Region-Based Segmentation and Classification for Ovarian Cancer Detection Using Convolution Neural Network.

Ovarian cancer is a serious sickness for elderly women. According to data, it is the seventh leading cause of death in women as well as the fifth most frequent disease worldwide. Many researchers classified ovarian cancer using Artificial Neural Networks (ANNs). Doctors consider classification accuracy to be an important aspect of making decisions. Doctors consider improved classification accuracy for providing proper treatment. Early and precise diagnosis lowers mortality rates and saves lives. On basis of ROI (region of interest) segmentation, this research presents a novel annotated ovarian image classification utilizing FaRe-ConvNN (rapid region-based Convolutional neural network). The input photos were divided into three categories: epithelial, germ, and stroma cells. This image is segmented as well as preprocessed. After that, FaRe-ConvNN is used to perform the annotation procedure. For region-based classification, the method compares manually annotated features as well as trained feature in FaRe-ConvNN. This will aid in the analysis of higher accuracy in disease identification, as human annotation has lesser accuracy in previous studies; therefore, this effort will empirically prove that ML classification will provide higher accuracy. Classification is done using a combination of SVC and Gaussian NB classifiers after the region-based training in FaRe-ConvNN. The ensemble technique was employed in feature classification due to better data indexing. To diagnose ovarian cancer, the simulation provides an accurate portion of the input image. FaRe-ConvNN has a precision value of more than 95%, SVC has a precision value of 95.96%, and Gaussian NB has a precision value of 97.7%, with FR-CNN enhancing precision in Gaussian NB. For recall/sensitivity, SVC is 94.31 percent and Gaussian NB is 97.7 percent, while for specificity, SVC is 97.39 percent and Gaussian NB is 98.69 percent using FaRe-ConvNN.

Cryptography-Based Medical Signal Securing Using Improved Variation Mode Decomposition with Machine Learning Techniques.

There is no question about the value that digital signal processing brings to the area of biomedical research. DSP processors are used to sample and process the analog inputs that are received from a human organ. These inputs come from the organ itself. DSP processors, because of their multidimensional data processing nature, are the electrical components that take up the greatest space and use the most power. In this age of digital technology and electronic gizmos, portable biomedical devices represent an essential step forward in technological advancement. Electrocardiogram (ECG) units are among the most common types of biomedical equipment, and their functions are absolutely necessary to the process of saving human life. In the latter part of the 1990s, portable electrocardiogram (ECG) devices began to appear on the market, and research into their signal processing and electronics design capabilities continues today. System-on-chip (SoC) design refers to the process through which the separate computing components of a DSP unit are combined onto a single chip in order to achieve greater power and space efficiency. In the design of biomedical DSP devices, this body of research presents a number of different solutions for reducing power consumption and space requirements. Using serial or parallel data buses, which are often the region that consumes the most power, it is possible to send data between the system-on-chip (SoC) and other components. To cut down on the number of needless switching operations that take place during data transmission, a hybrid solution that makes use of the shift invert bus encoding scheme has been developed. Using a phase-encoded shift invert bus encoding approach, which embeds the two-bit indication lines into a single-bit encoded line, is one way to solve the issue of having two distinct indicator bits. This method reduces the problem. The PESHINV approach is compared to the SHINV method that already exists, and the comparison reveals that the suggested PESHINV method reduces the total power consumption of the encoding circuit by around 30 percent. The computing unit of the DSP processor is the target of further optimization efforts. Virtually, all signal processing methods need memory and multiplier circuits to function properly.

Enhanced Network Intrusion Detection System.

A reasonably good network intrusion detection system generally requires a high detection rate and a low false alarm rate in order to predict anomalies more accurately. Older datasets cannot capture the schema of a set of modern attacks; therefore, modelling based on these datasets lacked sufficient generalizability. This paper operates on the UNSW-NB15 Dataset, which is currently one of the best representatives of modern attacks and suggests various models. We discuss various models and conclude our discussion with the model that performs the best using various kinds of evaluation metrics. Alongside modelling, a comprehensive data analysis on the features of the dataset itself using our understanding of correlation, variance, and similar factors for a wider picture is done for better modelling. Furthermore, hypothetical ponderings are discussed for potential network intrusion detection systems, including suggestions on prospective modelling and dataset generation as well.

