Multi-Label Classification of Chest X-ray Abnormalities Using Transfer Learning Techniques.

In recent years, deep neural networks have enabled countless innovations in the field of image classification. Encouraged by success in this field, researchers worldwide have demonstrated how to use Convolutional Neural Network techniques in medical imaging problems. In this article, the results were obtained through the use of the EfficientNet in the task of classifying 14 different diseases based on chest X-ray images coming from the NIH (National Institutes of Health) ChestX-ray14 dataset. The approach addresses dataset imbalances by introducing a custom split to ensure fair representation. Binary cross entropy loss is utilized to handle the multi-label difficulty. The model architecture comprises an EfficientNet backbone for feature extraction, succeeded by sequential layers including GlobalAveragePooling, Dense, and BatchNormalization. The main contribution of this paper is a proposed solution that outperforms previous state-of-the-art deep learning models average area under the receiver operating characteristic curve-AUC-ROC (score: 84.28%). The usage of the transfer-learning technique and traditional deep learning engineering techniques was shown to enable us to obtain such results on consumer-class GPUs (graphics processing units).

A Systematic Review of miRNA and cfDNA as Potential Biomarkers for Liquid Biopsy in Myocarditis and Inflammatory Dilated Cardiomyopathy.

Myocarditis and inflammatory dilated cardiomyopathy are cardiac diseases leading to heart failure. Liquid biopsy is a concept of replacing traditional biopsy with specialized blood tests. The study aim was to summarize and assess the usefulness of microRNAs and circulating free DNA as biomarkers of myocardial inflammation. For this systematic review, we searched Scopus, Embase, Web of Science, and PubMed. All studies measuring microRNAs in serum/plasma/cardiac tissue or circulating free DNA during myocarditis and non-ischemic dilated cardiomyopathy in humans in which healthy subjects or another cardiac disease served as a comparator were included. Data were extracted and miRNAs were screened and assessed using a scale created in-house. Then, highly graded miRNAs were assessed for usability as liquid biopsy biomarkers. Of 1185 records identified, 56 were eligible and 187 miRNAs were found. We did not identify any studies measuring circulating free DNA. In total, 24 of the screened miRNAs were included in the final assessment, 3 of which were selected as the best and 3 as potential candidates. We were not able to assess the risk of bias and the final inclusion decision was made by consensus. Serum levels of three miRNAs-miR-Chr8:96, miR-155, and miR-206-are the best candidates for myocardial inflammation liquid biopsy panel. Further studies are necessary to prove their role, specificity, and sensitivity.

A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults.

It is estimated that 2.6 million deaths worldwide can be attributed to hypercholesterolemia. The main reason for non-adherence to statin therapy are the statin-associated muscle symptoms (including nocebo/drucebo effect). In this case, apart from ezetimibe, nutraceuticals are prescribed. We aimed to assess the comparative efficacy of different nutraceuticals in terms of lowering low density lipoprotein cholesterol (LDL-C) and improving lipid profile. Electronic and hand searches were performed until February 2021. The inclusion criteria were the following: (1) randomized trial with any of the reportedly LDL-C lowering nutraceutical: artichoke, berberine, bergamot, garlic, green tea extract, plant sterols/stanols, policosanols, red yeast rice (RYR), silymarin or spirulina. (2) outcome either LDL-C (primary outcome), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) or serum triglycerides (TG). Random effects network meta-analysis (NMA) was performed to rank the effect of each intervention using frequentist approach. Finally, a total of 131 trials enrolling 13,062 participants were included. All analysed nutraceuticals except for policosanols were more effective in lowering LDL-C (-1.21 [-46.8 mg/dL] to -0.17 [-6.6 mg/dL] mmol/l reduction) and TC (-1.75 [-67.7 mg/dL] to -0.18 [7 mg/dL] mmol/l reduction) than placebo/no intervention. The most effective approaches in terms of LDL-C- and TC-lowering were bergamot and RYR (-1.21 [-46.8 mg/dl] and -0.94 [-36.4 mg/dl] mmol/l) reduction respectively. In conclusion, bergamot and RYR appear to be the most effective nutraceuticals in terms of LDL-C and TC reduction. Evidence for bergamot effect was based on relatively small study group and may require further investigations. Policosanols have no effect on the lipid profile.

