Notes

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Skin lesions are one of the typical symptoms of many diseases in humans and indicative of many types of cancer worldwide. Increased risks caused by the effects of climate change and a high cost of treatment, highlight the importance of skin cancer prevention efforts like this. The methods used to detect these diseases vary from a visual inspection performed by dermatologists to computational methods, and the latter has widely used automatic image classification applying Convolutional Neural Networks (CNNs) in medical image analysis in the last few years. This article presents an approach that uses CNNs with a NASNet architecture to recognize in a more accurate way, without segmentation, eight skin diseases. The model was trained end-to-end on Keras with augmented skin diseases images from the International Skin Imaging Collaboration (ISIC). The CNN architectures were initialized with weight from ImageNet, fine-tuned in order to discriminate well among the different types of skin lesions, and then 10-fold cross-validation was applied. Finally, some evaluation metrics are calculated as accuracy, sensitivity, and specificity and compare with other CNN trained architectures. This comparison shows that the proposed system offers higher accuracy results, with a significant reduction on the training paraments. To the best of our knowledge and based in the state-of-art recompiling in this work, the application of the NASNet architecture training with skin image lesion from ISIC archive for multi-class classification and evaluated by cross-validation, represents a novel skin disease classification system.
Trauma is ubiquitous and associated with negative effects on physical and mental health. Trauma-informed care (TIC) is a framework for mitigating these health effects and improving patients' engagement with medical care. Despite these clinical benefits, TIC is not routinely taught in undergraduate medical education.

We designed a session for first-year medical and dental students to introduce TIC principles and their application in patient care. The session focused on screening for and inquiring about trauma and responding to disclosures of trauma. Using live patient interviews, small-group discussions, and case-based role-plays, the session offered expert instruction and hands-on practice. Students completed pre- and postsession surveys and a 5-month follow-up survey. Students reported their comfort with screening for trauma and responding to disclosures of trauma before and after the session and at 5 months following the session.

Of the 164 student participants, 76% completed surveys during the session, and 50% completed the follow-up survey. More than one-third (34%) of respondents reported having received at least one disclosure of trauma from a patient within the first 5 months of medical school. Students' comfort with screening for trauma increased from 30% to 56%, and their comfort with responding to disclosure of trauma increased from 35% to 55%. These improvements persisted on reevaluation at 5 months.

We present a model for teaching trauma-informed communication skills to first-year medical and dental students. The intervention significantly increased students' comfort level and self-reported clinical skills, and benefits persisted at 5 months.
We present a model for teaching trauma-informed communication skills to first-year medical and dental students. The intervention significantly increased students' comfort level and self-reported clinical skills, and benefits persisted at 5 months.
Digital technologies hold promise for building capacity of non-specialist health workers towards scaling up depression care in low-resource settings. The purpose of this study was to describe the systematic approach to designing a digital program for training non-specialist health workers to deliver an evidence-based brief psychological treatment for depression, called the Healthy Activity Program, in primary care in rural India.

The design and development of the training program involved 5 steps 1) develop program blueprint; 2) create instructional content; 3) digitize content for a smartphone app; 4) develop a platform for uploading and hosting the digital content; and 5) user-testing and refinements to ensure program functioning. This was followed by field-testing and focus group discussions with non-specialist health workers recruited from primary care facilities in Madhya Pradesh, India, to inform further modifications and improvements to the digital training program.

