Value the utility of breast MRI abbreviated protocols for the screening of breast cancer in high-risk patients compared to the full protocol.We performed a retrospective review of 157 breast MRI of 82 high-risk patients practiced in our hospital between January 2011 and January 2017. Clinical, radiological and anatomopathological parameters were analyzed. Reading of the different protocols (MIP, abbreviated and full) was made by an expert radiologist. Subsequent statistical analysis was done.A total amount of 12 findings classified as BI-RADS 4 and 5 were identified and performed a biopsy, resulting 11 of them to be malignant (91.67 %) and 1 benign (8.33 %). The malignant wounds included 4 intraductal carcinoma (33.33 %) and 7 infiltrating ductal carcinoma (58.33 %). All injuries were detected with the three protocols and no significant differences were found between their respective area under the ROC curve (p = 0.0650).In our study there are no significant differences between the different protocols (MIP, abbreviated and full), which places the abbreviated protocol as a promising tool for breast cancer screening in high-risk patients.Valorar la utilidad de los protocolos abreviados de resonancia magnética (RM) mamaria en el cribado de cáncer de mama en pacientes de alto riesgo, en comparación con el protocolo completo, y determinar la precisión diagnóstica en la caracterización de las lesiones mamarias de ambos protocolos.Se revisaron retrospectivamente 157 estudios de RM mamaria de 82 pacientes de alto riesgo realizadas en nuestro centro, desde enero de 2011 hasta enero de 2017. Se analizaron parámetros clínicos, radiológicos y anatomopatológicos. Se realizó la lectura de los diferentes protocolos: MIP, abreviado y completo por un radiólogo experto. Posteriormente se hizo un análisis estadístico.Se identificaron un total de 12 lesiones clasificadas en categoría BI-RADS 4 y 5 que fueron biopsiadas, de las cuales 11 resultaron ser malignas (91,67 %) y 1 benigna (8,33 %). Las lesiones malignas fueron: 4 carcinomas intraductales (33,33 %) y 7 carcinomas ductales infiltrantes (58,33 %). Todas las lesiones fueron detectadas con los tres protocolos y no se encontraron diferencias significativas entre sus respectivas áreas bajo la curva (p = 0,0650).En nuestro estudio no existen diferencias significativas entre los distintos protocolos (MIP, abreviado y completo). El protocolo abreviado se perfila como una herramienta prometedora en el cribado de cáncer de mama en pacientes de alto riesgo.

Atomic layer deposition (ALD) is considered as a distinct type of chemical vapor deposition (CVD) where each precursor is injected into the chamber separately unlike other CVD processes. The ALD is based on a set of self-limiting surface reactions with the precursor unlike other CVD processes which are based on non-self-limiting gas phase reactions. As a result to the self-limiting deposition, ALD results in conformal coatings on flat and nanostructured substrates with high uniformity and high-precision of film thickness at the atomic scale. However, nano-island growth can be achieved in ALD under specific conditions. In this chapter, an overview and a brief background about the ALD research and process is presented in addition to the general growth mechanisms. After that, the deposition of ZnO and ZrO2 nano-islands using ALD is demonstrated. The electronic and structural properties of the islands are also studied. Finally, memory devices with nano-islands charge trapping layer are fabricated and characterized. The memory characteristics and charge emission mechanism are analyzed.

Spontaneous eye-blinks are a ubiquitous behavior. However, blink timing is not random, nor does it always follow physiological demands. Research rather suggests that blink timing, and thus the structure of blinking behavior, is influenced by cognitive processes, such as attention. Since attention is regarded a necessary precursor of media use phenomena, the present study investigates the relation between the structure of blinking behavior and the media use phenomenon of spatial presence. To this end, spontaneous eye-blinks have been observed in an experiment during the reception of a video story. The methods of T-pattern analysis, ISI distance, and IBI variability have been used to quantify stimulus-dependent blink structure, which has then been related to self-reports of spatial presence experiences. While the T-pattern analysis and ISI distance showed converging results for behavior structure, a hypothesized relation between more stimulus-dependent blink structure and stronger presence experiences was not found. On the contrary, blink data suggested a difference in attention allocation, whereas self-report data indicated no difference in presence experiences. This demonstrates that beyond self-report and the analysis of event frequencies, the analysis of behavior structure offers insights into behavior synchronization between participants, allowing for new inferences on internal processing of media stimuli.

