Two-dimensional segmentation of the retinal vascular network from optical coherence tomography

The automatic segmentation of the retinal vascular network from ocular fundus images has been performed by several research groups. Although different approaches have been proposed for traditional imaging modalities, only a few have addressed this problem for optical coherence tomography (OCT). Furthermore, these approaches were focused on the optic nerve head region. Compared to color fundus photography and fluorescein angiography, two-dimensional ocular fundus reference images computed from three-dimensional OCT data present additional problems related to system lateral resolution, image contrast, and noise. Specifically, the combination of system lateral resolution and vessel diameter in the macular region renders the process particularly complex, which might partly explain the focus on the optic disc region. In this report, we describe a set of features computed from standard OCT data of the human macula that are used by a supervised-learning process (support vector machines) to automatically segment the vascular network. For a set of macular OCT scans of healthy subjects and diabetic patients, the proposed method achieves 98% accuracy, 99% specificity, and 83% sensitivity. This method was also tested on OCT data of the optic nerve head region achieving similar results

Two-dimensional segmentation of the retinal vascular network from optical coherence tomography

The automatic segmentation of the retinal vascular network from ocular fundus images has been performed by several research groups. Although different approaches have been proposed for traditional imaging modalities, only a few have addressed this problem for optical coherence tomography (OCT). Furthermore, these approaches were focused on the optic nerve head region. Compared to color fundus photography and fluorescein angiography, two-dimensional ocular fundus reference images computed from three-dimensional OCT data present additional problems related to system lateral resolution, image contrast, and noise. Specifically, the combination of system lateral resolution and vessel diameter in the macular region renders the process particularly complex, which might partly explain the focus on the optic disc region. In this report, we describe a set of features computed from standard OCT data of the human macula that are used by a supervised-learning process (support vector machines) to automatically segment the vascular network. For a set of macular OCT scans of healthy subjects and diabetic patients, the proposed method achieves 98% accuracy, 99% specificity, and 83% sensitivity. This method was also tested on OCT data of the optic nerve head region achieving similar results

Stress no trabalho e indicadores fisiológicos: um estudo com wearable sensors

A saúde ocupacional tem sido uma preocupação crescente, podendo ser monitorizada através de dispositivos tecnológicos que longitudinalmente recolhem dados de bem-estar psicológico e de indicadores fisiológicos. Pretende-se investigar a relação entre perceção de stress, ritmo cardíaco, horas de sono e número de passos no trabalho, numa amostra de profissionais de empresas de tecnologia e área financeira. Em 3 empresas do distrito de Braga, 40 profissionais durante um mês avaliaram no final de cada dia de trabalho a perceção de stress e de motivação, e através da pulseira Xiaomi Miband3® as horas de sono leve/profundo, ritmo cardíaco e nº de passos. Semanalmente, avaliaram a qualidade do sono, perceção de stress (PSS) e fontes de stress específicas da empresa (total de 804 registos). Encontraram-se diariamente moderada motivação, stress e cansaço emocional/físico/cognitivo. A média do nº de passos foi de 4954, de sono profundo 118 e de sono leve 305 minutos. Semanalmente, a perceção de stress e a qualidade/quantidade de sono foram moderadas. As fontes de stress específicas mais referidas foram os prazos, volume/multiplicidade de tarefas, reuniões e falta de autonomia/recursos. O sono profundo correlaciona-se positivamente com mais cansaço emocional/cognitivo diários e com qualidade/tempo de sono semanal. São necessários mais estudos de saúde ocupacional longitudinais que rentabilizem as vantagens de novas tecnologias na avaliação do bem-estar psicológico/fisiológico dos trabalhadores.info:eu-repo/semantics/publishedVersio

Construction and evaluation of an educational video: nursing assessment and intervention of patients’ spiritual needs

