (1.7%) and gastric dysplasia (GD) in 4 patients (1.4%). In all these 9 patients with GC/GD at the follow-up, corpus IM was present at baseline and follow-up. Age <50 years (odds ratio [OR] 2.5), absence of pernicious anemia (OR 4.3), and absence of severe corpus atrophy (OR 2.3) were associated with corpus PPM without corpus IM. DISCUSSION: At the 4.2-year follow-up, in patients with CAG characterized at baseline with corpus PPM without corpus IM, GC or GD was not observed because these lesions were consistently associated with corpus IM. Corpus PPM without corpus IM was associated with younger age, absence of pernicious anemia, and severe corpus atrophy, suggesting a lower stage of disease progression. Corpus PPM alone seems not to be associated with GC, whose development seems to require the presence of corpus IM as a necessary step.
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Mucosa Gástrica/patologia , Gastrite Atrófica/complicações , Metaplasia/complicações , Neoplasias Gástricas/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Gastrite Atrófica/patologia , Humanos , Masculino , Metaplasia/patologia , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/patologia , Neoplasias Gástricas/patologia , Adulto JovemRESUMO
This study employs the Specificity Principle to examine the relative impacts of external (input quantity at home and at school, number of books and reading frequency at home, teachers' degree and experience, language usage, socioeconomic status) and internal factors (children's working memory, nonverbal intelligence, learning-related social-skills, chronological age, gender) on children's English-language development in phonological awareness (PA), receptive vocabulary (RV), and word reading (WR). Altogether, 736 four- to five-year-old Singaporean Mandarin-English speaking kindergarteners were assessed twice longitudinally. Their English-language PA, RV, and WR development was predicted using the eight external factors and five internal factors with Bayesian least absolute shrinkage and selection operators. Internal factors explained more variance than external factors in all three language domains. External factors had their largest impact on RV.
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Multilinguismo , Teorema de Bayes , Criança , Pré-Escolar , Humanos , Idioma , Desenvolvimento da Linguagem , VocabulárioRESUMO
We live within a context of unprecedented opportunities for brain research, with a flourishing of novel sensing technologies and methodological approaches [...].
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EncéfaloRESUMO
Central to the account of grounded procedures is the premise that mental experiences are grounded in physical actions. We complement this account by incorporating frameworks in cultural psychology and developmental neuroscience, with new predictions. Through the examples of vicarious experiences and demerit transfer, we discuss why, and how, separation and connection may operate somewhat differently across cultures.
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Características Culturais , Neurociências , Comportamento , HumanosRESUMO
Is noun dominance in early lexical acquisition a widespread or a language-specific phenomenon? Thirty Singaporean bilingual English-Mandarin learning toddlers and their mothers were observed in a mother-child play interaction. For both English and Mandarin, toddlers' speech and reported vocabulary contained more nouns than verbs across book reading and toy playing. In contrast, their mothers' speech contained more verbs than nouns in both English and Mandarin but differed depending on the context of the interaction. Although toddlers demonstrated a noun bias for both languages, the noun bias was more pronounced in English than in Mandarin. Together, these findings support early noun dominance as a widespread phenomenon in the lexical acquisition debate but also provide evidence that language specificity also plays a minor role in children's early lexical development.
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Idioma , Fala , Viés , Pré-Escolar , Feminino , Humanos , Mães , VocabulárioRESUMO
Large populations worldwide have been deprived from nature experiences due to mass quarantines and lockdowns during the COVID-19 pandemic, and face a looming mental health crisis. Virtual reality offers a safe and practical solution to increase nature exposure. This research examined the effects of virtual nature using a within-subject design with young adults (Study 1) and senior citizens (Study 2). Results from the young adult sample showed that walking in a virtual forest reduced negative affect due to enhanced nature connectedness, and reduced stress measured by heart rate. Consistently, the senior citizen sample reported improved positive affect due to enhanced nature connectedness after the virtual nature walk. Our findings unveil the underlying mechanism of how virtual nature may improve psychological well-being and demonstrated how virtual nature can be used as an intervention to promote mental health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10055-021-00604-4.
