The aim of the study is to present a new Convolutional Neural Network (CNN) based system for the automatic segmentation of the colorectal cancer. The algorithm implemented consists of several steps: a pre-processing to normalize and highlights the tumoral area, the classification based on CNNs, and a post-processing aimed at reducing false positive elements. The classification is performed using three CNNs: each of them classifies the same regions of interest acquired from three different MR sequences. The final segmentation mask is obtained by a majority voting. Performances were evaluated using a semi-automatic segmentation revised by an experienced radiologist as reference standard. The system obtained Dice Similarity Coefficient (DSC) of 0.60, Precision (Pr) of 0.76 and Recall (Re) of 0.55 on the testing set. After applying the leave-one-out validation, we obtained a median DSC=0.58, Pr=0.74, Re=0.54. The promising results obtained by this system, if validated on a larger dataset, could strongly improve personalized medicine.

Liver metastases (mts) from colorectal cancer (CRC) can have different responses to chemotherapy in the same patient. The aim of this study is to develop and validate a machine learning algorithm to predict response of individual liver mts. 22 radiomic features (RF) were computed on pretreatment portal CT scans following a manual segmentation of mts. RFs were extracted from 7x7 Region of Interests (ROIs) that moved across the image by step of 2 pixels. Liver mts were classified as non-responder (R-) if their largest diameter increased more than 3 mm after 3 months of treatment and responder (R+), otherwise. Features selection (FS) was performed by a genetic algorithm and classification by a Support Vector Machine (SVM) classifier. Sensitivity, specificity, negative (NPV) and positive (PPV) predictive values were evaluated for all lesions in the training and validation sets, separately. On the training set, we obtained sensitivity of 86%, specificity of 67%, PPV of 89% and NPV of 61%, while, on the validation set, we reached a sensitivity of 73%, specificity of 47%, PPV of 64% and NPV of 57%. Specificity was biased by the low number of R- lesions on the validation set. The promising results obtained in the validation dataset should be extended to a larger cohort of patient to further validate our method.Clinical Relevance— to personalize treatment of patients with metastastic colorectal cancer, based on the likelihood of response to chemotherapy of each liver metastasis.

We propose a framework for designing observers possessing global convergence properties and desired asymptotic behaviors for the state estimation of nonlinear systems. The proposed scheme consists in combining two given continuous-time observers: One, denoted as global, ensures (approximate) convergence of the estimation error for any initial condition ranging in some prescribed set, while the other, denoted as local, guarantees a desired local behavior. We make assumptions on the properties of these two observers, and not on their structures, and then explain how to unite them as a single scheme using hybrid techniques. Two case studies are provided to demonstrate the applicability of the framework. Finally, a numerical example is presented.

We study the design of state observers for nonlinear networked control systems (NCSs) affected by disturbances and measurement noise, via an emulation-like approach. That is, given an observer designed with a specific stability property in the absence of communication constraints, we implement it over a network, and we provide sufficient conditions on the latter to preserve the stability property of the observer. In particular, we provide a bound on the maximum allowable transmission interval (MATI) that guarantees an input-to-state stability (ISS) property for the corresponding estimation error system. The stability analysis is trajectory-based, utilizes small-gain arguments, and exploits a persistently exciting property of the scheduling protocols. This property is key in our analysis and allows us to obtain significantly larger MATI bounds in comparison to the ones found in the literature. Our results hold for a general class of NCSs; however, we show that these results are also applicable to NCSs implemented over a specific physical network called WirelessHART (WH). The latter is mainly characterized by its multihop structure, slotted communication cycles, and the possibility to simultaneously transmit over different frequencies. We show that our results can be further improved by taking into account the intrinsic structure of the WH–NCS model. That is, we explicitly exploit the model structure in our analysis to obtain an even tighter MATI bound that guarantees the same ISS property for the estimation error system. Finally, to illustrate our results, we present analysis and numerical simulations for a class of Lipschitz nonlinear systems and high-gain observers.

Background: Cochlear dysfunction can arise not only from various factors such as ear diseases but also from systemic disorders of the body. The occurrence of otologic symptoms such as hearing loss, dizziness, and tinnitus can be due to cardiovascular disorders. Therefore, current understandings in the field of the diagnosis and therapy of cardiovascular diseases (CVDs) should include, among others, evidence of otologic disorders. Objective: The aim of this study is to determine the association between risk factors for CVD and cochlear dysfunction. Methods: The cross-sectional study included 128 participants with major CVD risk factors who underwent auditory function examination (pure tone audiometry). Results: There were 52 women (40.6%) and 76 men (59.4%) in total. The mean age of the participants was 58 years (a range of 28–83 years). The mean age among participants with hearing loss was 60 (±10.88), whereas the mean age among participants that had normal hearing thresholds was 54 (±12.18). Sensorineural hearing loss (SNHL) was measured in 59% of participants, of most frequent mild degree hearing loss. The prevalence of SNHL was higher in participants with arterial hypertension (P < 0.001, OR = 5.881, 95% CI 2.694–12.837) and the most common among them was moderate degree hearing impairment (38%). There is also a statistically significant association of SNHL with dyslipidemia and elevated body mass index (P < 0.001, [OR]: 4.118, 95% [CI]: 1.873–9.053 and P< 0.001, [OR]: 1.517, 95% [CI]: 1.237–1.859 ) with moderate and profound hearing loss. Conclusion: Based on the data obtained, it seems that the presence of major cardiovascular risk factors was a significant predictor for cochlear dysfunction.

