How Can I Trust You? The Role of Facial Trustworthiness in the Development of Epistemic and Interpersonal Trust

Recently, researchers from developmental and clinical psychology highlighted epistemic trust (ET) as a key factor for personality disorders. ET is intended as the mental openness to information coming from others during social exchanges. ET develops from signals called ostensive cues, delivered through facial expressions during interactions in a secure attachment context. Similarly, interpersonal trust (IT) refers to the perception of others as not harmful, which is also developed through secure attachment relationships. Our purpose was to suggest a conceptualization of ET as a specific facet of IT. We hypothesize that positive experiences of caregiving promote IT development that includes a specific sense of trust toward others’ knowledge. Moreover, we suggest that the early ability to infer a judgment of trustworthiness from facial cues is the starting point for developing both IT and ET. This conceptualization supports the role of considering both IT and ET in the development of borderline pathology. Our purpose is to suggest a conceptualization of ET as a specific facet of IT. We hypothesize that positive experiences of caregiving promote IT development that includes a specific sense of trust toward others’ knowledge. Moreover, we suggest that the early ability to infer a judgment of trustworthiness from facial cues is the starting point for developing both IT and ET. This conceptualization supports the role of considering both IT and ET in the development of borderline pathology

Reweighting NNPDFs: the W lepton asymmetry

We present a method for incorporating the information contained in new datasets into an existing set of parton distribution functions without the need for refitting. The method involves reweighting the ensemble of parton densities through the computation of the chi-square to the new dataset. We explain how reweighting may be used to assess the impact of any new data or pseudodata on parton densities and thus on their predictions. We show that the method works by considering the addition of inclusive jet data to a DIS+DY fit, and comparing to the refitted distribution. We then use reweighting to determine the impact of recent high statistics lepton asymmetry data from the D0 experiment on the NNPDF2.0 parton set. We find that the D0 inclusive muon and electron data are perfectly compatible with the rest of the data included in the NNPDF2.0 analysis and impose additional constraints on the large-x d/u ratio. The more exclusive D0 electron datasets are however inconsistent both with the other datasets and among themselves, suggesting that here the experimental uncertainties have been underestimated.Comment: 36 pages, 22 figures: errors in Eqns.12,36,37 corrected and parts of Figs.1,6,10,13,15,19 replace

A first unbiased global NLO determination of parton distributions and their uncertainties

We present a determination of the parton distributions of the nucleon from a global set of hard scattering data using the NNPDF methodology: NNPDF2.0. Experimental data include deep-inelastic scattering with the combined HERA-I dataset, fixed target Drell-Yan production, collider weak boson production and inclusive jet production. Next-to-leading order QCD is used throughout without resorting to K-factors. We present and utilize an improved fast algorithm for the solution of evolution equations and the computation of general hadronic processes. We introduce improved techniques for the training of the neural networks which are used as parton parametrization, and we use a novel approach for the proper treatment of normalization uncertainties. We assess quantitatively the impact of individual datasets on PDFs. We find very good consistency of all datasets with each other and with NLO QCD, with no evidence of tension between datasets. Some PDF combinations relevant for LHC observables turn out to be determined rather more accurately than in any other parton fit.Comment: 86 pages, 41 figures. PDF sets available from http://sophia.ecm.ub.es/nnpdf/nnpdf_pdfsets.htm and from LHAPDF. Final version to be published in Nucl. Phys. B. Various typos corrected and small clarifications added, fig. 4 added, extended discussion of data consistency especially in sect 5.1 and 5.

O PROTAGONISMO ESTUDANTIL COMO BASE PARA UMA FORMAÇÃO MÉDICA DE QUALIDADE: UM RELATO DE EXPERIÊNCIA.

