Evolución de la atención de pacientes con cáncer de mama y riesgo genético en el Hospital General Universitario Gregorio Marañón: impacto de la implementación de una unidad multidisciplinar de cáncer heredofamiliar

La identificación de pacientes con cáncer de mama y riesgo genético ha demostrado un impacto en la disminución de la mortalidad por cáncer de mama y en la prevención de tumores metacrónicos. Por este motivo, las guías internacionales recomiendan que esta identificación se lleve a cabo en el contexto de un adecuado asesoramiento que permita a cada paciente y su familia establecer las medidas más adecuadas de diagnóstico, seguimiento o tratamiento en función de su carga genética. El objetivo principal de este trabajo es confirmar la hipótesis de que la sistematización de la atención de pacientes con cáncer de mama y criterios de riesgo en nuestra Institución a través de la implementación de una Unidad de Cáncer Heredofamiliar (UCHF) ha supuesto una mejora en la detección, derivación y manejo de pacientes con cáncer de mama y riesgo genético. Como objetivo secundario se realizó un análisis de las características de los pacientes portadores de mutación en comparación con los no mutados y se desarrolló un análisis de minimización de costes mediante el empleo de plataformas de secuenciación masiva..

Complete Response to Chemotherapy in A Patient with Unresectable Extrahepatic Cholangiocarcinoma

Introduction: Biliary tract cancer (BTC) is an uncommon tumor with bad prognosis. There is no curative treatment for patients with unresectable disease at diagnosis. There is a limited experience with second-line chemotherapy in advanced BTC since clinical trials are difficult to perform due to the rarity and heterogeneity of these tumors. Recent molecular studies have increased our understanding of the pathogenetic mechanism that underly the development of cholangiocarcinoma. These will help us to determine the significance of molecular alterations that occur in this disease and will direct the development of targeted therapy. Case Report: This case report describes a radiological complete response after three cycles of second-line chemotherapy with the combination of capecitabine and oxaliplatin in a patient with unresectable extrahepatic cholangiocarcinoma, after treatment with the combination of gemcitabine and cisplatin as first-line chemotherapy. Conclusion: Our case suggests that selected patients may demonstrate very good responses to chemotherapy. There is an urgent need to identify different molecular subtypes that could direct management of these patients.Medicin

Semantic Web technologies and bias in artificial intelligence: A systematic literature review

Bias in Artificial Intelligence (AI) is a critical and timely issue due to its sociological, economic and legal impact, as decisions made by biased algorithms could lead to unfair treatment of specific individuals or groups. Multiple surveys have emerged to provide a multidisciplinary view of bias or to review bias in specific areas such as social sciences, business research, criminal justice, or data mining. Given the ability of Semantic Web (SW) technologies to support multiple AI systems, we review the extent to which semantics can be a “tool” to address bias in different algorithmic scenarios. We provide an in-depth categorisation and analysis of bias assessment, representation, and mitigation approaches that use SW technologies. We discuss their potential in dealing with issues such as representing disparities of specific demographics or reducing data drifts, sparsity, and missing values. We find research works on AI bias that apply semantics mainly in information retrieval, recommendation and natural language processing applications and argue through multiple use cases that semantics can help deal with technical, sociological, and psychological challenges

Knowledge-Grounded Target Group Language Recognition in Hate Speech

Hate speech comes in different forms depending on the communities targeted, often based on factors like gender, sexuality, race, or religion. Detecting it online is challenging because existing systems are not accounting for the diversity of hate based on the identity of the target and may be biased towards certain groups, leading to inaccurate results. Current language models perform well in identifying target communities, but only provide a probability that a hate speech text contains references to a particular group. This lack of transparency is problematic because these models learn biases from data annotated by individuals who may not be familiar with the target group. To improve hate speech detection, particularly target group identification, we propose a new hybrid approach that incorporates explicit knowledge about the language used by specific identity groups. We leverage a Knowledge Graph (KG) and adapt it, considering an appropriate level of abstraction, to recognise hate speech-language related to gender and sexual orientation. A thorough quantitative and qualitative evaluation demonstrates that our approach is as effective as state-of-the-art language models while adjusting better to domain and data changes. By grounding the task in explicit knowledge, we can better contextualise the results generated by our proposed approach with the language of the groups most frequently impacted by these technologies. Semantic enrichment helps us examine model outcomes and the training data used for hate speech detection systems, and handle ambiguous cases in human annotations more effectively. Overall, infusing semantic knowledge in hate speech detection is crucial for enhancing understanding of model behaviors and addressing biases derived from training data