The Reassessed Potential of SARS-CoV-2 Attenuation for COVID-19 Vaccine Development-A Systematic Review.

Live-attenuated SARS-CoV-2 vaccines received relatively little attention during the COVID-19 pandemic. Despite this, several methods of obtaining attenuated coronaviruses are known. In this systematic review, the strategies of coronavirus attenuation, which may potentially be applied to SARS-CoV-2, were identified. PubMed, Scopus, Web of Science and Embase databases were searched to identify relevant articles describing attenuating mutations tested in vivo. In case of coronaviruses other than SARS-CoV-2, sequence alignment was used to exclude attenuating mutations that cannot be applied to SARS-CoV-2. Potential immunogenicity, safety and efficacy of the attenuated SARS-CoV-2 vaccine were discussed based on animal studies data. A total of 27 attenuation strategies, used to create 101 different coronaviruses, have been described in 56 eligible articles. The disruption of the furin cleavage site in the SARS-CoV-2 spike protein was identified as the most promising strategy. The replacement of core sequences of transcriptional regulatory signals, which prevents recombination with wild-type viruses, also appears particularly advantageous. Other important attenuating mutations encompassed mostly the prevention of evasion of innate immunity. Sufficiently attenuated coronaviruses typically caused no meaningful disease in susceptible animals and protected them from challenges with virulent virus. This indicates that attenuated COVID-19 vaccines may be considered as a potential strategy to fight the threat posed by SARS-CoV-2.

Automatic Actionable Information Processing and Trust Management towards Safer Internet of Things.

The security of the Internet of Things (IoT) is a very important aspect of everyday life for people and industries, as well as hospitals, military, households and cities. Unfortunately, this topic is still too little researched and developed, which results in exposing users of Internet of Things to possible threats. One of the areas which should be addressed is the creation of a database of information about vulnerabilities and exploits in the Internet of Things; therefore, the goal of our activities under the VARIoT (Vulnerability and Attack Repository for IoT) project is to develop such a database and make it publicly available. The article presents the results of our research aimed at building this database, i.e., how the information about vulnerabilities is obtained, standardized, aggregated and correlated as well as the way of enhancing and selecting IoT related data. We have obtained and proved that existing databases provide various scopes of information and because of that a single and most comprehensive source of information does not exist. In addition, various sources present information about a vulnerability at different times-some of them are faster than others, and the differences in publication dates are significant. The results of our research show that aggregation of information from various sources can be very beneficial and has potential to enhance actionable value of information. We have also shown that introducing more sophisticated concepts, such as trust management and metainformation extraction based on artificial intelligence, could ensure a higher level of completeness of information as well as evaluate the usefulness and reliability of data.

The gender gap in aversion to COVID-19 exposure: Evidence from professional tennis.

We study the gender differences in aversion to COVID-19 exposure using a natural experiment of the 2020 US Open. It was the first major tennis tournament after the season had been paused for six months, held with the same rules and prize money for men and women. We analyze the gender gap in the propensity to voluntarily withdraw because of COVID-19 concerns among players who were eligible and fit to play. We find that female players were significantly more likely than male players to have withdrawn from the 2020 US Open. While players from countries characterized by relatively high levels of trust and patience and relatively low levels of risk-taking were more likely to have withdrawn than their counterparts from other countries, female players exhibited significantly higher levels of aversion to pandemic exposure than male players even after cross-country differences in preferences are accounted for. About 15% of the probability of withdrawing that is explained by our model can be attributed to gender.

"Obesity and Insulin Resistance" Is the Component of the Metabolic Syndrome Most Strongly Associated with Oxidative Stress.

