Institutional Care and Family Reintegration: The Transition Process in the Voices of Young Brazilians

This article aims to present reflections on the transition from being institutionalised to autonomous life, from the perspective of deinstitutionalised young Brazilians. Five young adults participated in the pilot study. The Piagetian clinical method was used. Through semi-structured interviews, the following were investigated: causes of institutionalisation, preparation for transition, deinstitutionalisation and perspectives of present and future life. The results indicate that there was no effective preparation for transition from the institution to the family and/or independent life. Biological families have difficulties in achieving (re) integration and overcoming conflicts between parents and children. In conclusion, when leaving institutions, some young people manage to build their own arrangements for a new life trajectory, while others return to contexts of risk and life on the street. Public policies to assist these young people should be prioritised.

Sensitivity and Positive Prediction of Secured Electrocardiograph (ECG) Transmission using Fully Homomorphic Encryption Technique (FHE)

Health connected is a technology that links medical devices, telecommunications and security techniques. It empowers patients to be observed and treated remotely from their homes. Patient’s healthcare records with a connected healthcare system should be stored securely before transmitted for further investigation and interpretation. Electrocardiogram (ECG) is the clinical method utilized to screen heart execution and utilized for the detection of various arrhythmias. For diagnostic purposes, individuals with a background of heart diseases have long records of ECGs, which results in the requirement of a large amount of storage space and labor. Hence, there is a requirement for a system that involves digital signal processing and signal security so that the spared information is made sure about at one spot and an only authentic individual can see and utilize this ECG signal for additional findings. This study presents a set of security solutions that can be deployed in a connected healthcare territory, which includes the fully homomorphic encryption (FHE) techniques used to secure the ECG signals. The study helps the medical provider to record ECG signals confidentially and to prevent mistreatment. The study focuses on Pan and Tompkins algorithm methods for the detection of the ECG Signal. As a result, the output of the Pan and Tompkins algorithm for ECG signal processing with the FHE technique shows a sensitivity of 92.59% and a positive prediction of 90.00%.

Modified Functional Reach Test: Upper-Body Kinematics and Muscular Activity in Chronic Stroke Survivors

Effective control of trunk muscles is fundamental to perform most daily activities. Stroke affects this ability also when sitting, and the Modified Functional Reach Test is a simple clinical method to evaluate sitting balance. We characterize the upper body kinematics and muscular activity during this test. Fifteen chronic stroke survivors performed twice, in separate sessions, three repetitions of the test in forward and lateral directions with their ipsilesional arm. We focused our analysis on muscles of the trunk and of the contralesional, not moving, arm. The bilateral activations of latissimi dorsi, trapezii transversalis and oblique externus abdominis were left/right asymmetric, for both test directions, except for the obliquus externus abdominis in the frontal reaching. Stroke survivors had difficulty deactivating the contralesional muscles at the end of each trial, especially the trapezii trasversalis in the lateral direction. The contralesional, non-moving arm had muscular activations modulated according to the movement phases of the moving arm. Repeating the task led to better performance in terms of reaching distance, supported by an increased activation of the trunk muscles. The reaching distance correlated negatively with the time-up-and-go test score.

Choroidal Thickness Profile in Chorioretinal Diseases: Beyond the Macula

Enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source OCT (SS-OCT) have emerged as essential diagnostic tools in the study and management of various chorioretinal diseases. Evidence from early clinical studies using EDI-OCT and SS-OCT indicates that choroidal dysfunction plays a major role in the pathogenesis of chorioretinal diseases. Measurement of choroidal thickness (CT) has already become a major research and clinical method, and CT is considered as an indicator of choroidal status in a variety of ophthalmic diseases. Recently, CT measurement has also been proposed as a non-invasive marker for the early detection and monitoring of various systemic diseases. Among the several possible CT measurement locations, subfoveal CT has rapidly become a reliable parameter for measuring CT in healthy and diseased eyes. Moreover, recent advancements in OCT technology have enabled faster and wider imaging of the posterior part of the eye, allowing the various changes in CT as measured outside the macula to be shown accordingly. In this review, we first provide an overview of the results of clinical studies that have analyzed the healthy macular choroid and that in various chorioretinal diseases, and then summarize the current understanding of the choroid outside the macula. We also examine the CT profile as an index that encompasses both within and outside of the macula. Furthermore, we describe the clinical applications of ultrawide OCT, which enables visualization of the far periphery, and discuss the prospects for the development of more reliable choroidal parameters that can better reflect the choroid's characteristics.