Evaluation of access to oral health and the need for treatment in adolescents in a full-time school system

This study evaluated the self-perception of adolescents\u27 oral health and their oral conditions and the need for treatment in relation to dental caries. An epidemiological survey was carried out in the municipality of Belém, Pará, Brazil, in 2018. The sample consisted of 200 students, aged 11 to 16 years old, from a full-time public school. The data were collected through a questionnaire where their self-perception of their oral health was assessed and an intra-oral examination was carried out to assess oral health conditions in relation to dental caries, using the Dental Caries Index and need for treatment (ICDNT). The data analysis was based on the Chi-square test, and when the npq <5 restriction occurred, Fisher\u27s exact test was applied. The comparison between quantitative variables was performed using the Student\u27s t test. The average DMFT index was 3.57, with only 17% of the studied population free of caries. The carious component was the one with the greatest significance (3.14) and the need for treatment with the highest prevalence was the restoration of one face (47.5%). A percentage of 88.5% of the adolescents evaluated answered that they did not take a toothbrush to school. The studied sample had a moderate prevalence of caries compared to the parameters recommended by the WHO, but above the standard obtained in the national survey carried out in 2010. Therefore, it is necessary to implement measures aimed at improving the quality of oral health of these adolescents and a full-time system would be a ideal for implementing good habits and routines for the adolescent’s oral health

Postural Alterations in Breast Cancer Patients Undergoing Chemotherapy Treatment

Breast cancer (BC) is the most common malignant neoplasm in women worldwide. Chemotherapy (CT) remains essential in the treatment of this type of tumour. Patients may present musculoskeletal disorders due to the side effects of CT, which can lead to inability to walk, fall, or fractures associated with balance disorders. The objective of the present review is to analyse postural alterations in patients with BC undergoing CT. Previous reports both prospective and retrospective cohort studies from 2010 to 2020, were included. The results show a strong relationship between postural alterations and patients with BC undergoing CT treatment. These data suggest that exposure to CT is an important factor not only for the presence of balance alterations and risk of falls but also for the decrease of quality of life in these patients. These results point out the need to diagnose and assess postural alterations to prevent functional impact in BC patients through exercise programs

ENSINO COM PESQUISA E JÚRI SIMULADO COMO ESTRATÉGIAS DE ENSINO PARA DISCUTIR A EDUCAÇÃO ESCOLAR INDÍGENA

Resumo: As estratégias de ensino podem contribuir para uma aprendizagem significativa, ao mesmo tempo em que contribuem para a motivação intrínseca do aluno. Entre as várias estratégias de ensino, destacam-se, neste trabalho, o “ensino com pesquisa” e o “júri simulado” como procedimentos metodológicos para discutir a Educação Escolar Indígena na disciplina Educação Indígena, do 5º período do curso de Pedagogia de uma Instituição de Educação Superior na cidade de Barra do Corda - MA. Trata-se de um relato de experiência da aplicação das estratégias de ensino citadas para discutir questões pertinentes à educação escolar ofertadas nas comunidades indígenas. A relevância do tema escolhido se dá em razão desta região central do Estado do Maranhão apresentar um grande contingente populacional indígena das etnias Canela (Ramkokamekrá e Apaniekrá) e Tenetehara-Guajajara. As estratégias de ensino com pesquisa e júri simulado oportunizaram atividades desafiadoras para construir atitudes científicas e pedagógicas necessárias à compreensão do assunto investigado e discutido. Palavras-chave: Estratégia de ensino. Júri simulado. Ensino com pesquisa. Educação Escolar Indígena. RCNEI/Indígena.   Abstract: Teaching strategies may contribute to an effective instruction as well as to an intrinsic motivation of the student learning. Among the several teaching strategies, they are highlighted, in this paper, the “teaching with research” and the “mimic jury” as methodological procedures to discuss the indigenous school education, based on a school subject of the 5th school term, performed by a teacher education undergraduate course (named Pedagogy) in a local College in Barra do Corda - MA - Brazil. This is an experience report with its application that involves both strategies mentioned, to discuss issues which are relevant to the school education which is offered to the indigenous communities. Bearing in mind the enormous importance of the chosen theme, mainly because of the central region of the state of Maranhão that presents a large contingent indigenous population whose descendants are from the ethnic groups Canela (Ramkokamekrá and Apaniekrá) and Tenetehara-Guajajara. The strategies “teaching with research” and “mimic jury” have provided challenging activities to develop scientific and pedagogical atitudes necessary to understand the subject investigated and discussed. Keywords: teaching strategy. Mimic jury. Teaching with research. Indigenous school education. RCNEI/indigenous