Rationalising antibiotic use after low-risk vaginal deliveries in a hospital setting in India.

BACKGROUND: In 2017, a postoperative multidrug resistant case of urinary tract infection made obstetricians at Sitaram Bhartia Institute of Science and Research introspect the antibiotic usage in labouring mothers. Random case file reviews indicated overuse and variability of practice among care providers. This prompted us to explore ways to rationalise antibiotic use. METHODS: A multidisciplinary team of obstetricians, paediatricians and quality officers was formed to run this improvement initiative at a private hospital facility in India. Review of literature advocated formulating a departmental antibiotic policy. Creating this policy and implementing it using improvement methodology helped us rationalise antibiotic usage. INTERVENTIONS: We aimed to reduce the use of antibiotics from 42% to less than 10% in uncomplicated vaginal deliveries. We tested a series of sequential interventions using the improvement methodology of Plan-Do-Study-Act (PDSA) cycles, an approach recommended by the Institute for Healthcare Improvement. Learning from the PDSA cycle of the previous intervention helped decide the subsequent change ideas. The interventions included creation of a departmental antibiotic policy, staff engagement, and modification in documentation, concept of dual responsibility and team huddles as feedback opportunities. Information was analysed to understand the progress and improvement with change ideas. RESULTS: Background analysis revealed that antibiotic usage ranged from 24% to 69% and average rate of antibiotic prophylaxis was high (42.28%) in low-risk uncomplicated vaginal deliveries. The sequential changes resulted in reduction in antibiotic usage to 10% in the target population by 4 months. Sustained improvement was noted in the following months. CONCLUSION: We succeeded in implementing a departmental antibiotic policy aligning it with existing international guidelines and our local challenges. Antibiotic stewardship was one of the first major steps in our journey to avoid multidrug-resistant infections. Sustaining outcomes will involve continuous feedback to ensure engagement of all stakeholders in a hospital setting.

Unusually High Serum Levels of CA 19-9 in an Ovarian Tumour: Malignant or Benign?

Carbohydrate antigen 19-9 (CA 19-9) is a tumour marker found to be elevated in some ovarian tumours. We share our experience with a 55-year-old postmenopausal lady with unusually high CA19-9 levels arising from a benign mucinous cystadenoma of the ovary. The levels returned to normal eight weeks following staging laparotomy and a total abdominal hysterectomy with bilateral salpingo-oopherectomy. This report shows rare and significant elevation of CA 19-9 levels with benign mucinous cystadenomas of the ovary thus showing that women with unusually elevated tumour markers may actually harbour benign disease. The tumour markers should not be used to predict the malignant status of a tumour.

Maternal stress/distress, hormonal pathways and spontaneous preterm birth.

BACKGROUND: Although second-trimester blood corticotrophin-releasing hormone (CRH) levels are robustly associated with preterm birth, the findings with respect to cortisol have been inconsistent, as have been those relating stress hormones to measured stressors and maternal distress. METHODS: We measured plasma CRH, adrenocorticotrophic hormone (ACTH), cortisol, cortisol-binding globulin, oestradiol and progesterone at 24-26 weeks in a nested case-control study of 206 women who experienced spontaneous preterm birth and 442 term controls. We also related the hormonal levels to measures of environmental stressors, perceived stress and maternal distress (also assessed at 24-26 weeks) and to placental histopathology. RESULTS: With the exception of an unexpectedly low oestradiol:progesterone ratio among cases (adjusted odds ratio = 0.5 [95% confidence interval 0.3, 0.8] for ratios above the median in controls), none of the hormonal measures was independently associated with spontaneous preterm birth; placental histopathological evidence of infection/inflammation, infarction or decidual vasculopathy; or measures of maternal stress or distress. CRH levels were positively associated with cortisol, but not with ACTH, whereas ACTH was also positively associated with cortisol. CONCLUSIONS: Our findings suggest an intact pituitary-adrenal axis and confirm the positive feedback effect of cortisol on (placental) CRH. Neither of these hormonal pathways, however, was strongly linked to maternal stress/distress or to the risk of spontaneous preterm birth.

