Should a Sentinel Node Biopsy Be Performed in Patients with High-Risk Breast Cancer?

A negative sentinel lymph node (SLN) biopsy spares many breast cancer patients the complications associated with lymph node irradiation or additional surgery. However, patients at high risk for nodal involvement based on clinical characteristics may remain at unacceptably high risk of axillary disease even after a negative SLN biopsy result. A Bayesian nomogram was designed to combine the probability of axillary disease prior to nodal biopsy with customized test characteristics for an SLN biopsy and provides the probability of axillary disease despite a negative SLN biopsy. Users may individualize the sensitivity of an SLN biopsy based on factors known to modify the sensitivity of the procedure. This tool may be useful in identifying patients who should have expanded upfront exploration of the axilla or comprehensive axillary irradiation

Análisis de co-palabras aplicado a los artículos muy citados en Biblioteconomía y Ciencias de la Información (2007-2017)

Se identifican las relaciones entre los conceptos y las áreas temáticas principales dentro de la categoría Biblioteconomía y Ciencias de la Información de Web of Science, en el periodo 2007-2017, utilizando la herramienta analítica “Essential Science Indicators”. Partiendo de los artículos altamente citados, la metodología consistió en la aplicación de análisis de co-palabras así como técnicas estadísticas de análisis multivariante y visualización a través de un mapa de la ciencia. Los resultados principales mostraron que las áreas de mayor interés para los investigadores fueron los estudios sobre la Web 2.0 basados en la participación colaborativa de los usuarios, la evaluación de las actividades científica, las métricas alternativas, o Altmetrics, desarrolladas en las plataformas sociales y académicas, la seguridad y confianza en los entornos virtuales y, por último, la aplicación de plataformas digitales en el comercio electrónicoThis paper aims to identify the conceptual structure in the category Library and Information Sciences in the Web of Science, in the period 2007-2017, using the analytical tool Essential Science Indicators. Based on highly cited papers, the methodology consisted in the application of co-word analysis and multivariate analysis techniques and visualization through science mapping. The main results showed that the studies on Web 2.0 based on the collaborative participation of the users, the evaluation of scientific activities, as well as the alternative metrics developed in the social and academic platforms, such as Altmetrics, trust in virtual environments, and the application of information technologies in companies and digital e-commerce platforms were the areas of greatest interest to the researchers

Identification of inappropriate prescribing in a Brazilian nursing home using STOPP/START screening tools and the Beers' Criteria

The objective of this study was to determine the prevalence of Potentially Inappropriate Medication (PIM) use and associated factors, as well as the prevalence of Prescribing Omissions (PO). A cross-sectional study was conducted in a philanthropic Brazilian nursing home involving 46 individuals aged 60 years or older. The following information was collected from medical records and drug prescriptions: gender, age, health conditions and drugs used in the past thirty days. PIM and PO were identified according to the Beers' Criteria and the STOPP/START screening tools. Over one third (37%) of the population used at least one PIM according to the Beers' Criteria (n=17) and 60.9% according to the STOPP tool. A significant association was found between polypharmacy (use of five or more drugs) and use of PIM according to the Beers' Criteria, but not according to the STOPP. Eight residents (17.4%) were exposed to eight PO. This study allowed the diagnosis of a concerning drug utilization profile with use of a high number of PIMs. Thus, there is an evident need to implement strategies for improving geriatric prescription

The under-reported role of toxic substance exposures in the COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) and previous pandemics have been viewed almost exclusively as virology problems, with toxicology problems mostly being ignored. This perspective is not supported by the evolution of COVID-19, where the impact of real-life exposures to multiple toxic stressors degrading the immune system is followed by the SARS-CoV-2 virus exploiting the degraded immune system to trigger a chain of events ultimately leading to COVID-19. This immune system degradation from multiple toxic stressors (chemical, physical, biological, psychosocial stressors) means that attribution of serious consequences from COVID-19 should be made to the virus-toxic stressors nexus, not to any of the nexus constituents in isolation. The leading toxic stressors (identified in this study as contributing to COVID-19) are pervasive, contributing to myriad chronic diseases as well as immune system degradation. They increase the likelihood for comorbidities and mortality associated with COVID-19. For the short-term, tactical/reactive virology-focused treatments are of higher priority than strategic/proactive toxicology-focused treatments, although both could be implemented in parallel to reinforce each other. However, for long-term pandemic prevention, toxicology-based approaches should be given higher priority than virology-based approaches. Since current COVID-19 treatments globally ignore the toxicology component almost completely, only limited benefits can be expected from these treatments. © 2020 Elsevier Lt

Status and prospects of advanced fissile fuel breeders

Fusion--fission hybrid systems, fast breeder systems, and accelerator breeder systems were compared on a common basis using a simple economic model. Electricity prices based on system capital costs only were computed, and were plotted as functions of five key breeder system parameters. Nominally, hybrid system electricity costs were about twenty-five percent lower than fast breeder system electricity costs, and fast breeder system electricity costs were about forty percent lower than accelerator breeder system electricity costs. In addition, hybrid system electricity costs were very insensitive to key parameter variations on the average, fast breeder system electricity costs were moderately sensitive to key parameter variations on the average, and accelerator breeder system electricity costs were the most sensitive to key parameter variations on the average

Vaccine- and natural infection-induced mechanisms that could modulate vaccine safety

A degraded/dysfunctional immune system appears to be the main determinant of serious/fatal reaction to viral infection (for COVID-19, SARS, and influenza alike). There are four major approaches being employed or considered presently to augment or strengthen the immune system, in order to reduce adverse effects of viral exposure. The three approaches that are focused mainly on augmenting the immune system are based on the concept that pandemics/outbreaks can be controlled/prevented while maintaining the immune-degrading lifestyles followed by much of the global population. The fourth approach is based on identifying and introducing measures aimed at strengthening the immune system intrinsically in order to minimize future pandemics/outbreaks. Specifically, the four measures are: 1) restricting exposure to virus; 2) providing reactive/tactical treatments to reduce viral load; 3) developing vaccines to prevent, or at least attenuate, the infection; 4) strengthening the immune system intrinsically, by a) identifying those factors that contribute to degrading the immune system, then eliminating/reducing them as comprehensively, thoroughly, and rapidly as possible, and b) replacing the eliminated factors with immune-strengthening factors. This paper focuses on vaccine safety. A future COVID-19 vaccine appears to be the treatment of choice at the national/international level. Vaccine development has been accelerated to achieve this goal in the relatively near-term, and questions have arisen whether vaccine safety has been/is being/will be compromised in pursuit of a shortened vaccine development time. There are myriad mechanisms related to vaccine-induced, and natural infection-induced, infections that could adversely impact vaccine effectiveness and safety. This paper summarizes many of those mechanisms. © 2020 The Author(s

Link-the-Wiki : performance evaluation based on frequent phrases

In this paper, we discuss our participation to the INEX 2008 Link-the-Wiki track. We utilized a sliding window based algorithm to extract the frequent terms and phrases. Using the extracted phrases and term as descriptive vectors, the anchors and relevant links (both incoming and outgoing) are recognized efficiently