Neural network interpretation techniques for analysis of histological images of breast abnormalities

Background. Neural networks are actively used in digital pathology to analyze histological images and support medical decision-making. A common approach is to solve the classification problem, where only class labels are the only model responses. However, one should understand which areas of the image have the most significant impact on the model's response. Machine learning interpretation techniques help solve this problem. Aim. To study the consistency of different methods of neural network interpretation when classifying histological images of the breast and to obtain an expert assessment of the results of the evaluated methods. Materials and methods. We performed a preliminary analysis and pre-processing of the existing data set used to train pre-selected neural network models. The existing methods of visualizing the areas of attention of trained models on easy-to-understand data were applied, followed by verification of their correct use. The same neural network models were trained on histological data, and the selected interpretation methods were used to systematize histological images, followed by the evaluation of the results consistency and an expert assessment of the results. Results. In this paper, several methods of interpreting machine learning are studied using two different neural network architectures and a set of histological images of breast abnormalities. Results of ResNet18 and ViT-B-16 models training on a set of histological images on the test sample: accuracy metric 0.89 and 0.89, ROC_AUC metric 0.99 and 0.96, respectively. The results were also evaluated by an expert using the Label Studio tool. For each pair of images, the expert was asked to select the most appropriate answer ("Yes" or "No") to the question: "The highlighted areas generally correspond to the Malignant class." The "Yes" response rate for the ResNet_Malignant category was 0.56; for ViT_Malignant, it was 1.0. Conclusion. Interpretability experiments were conducted with two different architectures: the ResNet18 convolutional network and the ViT-B-16 attention-enhanced network. The results of the trained models were visualized using the GradCAM and Attention Rollout methods, respectively. First, experiments were conducted on a simple-to-interpret dataset to ensure they were used correctly. The methods are then applied to the set of histological images. In easy-to-understand images (cat images), the convolutional network is more consistent with human perception; on the contrary, in histological images of breast cancer, ViT-B-16 provided results much more similar to the expert's perception

Real-world experience with netakimab in the treatment of spondyloarthritis

Aim. To study the real-world efficacy and safety of netakimab in the treatment of ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Materials and methods. The retrospective analysis included 23 patients (13 males; 56.5%) aged 23 to 73 years (median 42, interquartile range 28 to 52 years) with AS (n=12) or PsA (n=11) who received netakimab therapy from February 2021 to April 2023. Disease activity was assessed every 3-6 months based on the C-reactive protein (CRP) level for all patients according to the BASDAI and ASDAS-CRP indices for AS, DAPSA and PASI for PsA. These indicators were analyzed before therapy and at the last visit to assess the effectiveness of treatment. The results are presented as median (interquartile range). Results. In all patients treated with netakimab (median duration of treatment 11 months), the CRP level decreased from 10.6 (3.1; 17.3) to 3.1 (1.9; 8.9) mg/L (absolute difference -7.5 mg/L, median relative reduction -60%; p=0.008), and the proportion of patients with elevated CRP decreased from 70 to 41%; p=0.039. In patients with AS (median duration of treatment 9 months), BASDAI score decreased from 5.8 (4.7; 6.5) to 3.0 (1.9; 3.8) points (absolute difference -2.8 points, median relative reduction of -45%; p=0.008) and ASDAS-CRP score decreased from 2.8 (1.9; 3.9) to 1.9 (1.7; 2.6) points (absolute difference -0.9 points, median relative reduction -21%; p=0.007). The proportion of patients with high AS activity (BASDAI≥4) decreased from 90% to 20% (p=0.031); however, there was no significant change in the CRP level (absolute difference -4.9 mg/L, median relative reduction -57%; p=0.110). In patients with PsA (median duration of treatment 18 months), the CRP level decreased from 12.0 (4.5; 17.3) to 3.3 (2.0; 7.8) mg/L (absolute difference -8.7 mg/L, median relative reduction -80%; p=0.041), the DAPSA score decreased from 23.0 (19.0; 30.5) to 6.3 (5.2; 13.5) points (absolute difference -16.7 points, median relative reduction -69%; p=0.018). Three (13%) patients reported mild to moderate adverse events. Conclusion. The obtained data confirm the effectiveness and safety of netakimab in treating AS and PsA in real-world practice