Non-stress-related factors associated with maternal corticotrophin-releasing hormone (CRH) concentration.

During pregnancy, most maternal corticotrophin-releasing hormone (CRH) is secreted by the placenta, not the hypothalamus. Second trimester maternal CRH concentration is robustly associated with the subsequent risk of preterm birth, and it is often assumed that physiological and/or psychological stress stimulates placental CRH release. Evidence supporting the latter assumption is weak, however, and other factors affecting maternal CRH have received little attention from investigators. We carried out a case-control study nested within a large, multicentre prospective cohort of pregnant women to examine potential 'upstream' factors associated with maternal CRH concentration measured at 24-26 weeks of gestation. The predictors studied included maternal age, parity, birthplace (as a proxy for ethnic origin), pre-pregnancy body mass index, height, smoking, bacterial vaginosis and vaginal fetal fibronectin (FFN) concentration. Women with high (above the median) plasma CRH concentration were significantly less likely to have been born in Sub-Saharan Africa or the Caribbean, less likely to be overweight or obese, and more likely to be smokers. Associations with maternal birthplace and BMI persisted in logistic regression analyses controlling for potential confounding variables and when restricted to term controls. A strong (but imprecise and statistically non-significant) association was also observed with high vaginal FFN concentration. Further studies are indicated both in animal models and human populations to better understand the biochemical and physiological pathways to CRH secretion and their aetiological role, if any, in preterm birth.

Stress pathways to spontaneous preterm birth: the role of stressors, psychological distress, and stress hormones.

The authors investigated a large number of stressors and measures of psychological distress in a multicenter, prospective cohort study of spontaneous preterm birth among 5,337 Montreal (Canada)-area women who delivered from October 1999 to April 2004. In addition, a nested case-control analysis (207 cases, 444 controls) was used to explore potential biologic pathways by analyzing maternal plasma corticotrophin-releasing hormone (CRH), placental histopathology, and (in a subset) maternal hair cortisol. Among the large number of stress and distress measures studied, only pregnancy-related anxiety was consistently and independently associated with spontaneous preterm birth (for values above the median, adjusted odds ratio = 1.8 (95% confidence interval: 1.3, 2.4)), with a dose-response relation across quartiles. The maternal plasma CRH concentration was significantly higher in cases than in controls in crude analyses but not after adjustment (for concentrations above the median, adjusted odds ratio = 1.1 (95% confidence interval: 0.8, 1.6)). In the subgroup (n = 117) of participants with a sufficient maternal hair sample, hair cortisol was positively associated with gestational age. Neither maternal plasma CRH, hair cortisol, nor placental histopathologic features of infection/inflammation, infarction, or maternal vasculopathy were significantly associated with pregnancy-related anxiety or any other stress or distress measure. The biologic pathways underlying stress-induced preterm birth remain poorly understood.

Maternal programming of sexual behavior and hypothalamic-pituitary-gonadal function in the female rat.

Variations in parental care predict the age of puberty, sexual activity in adolescence and the age at first pregnancy in humans. These findings parallel descriptions of maternal effects on phenotypic variation in reproductive function in other species. Despite the prevalence of such reports, little is known about potential biological mechanisms and this especially true for effects on female reproductive development. We examined the hypothesis that parental care might alter hypothalamic-pituitary-ovarian function and thus reproductive function in the female offspring of rat mothers that vary pup licking/grooming (LG) over the first week postpartum. As adults, the female offspring of Low LG mothers showed 1) increased sexual receptivity; 2) increased plasma levels of luteinizing hormone (LH) and progesterone at proestrus; 3) an increased positive-feedback effect of estradiol on both plasma LH levels and gonadotropin releasing-hormone (GnRH) expression in the medial preoptic region; and 4) increased estrogen receptor alpha (ERalpha) expression in the anterioventral paraventricular nucleus, a system that regulates GnRH. The results of a cross-fostering study provide evidence for a direct effect of postnatal maternal care as well as a possible prenatal influence. Indeed, we found evidence for increased fetal testosterone levels at embryonic day 20 in the female fetuses of High compared to Low LG mothers. Finally, the female offspring of Low LG mothers showed accelerated puberty compared to those of High LG mothers. These data suggest maternal effects in the rat on the development of neuroendocrine systems that regulate female sexual behaviour. Together with studies revealing a maternal effect on the maternal behavior of the female offspring, these findings suggest that maternal care can program alternative reproductive phenotypes in the rat through regionally-specific effects on ERalpha expression.