Spirituality is particularly important in health and illness transitions and is a fundamental dimension of healthcare. However, nurses often feel underprepared to provide spiritual care and the use of dynamic and interactive strategies, such as educational videos, can facilitate the development of this competency in undergraduate education. This study aimed to construct and evaluate an educational video lasting 10 min and 52 s for nursing students concerning the assessment of patients’ spiritual needs. The methodological study was based on the pre-production, production, and post-production phases of the video with an evaluation of the comprehension and comprehensiveness of the content. The results demonstrated the pre-production phase was considered appropriate by the judges and allowed the phase of production of the educational video, considered an educational resource by 100% the experts. Nursing students were enrolled in the evaluation and 75% considered the content and the learning experience useful for their future roles as nurses. So, the educational video was considered a tool that facilitated deepening knowledge about spirituality and motivated students to assess spirituality in clinical practice.info:eu-repo/semantics/publishedVersio

Anatomia foliar de espécies de Myrtaceae : contribuições à taxonomia e filogenia

Trabalhos taxonômicos e filogenéticos têm utilizado informações anatômicas e para contribuir com estes estudos examinaram-se cortes paradérmicos e transversais da porção mediana foliar de Campomanesia adamantium (Camb.) O. Berg, Myrcia cordiifolia DC., M. decrescens O. Berg e M. torta D.C. Os caracteres anatômicos foram comparados com os de outras espécies descritas na literatura. São características comuns às quatro espécies examinadas: epiderme uniestratificada, tricomas unicelulares, folhas hipoestomáticas, estômatos paracíticos, cavidades secretoras em ambas as faces, mesofilo dorsiventral e nervura mediana com feixes bicolaterais. Destacam-se os seguintes caracteres úteis para a taxonomia da família: formato das células comuns da epiderme, tricomas dibraquiados ou não, camadas celulares incolores subepidérmicas e formato da nervura mediana. O formato e número das células teto das glândulas foliares têm utilidade taxonômica. O exame de 144 exsicatas evidenciou que a glabrescência é um fenômeno comum. A queda dos tricomas pode ser devido à sua base estreita e à ausência de célula pedal nos mesmos. Analisaram-se os caracteres à luz de estudos filogenéticos recentes e do ponto de vista ecológico, destacando a hipótese relacionada às células e pidérmicas com possível função de célula de transferência. As características anatômicas forneceram dados para análises comparativas mais amplas entre os táxons de Myrtaceae e possibilitaram a construção de um cladograma, onde espécies de Leptospermum e Eucalyptus ocuparam posição basal, em consonância com filogenias relatadas na literatura. _______________________________________________________________________________ ABSTRACTTaxonomical and phylogenetical studies have used anatomical information. In order to contribute to these studies, paradermal and cross sections of the median leaf blade portion of Campomanesia adamantium (Camb.) O. Berg, Myrcia cordiifolia DC., M. decrescens O. Berg and M. torta D.C. were examined. The anatomical characters were compared to the other species described in the literature. Some characteristics were irrespective of the four examined species: unistratified epidermis, unicellular trichomes, hypostomatic leaves, paracytic stomata, oil glands on both sides, dorsiventral mesophyll and bicollateral bundles on the midrib. The following characters appear to be taxonomically useful in the family: epidermal common cell format, presence of dibrachiate trichomes, presence of colorless subepidermal cell layers and midrib shape. The morphology and number of overlying cells associated with the glands have taxonomic utility. The 144 exsicates examination showed that the glabrescence is a widespread phenomenon in the Myrtaceae. The trichome fall can be due to its narrow base and to the foot cell absence. The characters were analyzed in the light of recent phylogenetic studies, highlighting the hypothesis related to the presence of epidermal cells with possible transfer cell function. The anatomical features provided data for wider comparative analysis amongst Myrtaceae taxa and ensured the construction of a cladogram, where Leptospermum and Eucalyptus species occupied the basal position, in line with reported phylogenies