Introduction: Medical Education proposed by the traditional curriculum of universities is insufficient for quality professional training. Thus, it is clear that, despite the development of different spheres and skills in leadership by the individual being essential, the aforementioned grid still persists in medical schools. In order to promote a change in this reality, this paper reports the experience of students from the first period of medicine who managed to develop these skills through positions in different areas of activity. Experience report: On the subject of remote education, medicine freshmen decided to work in leadership and management of people in areas of action in a student organization. Areas such as Capacity Building, Administration, Marketing, Research and Activities in Medical Education and Human Rights and Peace were related to the performance of each of the freshmen through educational interventions and activities, in order to meet the demands of other students linked to this organization, supplementing the regular curriculum. Discussion: The exclusively hospital-centered and technical medical curriculum becomes insufficient for a quality Medical Education. Therefore the participation in extracurricular activities becomes essential as a complement to the professional's training. Thus, developing leadership skills and abilities and encouraging different activities can not only provide personal development, but also allow for an exchange of knowledge between students and the population involved in the activities, in addition to providing professional development from the beginning of graduation. Conclusion: Based on the experience of this report, students were able to develop leadership skills and acquire essential responsibilities to medical training since the first period of medical school. Therefore, the description of the experience of this work encourages the reproducibility of similar initiatives that can contribute to quality medical training for future health professionals.Introdução: A Educação Médica proposta pela matriz curricular tradicional da maioria das universidades no país é insuficiente para a formação profissional de qualidade, por pouco incentivar,  apesar de ser essencial, o desenvolvimento  de diferentes esferas e habilidades em liderança pelos discentes. A fim de fomentar a mudança dessa realidade, este trabalho relata a experiência de estudantes do primeiro período de medicina que conseguiram desenvolver essas habilidades por meio de cargos em diversos eixos de atuação. Relato da experiência: No contexto do ensino remoto, calouros de medicina decidiram atuar em cargos de liderança e de gestão de pessoas com eixos de atuação em uma organização estudantil. Eixos como Capacity Building, Administração, Marketing, Pesquisa e Atividades em Educação Médica e Direitos Humanos e Paz foram referentes à atuação de cada um dos calouros por meio de intervenções educativas e atividades, a fim de atender demandas de outros estudantes vinculados a essa organização, suplementando a matriz curricular regular. Discussão: O currículo médico exclusivamente hospitalocêntrico e técnico se torna insuficiente para uma Educação Médica de qualidade, logo a participação em atividades extracurriculares se torna essencial para uma complementação da formação do profissional. Dessa forma,  desenvolver competências e habilidades em liderança e incentivar diferentes atividades podem não só proporcionar um desenvolvimento pessoal, mas também permitir uma troca de conhecimento entre discentes e a população envolvida nas atividades, além de propiciar um desenvolvimento profissional desde o início da graduação. Conclusão: A partir da experiência deste relato, os estudantes conseguiram desenvolver habilidades de liderança e adquirir responsabilidades essenciais à formação médica desde o primeiro período do curso de medicina. Logo a descrição da experiência deste trabalho incentiva a reprodutibilidade de iniciativas semelhantes que possam contribuir para a formação médica de qualidade para futuros profissionais da saúde

Schwannoma Retroperitoneal Maligno

O schwannoma ou neurilenoma é um tumor raro que se desenvolve nas células de Schwann, na bainha dos nervos periféricos, tem crescimento lento, e pouca ou nenhuma sintomatologia, passando despercebido por um longo período. A finalidade deste trabalho é relatar dois casos de schwannoma maligno do retroperitônio, observados e tratados em nosso Serviço, bem como uma breve revisão da literatura à respeito desta patologia