Metabolic syndrome (MS) is not a homogeneous entity, but this term refers to the coexistence of factors that increase the risk for the development of type 2 diabetes and cardiovascular disease. There are different versions of the criteria for the diagnosis of MS, which makes the population of patients diagnosed with MS heterogeneous. Research to date shows that MS is associated with oxidative stress (OS), but it is unclear which MS component is most strongly associated with OS. The purpose of the study was to investigate the relationship between the parameters of OS and the presence of individual elements of MS in young adults, as well as to identify the components of MS by means of principal components analysis (PCA) and to investigate how the parameters of OS correlate with the presence of individual components. The study included 724 young adults with or without a family history of coronary heart disease (population of the MAGNETIC study). Blood samples were taken from the participants of the study to determine peripheral blood counts, biochemical parameters, and selected parameters of OS. In addition, blood pressure and anthropometric parameters were measured. In subjects with MS, significantly lower activity of superoxide dismutase (SOD), copper- and zinc-containing SOD (CuZnSOD), and manganese-containing SOD (MnSOD) were found, along with significantly higher total antioxidant capacity (TAC) and significantly lower concentration of thiol groups per gram of protein (PSH). We identified three components of MS by means of PCA: "Obesity and insulin resistance", "Dyslipidemia", and "Blood pressure", and showed the component "Obesity and insulin resistance" to have the strongest relationship with OS. In conclusion, we documented significant differences in some parameters of OS between young adults with and without MS. We showed that "Obesity and insulin resistance" is the most important component of MS in terms of relationship with OS.

Developing of Low-Cost Air Pollution Sensor-Measurements with the Unmanned Aerial Vehicles in Poland.

This article presents the capabilities and selected measurement results from the newly developed low-cost air pollution measurement system mounted on an unmanned aerial vehicle (UAV). The system is designed and manufactured by the authors and is intended to facilitate, accelerate, and ensure the safety of operators when measuring air pollutants. It allows the creation of three-dimensional models and measurement visualizations, thanks to which it is possible to observe the location of leakage of substances and the direction of air pollution spread by various types of substances. Based on these models, it is possible to create area audits and strategies for the elimination of pollution sources. Thanks to the usage of a multi-socket microprocessor system, the combination of nine different air quality sensors can be installed in a very small device. The possibility of simultaneously measuring several different substances has been achieved at a very low cost for building the sensor unit: 70 EUR. The very small size of this device makes it easy and safe to mount it on a small drone (UAV). Because of this device, many harmful chemical compounds such as ammonia, hexane, benzene, carbon monoxide, and carbon dioxide, as well as flammable substances such as hydrogen and methane, can be detected. Additionally, a very important function is the ability to perform measurements of PM2.5 and PM10 suspended particulates. Thanks to the use of UAV, the measurement is carried out remotely by the operator, which allows us to avoid the direct exposure of humans to harmful factors. A big advantage is the quick measurement of large spaces, at different heights above the ground, in different weather conditions. Because of the three-dimensional positioning from GPS receiver, users can plot points and use colors reflecting a concentration of measured features to better visualize the air pollution. A human-friendly data output can be used to determine the mostly hazardous regions of the sampled area.

[Children born from frozen embryos stored for 10 years -- analysis of 5 cases]. / Dzieci urodzone z zarodków przechowywanych w stanie zamrozenia przez 10 lat. Analiza 5 przypadków.

Faced with a scientific and legal debate on human embryo cryopreservation in Poland we show 5 documented clinical cases of successful thawing and transfer of embryos cryopreserved for a long period of time (8-11 years), resulting in successful delivery by the biological or the recipient mother. Cases described include patients with different infertility diagnoses, subjected to different hormonal stimulation treatments. Different oocyte fertilization methods were performed, and the obtained embryos were frozen after 2, 3 or 4 days of in vitro culture using methods employing various cryoprotective agents and freezing curves. As a result of performed thawing and transfer procedures normal, healthy babies were born. Our results are consistent with the international reports on successful long-term storage of embryos, (including the longest known period of over 19 years) resulting in no detectable reduction of the developmental potential after thawing. In light of data shown here, we do not see any medical or biological reasons for legally-regulated limitation of the period of frozen embryo storage. Moreover, if frozen, long-term stored embryos are not threatened by destruction and if prenatal adoption is a real, clinically documented option, we fail to see any reason for legal limitations of embryo cryopreservation in human infertility treatment.

