Systematic review of the use of financial incentives in treatments for obesity and overweight

Nine studies met the criteria for inclusion in this systematic review of randomized controlled trials of treatments for obesity and overweight involving the use of financial incentives, with reported follow-up of at least 1 year. All included trials were of behavioural obesity treatments. Justification of sample size and blinding procedure were not mentioned in any study. Attrition was well described in three studies and no study was analysed on an intention to treat basis. Participants were mostly women recruited through media advertisements. Mean age ranged from 35.7 to 52.8 years, and mean body mass index from 29.3 to 31.8 kg m−2. Results from meta-analysis showed no significant effect of use of financial incentives on weight loss or maintenance at 12 months and 18 months. Further sub-analysis by mode of delivery and amount of incentives although also non-statistically significant were suggestive of very weak trends in favour of use of amounts greater than 1.2% personal disposable income, rewards for behaviour change rather than for weight, rewards based on group performance rather than for individual performance and rewards delivered by non-psychologists rather than delivered by psychologists.The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Executive Health Department. The views expressed here are those of the authors. Alison Avenell is funded by a Career Scientist Award from the Chief Scientist Office of the Scottish Executive Health Departmen

COVID-19 and psoriasis: Is it time to limit treatment with immunosuppressants? A call for action

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An unusual presentation of genital herpes in a patient affected by lichen sclerosus et atrophicus: A case report and a combined treatment proposal

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The impact of transanal local excision of early rectal cancer on completion rectal resection without neoadjuvant chemoradiotherapy: a systematic review

Background The impact of transanal local excision (TAE) of early rectal cancer (ERC) on subsequent completion rectal resection (CRR) for unfavorable histology or margin involvement is unclear. The aim of this study was to provide a comprehensive review of the literature on the impact of TAE on CRR in patients without neoadjuvant chemoradiotherapy (CRT). Methods We performed a systematic review of the literature up to March 2020. Medline and Cochrane libraries were searched for studies reporting outcomes of CRR after TAE for ERC. We excluded patients who had neoadjuvant CRT and endoscopic local excision. Surgical, functional, pathological and oncological outcomes were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Results Sixteen studies involving 353 patients were included. Pathology following TAE was as follows T0 = 2 (0.5%); T1 = 154 (44.7%); T2 = 142 (41.2%); T3 = 43 (12.5%); Tx = 3 (0.8%); T not reported = 9. Fifty-three percent were > T1. Abdominoperineal resection (APR) was performed in 80 (23.2%) patients. Postoperative major morbidity and mortality occurred in 22 (11.4%) and 3 (1.1%), patients, respectively. An incomplete mesorectal fascia resulting in defects of the mesorectum was reported in 30 (24.6%) cases. Thirteen (12%) patients developed recurrence: 8 (3.1%) local, 19 (7.3%) distant, 4 (1.5%) local and distant. The 5-year cancer-specific survival was 92%. Only 1 study assessed anal function reporting no continence disorders in 11 patients. In the meta-analysis, CRR after TAE showed an increased APR rate (OR 5.25; 95% CI 1.27-21.8; p 0.020) and incomplete mesorectum rate (OR 3.48; 95% CI 1.32-9.19; p 0.010) compared to primary total mesorectal excision (TME). Two case matched studies reported no difference in recurrence rate and disease free survival respectively. Conclusions The data are incomplete and of low quality. There was a tendency towards an increased risk of APR and poor specimen quality. It is necessary to improve the accuracy of preoperative staging of malignant rectal tumors in patients scheduled for TAE

Use of noninvasive imaging in the management of skin cancer

6Purpose of review: To evaluate noninvasive imaging techniques in the management of skin cancers. Recent findings: In the last decades, a wide range of noninvasive imaging methods has been developed in the field of dermatooncology with the aim to detect and assess the several structural and molecular changes that characterize skin cancer development and progression. Summary: In this review, we discuss the current and emerging applications of noninvasive imaging approaches in skin cancer management, such as digital photography, dermoscopy, ultrasound sonography, reflectance confocal microscopy, optical coherence tomography, electrical impedance techniques, Raman spectroscopy, multispectral imaging, fluorescence imaging, and multispectral optoacustic tomography.partially_openopenGiuffrida, Roberta; Conforti, Claudio; Di Meo, Nicola; Deinlein, Teresa; Guida, Stefania; Zalaudek, IrisGiuffrida, Roberta; Conforti, Claudio; Di Meo, Nicola; Deinlein, Teresa; Guida, Stefania; Zalaudek, Iri

Evidence for proton acceleration and escape from the Puppis A SNR using Fermi-LAT observations

Supernova remnants (SNRs) are the best candidates for galactic cosmic ray acceleration to rela- tivistic energies via diffusive shock acceleration. The gamma-ray emission of SNRs can provide direct evidence of leptonic (inverse Compton and bremsstrahlung) and hadronic (proton-proton interaction and subsequently pion decay) processes. Puppis A is a ∼4 kyr old SNR interacting with interstellar clouds which has been observed in a broad energy band, from radio to gamma-ray. We performed a morphological and spectral analysis of 14 years of observations with Fermi-LAT telescope in order to study its gamma-ray emission. We found a clear asymmetry in high-energy brightness between the eastern and western sides of the remnant, reminiscent to that observed in the X-ray emission. The eastern side, interacting with a molecular cloud, shows a spectrum which can be reproduced by a pion decay model. Moreover, we analyzed two gamma-ray sources located close to the remnant. The hardness of their spectra suggests that the gamma-ray emission can be due to particles escaping from the shock of Puppis A

Integrating the concept of field cancerization in the classification and risk assessment of cutaneous squamous cell carcinoma: proposal for a new classification and terminology of keratinocyte skin cancer.

The term keratinocyte skin cancer (KC) stands as an umbrella for different stages within the progression of cutaneous squamous cell carcinoma (cSCC). 1\u20102 Its earliest form is named actinic keratosis (AK), while for the in\u2010situ form different synonyms, namely intraepidermal carcinoma (IEC), Bowen's Diseases (BD) and cutaneous squamous cell carcinoma in situ [cSCC(Tis)] or intraepithelial squamous cell carcinoma (iSCC) are used.3 Instead, cSCC is histopathologically classified into well, moderately and poorly differentiated subtypes

Investigating halo substructures with annual modulation signature

Galaxy hierarchical formation theories, numerical simulations, the discovery of the Sagittarius Dwarf Elliptical Galaxy (SagDEG) in 1994 and more recent investigations suggest that the dark halo of the Milky Way can have a rich phenomenology containing non thermalized substructures. In the present preliminary study, we investigate the case of the SagDEG (the best known satellite galaxy in the Milky Way crossing the solar neighbourhood) analyzing the consequences of its dark matter stream contribution to the galactic halo on the basis of the DAMA/NaI annual modulation data. The present analysis is restricted to some WIMP candidates and to some of the astrophysical, nuclear and particle Physics scenarios. Other candidates such as e.g. the light bosonic ones, we discussed elsewhere, and other non thermalized substructures are not yet addressed here.Comment: 17 pages, 10 figures, to appear in Eur. Phys. J.