The transcription factor nerve growth factor-inducible protein a mediates epigenetic programming: altering epigenetic marks by immediate-early genes.

Maternal care alters epigenetic programming of glucocorticoid receptor (GR) gene expression in the hippocampus, and increased postnatal maternal licking/grooming (LG) behavior enhances nerve growth factor-inducible protein A (NGFI-A) transcription factor binding to the exon 1(7) GR promoter within the hippocampus of the offspring. We tested the hypothesis that NGFI-A binding to the exon 1(7) GR promoter sequence marks this sequence for histone acetylation and DNA demethylation and that such epigenetic alterations subsequently influence NGFI-A binding and GR transcription. We report that (1) NGFI-A binding to its consensus sequence is inhibited by DNA methylation, (2) NGFI-A induces the activity of exon 1(7) GR promoter in a transient reporter assay, (3) DNA methylation inhibits exon 1(7) GR promoter activity, and (4) whereas NGFI-A interaction with the methylated exon 1(7) GR promoter is reduced, NGFI-A overexpression induces histone acetylation, DNA demethylation, and activation of the exon 1(7) GR promoter in transient transfection assays. Site-directed mutagenesis assays demonstrate that NGFI-A binding to the exon 1(7) GR promoter is required for such epigenetic reprogramming. In vivo, enhanced maternal LG is associated with increased NGFI-A binding to the exon 1(7) GR promoter in the hippocampus of pups, and NGFI-A-bound exon 1(7) GR promoter is unmethylated compared with unbound exon 1(7) GR promoter. Knockdown experiments of NGFI-A in hippocampal primary cell culture show that NGFI-A is required for serotonin-induced DNA demethylation and increased exon 1(7) GR promoter expression. The data are consistent with the hypothesis that NGFI-A participates in epigenetic programming of GR expression.

Salivary cortisol secretion in remitted bipolar patients and offspring of bipolar parents.

OBJECTIVES: It is generally believed that cortisol secretion normalizes during clinical remission in mood disorders. However, this assumption has been challenged by preliminary reports of enhanced cortisol secretion in remitted bipolar patients and in the offspring of bipolar parents. The purpose of this study is to replicate findings of increased cortisol secretion during clinical remission in bipolar patients and in the offspring of bipolar parents, rigorously controlling for known confounders. METHODS: We conducted intensive cortisol sampling (six samples per day for three test days, on three consecutive weekends) on 15 bipolar type I and type II patients and 28 unrelated offspring of bipolar parents. Offspring had a history of unipolar depression. Participation was restricted to cases in complete sustained remission. Controls were matched as closely as possible for age, sex, and education. Mood and sleep measures were recorded on each sampling day. RESULTS: In total, 743 samples were collected from the patient group and 576 from controls. Correcting for repeat measures, there was no statistically significant difference in cortisol secretion at any sampling time between remitted bipolar patients, remitted offspring of bipolar parents, and normal controls. The cortisol waking response did not differ between patients and controls. Covariates, including sex, age, Beck depression score and hours of sleep, were not statistically significant. CONCLUSIONS: Our observations are consistent with the view that complete sustained clinical remission is associated with normal salivary cortisol levels throughout the day. A personal or family history of bipolar disorder per se does not appear to confer added risk for increased salivary cortisol secretion during sustained clinical remission.

Reversal of maternal programming of stress responses in adult offspring through methyl supplementation: altering epigenetic marking later in life.

Stress responses in the adult rat are programmed early in life by maternal care and associated with epigenomic marking of the hippocampal exon 1(7) glucocorticoid receptor (GR) promoter. To examine whether such epigenetic programming is reversible in adult life, we centrally infused the adult offspring with the essential amino acid L-methionine, a precursor to S-adenosyl-methionine that serves as the donor of methyl groups for DNA methylation. Here we report that methionine infusion reverses the effect of maternal behavior on DNA methylation, nerve growth factor-inducible protein-A binding to the exon 1(7) promoter, GR expression, and hypothalamic-pituitary-adrenal and behavioral responses to stress, suggesting a causal relationship among epigenomic state, GR expression, and stress responses in the adult offspring. These results demonstrate that, despite the inherent stability of the epigenomic marks established early in life through behavioral programming, they are potentially reversible in the adult brain.

