RESUMO Objetivo: desenvolver um modelo facilmente acessível para o treinamento da prática motora inicial em microcirurgia a partir da utilização de grãos de milho. Métodos: foram utilizados dez grãos de milho (Zea mays). Realizou-se um corte longitudinal de 7mm em uma das faces do grão de milho. O treinamento consistiu na realização de 4 pontos simples entre as bordas da incisão, utilizando fio de mononáilon 10-0. Os parâmetros analisados foram 1) custo do modelo; 2) tempo de montagem do sistema de teste do modelo; 3) tempo de realização dos nós; 4) distância entre os pontos. Resultados: em todos os grãos testados foi possível realizar o treinamento de sutura microcirúrgica proposto, sem dificuldade ao procedimento. O tempo médio para a realização dos 4 pontos foi de 6,51±1,18 minutos. O custo total do modelo simulatório foi de R$3,59. A distância média entre os pontos foi de 1,7±0,3mm. O modelo desenvolvido a partir de grãos de milhos apresenta custo extremamente baixo quando comparado ao uso de animais ou de simuladores de alta tecnologia. Outras vantagens são fácil disponibilidade de grãos de milho em conserva e possibilidade de serem realizados mais de quatro pontos ao longo da incisão de 7mm. Conclusão: o modelo de treinamento desenvolvido é de baixo custo, de fácil aquisição e viável para o treinamento de habilidades manuais básicas em microcirurgia.

Introduction: Deep learning (DL) has shown promising results for mammographic breast cancer diagnosis. However, the impact of artificial intelligence (AI) in the screening process have not yet been fully addressed in terms of workload reduction, which has potential to decrease healthcare disparities. Radiologists are tasked with overwhelming volumes of screening mammograms, particularly in medically underserved areas. Therefore, when applied to workflow improvement, AI might be a tool to reduce healthcare disparities. The purpose of this systematic review and meta-analysis was to assess if AI-based triaging of breast cancer screening mammograms could reduce the radiologist’s workload with non-inferior sensitivity. Methods: PubMed, EMBASE, Cochrane Central and Web of Science databases were systematically searched for studies that evaluated AI algorithms on computer-aided triage of breast cancer screening mammograms. We extracted data from homogenous studies and performed a proportion meta-analysis with random-effects model to verify the radiologist’s workload reduction and the software’s sensitivity. Results: A total of 14 studies were systematically selected. Three studies using the same commercially available DL algorithm were included in the meta-analysis, with 156852 examinations evaluated at the threshold of 8. The radiologist’s workload decreased by 68.3% (95%CI 0.655-0.711, I² = 98.76%, p < 0.001), with a sensitivity of 93.1% (95%CI 0.882-0.979, I² = 83.86%, p = 0.002). Conclusion: Our findings suggest that DL computer-aided triage of breast cancer screening mammograms significantly reduces the radiologist’s workload with high sensitivity. Although AI’s implementation remains complex and heterogeneous, it is a promising tool to optimize healthcare resources with a potential large impact in low resource settings that struggle with workforce shortage. Citation Format: Debora Xavier, Isabele A. Miyawaki, Carlos Alberto Campello Jorge, Matheus Jose Barbosa Moreira, Bruno M. Carvalho, Felipe Batalini. Artificial intelligence-based triaging of breast cancer screening mammograms and radiologist workload reduction: a systematic review and meta-analysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-04-06.

Objectives: develop an easily accessible model for training the initial motor practice in microsurgery using corn kernels. Methods: ten corn kernels (Zea mays) were used. A 7mm longitudinal cut was made on one side of the corn grain. The training consisted of performing 4 simple knots between the edges of the incision, using 10-0 mononylon thread. The parameters analyzed were 1) cost of the model; 2) assembly time of the model test system; 3) time for performing the knots; 4) distance between the knots. Results: in all corn kernels tested, it was possible to perform the proposed microsurgical suture training, without any difficulty in the procedure. The average time to perform the 4 knots was 6.51±1.18 minutes. The total cost of the simulator model was R$3.59. The average distance between the knots was 1.7±0.3mm. The model developed from corn grains has an extremely low cost when compared to the use of animals or high-tech simulators. Other advantages are the easy availability of canned corn kernels and the possibility of making more than four knots along the 7mm incision. Conclusion: the training model developed has low cost, is easy to acquire and viable for training basic manual skills in microsurgery.

Resumo Objetivo Avaliar os efeitos do colágeno hidrolisado e do peptídeo de colágeno no tratamento de lesões condrais superficiais de ratos. Método Foram utilizados 18 Rattus norvegicus nesta pesquisa. O dano articular foi induzido por uma única infiltração intra-articular de iodoacetato de sódio (solução 2 mg), injetada através do ligamento patelar da articulação dos animais previamente anestesiados. Os animais foram distribuídos em três grupos: grupo controle, grupo peptídeo de colágeno e grupo colágeno hidrolisado. O tratamento foi realizado por 30 dias com a administração via oral do peptídeo de colágeno ou do colágeno hidrolisado. Posteriormente, foi realizada a eutanásia dos experimentos e seguiu-se para o estudo das alterações condrais articulares. Os resultados foram avaliados conforme contagem de condrócitos por cluster e através da avaliação histológica segundo Pritzker et al. Resultados Ao observar os estágios de lesão, não foi observada significância estatística entre os grupos controle, colágeno hidrolisado e peptídeo de colágeno (p = 0,11). Ao observar os escores, houve significância estatística na comparação do grupo tratado com colágeno hidrolisado e o grupo peptídeo colágeno (p < 0,05), porém sem diferença estatística em relação ao grupo controle. Conclusão Os tratamentos propostos da lesão condral induzida com uso de colágeno hidrolisado ou peptídeos de colágeno via oral mostraram-se eficazes, com estabilização ou regressão da lesão apresentada em ratos, merecendo novas pesquisas experimentais com o intuito de compreender e melhorar o desfecho primário deste trabalho.

Background Brazil remains endemic for infection by the human immunodeficiency virus (HIV) and leprosy, having a major impact on public health and the life quality of affected patients. Although the relevance of this co-infection is recognized, several aspects, such as the immune response, are not yet fully understood. The objective of this study was to investigate the expression of FOXP3+ Treg cells in leprosy skin lesions and to correlate their clinical forms, laboratory characteristics (CD4, CD8, and CV), and the immune reconstitution syndrome in HIV-leprosy co-infection. Methodology/Principal findings An observational, cross-sectional, and analytical study was carried out comparing four groups of patients: those with concomitant diagnosis of leprosy and HIV infection without a leprosy reaction, those with leprosy and HIV co-infection patients with a reverse reaction (RR), those with leprosy without HIV and without reaction, and those with leprosywithout HIV and with RR. The patients were diagnosed at a dermatology outpatient clinic located in Belém, Pará, Brazil, from 2003 to 2017. In the sample studied, there was a positive correlation between FOXP3+ cell density and viral load, negative correlation with blood CD4+ (not statistically significant), significant positive correlation in CD8 count in patients with leprosy reaction, and positive relationship in patients with IRIS. The density of cells expressing FOXP3 was higher in the BL/LL forms in patients without HIV, although the difference was not statistically significant. However, the cell mean was higher in the TT/BT forms in patients co-infected with leprosy and HIV, showing contradictory results. Conclusions/Significance These findings support that higher activity of the HIV may stimulate or result in a higher expression of FOXP3-Tregs and that they may be involved in active immunosuppression observed at the infection site at the tissue level. This supports the need to expand studies on FOXP3+ Treg cells in co-infected patients.