Training program development oe adopted and replicated in other settings.
This study illustrates a step-wise approach to combine evidence-based content with iterative feedback from stakeholders to develop a digital training program tailored to the context in a low-resource setting. Further research is needed to validate this approach and to evaluate the effectiveness of the final modified digital training program, while considering whether this approach can be adopted and replicated in other settings.Herein, a simple model setup is presented to spray fine liquid droplets containing nanoparticles in an air stream transporting this toward a filter material. The nanoparticles are made of silica and tagged with a fluorescent dye in order to render the trace of the particles easily visible. The silica nanoparticles, in a first approximation, mimic virus (severe acute respiratory syndrome coronavirus 2) particles. The setup is used to evaluate different tissues, nowadays, in times of the coronavirus pandemic, commonly used as facemasks, with regard to their particle retention capability. The setup enables adjusting different "breathing scenarios" by adjusting the gas flow speed and, thereby, to compare the filter performance for these scenarios. The effective penetration of particles can be monitored via fluorescence intensity measurements and is visualized via scanning electron micrographs and photographs under UV light. Ultimately, a strong increase of particle penetration in various mask materials as function of flow speed of the droplets is observed and an ultimate retention is only observed for FFP3 and FFP2 masks.Cellular processes, including differentiation, proliferation, and migration, have been linked to the alignment (anisotropy) and orientation (directionality) of collagen fibers in the native extracellular matrix (ECM). Given the critical role that biophysical cell-matrix interactions play in regulating biological functions, several microfluidic-based methods have been used to establish 3D collagen gels with defined fiber properties; these gels have helped to establish quantitative relationships between structural ECM cues and observed cell responses. selleck chemicals llc Although existing microfluidic fabrication methods provide excellent definition over collagen fiber anisotropy, they have not demonstrated the independent control over fiber anisotropy and directionality necessary to replicate in vivo collagen architecture. Therefore, to advance collagen microengineering capabilities, we present a user-friendly technology platform that uses controlled fluid flows within a non-uniform microfluidic channel network to create collagen landscapes that can be tuned as a function of extensional strain rate. Herein, we demonstrate capabilities to i) control the degree of fiber anisotropy, ii) create spatial gradients in fiber anisotropy, iii) independently define fiber directionality, and iv) generate multi-material interfaces within a 3D environment. We then address the practical issue of integrating cells into microfluidic systems by using a peel-off template technique to provide direct access to microengineered collagen gels, and demonstrate that cells respond to the defined properties of the landscape. Finally, the platform's modular capability is highlighted by integrating a sub-micrometer thick porous parylene membrane onto the microengineered collagen as a method to define cell-substrate interactions.Somos Dign@s, a collective, composed by students, professors, and human rights activists, concerned about the crisis of human rights and civil liberties in Puerto Rico designed a successful national campaign for human rights known as "Trayecto Dignidad" or "The Journey toward Dignity." This educational campaign emulated the Freedom Riders initiative of the 1960s. Throughout this article, we discuss the participatory action research (PAR) methodology designed by Somos Dign@s which frames the work of our Trayecto Dignidad campaign. Our methodology is based on the theoretical approaches of De Sousa-Santos (2002) and his conceptualization of human rights as having to rise through a process of "Globalization from below"; that is, a process of globalization that allows oppressed classes to advocate for their human rights. Five campaigns have been implemented since 2011. Some results have shown the need (1) to continue educating about human and civil rights; (2) to educate and reinforce public policies to address discrimination based on race, social class, and gender particularly in the work setting; (3) to universalize health services; (4) to conduct a debt audit and advocate for the right of people of Puerto Rico to self-determination (UN Resolution 1514 XV); and (5) to integrate a public policy education based on gender perspective on schools and declare the State of Emergency for the femicides.In the wake of COVID-19, facemasks reveal the complicated dynamics of xenophobia and violence against Asian Americans within the intersections of science, religion, and cultural diversities. This review explores what some of these complications are and how they evoke anti-Asian sentiment, introducing the different intentions of facemask usage such as hygiene, religion and criminality, and scrutiny of the uniqueness of the Asian immigrant position. Analyzing the mask-related cases against Asian immigrants in the contemporary US culture, the complex sociopolitical and cultural meanings of facemasks and their transformative functions in the context of the COVID-19 pandemic are explored. The facemask, as a symbol of power and control, re-fortifies itself to become another representation to escalate racial discriminations and violence against Asian immigrant groups. At the same time, it functions as a tool to protect us. Demonstrating these sociocultural complexities, this article asks us to give more attention to the current anti-Asian violence and the hidden struggles that Asian immigrants experience.Current efforts of modelling COVID-19 are often based on the standard compartmental models such as SEIR and their variations. As pre-symptomatic and asymptomatic cases can spread the disease between populations through travel, it is important to incorporate mobility between populations into the epidemiological modelling. In this work, we propose to modify the commonly-used SEIR model to account for the dynamic flight network, by estimating the imported cases based on the air traffic volume and the test positive rate. We conduct a case study based on data found in Canada to demonstrate how this modification, called Flight-SEIR, can potentially enable (1) early detection of outbreaks due to imported pre-symptomatic and asymptomatic cases, (2) more accurate estimation of the reproduction number and (3) evaluation of the impact of travel restrictions and the implications of lifting these measures. The proposed Flight-SEIR is essential in navigating through this pandemic and the next ones, given how interconnected our world has become.
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