Purpose: To report a rare occurrence of ocular dirofilariasis in Bosnia and Herzegovina and provide a short overview on clinical characteristics and treatment options for ocular dirofilariasis. Methods: A 75-year-old woman was admitted to the University Clinical Centre Tuzla with pain and redness in her left eye. A live, white, coiled, and active worm was noticed in subconjunctival space of bulbar conjunctiva. Results: After successful surgical extraction, the parasite was identified as the adult form of Dirofilaria repens. There were no signs of intraocular or systemic inflammation. Conclusion: Ophthalmologists should have in mind a possible infestation, especially in cases with repeated inflammatory reactions and swelling of the ocular region, which does not respond to conventional therapy.

Background: Hereditary transthyretin amyloidosis (hATTR) is an autosomal dominantly inherited disorder caused by an accumulation of amyloid fibrils in tissues due to mutations in the transthyretin (TTR) gene. The prevalence of hATTR is still unclear and likely underestimated in many countries. In order to apply new therapies in a targeted manner, early diagnosis and knowledge of phenotype-genotype correlations are mandatory. This study aimed to assess the prevalence and phenotypic spectrum of hATTR in Austria. Methods: Within the period of 2014–2019, patients with ATTR-associated cardiomyopathy and/or unexplained progressive polyneuropathies were screened for mutations in the TTR gene. Results: We identified 43 cases from 22 families carrying 10 different TTR missense mutations and confirmed two mutational hot spots at c.323A>G (p.His108Arg) and c.337G>C (p.Val113Leu). Two further patients with late onset ATTR carried TTR variants of unknown significance. The majority of patients initially presented with heart failure symptoms that were subsequently accompanied by progressive polyneuropathy in most cases. A total of 55% had a history of carpal tunnel syndrome before the onset of other organ manifestations. Conclusions: Our study underlined the relevance of hATTR in the pathogenesis of amyloid-driven cardiomyopathy and axonal polyneuropathy and indicated considerable genetic heterogeneity of this disease in the Austrian population. The estimated prevalence of hATTR in Austria based on this study is 1:200,000 but a potentially higher number of unknown cases must be taken into account. With respect to new therapeutic approaches, we strongly propose genetic testing of the TTR gene in an extended cohort of patients with unexplained heart failure and progressive polyneuropathy.

Recent catastrophic consequences of coronavirus pandemic stimulate some deeper analysis of present level of globalization, particularly connected with public health problems One definition of globalization may be that it is the integration of capital, technology, and information across national borders in a way that is creating a single global market and, to some degree, a global village Besides economic, it includes many different processes such as development of communications systems, the increase in human mobility, the integration of trade and investment across boundaries, the spread of democracy and human rights, the increasing role of nongovernmental organizations in international politics, the growing concern about global epidemics, and ecological matters such as climate change that are happening at the same time and in many cases reinforcing one another Up till now, in June 2020, there have been over 20,000 published scientific papers on Coronavirus Disease-2019 (COVID-19), which is an unprecedented level of interest in any topic in the entire history of science Besides the described effect of remdesivir on reducing the length of the illness and the announced research on the effect of dexamethasone on reducing the mortality rate, science has not offered any other news on medication effectiveness so far After the vaccine’s effectiveness in developing antibodies and protecting from COVID-19 is proven, then its safety will need to be proven Vaccines have to be harmless and their only effect on the organism should be the developing of permanent immunity to the novel coronavirus However, never have we in history, as humanity, had planned to simultaneously vaccinate 4 or 5 billion people Most of us welcomed positive globalization process, but with the recent pandemic of corona disease, we are introducing negative part of globalization with many unpredictable developments Indeed, globalization is both inevitable and usually desirable and contains advantageous and disadvantageous issues It is a source of both hope and of apprehension and is an accelerating process in flow of information, technology, goods and services, and production means Globalization has a complex influence on perinatal health The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care