Newborn whit a derivative chromosome X and ambiguous genitalia

Translocations involving the short arms of the X and Y in human chromosomes are uncommon. One of the primary functions of the X and Y chromosomes is gender phenotype determination. Here we report a newborn female with ambiguous genitalia and abnormal X chromosome. Karyotype was performed using the standard methods and Fluorescence in situ hybridization (FISH) directed for the SRY gene was used for confirmation of the clinical and cytogenetic suspicion. Chromosomal microarray analysis (CMA) was performed using CytoScan HD (Affimetrix®) to identified gains/loses on the der(X) chromosome. The analyse revealed one abnormal X chromosome in a female karyotype. Considering the ambiguous genitalia clinical information the abnormal X was considered to be compatible with a translocation X/Y. This was confirmed by the presence of signal for the SRY using FISH. CMA allowed to clarify a loss of 12.34 Mb at Xp22.33p22.2 and a gain of 7.41 Mb at Yp11.31p11.2 (ISCN = arr[GRCh37] Xp22.33p22.2(2703632_15050955)x1,Yp11.31p11.2(2650140_10059230)x1). The X deleted region includes several OMIM morbid genes, including CLCN4. Mutations in CLCN4 are associated with intellectual disability and impaired language development, and heterozygous females can be as severely affected as male. The gain on the Y encompasses nine OMIM genes, including the SRY gene, involved in the sexual male development. This additional information can be of great value for the child development. Translocations of segments of Y chromosome containing SRY are described in sexual reversion and true hermafroditism cases, which could explain the reason for referral for the newborn. Nevertheless, translocations between the X/Y chromosomes in females are expected to have a skewed inativation pattern in favour of the abnormal X and X-inativation studies could prove this likelihood. If a normal developmental of the child is observed over time this will be likely due to the preferable inativation of the abnormal X. Presently the child is about 1-year-old and she presents normal uterus, ovarian, and external genitalia, with absence of male gonads. No other clinical features have been identified.N/

PERCEPTIONS OF POSTPARTUM WOMEN ABOUT EDUCATIONAL PRACTICES DEVELOPED IN A NORMAL BIRTH CENTER: A DESCRIPTIVE-EXPLORATORY STUDY

Objective: to understand the meanings of postpartum women about the educational practices developed in a Normal Birth Center.Method: descriptive-exploratory study, of qualitative approach, with 15 postpartum women assisted at the Haydeê Pereira Sena Normal Childbirth Center, in the metropolitan region of Pará, Brazil. Semi structured interviews were used from August to November 2020. Data were transcribed and submitted to content analysis in the thematic modality.Results: it was found that the activities developed by the nurse midwives promote a link to the visibility of the site as a service that seeks to welcome and support women, ensuring greater tranquility, confidence, and respect at the time of birth.Conclusion: the results translate the need to encourage educational practices to ensure rights and respect for women, such as quality assistance, a welcoming environment, aggregating tranquility, and confidence for normal birth. Thus, it contributes effectively to the practice of obstetric nursing with direct impact on the care of women and families

Perception index of environmental education in fundamental education schools in a city on the Brazil / Bolivia frontier

Objective: to analyze the Environmental Education Perception Index in the light of national curricular parameters (PCN’s) within the scope of elementary education in state schools in the city of Guajará-Mirim, Rondônia, on the Brazil / Bolivia border. Method: for this study, factor analysis was used as a mechanism for building performance indices for each parameter studied. The Statistical Package for the Social Sciences - SPSS [30] tool was used to determine the proposed indexes that followed the scale advocated by Hair et al [21]. Results: the results presented by the teachers of the 4 schools correspond to the perception index considered “good” with an average index of 0.699. The average perception index of school technicians and managers was 0.591, considered a “regular” index. The students had an average performance of 0.537, considered a “regular” performance index. The general IPEA among all schools surveyed was considered “regular” with a performance index of 0.597. Conclusion: the fact that Guajará-Mirim has 92% of its territory occupied by Conservation Units and Indigenous Lands and a strong environmental policy does not correspond to the level of abstraction applied by formal Environmental Education. Environmental Education given in Guajará-Mirim elementary schools imposes considerable risks on the environmental conscience of future generations, as it presents certain deficiencies in fulfilling its institutional role as a social transformer, configuring itself as a limiter of sustainable development and awareness environmental