Long-term consequences of neonatal rearing on central corticotropin-releasing factor systems in adult male rat offspring.

In a series of studies on the long-term consequences of neonatal rearing, we compared hypothalamic and extrahypothalamic central corticotropin-releasing factor (CRF) systems in male rats reared under conditions of animal facility rearing, nonhandling (HMS0), handling with brief maternal separation for 15 min (HMS15), or handling with moderate maternal separation for 180 min (HMS180) daily from postnatal days 2-14. CRF-like immunoreactivity (CRFir) was elevated in lumbar cerebrospinal fluid of adult HMS180 and HMS0 rats relative to the other groups. In the paraventricular nucleus, central nucleus of the amygdala, bed nucleus of the stria terminalis, and locus coeruleus, CRFir and CRF mRNA levels were significantly elevated in HMS0 and HMS180 rats. Neonatal maternal separation was associated with regionally specific alterations in CRF receptor type 1 (CRF1) mRNA density in HMS180 rats. No rearing-associated differences in CRF2alpha binding were apparent in either the lateral septum or the ventromedial hypothalamus. These findings indicate that early rearing conditions can permanently alter the developmental set-point of central CRF systems, and potentially influence the expression of behavioral and endocrine responses to stress throughout life, thereby providing a possible neurobiological substrate for the relationship between early life events and increased vulnerability for hypothalamic-pituitary-adrenal axis and coping skill alterations and the frequency of mood disorders in patients with a history of such experiences.

Epigenetic programming by maternal behavior.

Here we report that increased pup licking and grooming (LG) and arched-back nursing (ABN) by rat mothers altered the offspring epigenome at a glucocorticoid receptor (GR) gene promoter in the hippocampus. Offspring of mothers that showed high levels of LG and ABN were found to have differences in DNA methylation, as compared to offspring of 'low-LG-ABN' mothers. These differences emerged over the first week of life, were reversed with cross-fostering, persisted into adulthood and were associated with altered histone acetylation and transcription factor (NGFI-A) binding to the GR promoter. Central infusion of a histone deacetylase inhibitor removed the group differences in histone acetylation, DNA methylation, NGFI-A binding, GR expression and hypothalamic-pituitary-adrenal (HPA) responses to stress, suggesting a causal relation among epigenomic state, GR expression and the maternal effect on stress responses in the offspring. Thus we show that an epigenomic state of a gene can be established through behavioral programming, and it is potentially reversible.

Natural variations in maternal care are associated with estrogen receptor alpha expression and estrogen sensitivity in the medial preoptic area.

Lactating rats exhibit stable individual differences in pup licking/grooming (LG) over the first week postpartum. Such naturally occurring variations in maternal behavior are associated with differences in estrogen-inducible oxytocin receptors in the medial preoptic area (MPOA) of the hypothalamus. We compared levels of ER alpha and ER beta mRNA in the MPOA of lactating High or Low LG mothers as well as in their nonlactating, female offspring, which inherit the maternal phenotype of their mothers. Among lactating females, High LG females exhibited significantly elevated levels of ER alpha mRNA compared with Low LG females. Likewise, the adult, virgin female offspring of High LG mothers showed higher levels of ER alpha mRNA in the MPOA compared with those of Low LG mothers. There were no group differences in levels of ER beta mRNA. Differences in ER alpha protein expression in the MPOA were confirmed using Western blot analysis. To further characterize the effects of estrogen in the MPOA, cFos immunoreactivity was compared in ovariectomized, adult offspring of High and Low LG dams treated with estradiol or oil. Increased cFos activity in the anterior ventral nucleus of the MPOA was observed in estradiol-treated High LG, but not Low LG females. These findings suggest that natural variations in maternal care are associated with differences in ER alpha expression in the MPOA and that such differences are transmitted from the mother to her female offspring.