Mitochondrial Respiration of Platelets: Comparison of Isolation Methods

Multiple non-aggregatory functions of human platelets (PLT) are widely acknowledged, yet their functional examination is limited mainly due to a lack of standardized isolation and analytic methods. Platelet apheresis (PA) is an established clinical method for PLT isolation aiming at the treatment of bleeding diathesis in severe thrombocytopenia. On the other hand, density gradient centrifugation (DC) is an isolation method applied in research for the analysis of the mitochondrial metabolic profile of oxidative phosphorylation (OXPHOS) in PLT obtained from small samples of human blood. We studied PLT obtained from 29 healthy donors by high-resolution respirometry for comparison of PA and DC isolates. ROUTINE respiration and electron transfer capacity of living PLT isolated by PA were significantly higher than in the DC group, whereas plasma membrane permeabilization resulted in a 57% decrease of succinate oxidation in PA compared to DC. These differences were eliminated after washing the PA platelets with phosphate buffer containing 10 mmol·L−1 ethylene glycol-bis (2-aminoethyl ether)-N,N,N′,N′-tetra-acetic acid, suggesting that several components, particularly Ca2+ and fuel substrates, were carried over into the respiratory assay from the serum in PA. A simple washing step was sufficient to enable functional mitochondrial analysis in subsamples obtained from PA. The combination of the standard clinical PA isolation procedure with PLT quality control and routine mitochondrial OXPHOS diagnostics meets an acute clinical demand in biomedical research of patients suffering from thrombocytopenia and metabolic diseases.

La Résilience chez des Adolescentes Victimes d’agressions Sexuelles Commises par des Femmes en Côte d’Ivoire

L’objectif de cette étude menée sur trois adolescentes en foyer d’accueil, est de comprendre le processus de résilience à travers des facteurs individuels, chez des victimes d’agressions sexuelles commises par des femmes, à Abidjan (Côte d’Ivoire). L’Hypothèse postule que ces facteurs sont déterminants dans la reconstruction résiliente. La méthode clinique et l’étude de cas ont guidé le choix des instruments de collecte des données, à savoir : le CD-RISC de Connor et Davidson (2003) et l’Exercice de résilience de Strümpfer (2001). La théorie des facteurs de protection de Garmezy (1990) a permis d’interpréter les résultats par le biais de l’analyse qualitative du contenu des réponses. Ces résultats montrent que les facteurs individuels interviennent dans la construction résiliente. Ceux-ci identifient la compétence cognitive, la spiritualité et la confiance en soi comme facteurs de protection de la résilience chez les participantes à l’étude. The objective of the study on three adolescent girls in foster home, is to understand the process of resilience through individual factors, in victims of sexual assault committed by women, in Abidjan (Ivory Coast). The hypothesis postulates that these are determinants in resilient reconstruction. The clinical method and the case study guided the choice of data collection instruments, namely: the CD-RISC of Connor and Davidson (2003) and the Résilience Exercise of Strümpfer (2001). Garmezy’s protective factor theory allowed us to interpret the results through qualitative analysis of the content of responses. These results show that individual factors are involved in resilient construction. They identify cognitive competences, spirituality and self-confidence as protective factors for resilience in the study participants.

A Time-Course-Based Estimation of the Human Medial Olivocochlear Reflex Function Using Clicks

The auditory efferent system, especially the medial olivocochlear reflex (MOCR), is implicated in both typical auditory processing and in auditory disorders in animal models. Despite the significant strides in both basic and translational research on the MOCR, its clinical applicability remains under-utilized in humans due to the lack of a recommended clinical method. Conventional tests employ broadband noise in one ear while monitoring change in otoacoustic emissions (OAEs) in the other ear to index efferent activity. These methods, (1) can only assay the contralateral MOCR pathway and (2) are unable to extract the kinetics of the reflexes. We have developed a method that re-purposes the same OAE-evoking click-train to also concurrently elicit bilateral MOCR activity. Data from click-train presentations at 80 dB peSPL at 62.5 Hz in 13 young normal-hearing adults demonstrate the feasibility of our method. Mean MOCR magnitude (1.7 dB) and activation time-constant (0.2 s) are consistent with prior MOCR reports. The data also suggest several advantages of this method including, (1) the ability to monitor MEMR, (2) obtain both magnitude and kinetics (time constants) of the MOCR, (3) visual and statistical confirmation of MOCR activation.