Functional and structural findings of neurodegeneration in early stages of diabetic retinopathy:cross-sectional analyses of baseline data of the EUROCONDOR project

Cross-sectional study evaluating the relationship between: a) functional and structural measurements of neurodegeneration in initial stages of diabetic retinopathy (DR); and b) presence of neurodegeneration and early microvascular impairment. We analyzed baseline data of patients with type 2 diabetes (n=449) enrolled in the EUROCONDOR study (NCT01726075). Functional studies by multifocal ERG (mfERG) evaluated neurodysfunction and structural measurements using spectral domain optical-coherence tomography (SD-OCT) evaluated neurodegeneration. The mfERG P1 amplitude was more sensitive than the P1 implicit time (IT), and was lower in patients with ETDRS 20-35 than in patients with ETDRS <20 (p=0.005). In 58% of cases, mfERG abnormalities were present in the absence of visible retinopathy. Correspondence between SD-OCT thinning and mfERG abnormalities was shown in 67% of the eyes with ETDRS <20 and in 83% of the eyes with ETDRS 20-35. Notably, 32% of patients with ETDRS 20-35 presented no abnormalities in mfERG or SD-OCT. We conclude that there is a link between mfERG and SD-OCT measurements which increases with the presence of microvascular impairment. However, in our particular study population (ETDRS ≤ 35) a significant proportion of patients had normal GC-IPL thickness and normal mfERG findings. We raise the hypothesis that neurodegeneration may play a role in the pathogenesis of DR in many, but not in all type 2 diabetic patients

Improving access to community-based pulmonary rehabilitation: 3R protocol for real-world settings with cost-benefit analysis

Background: Pulmonary rehabilitation (PR) has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. Methods: A 12-week community-based PR will be implemented in primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers (dyads patientcaregivers) will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea (modified Medical Research Council Questionnaire), fatigue (Checklist of individual strength and Functional assessment of chronic illness therapy – fatigue), cough and sputum (Leicester cough questionnaire and Cough and sputum assessment questionnaire), impact of the disease (COPD Assessment Test), emotional state (The Hospital Anxiety and Depression Scale), number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion (Family Adaptation and Cohesion Scale). Other clinical outcomes will be peripheral (biceps and quadriceps-hand held dynamometer, 1 or 10 repetition-maximum) and respiratory (maximal inspiratory and expiratory pressures) muscle strength, muscle thickness and cross sectional area (biceps brachialis, rectus femoris and diaphragm-ultrasound imaging), exercise capacity (six-minute walk test and one-minute sit to stand test), balance (brief-balance evaluation systems test) and physical activity (accelerometer). Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted.Discussion: This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. Trial registration: The trial was registered in the ClinicalTrials.gov U.S. National Library of Medicine, on 10th January, 2019 (registration number: NCT03799666). Keywords: Exercise training, Education and psychosocial support, Chronic respiratory diseases, Primary healthcare, Cost-benefit.This work, was funded by Fundo Europeu de Desenvolvimento Regional (FEDER) - Comissão Diretiva do Programa Operacional Regional do Centro and by Fundação para a Ciência e Tecnologia - FCT (SAICT-POL/23926/2016), and partially funded by Programa Operacional Competitividade e Internacionalização (COMPETE), through COMPETE 2020 (POCI-01-0145- FEDER-016701 and POCI-01-0145-FEDER-007628) and FCT (UID/BIM/04501/ 2013 and UID/BIM/04501/2019). CJ has a post-doctoral grant (SFRH/BPD/ 115169/2016) funded by FCT, co-financed by the European Social Fund (POCH) and Portuguese national funds from MCTES (Ministério da Ciência, Tecnologia e Ensino Superior).publishe