[Coexistence of Crohn disease and Wegener granulomatosis in a 15-year-old patient]. / Wspolwystepowanie choroby lesniowskiego-Crohna z Ziarniniakiem Wegenera U 15-letniej pacjentki.

Crohn disease is being diagnosed more and more frequently in children and teenagers. Clinical symptoms are mainly related to the gastrointestinal tract, however there are many reports in the literature about the coexistence of Crohn disease with other autoimmunological disorders such as celiac disease, autoimmune hypothyroidism, systemic lupus erythematosus and Wegener granulomatosis. We report a 15-year-old patient with Crohn disease who also developed Wegener granulomatosis. The presented case illustrates the difficulties in establishing the diagnosis when symptoms of the original disease are superimposed on symptoms of a different disorder.

An observational study of assisted reproductive technology outcomes in new European Union member states: an overview of protocols used for ovarian stimulation.

BACKGROUND: The development of new fertility treatment options has facilitated individualized assisted reproductive technology (ART) protocols to improve outcomes. Manufacturing improvements to recombinant human follitropin alfa have allowed precise dosing based on mass (filled-by-mass; FbM) rather than bioactivity (filled-by-bioassay; FbIU). Continued monitoring and reporting of follitropin alfa treatment outcomes in routine clinical practice is essential. OBJECTIVE: To provide an overview of the frequency of different controlled ovarian-stimulation protocols used in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles in new European Union member states, and to provide post-registration efficacy and safety data on follitropin alfa. RESEARCH DESIGN AND METHODS: A 2-year, prospective, observational, multicentre, Phase IV study conducted at ART clinics in the Czech Republic, Estonia, Latvia, Lithuania, Poland, Slovakia and Slovenia. Women aged 18-47 years undergoing ovarian stimulation with follitropin alfa for conventional IVF or ICSI were eligible for inclusion. The main treatment outcome was cumulative clinical pregnancy rate. Data were analysed descriptively. RESULTS: Clinical pregnancy outcomes were available for 4055 of 4085 (99.3%) patients. In total, 1897 (46.8%) patients used follitropin alfa FbIU; 2133 (52.6%) used follitropin alfa FbM. Clinical pregnancy was achieved by 39.5% (1603/4055) of patients. A greater proportion of patients with polycystic ovary syndrome achieved a clinical pregnancy than those with endometriosis (41.8% vs 37.8%, respectively). A higher cumulative pregnancy rate was observed with the use of follitropin alfa FbM than follitropin alfa FbIU (41.3% vs 37.8%, respectively; p = 0.02). CONCLUSIONS: This study represents the most comprehensive audit of individualized ART in clinical practice in Central and Eastern Europe. Overall, clinical pregnancy was achieved by 39.5% of patients after stimulation with follitropin alfa. The use of follitropin alfa FbM resulted in a higher cumulative pregnancy rate than did the FbIU formulation. However, limitations of the study include the observational and non-comparative study design, and descriptive nature of statistical analyses; furthermore, the study was not designed to make direct comparisons between the success rates of different ovarian-stimulation protocols.

Diagnosing and management of iatrogenic moderate and severe ovarian hyperstymulation syndrome (OHSS) in clinical material.

Severe ovarian hyperstymulation syndrome is a rare but potentially life-threatening complication in patients undergoing assisted reproductive techniques (ART). The pathogenesis of this condition is likely to be multifactorial. The aim of the retrospective study was to present management in moderate and severe iatrogenic ovarian hyperstymulation syndrome (OHSS) in clinical material. The study group was 19 women, admitted to the Department of Obstetrics and Gynecology in Central Clinical Hospital of Ministry of Interior and Administration in Warsaw from large outpatient infertility center "Novum" in Warsaw with moderate and severe OHSS between 14.07.2004 and 8.11.2005. Laboratory tests and ultrasound examination of the ovarian size and ascites were performed, abdominal circumference was measured. Patients were treated with rehydration with intravenous crystalloids and colloids, diuretics, antibiotics, anticoagulants and ultrasound-guided paracentesis if symptoms of ascites become severe (ascites causes pain and compromised pulmonary function). Oral intake of water was restricted, monitoring of fluid intake and output, and daily monitoring of body weight was performed. During treatment controlled laboratory tests were done. In one patient occurred intra-abdominal hemorrhage from ovarian rupture and laparotomy with oophorectomy was performed. The ovarian hyperstimulation syndrome is still a difficult diagnostic and therapeutic problem and more studies are required to elucidate pathophysiology of OHSS. Because of still unknown etiology treatment is empirical and in most of cases bases on experience of medical team. Thus, the management in individual patients varies according to the severity of ovarian hyperstymulation syndrome and its complications.