O manejo odontológico do paciente bipolar em litioterapia, com ênfase para a cárie dentária, no método clínico de intervenção : estudo de casos

The present work is a case study of 8 bipolar patients under lithium therapy, being all of them members of the lithium group of the Hospital de Clínicas de Porto Alegre. It describes the dental management of bipolar patients under lithium therapy, emphasizing dental caries and the clinical method of intervention. The work was divided into three phases, existing a ninety-day interval between each ofthem. In the first part ofthe research, dental examinations were carried out and the patients were interviewed with the special purpose of describing each one of them regarding his buccal health. They were also inquired about their experience in living with the bipolar disease, about the medication taken and its side effects. The patients received dental treatment according to the clinical method as they also attended health educational sessions destined to increase their autonomy up to the dental dismissal. In the second and third phases, the exams that had been carried out in the first phase were repeated in order to analyze the commitment of each bipolar patient to the proposed dental treatment. The questions about the relationship between the bipolar patient and the treatment of this disease were also repeated. It was concluded that the results of the dental exams were related to the degree of stabilization of the bipolar disease; the patients detaining the best results in the dental treatment were those who had the bipolar disease stabilized. It was concluded that, having in mind the occurrence frequency of bipolar disease, it would be plausible that a denfist who works in the Public Service sooner or later would attend bipolar patients; bipolar patients are a peculiar population group that need a specific dental program; the planning and scheduling of these specific odontological programs for bipolars should take into account the disruptions in the dental therapy, caused by the disease and it is also necessary to renegotiate with the bipolar, his responsibilities and his motivation for buccal self-care, which will result in more frequent dental visits.

Deep-Learning Radiomics for Discrimination Conversion of Alzheimer's Disease in Patients With Mild Cognitive Impairment: A Study Based on 18F-FDG PET Imaging

Objectives: Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder and the most common form of dementia in the older people. Some types of mild cognitive impairment (MCI) are the clinical precursors of AD, while other MCI forms tend to remain stable over time and do not progress to AD. To discriminate MCI patients at risk of AD from stable MCI, we propose a novel deep-learning radiomics (DLR) model based on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) images and combine DLR features with clinical parameters (DLR+C) to improve diagnostic performance.Methods:18F-fluorodeoxyglucose positron emission tomography (PET) data from the Alzheimer's disease Neuroimaging Initiative database (ADNI) were collected, including 168 patients with MCI who converted to AD within 3 years and 187 patients with MCI without conversion within 3 years. These subjects were randomly partitioned into 90 % for the training/validation group and 10 % for the independent test group. The proposed DLR approach consists of three steps: base DL model pre-training, network features extraction, and integration of DLR+C, where a convolution network serves as a feature encoder, and a support vector machine (SVM) operated as the classifier. In comparative experiments, we compared our DLR+C method with four other methods: the standard uptake value ratio (SUVR) method, Radiomics-ROI method, Clinical method, and SUVR + Clinical method. To guarantee the robustness, 10-fold cross-validation was processed 100 times.Results: Under the DLR model, our proposed DLR+C was advantageous and yielded the best classification performance in the diagnosis of conversion with the accuracy, sensitivity, and specificity of 90.62 ± 1.16, 87.50 ± 0.00, and 93.39 ± 2.19%, respectively. In contrast, the respective accuracy of the other four methods reached 68.38 ± 1.27, 73.31 ± 6.93, 81.09 ± 1.97, and 85.35 ± 0.72 %. These results suggested the DLR approach could be used successfully in the prediction of conversion to AD, and that our proposed DLR-combined clinical information was effective.Conclusions: This study showed DLR+C could provide a novel and valuable method for the computer-assisted diagnosis of conversion to AD from MCI. This DLR+C method provided a quantitative biomarker which could predict conversion to AD in MCI patients.