Five-Class Classification of Cervical Pap Smear Images: A Study of CNN-Error-Correcting SVM Models / 대한의료정보학회지

Objectives@#Different complex strategies of fusing handcrafted descriptors and features from convolutional neural network (CNN) models have been studied, mainly for two-class Papanicolaou (Pap) smear image classification. This paper explores a simplified system using combined binary coding for a five-class version of this problem. @*Methods@#This system extracted features from transfer learning of AlexNet, VGG19, and ResNet50 networks before reducing this problem into multiple binary sub-problems using error-correcting coding. The learners were trained using the support vector machine (SVM) method. The outputs of these classifiers were combined and compared to the true class codes for the final prediction. @*Results@#Despite the superior performance of VGG19-SVM, with mean ± standard deviation accuracy and sensitivity of 80.68% ± 2.00% and 80.86% ± 0.45%, respectively, this model required a long training time. There were also false-negative cases using both the VGGNet-SVM and ResNet-SVM models. AlexNet-SVM was more efficient in terms of running speed and prediction consistency. Our findings also showed good diagnostic ability, with an area under the curve of approximately 0.95. Further investigation also showed good agreement between our research outcomes and that of the state-of-the-art methods, with specificity ranging from 93% to 100%. @*Conclusions@#We believe that the AlexNet-SVM model can be conveniently applied for clinical use. Further research could include the implementation of an optimization algorithm for hyperparameter tuning, as well as an appropriate selection of experimental design to improve the efficiency of Pap smear image classification.

Lymphocytotoxic antibodies & immunity in pulmonary tuberculosis.

To understand whether the presence of cold reactive lymphocytotoxic antibodies (LCA) (reactive at 15 degrees C) in the system has any effect on immunity to tuberculosis lymphocytotoxic antibodies to adherent cells (enriched-B cells) and non-adherent cells were studied in active-TB (n = 42) and inactive-TB (cured) patients (n = 49) and healthy controls (n = 32). The plasma samples of inactive-TB patients showed higher percentage of positivity for lymphocytotoxic antibodies (36.7%) than the active-TB patients (21.4%) and control subjects (18.8%). No significant difference on antibody and lymphocyte response against Mycobacterium tuberculosis culture filtrate antigens was observed between LCA positive and LCA negative active-TB patients and normal healthy controls. Further, determination of HLA-DR phenotype of the patients and control subjects showed that individuals positive for lymphocytotoxic antibodies were more among HLA-DR2 positive and DR7 positive active-TB patients and control subjects than non-DR2 and non-DR7 subjects. The present study suggests that the cold reactive lymphocytotoxic antibodies may be against B-lymphocytes and persistent for a longer time. HLA-DR2 and -DR7 may be associated with the occurrence of LCA activity. Further, the presence of LCA has no immunoregulatory role on immunity to tuberculosis.

Influence of HLA-DR2 phenotype on humoral immunity & lymphocyte response to Mycobacterium tuberculosis culture filtrate antigens in pulmonary tuberculosis.

Association of HLA-DR2 genes/gene products has been shown with pulmonary tuberculosis (PTB) patients in India. In the present study, the influence of HLA-DR2 and non-DR2 genes/gene products on immunity to tuberculosis has been studied. Plasma samples of -DR2 positive patients (active and inactive TB) showed a higher antibody titre to Mycobacterium tuberculosis culture filtrate antigens than non-DR2 (-DR2 negative) patients. Immunoblot analysis revealed a trend towards an increased percentage of DR2 positive patients recognizing 38, 32/34 and 30/31 kDa antigens of M. tuberculosis than DR2 negative patients. A low spontaneous lymphoproliferative response (without antigen stimulation) was seen in HLA-DR2 positive active TB patients than HLA-DR2 negative patients. However, the antigen stimulated lymphocyte response was higher in the -DR2 positive patients (active and inactive TB) when compared to non-DR2 patients. Further, an inversional correlation between antibody titre and spontaneous as well as antigen induced lymphocyte response (measured by 3H thymidine uptake and expressed as counts per minute) was seen in HLA-DR2 positive active PTB patients than non-DR2 patients. The present study suggests that HLA-DR2 genes/gene products may be associated with a regulatory role in the mechanism of disease susceptibility to tuberculosis. The genes while augmenting the humoral immune response, they suppress the spontaneous and antigen induced lymphocyte response in -DR2 positive patients with active disease.

HLA antigen profile in pulmonary tuberculosis patients & their spouses.

HLA-A, -B, -DR and -DQ antigen profile was studied in pulmonary tuberculosis patients (n = 209) and their spouses (family contacts; n = 50) and healthy volunteers (n = 72). An increased frequency of HLA-A-10, B7, B15, DR2 and DQ1 was seen in the pulmonary-TB (PTB) patients when compared to the total control subjects (n = 122). However, a significant increase was seen only with HLA-DR2 (P < 0.001; Pc < 0.01; Relative Risk 2.3) and -DQ1 (P < 0.005; Pc < 0.015; Relative Risk 2.8). Among the spouses and the corresponding patients, a similar increase of HLA-DR2 was seen. A decreased frequency of HLA-A19, B8, B17, B35, DR5 and DR6 were seen in PTB as compared to control groups. The present study suggested that HLA-DR2 and DQ1 genes/gene products may be associated with the susceptibility to tuberculosis either alone or in combination with other HLA or non-HLA genes.

Avaliacao e tendencias economico-profissionais do medico: um estudo sobre o futuro da profissao medica. / Evaluation and economic-profissional trend of physicians: a study on the future of the medical profession

Um estudo amplo e pioneiro no Brasil e feito sobre o futuro do exercicio profissional da Medicina a partir das aspiracoes de medicos e pacientes. Sao analisados fatores determinantes desse futuro, mostrando quanto ganha o medico, qual sua renda familiar, como exerce sua profissao, qual a rentabilidade e o futuro do consultorio medico - extincao ou florescimento - e como e feito esse tipo de atendimento entre nos