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BACKGROUND : Image-enhanced endoscopy (IEE) improves the accuracy of endoscopic diagnosis. We aimed to assess the value of IEE for gastric preneoplastic conditions and neoplastic lesions. METHODS : Medline and Embase were searched until December 2018. Studies allowing calculation of diagnostic measures were included. Risk of bias and applicability were assessed using QUADAS-2. Subgroup analysis was performed to explore heterogeneity. RESULTS : 44 studies met the inclusion criteria. For gastric intestinal metaplasia (GIM), narrow-band imaging (NBI) obtained a pooled sensitivity and specificity of 0.79 (95â%CI 0.72-0.85) and 0.91 (95â%CI 0.88-0.94) on per-patient basis; on per-biopsy basis, it was 0.84 (95â%CI 0.81-0.86) and 0.95 (95â%CI 0.94-0.96), respectively. Tubulovillous pattern was the most accurate marker to detect GIM and it was effectively assessed without high magnification. For dysplasia, NBI showed a pooled sensitivity and specificity of 0.87 (95â%CI 0.84-0.89) and 0.97 (95â%CI 0.97-0.98) on per-biopsy basis. The use of magnification improved the performance of NBI to characterize early gastric cancer (EGC), especially when the vessel plus surface (VS) classification was applied. Regarding other technologies, trimodal imaging also obtained a high accuracy for dysplasia (sensitivity 0.93 [95â%CI 0.85-0.98], specificity 0.98 [95â%CI 0.92-1.00]). For atrophic gastritis, no specific pattern was noted and none of the technologies reached good diagnostic yield. CONCLUSION : NBI is highly accurate for GIM and dysplasia. The presence of tubulovillous pattern and the VS classification seem to be useful to detect GIM and characterize EGC, respectively. These features should be used in current practice and to standardize endoscopic criteria for other technologies.
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Lesões Pré-Cancerosas , Neoplasias Gástricas , Humanos , Aumento da Imagem , Metaplasia , Imagem de Banda Estreita , Lesões Pré-Cancerosas/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagemRESUMO
This report coordinates assessments of five types of behavioral responses in new mothers to their own infants' cries with neurobiological responses in new mothers to their own infants' cries and in experienced mothers and inexperienced nonmothers to infant cries and other emotional and control sounds. We found that 684 new primipara mothers in 11 countries (Argentina, Belgium, Brazil, Cameroon, France, Kenya, Israel, Italy, Japan, South Korea, and the United States) preferentially responded to their infants' vocalizing distress by picking up and holding and by talking to their infants, as opposed to displaying affection, distracting, or nurturing. Complementary functional magnetic resonance imaging (fMRI) analyses of brain responses to their own infants' cries in 43 new primipara US mothers revealed enhanced activity in concordant brain territories linked to the intention to move and to speak, to process auditory stimulation, and to caregive [supplementary motor area (SMA), inferior frontal regions, superior temporal regions, midbrain, and striatum]. Further, fMRI brain responses to infant cries in 50 Chinese and Italian mothers replicated, extended, and, through parcellation, refined the results. Brains of inexperienced nonmothers activated differently. Culturally common responses to own infant cry coupled with corresponding fMRI findings to own infant and to generic infant cries identified specific, common, and automatic caregiving reactions in mothers to infant vocal expressions of distress and point to their putative neurobiological bases. Candidate behaviors embedded in the nervous systems of human caregivers lie at the intersection of evolutionary biology and developmental cultural psychology.
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Choro/psicologia , Comportamento Materno/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Adulto , Encéfalo/fisiologia , Emoções/fisiologia , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética/métodos , Masculino , Neurobiologia/métodos , Adulto JovemRESUMO
Fixation time measures have been widely adopted in studies with infants and young children because they can successfully tap on their meaningful nonverbal behaviors. While recording preverbal children's behavior is relatively simple, analysis of collected signals requires extensive manual preprocessing. In this paper, we investigate the possibility of using different Machine Learning (ML)-a Linear SVC, a Non-Linear SVC, and K-Neighbors-classifiers to automatically discriminate between Usable and Unusable eye fixation recordings. Results of our models show an accuracy of up to the 80%, suggesting that ML tools can help human researchers during the preprocessing and labelling phase of collected data.
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Aprendizado de Máquina , Criança , Pré-Escolar , Humanos , LactenteRESUMO
A key access point to the functioning of the autonomic nervous system is the investigation of peripheral signals. Wearable devices (WDs) enable the acquisition and quantification of peripheral signals in a wide range of contexts, from personal uses to scientific research. WDs have lower costs and higher portability than medical-grade devices. However, the achievable data quality can be lower, and data are subject to artifacts due to body movements and data losses. It is therefore crucial to evaluate the reliability and validity of WDs before their use in research. In this study, we introduce a data analysis procedure for the assessment of WDs for multivariate physiological signals. The quality of cardiac and electrodermal activity signals is validated with a standard set of signal quality indicators. The pipeline is available as a collection of open source Python scripts based on the pyphysio package. We apply the indicators for the analysis of signal quality on data simultaneously recorded from a clinical-grade device and two WDs. The dataset provides signals of six different physiological measures collected from 18 subjects with WDs. This study indicates the need to validate the use of WDs in experimental settings for research and the importance of both technological and signal processing aspects to obtain reliable signals and reproducible results.