BACKGROUND Stroke volume response during stress is a major determinant of functional status in heart failure and can be measured by two-dimensional (2-D) volumetric stress echocardiography (SE). The present study hypothesis is that SE may identify mechanisms underlying the change in stroke volume by measuring preload reserve through end-diastolic volume (EDV) and left ventricular contractile reserve (LVCR) with systolic blood pressure and end-systolic volume (ESV). METHODS We enrolled 4,735 patients (age 63.6 ± 11.3 yrs, 2800 male) referred to SE for known or suspected coronary artery disease (CAD) and/or heart failure (HF) in 21 SE laboratories in 8 countries. In addition to regional wall motion abnormalities (RWMA), force was measured at rest and peak stress as the ratio of systolic blood pressure by cuff sphygmomanometer/ESV by 2D with Simpson's or linear method. Abnormal values of LVCR (peak/rest) based on force were ≤1.10 for dipyridamole (n=1,992 patients) and adenosine (n=18); ≤2.0 for exercise (n=2,087) or dobutamine (n=638). RESULTS Force-based LVCR was obtained in all 4,735 pts. Lack of stroke volume increase during stress was due to either abnormal LVCR and/or blunted preload reserve, and 57 % of patients with abnormal LVCR nevertheless showed increase in stroke volume. CONCLUSIONS Volumetric SE is highly feasible with all stresses, and more frequently impaired in presence of ischemic RWMA, absence of viability and reduced coronary flow velocity reserve. It identifies an altered stroke volume response due to reduced preload and/or contractile reserve.

Reptiles, especially turtles, are becoming increasingly popular as pets. The haematological evaluation of turtles is an irreplaceable diagnostic tool in veterinary practice. However, the morphologic distinctiveness of turtle blood limits the use of electronic cell-counting devices, making time-consuming, manual counting techniques and evaluation of blood smears necessary. Many samples are dispatched to a laboratory over long distances, where a delay of 24 h or more may occur. At weekends, this interval may exceed 48 h. The objective of the present study was to determine the effect of storage duration at refrigerator temperature (4 °C) on the counts of red blood cells (RBC) and white blood cells (WBC), and on the mean corpuscular volume (MCV) and packed cell volume (PCV) in blood samples from healthy adult red-eared sliders. Blood samples were collected by venipuncture from the occipital venous sinus from six apparently healthy adult red-eared sliders, aged 2 to 4 years. Blood samples were analysed immediately after sampling to obtain the baseline value (BV) of the red blood cell count, white blood cell count and packed cell volume percentage. Blood was stored at 4 °C and the haematological analyses were performed after 24h, 48h and 72h. The results showed the same level of stability for RBC and WBC count, and MCV values during 72 hours of storage at 4 °C and for PCV during 48 hours. Handling of blood samples, and duration of storage of the blood samples can significantly influence the results/values of haematological tests. Consequently, the obtained values of the determined haematological parameters of improperly stored or handled blood samples can give a misleading interpretation of the results on the animal’s health status.

The Bosnia and Herzegovina (BiH) erosion map was made in 1985, however, over a period of 35 years, there has been a substantial change in the values of most erosion factors, resulting in the change of the erosion intensity. Changes relate to demographics, urbanization and land use as well as climate. The increase in temperature and the occurrence of extremes caused significant environmental and economic consequences (May 2014 floods). This situation is more pronounced in the northern part of the country, especially in the lower parts of the larger basins. Risk assessment procedures using modern software and hardware solutions can help decision-makers to recognize sites where forest should not be cut down, certain crops should not be grown or soil conversation measures are necessary. Therefore, the aim of this research is to estimate the intensity of erosion processes in one such watershed in BiH the Brka watershed, taking into consideration current conditions and using modern hardware and software solutions. To calculate erosion intensity the Gavrilovic method supported with GIS techniques was used. The soil protection (x), soil erodibility (y) and type and extent of erosion (φ) coefficients were calculated using digital maps: CORINE 2018 (grid size 100 m x 100 m) land cover, soil map of BiH and open-source satellite images. The slope was calculated from the BiH digital elevation model (25 m x 25 m). The Brka watershed area (184.09 km 2 ) was divided into four basins: Maočka Rijeka (51.56 km 2 ), Rahička Rijeka (24.26 km 2 ), Zovičica (75.30 km 2 ) and direct basin of Brka (32.94 km 2 ). The highest average erosion intensity was determined for Zovičica basin, where Z=0.56. The calculated mean annual production of sediment per basin varies from 5,746 for Rahička Rijeka to 57,089 m 3 year -1 for Zovičica, with total Brka river watershed sediment yield of 120,754 m 3 year -1 .

Cervical cancer is the fourth most common malignancy in women worldwide and a leading cause of cancer-related mortality in developing countries. Important etiological factors in this cancer are high-risk human papillomaviruses (HPV), as roughly 96% of cervical cancer cases are positive for these oncoviruses. On the other hand, it has been recently pointed out that E6/E7 oncoproteins of high-risk HPV can upregulate the programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) axis. Likewise, several recent reports showed that checkpoint blockades targeting PD-1/PD-L1 pathways have achieved efficient clinical responses via suppressing cancer progression and improving survival in several types of human cancers including metastatic cervical cancer. In this review, we summarize recent advances in our understanding of the PD-1/PD-L1 signaling pathway and its interaction with high-risk HPV and their oncoproteins, which could have an important impact on the management of HPV-associated cancers including cervical.