INPUT DEVICE RESEARCH FOR DIGITAL PATHOLOGY. AN ERGONOMIC OUTLOOK

Introduction/ Background Digital Pathology represents a technological innovation that introduces changes in the traditional work of pathologists. In this regard, an important issue that has not been enough emphasized is the image handling from an ergonomic point of view to avoid work-related musculoskeletal disorders (MSD). Aims The aim of this study was to investigate a proper input device for digital pathology. Methods Research was conducted in two phases: 1. Comparative study to find an optimal external controller. Eight medical students analyzed 11 input devices: keyboard (HP), conventional mouse (HP), vertical mouse (CLS), touchpad (Logitech), 3 trackballs (Logitech, Kensington Expert and Ulove), Rollermouse (Contour), Ergopointer (Märzhäuser Sensotech), gamepad (Logitech) and a touchless device (Leap-Motion), using them with the Image Viewer software (Ventana). The web-based Fitts´ law test (UC Berkeley) was used to objectify the accuracy of each device, randomly. 12 items were included in the questionnaire: comfort, technical aspects (cursor movement and objective achievement), prospects, overall satisfaction, prior experience, and others. 2. Evaluation by two experienced pathologists (MPR and ANO, 55 and 50 year-old, respectively) the best rated input device and comparison with a voice recognition system (Invox Medical Dictation) using a headset microphone (Plantronics), rating perceived workload using NASA Task Load Index with 28 whole slide images. Digital Image Hub (Leica) with a 4 MegaPixel display (Barco) was used. Data were processed with SPSS 21.0. Results Correlation between technical aspects of the evaluated devices and accuracy (Fitts´ law test), and comfort with overall satisfaction existed (p<0.05). The assessment concluded that vertical mouse was the best rated input device. However, it has a slightly higher perceived workload in comparison with the voice recognition system, which was the proper controller for digital pathology in this study. Conclusion: We describe a methodology that can study and compare input devices for future workstations in digital pathology. Pathologists should be involved in this process trying to find ergonomic devices that prevent MSD. Voice recognition can function as a good handsfree device for digital pathology and could be considered in physical disability situations. Further studies using electromyography, accelerometry and 3D reconstruction analysis could provide additional ergonomic information

Alopecia frontal fibrosante: relato de seis casos Frontal fibrosing alopecia: report of six cases

Alopecia frontal fibrosante é forma progressiva de alopecia cicatricial. Os casos iniciais foram relatados a partir 1994, na Austrália, em pacientes do sexo feminino pós-menopausa. Desde então inúmeros casos foram descritos na literatura sugerindo que ela é mais prevalente do que inicialmente se supunha. Seu curso progressivo se assemelha ao da alopecia androgenética; histologicamente, entretanto, o infiltrado liquenóide é evidente. O artigo relata seis casos brasileiros e discute a alopecia frontal fibrosante dentro do grupo das alopecias cicatriciais, como variante do líquen plano pilar.<br>Frontal fibrosing alopecia is a progressive cicatricial alopecia. The first cases were described in Australia in postmenopausal women, in 1994. Since then, numerous cases were reported, suggesting that frontal fibrosing alopecia is more prevalent than initially thought. Its progressive course in postmenopausal women, clinically resembles androgenetic alopecia; however, histologically, lichenoid infiltrate is evident. This article report six brazilian cases of frontal fibrosing alopecia and discusses them in the context of cicatricial alopecias, as a variant of lichen planopilaris

Deepwater fold-and-thrust belt along New Caledonia's western margin: relation to post-obduction vertical motions

Classically, deepwater fold-and-thrust belts are classified in two main types, depending if they result from near- or far-field stresses and the understanding of their driving and triggering mechanism is poorly known. We present a geophysical dataset off the western margin of New Caledonia (SW Pacific) that reveals deformed structures of a deepwater fold-and-thrust belt that we interpret as a near-field gravity-driven system, which is not located at a rifted passive margin. The main factor triggering deformation is inferred to be oversteepening of the margin slope by post-obduction isostatic rebound. Onshore erosion of abnormally-dense obducted material, combined with sediment loading in the adjacent basin, has induced vertical motions that have caused oversteepening of the margin. Detailed morpho-bathymetric, seismic stratigraphic and structural analysis reveals that the fold-and-thrust belt extends 200 km along the margin, and 50 km into the New Caledonia Trough. Deformation is rooted at depths greater than 5 km beneath the seafloor, affects an area of 3500 km2, and involves a sediment volume of approximately 13 000 km3. This deformed belt is organized into an imbricate fan system of faults, and one out-of-sequence thrust fault affects the seabed. The thrust faults are deeply rooted in the basin along a low-angle floor thrust and connected to New Caledonia Island along a major detachment. This study not only provides a better knowledge of the New Caledonia margin, but also provides new insight into the mechanisms that trigger deepwater fold-and-thrust belts

Differences in Comorbidity Burden Between those with Chronic Kidney Disease and Normal Renal Function

Introduction and Aims: Chronic kidney disease (CKD) and renal replacement therapy are both associated with significant mortality and morbidity. Co-existing comorbidity is common. The degree to which the increased morbidity and mortality is a result of the CKD, and how much a result of the co-existing comorbidity is less clear. We aimed to describe the range of comorbidity at baseline in a population cohort containing all identified within a healthcare region with CKD, those on RRT and a sample of 20,000 individuals from the same population with normal renal function. Methods: The GLOMMS-II cohort contained all individuals with a low eGFR (<60) ml/min/1.73m2 measured in our healthcare region in 2003 (in 2/3 of these with “CKD” the low eGFR was present for at least 90 days, in 1/3 with “impaired eGFR” it was not present for at least 90 days); all those with raised PCR and ACR; all those receiving RRT and a 20,000 sample of those with only normal eGFR measurements in 2003. Data-linkage to hospital episode statistics in the five years prior gave information on comorbidity in 2003. The prevalence of common comorbidities in the subgroups of the cohort is described. The odds of having each comorbidity at baseline with adjustment for age and sex are presented. Results: The prevalence of most comorbidities was higher in those with more advanced CKD (including RRT, as table). After correction for age and sex, vascular comorbidity, diabetes and haematological malignancy continued to be strongly associated with more advanced CKD. The association for other comorbidities was less marked, particularly for dementia. Impaired eGFR was also associated with many of these comorbidities Conclusions: More advanced CKD was strongly associated with vascular comorbidity and diabetes even after correction for age. This association may in part be due to the role of these comorbidities in the aetiology of CKD, as well as a consequence. In the assessment of outcomes in CKD, the effect of these comorbidities on outcome over and above that of CKD itself should be investigated further