To determine the extent to which human rights considerations influence the attitudes of healthcare providers in Brazil with regard to access to the human papillomavirus (HPV) vaccine for females over 13 and males of all ages.From May to August 2015, we conducted a cross-sectional study among healthcare providers in eight public health clinics in the city of Mauá, Brazil. Frequency analysis was conducted across three subject areas: access, knowledge, and attitudes.A total of 154 surveys were analyzed. Providers reported their perception that Brazilians do not have equal access to health (80%) and the vaccine exclusions limit an individual's right to health (72%). Providers stated it is medically effective to vaccinate females over the age of 13 (77%), these females should be vaccinated (84%), and they would vaccinate them (82%). Similar responses were reported for males.Cervical cancer is the 4th leading cause of cancer among females in Brazil. Most cervical cancer cases are caused by persistent HPV infection, preventable through HPV vaccination. Limiting access to the HPV vaccine when medically efficacious is a perceived infringement of an individual's right to health. Brazil has a constitutional responsibility to reduce these access barriers.

A systematic evaluation of the relationship between frailty and large artery atherosclerosis (LAA) burden has not been carried out. Here, we aimed to assess the association between these variables in community-dwelling older adults living in Atahualpa (rural Ecuador).Participants underwent frailty assessment and determinations of LAA in several vascular beds. Frailty was estimated by the Edmonton Frailty Scale (EFS). LAA was investigated in the peripheral vascular bed by means of ankle-brachial index determinations, in the extracranial carotid bed by B-mode ultrasounds, and in the intracranial bed by high-resolution CT and time-of-flight MRA. Ordinal logistic regression with interaction models were fitted to assess the independent association between levels of cognitive frailty and the LAA burden. Casual mediation and sensitivity analysis, and the E value, evaluated the effect of age in this association.Out of 331 included individuals, 176 (53%) were robust and the remaining 47% were either pre-frail (n = 78) or frail (n = 77). Atherosclerosis affected only one (any) vascular bed in 111 (34%) individuals, two beds in 75 (23%), and three beds in 22 (7%); the remaining 123 (37%) had no evidence of atherosclerosis. Univariate analysis showed a significant inverse association between the robust status of cognitive frailty and LAA burden (p = 0.006). This association vanishes after considering the effect of covariates. Causal mediation analysis confirms that age captures 51.8% (95% C.I.: 34.6 to 97.2%) of the effect of the association. Sensitivity analysis and E-value computation find that the amount of bias provided by age is enough to explain away the effect estimate.This study found no independent relationship between cognitive frailty and LAA burden.

A large body of evidence suggests that sleep plays a key role in a number of cognitive functions. Interestingly, sleep parameters as measured objectively using polysomnography do not always correspond to the subjective experience of sleep quality. Recently, we have demonstrated that insomnia is associated with lower serum levels of brain-derived neurotrophic factor (BDNF), a neurotrophin involved in neuroplasticity and adult hippocampal neurogenesis. The present study aimed at exploring the relationships between objective and subjective sleep measures and cognitive functions and the role of serum BDNF.

Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associated with this zoonosis. This review searched the seroprevalence studies and case reports in six North African countries: Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, since 1990. The search also included studies on the environmental factors related to the risk of transmission. Most of the published epidemiological studies were done in Egypt. Cross-sectional and case-control studies in Egypt demonstrated that toxocariasis is a significant zoonosis that could be associated with conditions like bronchial asthma allergies and certain neuropsychiatric disorders. The population at risk of this infection includes all ages, both genders, in contact with dogs, resident in rural areas with poor housing conditions. The publications from Tunisia, Morocco and Algeria are limited to case reports and retrospective analyses of cases, but the disease is probably under-diagnosed in these three countries. There are no published reports on human toxocariasis in Libya and Sudan during the period covered by the review. Animal studies confirm high infection rates of dogs with Toxocara canis in North Africa. There is also evidence of wide-spread contamination of soil and water with Toxocara spp. eggs. Moreover, the use of untreated wastewater for irrigation in parts of North Africa could be a source of contamination of agricultural products with eggs of Toxocara spp. Population-based studies on human toxocariasis are recommended, using standardized diagnostic tests. These surveys should also assess risk factors to guide preventive measures.

Background: Common tumor metastasis sites for intrahepatic cholangiocarcinoma (ICC) include regional lymph nodes as well as liver metastasis as an indication of tumor recurrence. The main route for the spread of tumor cells is generally via lymph vessels. This lymphatic pathway could be responsible for a rapid spread of the disease and the high lethality associated with ICC. Here we present a case report of the first described prostatic metastasis from primary ICC. Case Presentation: A 77-year-old patient with a history of ICC who received mesohepatectomy (MH) with positive resection margins (R1) after initial surgery for a centrally located liver tumor presented to a tertiary hospital due to intermittent episodes of gross hematuria and obstructive micturition.During transurethral resection of the prostate (TUR-P) a large suspicious mass involving the left prostate lobe of prostate occurred. The histopathology report revealed a carcinoma showing the same histopathological and immunophenotypical features as the primary hepatic tumor. The patient develops an early tumor recurrence with metastases to the prostate, local lymph nodes and the liver after the primary surgical resection. He is now going to receive systemic chemotherapy as well as stereotactic radiofrequency ablation (SRFA) of liver for the liver metastases. Conclusion: This case report represents to our knowledge the first case of prostate metastasis from primary ICC.