A PRODUÇÃO DE UM JOGO RPG ELETRÔNICO COMO ABORDAGEM INTEGRADA DE SISTEMAS DO CORPO HUMANO: UM RELATO DE EXPERIÊNCIA

Introduction: The traditional education, based on expositive classes in which the teachers are the protagonists and the students are put as passive spectators, is still used by the majority of educational institutions. However, some methods can make students directly responsible for their knowledge and have shown to be effective in encouraging autonomy and reasoning. Furthermore, during the Covid-19 pandemic, there was a need to change the way of teaching, investing in active and attractive methodologies, such as electronic games, to ensure that learning is satisfying.Therefore, the objective of this report is to describe the experience of elaborating an educational game for and to medical students. Experience report: Based on the proposal of an academic work from the medical course, the game "Pâncrea Bit", a storyteller role playing game, was created and it integrated some subjects as diabetes 3C and chronic pancreatitis by a group with 13 participants which divided the functions. In addition, an educational material was produced with the topics covered in the game and complementary image animations. Discussion: Although there is no scientific proof of the efficiency of the educational method utilizing games in comparison to the traditional when analyzing the professionals quality, it is already known that this kind of teaching gives more satisfaction to the students.This was demonstrated by the massive participation of other students in conducting and solving the “Pâncrea Bit” quizzes. Conclusion: The gamification aroused interest, motivation and introduced the student as protagonist besides contributing to long-term memory, showing that is a valid  and applicable method to concretize knowledge in every learning stage.Introdução: A forma tradicional de educação, baseada em aulas expositivas, nas quais os professores são figuras protagonistas e o estudante é colocado na posição de espectador passivo, ainda é a mais utilizada pela maioria das instituições de ensino. Entretanto, alguns métodos podem transformar o estudante em ator diretamente responsável pela obtenção do seu conhecimento e demonstram ser eficazes ao incentivar autonomia e raciocínio. Ademais, durante a pandemia do Covid-19, houve a necessidade de modificação do método de ensino, sendo necessário o investimento em metodologias ativas e atrativas, como jogos eletrônicos, para garantir que a aprendizagem ocorra de forma satisfatória. Portanto, este relato objetiva descrever a experiência da elaboração de um jogo didático por estudantes de medicina para seus pares. Relato de experiência: A partir da proposta de um trabalho acadêmico do curso de medicina, houve a criação do jogo intitulado “Pâncrea Bit”, do tipo role playing game (RPG) storyteller, no qual houve a integração de conteúdos do curso médico (diabetes tipo 3C e pancreatite crônica) e a divisão de funções entre os 13 integrantes do grupo. Ademais, foi produzido um material didático com os assuntos abordados do jogo e animações em imagens complementares. Discussão: Apesar de não haver comprovação científica da eficácia do método ativo, através de jogos, em relação ao método tradicional, quando se trata de formar melhores profissionais, sabe-se que essa forma de ensino aumenta a satisfação do educando. Isso foi demonstrado com a participação maciça de outros estudantes na condução e resolução dos quizzes do “Pâncrea Bit”. Conclusão: A gamificação despertou interesse, motivação e introdução do aluno como protagonista, além de contribuir para a memória de longo prazo, mostrando-se um método válido e aplicável para a solidificação do conhecimento em diversos estágios de aprendizagem

Comparison and combination of a hemodynamics/biomarkers-based model with simplified PESI score for prognostic stratification of acute pulmonary embolism: findings from a real world study

Background: Prognostic stratification is of utmost importance for management of acute Pulmonary Embolism (PE) in clinical practice. Many prognostic models have been proposed, but which is the best prognosticator in real life remains unclear. The aim of our study was to compare and combine the predictive values of the hemodynamics/biomarkers based prognostic model proposed by European Society of Cardiology (ESC) in 2008 and simplified PESI score (sPESI).Methods: Data records of 452 patients discharged for acute PE from Internal Medicine wards of Tuscany (Italy) were analysed. The ESC model and sPESI were retrospectively calculated and compared by using Areas under Receiver Operating Characteristics (ROC) Curves (AUCs) and finally the combination of the two models was tested in hemodinamically stable patients. All cause and PE-related in-hospital mortality and fatal or major bleedings were the analyzed endpointsResults: All cause in-hospital mortality was 25% (16.6% PE related) in high risk, 8.7% (4.7%) in intermediate risk and 3.8% (1.2%) in low risk patients according to ESC model. All cause in-hospital mortality was 10.95% (5.75% PE related) in patients with sPESI score ≥1 and 0% (0%) in sPESI score 0. Predictive performance of sPESI was not significantly different compared with 2008 ESC model both for all cause (AUC sPESI 0.711, 95% CI: 0.661-0.758 versus ESC 0.619, 95% CI: 0.567-0.670, difference between AUCs 0.0916, p=0.084) and for PE-related mortality (AUC sPESI 0.764, 95% CI: 0.717-0.808 versus ESC 0.650, 95% CI: 0.598-0.700, difference between AUCs 0.114, p=0.11). Fatal or major bleedings occurred in 4.30% of high risk, 1.60% of intermediate risk and 2.50% of low risk patients according to 2008 ESC model, whereas these occurred in 1.80% of high risk and 1.45% of low risk patients according to sPESI, respectively. Predictive performance for fatal or major bleeding between two models was not significantly different (AUC sPESI 0.658, 95% CI: 0.606-0.707 versus ESC 0.512, 95% CI: 0.459-0.565, difference between AUCs 0.145, p=0.34). In hemodynamically stable patients, the combined endpoint in-hospital PE-related mortality and/or fatal or major bleeding (adverse events) occurred in 0% of patients with low risk ESC model and sPESI score 0, whilst it occurred in 5.5% of patients with low-risk ESC model but sPESI ≥1. In intermediate risk patients according to ESC model, adverse events occurred in 3.6% of patients with sPESI score 0 and 6.65% of patients with sPESI score ≥1.Conclusions: In real world, predictive performance of sPESI and the hemodynamic/biomarkers-based ESC model as prognosticator of in-hospital mortality and bleedings is similar. Combination of sPESI 0 with low risk ESC model may identify patients with very low risk of adverse events and candidate for early hospital discharge or home treatment.