Letter of interest for a neutrino beam from Protvino to KM3NeT/ORCA

The Protvino accelerator facility located in the Moscow region, Russia, is in a good position to offer a rich experimental research program in the field of neutrino physics. Of particular interest is the possibility to direct a neutrino beam from Protvino towards the KM3NeT/ORCA detector, which is currently under construction in the Mediterranean Sea 40 km offshore Toulon, France. This proposal is known as P2O. Thanks to its baseline of 2595 km, this experiment would yield an unparalleled sensitivity to matter effects in the Earth, allowing for the determination of the neutrino mass ordering with a high level of certainty after only a few years of running at a modest beam intensity of ≈ 90 kW. With a prolonged exposure (≈1500 kWyear), a 2σ sensitivity to the leptonic CP-violating Dirac phase can be achieved. A second stage of the experiment, comprising a further intensity upgrade of the accelerator complex and a densified version of the ORCA detector (Super-ORCA), would allow for up to a 6σ sensitivity to CP violation and a 10º−17º resolution on the CP phase after 10 years of running with a 450 kW beam, competitive with other planned experiments. The initial composition and energy spectrum of the neutrino beam would need to be monitored by a near detector, to be constructed several hundred meters downstream from the proton beam target. The same neutrino beam and near detector set-up would also allow for neutrino-nucleus cross section measurements to be performed. A short-baseline sterile neutrino search experiment would also be possible

Measurement of the W+W- production cross section in p(p)over-bar collisions at root s=1.96 TeV using dilepton events

We present a measurement of the W+W- production cross section using 184 pb(-1) of p (p) over bar collisions at a center-of-mass energy of 1.96 TeV collected with the Collider Detector at Fermilab. Using the dilepton decay channel W+W-→ l(+)ν l(-)(ν) over bar, where the charged leptons can be either electrons or muons, we find 17 candidate events compared to an expected background of 5.0(-0.8)(+2.2) events. The resulting W+W- production cross-section measurement of σ(p (p) over bar → W+W-)=14.6(-5.1)(+5.8)(stat)(-3.0)(+1.8)(syst)± 0.9(lum) pb agrees well with the standard model expectation

Osteoporosis in a physician's practice

The paper deals with the problem of osteoporosis (OP) in patients with chronic somatic diseases. It gives the data available in the literature and the authors' findings on the prevalence of OP. Particular attention is paid on the pathogenetic aspects of a relationship between OP and cardiovascular diseases. The extraskeletal effects of vitamin Dз deficiency and the results of a 24-month follow-up of patients receiving various antiresorptive agents are described

Revision Reconstruction of the Cervical Spine in a Patient With Early Deep Surgical Site Infection Complicated by Angular Kyphosis: Case Report and Review

Background. Deep surgical site infection (DSSI) is one of the most severe complications in spinal surgery. The timing and nature of DSSI are the determining criteria in the choice of treatment tactics. The uniqueness of the clinical observation is the combination of early DSSI, epidural abscess and angular kyphotic deformity formed after a course of conservative antibacterial therapy in a patient who underwent surgery for degenerative-dystrophic disease of the cervical spine. Correction of angular kyphosis, removal of fractured vertebrae, interbody implants and three-column cervical reconstruction were performed in one surgical session. Case presentation. A 57-year-old patient was admitted to the clinic after staged surgical interventions on the cervical spine for multilevel degenerative stenosis of the spinal canal. The primary surgical interventions were complicated by DSSI in the early period after the second surgery with formation of angular kyphosis of the cervical spine. The patient underwent revision one-stage reconstructive intervention to correct the deformity, decompress the spinal canal, and three-column reconstruction of C3-7 segments. Long-term follow-up showed persistent reduction of pain syndrome, improved quality of life and absence of recurrence of DSSI. Conclusion. The presented case illustrates the possibilities of one-stage revision three-column cervical spine reconstruction for correction of sagittal profile, decompression of intracanal neural structures and ensuring stability of operated segments. Use of DSSI treatment algorithms based on Prinz V. and Vajkoczy P. classification contributes to the selection of the optimal tactics of patient management

On the safety of glucosamine sulfate in patients with insulin resistance

Aim. Insulin resistance, metabolic syndrome and type 2 diabetes mellitus (T2DM) stimulate the development of chronic inflammation and make it difficult to rehabilitate patients with any comorbid pathology. In particular, T2DM impairs cartilage metabolism, leading to osteoarthritis (OA). For the treatment of arthropathogenic effects of diabetes mellitus, non-steroidal anti-inflammatory drugs (NSAIDs), drugs based on glucosamine sulfate (GS) and chondroitin sulfate (CS) are used. Materials and methods. Computer analysis of texts 21 777 publications. Results. GS is one of the safest OA therapies. Nexperimental and clinical studies have shown that HS can safely be used to treat OA in patients with type 2 diabetes. The anti-inflammatory effects of GS and the CS inhibition of O-acetylglucosamination processes by the molecules indicate the possibility of preventing the complications of type 2 diabetes. Conclusion. Despite the presence of the root "gluco" in the name of the GS, this substance does not stimulate the formation or progression of insulin resistance