IntroductionMajor depressive disorders (MDD) are among the most prevalent psychiatric disorders worldwide. While there is abundant literature showing that an increased cortisol secretion, understood as a proxy of the deteriorated hypothalamus-pituitary-adrenocortical axis activity (HPA AA), and poor cognitive performance are tightly related, less is known as regards to the HPA AA and higher cognitive information processes such as problem solving.AimsInvestigating the association between cortisol secretion and problem solving performance among patients with MDD.MethodsFifteen inpatients with MDD (HDRS > 24; mean age: 59 years; 80% females) underwent a pharmacologic HPA AA challenge both at baseline and six weeks later to assess the cortisol secretion. They were treated with standard antidepressants at therapeutic dosages. Further, they learned how to solve the Tower-of-Hanoi problem-solving task (ToH-PS-T) and how to apply the problem solving strategy to other tasks (transfer). Testing occurred both at baseline and six weeks later. Outcome variables were symptoms of depression, cortisol secretion and the performance to transfer the acquired ToH-PS-T.ResultsBoth symptoms of depression and cortisol secretion decreased over time, and transfer performance increased over time. Neither at baseline nor six weeks later, symptoms of depression, transfer performance and cortisol secretion were statistically related.ConclusionsThe pattern of results suggests that cortisol secretion as a proxy of physiological stress regulation, symptoms of depression, and higher order cognitive performances seem unrelated. Given that cognitive information processing performance substantively increased regardless from depression and cortisol secretion, problem-solving skills need to be focused separately.Disclosure of interestThe authors have not supplied their declaration of competing interest.

BackgroundThe concept of mental toughness has gained increasing importance among non-elite athletes for its psychological importance and explanatory power for a broad range of health-related behaviors. On the flip side, no study has focused so far on the psychological origins of mental toughness. Therefore, the aims of the present study were three-fold: to explore, to what extent psychological profiles of preschoolers at the age of five years predicted mental toughness scores and sleep disturbances at the age of 14 years, and to explore possible gender differences.MethodNine years after their first assessment at the age of five years (preschoolers), a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females) took part in the present follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ), covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, mental toughness, and sleep disturbances.ResultsPreschoolers with high prosocial behavior and low internalizing and externalizing problems, as rated by parents and teachers, at the age of 14 years self-reported higher mental toughness and lower sleep disturbances. At the age of 14 years, and relative to their male counterparts, female participants reported lower MT scores and higher sleep disturbances.ConclusionsThe pattern of results suggests that mental toughness traits during adolescence have their origins during pre-school years.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Mesenchymal stromal cell (MSC) infusion could be a means to establish tolerance in solid organ recipients. The aim of this prospective, controlled, phase I study was to evaluate the feasibility, safety and tolerability of a single infusion of MSCs in liver transplant recipients.Ten liver transplant recipients under standard immunosuppression received 1.5–3 × 106/kg third-party unrelated MSCs on postoperative day 3 ± 2, and were prospectively compared to a control group of ten liver transplant recipients. As primary endpoints, MSC infusion toxicity was evaluated, and infectious and cancerous complications were prospectively recorded until month 12 in both groups. As secondary endpoints, rejection rate, month-6 graft biopsies, and peripheral blood lymphocyte phenotyping were compared. Progressive immunosuppression weaning was attempted from month 6 to 12 in MSC recipients.No variation in vital parameters or cytokine release syndrome could be detected during and after MSC infusion. No patient developed impairment of organ functions (including liver graft function) following MSC infusion. No increased rate of opportunistic infection or de novo cancer was detected. As secondary endpoints, there was no difference in overall rates of rejection or graft survival. Month-6 biopsies did not demonstrate a difference between groups in the evaluation of rejection according to the Banff criteria, in the fibrosis score or in immunohistochemistry (including Tregs). No difference in peripheral blood lymphocyte typing could be detected. The immunosuppression weaning in MSC recipients was not successful.No side effect of MSC infusion at day 3 after liver transplant could be detected, but this infusion did not promote tolerance. This study opens the way for further MSC or Treg-based trials in liver transplant recipients.Therapy with mesenchymal stromal cells (MSCs) has been proposed as a means to improve results of solid organ transplantation. One of the potential MSC role could be to induce tolerance after liver transplantation, i.e. allowing the cessation of several medications with severe side effects. This study is the first-in-man use of MSC therapy in ten liver transplant recipients. This study did not show toxicity after a single MSC infusion but it was not sufficient to allow withdrawal of immunosuppression.Clinical trial registration number: Eudract: # 2011-001822-81, ClinicalTrials.gov: # NCT 01429038.