[Pregnancy in a woman with Turner syndrome--two new cases]. / Ciaza u kobiety z zespolem Turnera--dwa nowe przypadki.

Pregnancies resulting from a spontaneous ovulation and fertilization are extremely rare in women with Turner syndrome. The majority of them end with abortion, still-born, or neonates with congenital defects. The article presents two women with Turner syndrome, mosaic karyotype 45,X/46,XX, who got pregnant without any medical intervention. The course of one pregnancy was complicated by imminent premature delivery, pyelonephritis and anaemia. Because of the lack of progress and threatening infection, the delivery was conducted by caesarean section in 40th week of pregnancy. Healthy male neonate was born. The other patient gave birth in 38th week of pregnancy to a healthy baby boy, by caesarean section, because of lack of progress in delivery. Children develop correctly. It is important to note, that despite distinct clinical features, in first patient Turner syndrome was identified 3 years after delivery.

[Serum androgens concentrations in women with idiopathic premature ovarian failure]. / Stezenia androgenów w surowicy krwi u kobiet z idiopatycznym przedwczesnym wygasaniem czynnosci jajników.

In this paper we investigated androgen serum concentration in women with idiopathic premature ovarian failure (POF). The research was conducted in 30 patients with POF and results of analysis were compared to 15--women after surgical oophorectomy and to groups of women matched in radomization: postmenopausal women (35 subjects) and healthy fertile women (27 subjects). We established that subjects with POF showed about 50% lower concentration of free testosterone compared to women who had undergone natural menopause and to fertile controls. Androstendione concentration was similar in all researched groups and was significantly lower than in fertile controls. Both women with POF and postmenopausal subjects showed lower concentration of dehydroepiandrosterone-sulfate (DHEA-S) compared to fertile women. Analysis of the results allowed us to come to conclusion that POF women, like women after surgical oophorectomy, suffer from relative androgen deficiency.

[The ovarian hyperstimulation syndrome--diagnostic criteria, management procedures]. / Zespól hyperstymulacji jajników--kryteria rozpoznania, sposoby postepowania.

The ovarian hyperstimulation syndrome (OHSS) is still a difficult diagnostic and therapeutic problem. OHSS is associated with significant hypertrophy of the ovaries associated with the loss of the intravascular fluid to the third space which results in hypovolaemia, oliguria, electrolyte imbalance, and a rise in haematocrit. The endogenous OHSS is rare. Most often OHSS appears as a complication of induction of ovulation. The fundamental issue in pathophysiology of OHSS is an increase of capillary permeability which results in the leakage of fluid to the third space. The vascular endothelial growth factor--VEGF--is considered to be the factor directly responsible for the processes involved. The most common are the mild and moderate forms of the syndrome. The severe form of OHSS is a life-threatening condition. The following symptoms may be present: ascites, pleural and pericardial effusion, oliguria, dyspnoea with tachypnoe, tachycardia, adult respiratory distress syndrome, renal failure, venous thrombosis, ischaemic stroke, haemorrhage from a ruptured ovary. Therapy should be based on the correction of hypovolaemia, hypotension and oliguria. Antithrombotic prophylaxis is an integral part of the OHSS management. Some interesting attempts have been undertaken to re-infuse the protein-rich ascites fluid directly to the systemic circulation, so called continuous auto-transfusion system of the ascites (CATSA).