Update on systemic treatment in early triple negative breast cancer

Triple negative breast cancer (TNBC) is a heterogeneous disease representing about 15% of all breast cancers. TNBC are usually high-grade histological tumors, and are generally more aggressive and difficult to treat due to the lack of targeted therapies available, and chemotherapy remains the standard treatment. There is a close relationship between pathological complete response after chemotherapy treatment and higher rates of disease-free survival and overall survival. In this review of systemic treatment in early triple negative breast cancer, our purpose is to analyze and compare different therapies, as well as to highlight the novelties of treatment in this breast cancer subtype.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors acknowledge grant CB16-12-00350 from CIBEROnc, the AMACMA foundation, and Lopez Trigo 2017.Medicin

Estimating Ground Truth in a Low-labelled Data Regime: A Study of Racism Detection in Spanish

Obtaining reliable and quality training datasets is resource-intensive, especially in interpretation and human judgment tasks, such as racism detection. Related work reveals that annotators subjected to hate are more sensitive to labelling something as offensive and advocate giving more voice to these collectives. This study analyses a new dataset for detecting racism in Spanish, focusing on solving a ground truth estimate given a few labels and high disagreement. Most annotators may not have previous experience with racism, as only three belong to the Black community. Our empirical results show better performance at lower thresholds for classifying messages as racist, which may be due to how annotators being permissive in identifying racist content propagates to the model. This analysis can be crucial for tailoring a general model to the specific needs of a particular individual or group. Especially in applications such as online abuse, detection models that reflect the viewpoint of crowdworkers may not be sufficient to detect all the intricacies of these social challenges

Valoración e intervención nutricional en pacientes oncológicos hospitalizados en riesgo de desnutrición o con desnutrición : evaluación del efecto sobre parámetros antropométricos y de composición corporal

Introducción: la desnutrición es un problema frecuente en los pacientes oncológicos que empeora durante la hospitalización y se asocia con mayor morbimortalidad y deterioro de la calidad de vida. Objetivos: describir el efecto de la implantación de un protocolo de valoración y soporte nutricional sobre el estado nutricional de pacientes oncológicos hospitalizados. Métodos: estudio prospectivo, no controlado y cuasiexperimental en pacientes oncológicos ingresados en un servicio de oncología de forma consecutiva, independientemente de su estado nutricional, entre septiembre de 2019 y marzo de 2020. Se determinaron los parámetros antropométricos, la composición corporal y la fuerza prensora de la mano al ingreso y al alta. Se calculó el porcentaje de pacientes con desnutrición, dinapenia y sarcopenia al ingreso y al alta. Resultados: un total de 90 pacientes oncológicos participaron en este estudio (edad media: 66 años, 67,8 % hombres). El 33,2 % de los pacientes presentaban un tumor en el tracto gastrointestinal y el 73,3 % de los pacientes se encontraban en estadio IV. El 95 % necesitaron soporte nutricional (suplementación nutricional, nutrición enteral o nutrición parenteral). Tras la intervención nutricional no se encontraron diferencias en los parámetros antropométricos, con una pérdida de peso media de 0,1, aunque se observaron mejorías en la composición corporal. El porcentaje de pacientes desnutridos se mantuvo estable al ingreso y al alta independientemente del criterio empleado Conclusiones: la implementación de un protocolo de valoración y soporte nutricional al ingreso en pacientes oncológicos puede ayudar a evitar o retrasar el empeoramiento de su estado nutricional durante la hospitalización