Social determinants of place attachment at a World Heritage site

While the work on place attachment is extensive, it neglects to focus on residents' and tourists' perspectives of the construct concurrently. Additionally, the role that social factors play in forging attachment to place is lacking within the tourism literature. This work focuses on whether residents' (n = 469) and tourists' (n = 461) degree of place attachment at the Osun Oshogbo Cultural Festival (Nigeria) were significantly different. Examining the psychometric properties of the place attachment scale in an international context was a second aim. The final purpose of this work was to assess whether social factors (i.e., frequency of interaction and emotional closeness) between residents and tourists could explain the resulting CFA place attachment factors. MANOVA results revealed tourists demonstrated a significantly higher degree of attachment. Each social determinant predicted the attachment factors for both samples, with the two independent variables explaining higher degrees of variance among residents

Η τοξικότητα των νεότερων ανοσοθεραπευτικών μορίων στο δέρμα και το νεφρό. Παθολογοανατομική και κλινική έκφραση

Εισαγωγή Οι πρόσφατες εξελίξεις στην ανοσολογία του καρκίνου, έχουν ενσωματώσει τη χρήση των αναστολέων σημείων ελέγχου του ανοσοποιητικού συστήματος (immune check point inhibitors-ICIs) στη καθ’ημέρα κλινική ογκολογική πράξη. Ωστόσο, τα νεότερα αυτά αντισώματα, ενέχονται για ανεπιθύμητες ενέργειες από όλα τα συστήματα, ιδιαίτερα των νεφρών και του δέρματος. Η γνώση και η βαθύτερη κατανόηση των υποκείμενων παθοφυσιολογικών μηχανισμών δράσης των νέων αυτών θεραπειών, μπορεί να καθοδηγεί πιο εμπεριστατωμένα τις κλινικές αποφάσεις. Μεθοδολογία Η παρούσα μελέτη περιλαμβάνει ανασκόπηση της υπάρχουσας βιβλιογραφίας σχετικά με την τοξικότητα των ICIs σε ασθενείς με κακοήθη νεοπλάσματα, από τους νεφρούς και το δέρμα. Περιλαμβάνει επίσης αναδρομική μελέτη σε σειρά ασθενών , οι οποίοι παρουσίασαν ανεπιθύμητες ενέργειες από τους νεφρούς και το δέρμα, μετά από λήψη ICIs και νοσηλεύθηκαν στην Ογκολογική Κλινική του Γενικού Νοσοκομείου «ο Ευαγγελισμός», στην τελευταία διετία. Αποτελέσματα Στη μελέτη παρουσιάζονται έντεκα ασθενείς με τοξικότητα από τους νεφρούς και επτά ασθενείς με τοξικότητα του δέρματος από ICIs. Τα κύρια δημογραφικά , και κλινικά χαρακτηριστικά των ασθενών παρουσιάζονται και συζητούνται τα ιστολογικά δεδομένα από τις βιοψίες των σχετικών βλαβών. Συμπεράσματα Πρόκειται για μια μελέτη καταγραφής και παρουσίασης δεδομένων της τοξικότητας στους νεφρούς και το δέρμα από χρήση ICIs σε ογκολογικούς ασθενείς. Παρέχει στοιχεία σχετικά με κλινικά, και παθολογοανατομικά χαρακτηριστικά των βλαβών , με σκοπό την ευαισθητοποίηση , των κλινικών στην έγκαιρη αναγνώριση των νεότερων αυτών τοξικοτήτων, για να δρομολογούντα οι δέουσες θεραπευτικές παρεμβάσεις.Introduction Recent advances in cancer immunotherapy have incorporated immune check point inhibitors (ICIs) in several therapeutic algorithms of various cancers. Hence, these medical agents have been associated with several adverse events from all body systems, particularly skin and renal. Methodology This paper reviews the existing literature regarding renal and skin toxicity from ICIs in cancer patients. A retrospective study of cancer patients in Greece, who presented with ICI- related renal and cutaneous adverse recorded events at Oncology Department of Evaggelismos General Hospital, in a mean time of 2 subsequent years, is also provided. Results Eleven patients with renal toxicity post ICIs treatment were included in our study and seven patients with cutaneous ICI- related adverse reactions . All demographic, clinical and histological data are presented and discussed. Conclusion This study describes in details, the characteristics of ICI- related renal and cutaneous toxicity. It provides evidence about promptly detection of clinical features in skin and renal in association with ICI- related toxicities and fully explains these special distinct histological patterns

Immune Checkpoint Inhibitors’ Associated Renal Toxicity: A Series of 12 Cases

We present a series of twelve patients, bearing a wide range of solid malignancies, who received either PD-L1 or a combination of PD-L1 and CTLA-4 inhibitors. Following immunotherapy administration, they exhibited the clinical signs indicative of renal toxicity, including increased serum creatinine levels, proteinuria, nephrotic syndrome and/or hematuria. All patients underwent renal biopsy. Results: All cases demonstrated some degree of interstitial inflammation and tubular injury, while in five patients, glomerular alterations consistent with a specific glomerulopathy were also observed: secondary “lupus-like” membranous glomerulopathy in two cases and membranoproliferative glomerulonephritis, IgA glomerulonephritis and secondary AA amyloidosis in each of the remaining three patients. The two patients with “lupus-like” nephritis and the one with amyloidosis experienced nephrotic syndrome, while their creatinine was within normal range. In the remaining nine cases, deterioration of renal function was the main manifestation. Conclusion: Our findings harmonize with bibliographical data that identify tubulointerstitial nephritis as the most frequent histological lesion related to ICIs administration. The preferential involvement of tubulointerstitial tissue could be associated with the reported higher expression levels of PD-L1 on tubular epithelial cells, compared to glomeruli. On the other hand, glomerular involvement is probably a consequence of a systemic immune system reconstruction, induced by immune-checkpoints inhibition

Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma

Abstract Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance. Explainable AI (XAI) methods can help to increase transparency, yet often lack precise, domain-specific explanations. Moreover, the impact of XAI methods on dermatologists’ decisions has not yet been evaluated. Building upon previous research, we introduce an XAI system that provides precise and domain-specific explanations alongside its differential diagnoses of melanomas and nevi. Through a three-phase study, we assess its impact on dermatologists’ diagnostic accuracy, diagnostic confidence, and trust in the XAI-support. Our results show strong alignment between XAI and dermatologist explanations. We also show that dermatologists’ confidence in their diagnoses, and their trust in the support system significantly increase with XAI compared to conventional AI. This study highlights dermatologists’ willingness to adopt such XAI systems, promoting future use in the clinic