123 research outputs found

    Effects of Spatial Food Distribution on Search Behavior in Rats (Rattus norvegicus)

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    To analyze how search strategies are adapted according to the geometric distribution of food sources, the authors submitted rats to a search task in which they had to explore 9 food trays in an open field and avoid visiting already-depleted trays. Trays were spatially arranged in 4 independent configurations: a cross, a 3 × 3 matrix, 3 clusters of 3 trays each, and a random configuration. Rats exhibited differential search efficiency as a specific effect of the susceptibility of the configurations to being explored in a principled way: Crosses were first, matrices or clusters were in the middle, and random configurations were last. Although no exhaustive searches or highly principled patterns were observed in any of the configurations, performances improved as the sessions went by. Thus, structural affordances of the environment influence the construction not only of search strategies but also of information linked to where the reward is. © 2007 American Psychological Association

    Postpartum hemorrhage management, the importance of timing.

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    Postpartum hemorrhage is defined as a blood loss equal to or greater than 500 ml, which can occur from 24 hours to six weeks after delivery. It is a critical event with a rapid and devastating evolution, which can quickly lead to maternal shock and death. Many efforts have been made to create international and multisectoral guidelines that allow to face an event that represents the cause of about one quarter of maternal deaths. It is crucial to create a team able to act promptly in accordance with shared protocols. The availability of shared guidelines and protocols and the organization of periodic simulations and teamwork training are part of the fundamental initiatives that can promote the safety of perinatal care. The purpose of this document is to give clinicians the tools to minimize the risks associated with inadequate management of hemorrhagic emergency, avoiding the risk of “too little or too late” and giving patients maximum safety

    The Three Hundred Project: Mapping The Matter Distribution in Galaxy Clusters Via Deep Learning from Multiview Simulated Observations

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    A galaxy cluster as the most massive gravitationally-bound object in the Universe, is dominated by Dark Matter, which unfortunately can only be investigated through its interaction with the luminous baryons with some simplified assumptions that introduce an un-preferred bias. In this work, we, {\it for the first time}, propose a deep learning method based on the U-Net architecture, to directly infer the projected total mass density map from idealised observations of simulated galaxy clusters at multi-wavelengths. The model is trained with a large dataset of simulated images from clusters of {\sc The Three Hundred Project}. Although Machine Learning (ML) models do not depend on the assumptions of the dynamics of the intra-cluster medium, our whole method relies on the choice of the physics implemented in the hydrodynamic simulations, which is a limitation of the method. Through different metrics to assess the fidelity of the inferred density map, we show that the predicted total mass distribution is in very good agreement with the true simulated cluster. Therefore, it is not surprising to see the integrated halo mass is almost unbiased, around 1 per cent for the best result from multiview, and the scatter is also very small, basically within 3 per cent. This result suggests that this ML method provides an alternative and more accessible approach to reconstructing the overall matter distribution in galaxy clusters, which can complement the lensing method.Comment: 15 pages, 13 figures, published in MNRA

    The Role of Endoscopic Ultrasonography (EUS) in Metastatic Tumors in the Pancreas: 10 Years of Experience from a Single High-Volume Center

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    Background: Metastatic pancreatic lesions (MPLs) are relatively uncommon, constituting 2 to 5% of all pancreatic tumors. They often manifest as solitary lesions without distinct clinical symptoms, usually identified incidentally during radiologic imaging for the surveillance of prior malignancies. Differentiating these lesions from primary pancreatic tumors presents a significant challenge due to their nonspecific presentation. Methods: We aimed to prospectively assess the effectiveness of endoscopic ultrasound (EUS) and EUS-guided fine needle aspiration/biopsy (EUS-FNA/B) in diagnosing MPLs in a carefully selected cohort of patients presenting with pancreatic masses. Additionally, we sought to examine the relevance of specific EUS findings in supporting the initial diagnosis of MPLs and their agreement with the definitive cytological diagnosis. This study retrospectively analyzed data from 41 patients diagnosed with MPLs between 2013 and 2023, focusing on their clinical and pathological characteristics, the echogenic features of the pancreatic lesions, and the techniques used for tissue acquisition. Results: The incidence of MPLs in our cohort was 3.53%, with the most frequent primary tumors originating in the kidney (43.90%), colorectum (9.76%), lung (9.76%), lymphoma (9.76%), and breast (4.88%). MPLs typically presented as hypoechoic, oval-shaped lesions with well-defined borders and were predominantly hypervascular. Interestingly, 68.29% of the cases were discovered incidentally during follow-up of the primary tumors, while the involvement of the common bile duct was uncommon (19.51%). Conclusions: EUS and EUS-FNA/B have been validated as valuable diagnostic tools for identifying MPLs. While our findings are promising, further multicenter studies are necessary to corroborate these results and elucidate the predictive value of specific EUS characteristics in determining the metastatic origin of pancreatic lesions

    Generating galaxy clusters mass density maps from mock multiview images via deep learning

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    Galaxy clusters are composed of dark matter, gas and stars. Their dark matter component, which amounts to around 80% of the total mass, cannot be directly observed but traced by the distribution of diffused gas and galaxy members. In this work, we aim to infer the cluster’s projected total mass distribution from mock observational data, i.e. stars, Sunyaev-Zeldovich, and X-ray, by training deep learning models. To this end, we have created a multiview images dataset from The Three Hundred simulation that is optimal for training Machine Learning models. We further study deep learning architectures based on the U-Net to account for single-input and multi-input models. We show that the predicted mass distribution agrees well with the true one

    Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

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    IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

    Coronary microvascular resistance: methods for its quantification in humans

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    Coronary microvascular dysfunction is a topic that has recently gained considerable interest in the medical community owing to the growing awareness that microvascular dysfunction occurs in a number of myocardial disease states and has important prognostic implications. With this growing awareness, comes the desire to accurately assess the functional capacity of the coronary microcirculation for diagnostic purposes as well as to monitor the effects of therapeutic interventions that are targeted at reversing the extent of coronary microvascular dysfunction. Measurements of coronary microvascular resistance play a pivotal role in achieving that goal and several invasive and noninvasive methods have been developed for its quantification. This review is intended to provide an update pertaining to the methodology of these different imaging techniques, including the discussion of their strengths and weaknesses

    Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

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    Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk
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